Adding Counseling May Increase Weight Loss

Behavioral therapy in primary care settings may increase weight loss in obese patients

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Diet and exercise can be effective weight loss methods. But recent research has found that adding another technique may make them even more effective.

The Centers for Medicare and Medicaid Services (CMS) has approved primary care doctors to provide weight loss counseling to their obese patients. Recent research has aimed to test whether this was effective.

The authors of a new study found very little data on whether doctors were providing diet counseling. They did find, however, that obese patients who received counseling and diet and exercise advice from trained professionals lost the most weight.

"Although this review found limited data to support the delivery of intensive behavioral weight loss counseling by physicians and other primary care practitioners, these health professionals are likely to continue to play a critical role," wrote the researchers, led by Thomas A. Wadden, PhD, of the University of Pennsylvania Perelman School of Medicine in Philadelphia.

According to Tina Marinaccio, a Certified Personal Trainer (CPT) and Registered Dietitian (RD) from Morristown, New Jersey, "Dietary counseling provides support and accountability, helping the client to keep personal goals in the forefront of their thinking. It fleshes out some direction, like getting in your car and setting the GPS when you're not sure how to get to where you want to go."

Marinaccio, who was not involved in this study, told dailyRx News one reason why such counseling can be so useful. "The volumes of information available online should theoretically be helpful," she said. "Unfortunately, as consumers wade through varying philosophies, often conflicting, they may come away more confused. The biggest complaint I get in my practice is that despite all of the information available, they still do not know what to eat."

For their study, Dr. Wadden and colleagues reviewed findings from 12 past studies that included 3,983 patients in total. The studies were published between 1980 and 2014. The patients were treated for obesity and given techniques to help them lose weight.

Three methods were used in the studies to help patients lose weight: reducing calorie intake, increasing exercise and undergoing behavioral therapy.

Behavioral therapy is counseling aimed at changing behavior by replacing bad habits with good ones. For instance, a doctor might counsel an obese patient who eats when he or she is stressed to take a walk around the block rather than head for the pantry when stress hits. The CMS guidelines called for 14 face-to-face behavioral counseling sessions that lasted 10 to 15 minutes each over six months.

Patients treated with all three methods lost the most weight. They lost from 0.7 to 14.5 pounds.

The weight change of patients who did not receive behavioral counseling ranged from gaining 2 pounds to losing 4.4 pounds.

"Intensive behavioral counseling can induce clinically meaningful weight loss," the study authors wrote.

The research was published online Nov. 3 in JAMA.

The National Institute of Diabetes and Digestive and Kidney Diseases funded the research. Dr. Wadden and co-author Adam G. Tsai, MD, received support from or advised weight loss companies.

Review Date: 
November 4, 2014
Last Updated:
November 11, 2014