Lifestyle prescriptions for obesity treatment in primary care: a narrative review.

PURPOSE: This review aims to synthesize the most up-to-date evidence on effective lifestyle prescriptions for managing patients with obesity in the primary care setting. METHODS: A comprehensive literature search was conducted through June 2025 using major domestic and international databases, including PubMed, Google Scholar, and RISS, as well as the websites of relevant academic societies. The search strategy employed keywords such as "obesity," "primary care," "lifestyle intervention," "diet," "exercise," and "behavioral therapy" in both English and Korean. RESULTS: Effective obesity management should be grounded in the new paradigm of adiposity-based chronic disease, which focuses on preventing and treating the medical complications associated with excessive fat accumulation. The essential components of a successful lifestyle prescription comprise 3 pillars: diet, exercise, and behavioral therapy. An individualized dietary plan that achieves an energy deficit of 500-750 kcal is fundamental. Exercise prescriptions should recommend a combination of aerobic and resistance training, along with strategies to minimize sedentary time. In behavioral therapy, high-intensity behavioral counseling, the 6A model (ask, assess, advise, agree, assist, arrange), self-monitoring, and cognitive-behavioral therapy techniques have all demonstrated efficacy. CONCLUSION: Primary care physicians are not only capable but also uniquely positioned to lead long-term, patient-centered obesity management. Their comprehensive and integrative perspective makes them one of the most efficient and scalable resources in addressing the obesity epidemic.