(Weak for | Reviewed, Amended) Discussion As part of lifestyle modification, weight loss has been found to improve blood pressure in patients with HTN and overweight/obesity. Overall, reduction in weight or BMI had a positive effect on blood Therefore, the Work Group suggests advising patients with HTN and overweight/obesity to lose weight to reduce blood pressure. Although the confidence in the quality of the evidence is very low,[102-109] the Work Group believes the benefits outweigh the harms. As far as specific interventions for weight loss, the Work Group suggests offering diet directed at weight loss for treatment of HTN 11 See the VA/DoD Clinical Practice Guideline for Screening and Management of Obesity and Overweight. Available at: https://www.healthquality.va.gov/guidelines/CD/obesity/. (see Recommendation 15).[106-108] Additionally, the Work Group recommends neither for nor against weight loss medications for the treatment of HTN (see Recommendation 16).[103] Lastly, there is insufficient evidence to recommend for or against bariatric surgery for the treatment of HTN in patients with obesity and HTN (see Recommendation 17).[104,105] As Recommendation 14 is a Reviewed, Amended recommendation, the Work Group systematically reviewed evidence related to this recommendation identified in the evidence review conducted as part of this guideline update.[102-109] The confidence in the quality of the evidence supporting dietary and lifestyle interventions for blood pressure reduction through weight loss was low to very low. The Work Group believes that the benefits of diet and lifestyle modifications outweigh the harms. There will be variability in patient values and preferences, as not all patients will want to lose the weight or be accepting of a lifestyle modification. Thus, the Work Group decided upon a Weak for recommendation. Recommendation 15. For patients with hypertension and overweight/obesity, we suggest offering a diet directed at weight loss for the treatment of hypertension. 