Chinese Guidelines for Behavioral and Lifestyle Interventions for Obesity

Obesity is a chronic disease characterized by abnormal or excessive fat accumulation, that significantly increases the risk of multiple health complications. Weight loss among individuls with obesity can reduce disease risk and improve both physical and social functioning. Behavior and lifestyle interventions (BLIs) constitute the cornerstone of weight management and should adhere to the principles of effectiveness, gradual progression, comprehensiveness, and individualization. BLIs implementation strategies incorporate established behavior change theories, behavioral change techniques (BCTs), and cognitive behavioral therapy (CBT). Dietary behavioral intervention strategies encompass controlling total energy intake, adjusting dietary patterns, and scientifically managing eating time, manner, location, and emotional factors. Exercise intervention strategies include providing psychological and behavioral support and prescribing individualized exercise regimens. Psychological interventions should integrate BCTs with cognitive restructuring to modify values and beliefs regarding diet and physical activity. Sleep interventions should emphasize education and self-management, CBT, relaxation training, regular exercise, light therapy, and circadian rhythm regulation. The BLIs process comprises pre-intervention assessment, priority determination, intervention objectives, content, settings, delivery methods, intensity, duration, and outcome evaluation, while emphasizing the implementation of a multidisciplinary team (MDT) collaborative care model. Childhood and adolescent obesity interventions should adopt family-based, school-based, community-based, clinical, multi-sector, and full developmental life-cycle strategies. Digital technologies should focus on enhancing precision diagnosis, personalized interventions, and full-cycle monitoring. BLIs effectiveness evaluation includes formative evaluation, process evaluation, and outcome evaluation, integrated with comprehensive judgment based on high-quality research evidence. Other critical considerations include improving practical effectiveness, preventing weight regain, enhancing cultural adaptability, and ensuring rational application and standardized referral for pharmacotherapy and bariatric surgery.