Table 2.

Recommendations to potentially improve patient treatment success

• Diagnose obesity as class I, II, or III to identify appropriate treatment intensity.

• Aim for a 5–10% weight loss for class I and/or if the goal is to prevent diabetes and/or promote remission of a mild–moderate complication (e.g., hypertension, dyslipidemia) [17]. Consider adding pharmacotherapy early on to increase the chance of a 5% weight loss.

• Aim for a 10–20% weight loss for patients with class II or III and/or a moderate complication (e.g., nonalcoholic fatty liver disease [96, 97], obstructive sleep apnea (OSA) [98, 99], or mild–moderate type 2 diabetes [100]). Consider discussing surgery if lifestyle and pharmacotherapy are insufficient.

• Aim for a >20% weight loss for class II or III and/or a severe complication (e.g., poorly controlled diabetes) and consider bariatric surgery early on as it is the most efficacious in reaching this desired weight loss goal, especially in the setting of diabetes (65).

• Create and document an obesity treatment plan.

• Develop a system for routine follow-up at a minimum of every 3 months (more frequent if possible) during the “core” weight loss phase, increasing interval follow-up during the “maintenance” phase (every 6–12 months).