Clinical Review State of the Art Review

Obesity in the US: what is the best role for primary care?

BMJ 2015; 350 doi: (Published 05 February 2015) Cite this as: BMJ 2015;350:g7846
  1. Jamy Ard, associate professor
  1. 1Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC 27157, USA
  1. Correspondence to: J Ard jard{at}


The increasing prevalence of obesity together with projected increases in diabetes over the next 20-30 years will put a substantial strain on the finances and resources of the US healthcare system. The best opportunity for broad scale treatment of obesity may lie in the primary care setting. This review assesses the evidence on the efficacy of treatment for obesity delivered in primary care in the United States. It summarizes an earlier systematic review, recent obesity treatment guidelines, and subsequent US based trials with a minimum follow-up of six months in which at least one member of a primary care team helped deliver comprehensive behavioral obesity treatment to adults with overweight or obesity. Overall, the evidence suggests that obesity treatment delivered in primary care has limited effectiveness. Questions remain about the optimal role of the primary care provider in the treatment of obesity and the prevention of weight gain, as well as potential systems approaches to the treatment of obesity.


  • Competing interests: I have read and understood BMJ policy on declaration of interests and declare the following interests: I receive research support and am a consultant medical director for Nestlé Healthcare Nutrition; I have also received research support and consultant fees from Vivus and consultant fees from Novo Nordisk and Eisai pharmaceutical.

  • Provenance and peer review: Commissioned; externally peer reviewed.

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