Health Day News — Offering intensive behavioral counseling is recommended for overweight and obese patients with cardiovascular risk factors, according to a final recommendation statement from The United States Preventive Services Task Force (USPSTF).

After reviewing data from 74 trials relating to the benefits and harms of primary care-delivered counseling interventions, Michael L. LeFevre, MD, MSPH, of the USPSTF in Rockville, Md., and colleagues analyzed patient outcomes. Their findings were published in the Annals of Internal Medicine.

Evidence reviewed by the USPSTF demonstrated the effectiveness of intensive behavioral counseling interventions in health behavior outcomes and selected intermediate clinical outcomes after 12 to 24 months.

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Total cholesterol levels decreased by approximately 3 to 6 mg/dL and LDL cholesterol levels decreased by 1.5 to 5 mg/dL among those who received counseling. Weight decreased by a standardized mean difference of 0.026, which translated to a BMI reduction of 0.5 to 1.5 kg/m.2

Offering or referring overweight or obese adults with additional cardiovascular disease risk factors to intensive behavior counseling interventions is a Grade B recommendation, and applies to patients aged 18 years and older in primary-care settings who are overweight or obese and have additional cardiovascular disease risk factors, including hypertension, dyslipidemia, impaired fasting glucose, or metabolic syndrome.

This recommendation is intended to complement the USPSTF’s 2012 recommendation on behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention in persons without cardiovascular risk factors (C recommendation), noted the researchers.


  1. LeFevre M et al. Annals of Internal Medicine. 2014; doi: 10.7326/M14-1796