Which organizations have released guidelines for the screening and/or risk reduction of obesity in the prevention of cardiovascular disease (CVD)?

Updated: May 25, 2018
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Answer

Answer

Recognizing that obesity increases the likelihood of developing other CVD risk factors, including hypertension, dyslipidemia, and type 2 diabetes, the following organizations have released guidelines for the screening and/or risk reduction:

  • US Preventive Services Task Force (USPSTF)
  • American Heart Association(AHA)/American College of Cardiology (ACC)/The Obesity Society (TOS)
  • Department of Veteran’s Affairs (VA)/Department of Defense (DoD)
  • National Heart, Lung and Blood Institute (NHLBI)

A comparison of the recommendations for obesity screening are listed in Tables 2 and 3, below.

Table 2. Obesity Screening and Intervention Recommendations for Adults (Open Table in a new window)

Issuing Organization

Year

Screening Populations

Recommendations

Screening Interval

US Preventive Services Task Force (USPSTF) [16]

2012

All adults

Refer patients with a body mass index (BMI) of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions.

N/A

American Heart Association/American College of Cardiology /The Obesity Society (AHA/ACC/TOS) [17]

2013

All adults

Screen adult patients to establish a diagnosis of overweight or obesity

by calculating BMI

Counsel overweight and obese adults with cardiovascular risk factors (hypertension, hyperlipidemia, hyperglycemia) that lifestyle changes that produce even modest, sustained weight loss of 3%-5% produce clinically meaningful health benefits, and greater weight losses produce greater benefits

Annually

Department of Veterans Affairs /Department of Defense (VA/DoD) [18]

2014

All adults

Screen adult patients to establish a diagnosis of overweight or obesity

by calculating BMI

Assess for the presence of obesity-associated conditions among overweight patients or patients with increased waist circumference.

Consider providing normal and overweight patients with information and behavioral counseling regarding healthy diet and physical activity behaviors

Offer patients with obesity-associated conditions comprehensive lifestyle intervention for weight loss to improve lipid levels, blood pressure and/or glucose control

Annually

Table 3. Obesity Screening and Intervention Recommendations for Children and Adolescents. (Open Table in a new window)

Issuing Organization

Year

Screening Populations

Recommendation

Screening Interval

US Preventive Services Task Force (USPSTF) [19]

2010 (update in progress)

All overweight or obese children and adolescents (6-17 years)

Offer or refer to comprehensive, intensive behavioral intervention to promote improvement in weight status

N/A

National Heart, Lung and Blood Institute (NHLBI) [13]

2011

2 to 5 years with BMI >95th percentile

 

 

6 to 11 years

 

 

BMI 85th-95th percentile

 

 

BMI >95th percentile with no comorbidities

 

 

BMI >95th percentile with comorbidities or BMI > 97th percentile, or progressive rise in BMI despite therapy

 

 

12 to 20 years

 

BMI 85th-95th percentile

 

 

 

BMI >95th percentile with no comorbidities

 

 

BMI >95th percentile with comorbidities or BMI 35 kg/m2

Family-based weight gain prevention with parents as focus; registered dietician (RD) counseling; moderate-to-vigorous physical activity (MVPA) prescription; limit sedentary screen time

 

Excessive weight gain prevention with parents as focus; reinforce physical activity recommendations

 

Office-based weight loss plan with parents as focus; RD counseling; MVPA prescription; limit sedentary screen time

 

Refer to comprehensive multidisciplinary weight loss program for intensive

management

 

 

 

Excess weight gain prevention with adolescent as change agent, reinforced physical activity recommendations

 

 

Office-based weight loss plan: Family-centered with adolescent as change agent, RD counseling, treat for increased MVPA, decreased sedentary time

 

 

Refer to comprehensive lifestyle weight loss program for intensive management

3 month follow-up

 

 

 

6 month follow-up

 

 

 

6 month follow-up

 

 

 

6 month follow-up

 

 

 

6 month follow-up

 

 

6 month follow-up

 

 

6-12 month follow-up


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