Recomendations for the first appointment of adult persons with obesity

Abstract

The main objective of this recommendation is to establish the best strategies for obesity management in the first medical appointmet. For this, we formulated three “PICO questions” and we have answered based on the analysis of the available scientific evidence.
Our main conclusions were:
• In the first medical appointment of an adult patient with obesity, the motivational interview is more effective compared to the traditional approach for weight loss since it also allows to reinforce the patient's motivation and stimulate their participation in a behavioral change.
• For the obesity diagnosis, the body mass index continues to be a useful and simple detection tool; however, it is imperative to extend the view of obesity and establish the risk of complications in the first appointment, for this both the Edmonton staging system and the ABCD method are useful tools in addition to the body mass index.
• Aerobic physical activity is still recommended for its benefit in fat mass loss, mainly visceral, however, when combining anaerobic physical activity, the results are superior to the isolated aerobic strategy.
Conclusions: the approach to obesity in the first consultation should be based on a motivational interview to improve adherence; the diagnosis of obesity should be made by calculating the body mass index with an aditional tool that allows predicting the risk of complications; physical activity should combine aerobic as well as anaerobic strategies to improve both anthropometric and metabolic parameters.