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Understanding New Obesity and Healthy Living Guidelines


The American Heart Association and American College of Cardiology recently unveiled new guidelines designed to help people lead a healthy lifestyle and help physicians treat people who are overweight or obese.

The guidelines were published in the AHA journal Circulation and the Journal of the American College of Cardiology, and the obesity guidelines were also published by Obesity: Journal of the Obesity Society. But as guidelines published in medical journals tend to be, the guidelines are pretty wonky — so the Inside Track put together the primer below to help people understand them.

What are these new guidelines for exactly?

The guidelines are designed to encourage healthier habits and lifestyle choices. The Joint Healthy Living Clinical Practice guideline aims to help people eat a heart-healthy diet and take part in regular physical activity, thereby lowering their risk of heart attacks, stroke and other cardiovascular diseases. The Clinical Practice Guideline urges doctors to consider obesity a disease and offers a roadmap for healthcare providers to treat adults who are overweight or obese.

Tell me more about the Joint Healthy Living guidelines.

This new guideline report is based on a systematic evidence review that summarizes key nutrition and physical activity topics for the management of blood pressure and blood cholesterol. The guideline recommends eating a heart-healthy diet that emphasizes fruits, vegetables and whole grains, while including low-fat dairy products, fish, poultry and nuts, and limiting red meat, sweets and sugary drinks.  The dietary pattern should reduce saturated fat, trans fat and sodium intake. It also recommends people take part in moderate-to-vigorous aerobic exercise for about 40 minutes three to four times a week.

Will following the Joint Healthy Living guidelines help lower obesity?

The guidelines are specifically designed to manage blood cholesterol and blood pressure to reduce heart attacks, strokes and other heart conditions. They do not directly address adaptations for a weight-loss diet, but are compatible with reducing overall calorie intake — and thus, are likely to help people reach a healthy weight.

OK, tell me about that other guideline now.

The Clinical Practice Guideline offers healthcare providers a roadmap to help their patients achieve and maintain a healthy weight. This includes developing individualized plans for patients and focus on behavior change.

What are doctors and other healthcare providers encouraged to do?

The report urges healthcare providers to develop individualized weight loss plans that include a moderately reduced calorie diet, a program of increased physical activity and the use of behavioral strategies to help patients achieve and maintain a healthy body weight. It also recommends healthcare providers calculate patients’ body mass index (BMI) at annual visits or more frequently, helping to identify those who might be at higher risk of heart disease and stroke because of their weight.

That all sounds great, but isn’t it tough for people to stick with such changes?

It certainly is. That’s why the report notes that a patient should work with a trained healthcare professional, such as a registered dietitian, behavioral psychologist or other trained weight loss counselor in a primary care setting. The most effective behavior change programs include two to three in-person meetings a month for at least six months. Web or phone-based programs also are an option, but they typically aren’t as effective as face-to-face programs.   

Are these programs affordable for most people?

Currently, comprehensive lifestyle programs like these are not widely available, but coverage is improving. Medicare began covering behavioral counseling for patients affected by obesity in 2012. Under the Affordable Care Act, most private insurance companies are expected to cover similar counseling by 2014.

How do I find out more about either of these guidelines?

Click here to visit the American Heart Association Guideline Resource Center for more information.