lose weight (no matter how much one desires or needs to lose or one's age, state of health, or stage of life) should arouse suspicion that the program might not be sound.

Consumer's Perspective: Should I Be in This Program Given My Goals and Characteristics?

Because consumers decide on their own or with the help of others (e.g., family, friends, or health-care providers) whether to enter a weight-loss program and which one to choose, they must consider carefully their weight-loss goals and whether they are appropriate candidates for weight loss, and decide whether the time is right for them to devote the considerable attention and effort required to succeed. It is important that consumers commit time and energy to losing weight and maintaining the weight loss; they will fail if they do not make sincere efforts, no matter how good the program.

We believe that individuals should have the right to select the therapeutic modality they believe to be most suited to their needs or to select no treatment—although we hope they will seek guidance from health-care providers in making their decision. Some individuals may find treatment too onerous or otherwise unsuitable. In this case, they should expect that the provider will not withhold medical assistance required to treat any medical problems that might be related to their weight or hold them accountable for those problems.

Individuals should expect a program to provide them with sufficient information to help assess whether they are appropriate or inappropriate potential candidates. We strongly recommend that those contemplating a do-it-yourself or nonclinical program be evaluated first by a health-care provider (or have been assessed in the recent past) before proceeding. They should discuss the program or product with their health-care provider to determine whether it is sound and appropriate. Individuals who are extremely obese (i.e., BMI >40) and have failed at attempts to lose weight should discuss with their health-care provider the risks they face and the options available to them, such as gastric surgery and medications. These two options should be used as appropriate with a program of diet, physical activity, and behavior modification.

Criterion 2: Soundness and Safety of the Program

Weight-management programs should be based on sound biological and behavioral principles and should be relatively safe for their intended



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