Weight-loss programs for adults with a BMI of 30 or higher
For adults with a body mass index (BMI) of 30 or higher, the USPSTF recommends that clinicians offer or refer them to an intensive weight-loss program that combines diet changes and more physical activity (grade B, 2018). (USPSTF, 2018)
BMI is a starting point, not a diagnosis. The USPSTF notes that waist size may be a reasonable alternative to BMI for some groups. (USPSTF, 2018) Talk to your doctor about what your numbers mean for you.
- USPSTF grade
- B
- Who
- Adults with a BMI of 30 or higher
- Ages
- 18 and older
- What
- Intensive diet and activity program
How BMI is worked out, and the USPSTF terms
| BMI | USPSTF term | This recommendation |
|---|---|---|
| 25 to 29.9 | Overweight | Not covered by this grade B |
| 30 to 34.9 | Obesity, class 1 | Offer or refer to a program |
| 35 to 39.9 | Obesity, class 2 | Offer or refer to a program |
| 40 or higher | Obesity, class 3 | Offer or refer to a program |
BMI is your weight in kilograms divided by your height in meters squared. The recommendation applies to adults 18 and older. Measuring BMI is already part of routine care, so the USPSTF focused on what helps after it. (USPSTF, 2018)
Overweight or obesity is also what makes adults 35 to 70 eligible for diabetes screening. Read more: diabetes screening.
What an intensive program looks like
Most programs in the studies the USPSTF reviewed aimed for a weight loss of 5% or more through diet changes and more activity. Most lasted 1 to 2 years, with 12 or more sessions in the first year. (USPSTF, 2018)
They were run in groups, one to one, or by phone, web or app, often by dietitians, psychologists, exercise specialists or lifestyle coaches rather than the primary care clinician. Common parts were weighing yourself regularly, problem solving, peer support and planning for setbacks. (USPSTF, 2018)
In people with obesity and raised blood sugar, these programs lowered the chance of developing type 2 diabetes. The USPSTF judged the harms as small to none. (USPSTF, 2018)
Medicines and surgery
The USPSTF found that weight-loss medicines added to a program led to more weight loss in trials, but the trials enrolled very selected people and many dropped out, so it is unclear how well the results apply in everyday care. Surgery and devices were outside the review, as primary care does not provide them. (USPSTF, 2018)
Whether a medicine or surgery fits you is a decision to make with your doctor.
What Medicare covers
Medicare Part B covers obesity screening and behavioral counseling if your BMI is 30 or more. The counseling must come from your primary care doctor or another primary care provider in a primary care setting, and you must meet certain weight-loss requirements for coverage to continue. You pay nothing if the provider accepts assignment. (Medicare.gov)
Medicare.gov also describes a GLP-1 Bridge that covers certain weight-loss drugs for some people with Part D drug coverage who meet its requirements. Ask your doctor or plan whether it applies to you. (Medicare.gov)
Questions people ask
What BMI qualifies for a weight-loss program?
The USPSTF grade B covers adults with a BMI of 30 or higher; a BMI of 25 to 29.9 is not included. If you have heart risk factors such as high blood pressure or abnormal cholesterol, a separate USPSTF recommendation covers diet and activity counseling. Read more: healthy eating and activity counseling. (USPSTF, 2018)
Is weight-loss counseling covered by insurance?
HealthCare.gov lists obesity screening and counseling among the preventive services many plans must cover at no cost to you. Medicare Part B covers obesity counseling with a primary care provider for a BMI of 30 or more. Check with your plan. (HealthCare.gov) (Medicare.gov)
How much weight do these programs aim for?
Most programs in the USPSTF review aimed for a loss of 5% or more of starting weight, an amount the FDA considers clinically important. Programs that help keep weight off after a loss reduced weight regain. (USPSTF, 2018)
Should I take a weight-loss drug?
The USPSTF did not make a recommendation on drugs alone. It found the trial results hard to apply to everyday care because of who took part and how many dropped out. Talk to your doctor about whether a medicine fits you. (USPSTF, 2018)
This page explains what the guidelines say. It cannot tell you what is right for you: talk to your doctor.