Changing the endpoints for determining effective obesity management

Prog Cardiovasc Dis. 2015 Jan-Feb;57(4):330-6. doi: 10.1016/j.pcad.2014.10.002. Epub 2014 Oct 25.


Health authorities worldwide recommend weight loss as a primary endpoint for effective obesity management. Despite a growing public awareness of the importance of weight loss and the spending of billions of dollars by Americans in attempts to lose weight, obesity prevalence continues to rise. In this report we argue that effective obesity management in today's environment will require a shift in focus from weight loss as the primary endpoint, to improvements in the causal behaviors; diet and exercise/physical activity (PA). We reason that increases in PA combined with a balanced diet are associated with improvement in many of the intermediate risk factors including cardiorespiratory fitness (CRF) associated with obesity despite minimal or no weight loss. Consistent with this notion, we suggest that a focus on healthy behaviors for the prevention of additional weight gain may be an effective way of managing obesity in the short term.

Keywords: Diet; Exercise; Obesity; Physical activity; Weight loss.

Publication types

  • Review

MeSH terms

  • Adult
  • Body Mass Index
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Diet Therapy* / methods
  • Diet Therapy* / psychology
  • Disease Management
  • Endpoint Determination / methods*
  • Exercise
  • Feeding Behavior / physiology
  • Feeding Behavior / psychology
  • Female
  • Health Behavior*
  • Humans
  • Male
  • Motor Activity*
  • Obesity* / complications
  • Obesity* / diagnosis
  • Obesity* / psychology
  • Obesity* / therapy
  • Physical Fitness* / physiology
  • Physical Fitness* / psychology
  • Randomized Controlled Trials as Topic
  • Risk Reduction Behavior
  • Weight Loss