Studies of metabolic surgery confirm that weight loss is associated with improvements in glucose control, BP, indicators of inflammation, and lipid 2. Available strategies for helping patients achieve meaningful weight loss include intensive behavioral counseling, drugs to reduce appetite, and bariatric surgery. Of these, intensive behavioral counseling is recommended as the first option in evidence- based guidelines because of its greater effective- ness and safety compared with pharmacotherapy and greater safety and lower cost compared with Components of multicomponent behavioral programs typically include goal setting, feedback, problem solving, coaching for physical activity, and frequent indi- vidual or group meetings (at least 12 sessions in the first year).300 Examples include the Diabetes and CLINICAL STATEMENTS AND GUIDELINES Kleindorfer the Counterweight Program.258 On average, behavior-based programs achieve 2.4 kg greater weight loss than control intervention over up to 24 month, and participants are more likely to lose 5% of their body weight.281 Ideally, patients with obe- sity, according to need, are offered care in a com- prehensive bariatric program in which all strategies for weight reduction are offered. 3. In 2012, the US Preventive Services Task Force issued a Grade B recommendation to screen all adults for obesity.301 The recommendation is con- sistent with the AHA guideline on obesity from 2013 and more recent guidance from other pro- Although there is no direct evidence that weight loss interventions among patients with acute ischemic stroke reduce risk for recurrent stroke or otherwise improve future brain health, there is clear evidence that intensive counseling can help patients achieve meaningful weight loss.281 The US Preventive Services Task Force determined that the risks for intensive counseling were small to none.300 For selected patients, pharmacotherapy and bariatric surgery also may be effective, although surgical trials typically have excluded patients with stroke. 