In this regard, however, some professional organizations recommend targeting reduce the risk for hypoglycemia in elderly indi- viduals with limited life expectancy or significant Recommendations for Obesity Referenced studies that support recommendations are summarized in online Data Supplements 16 and 17. COR LOE Recommendations In patients with ischemic stroke or TIA and who are overweight or obese, weight loss is recommended to improve the ASCVD risk In patients with ischemic stroke or TIA who are obese, referral to an intensive, multicompo- nent, behavioral lifestyle-modification program is recommended to achieve sustained weight In patients with ischemic stroke or ASCVD, calculation of BMI is recommended at the time of their event and annually thereafter, to screen for and to classify obesity. Synopsis Approximately 38% of US adults have obesity.282 By 2030, prevalence is expected to reach 50%.283 In popu- lation studies, obesity increases risk for ischemic stroke by 50% to 100% compared with patients who have a The causal pathway from obesity to stroke risk is mediated by factors that track closely with weight, particularly elevated BP, AF, dyslipidemia, Obesity can be treated with inten- sive behavioral counseling to change eating patterns, medications that reduce appetite, and metabolic surgery. Weight loss of as little as 5% to 10% produces meaning- ful improvements in vascular risk factors.279 Only 1 trial has tested the effect of an intensive lifestyle interven- tion for weight loss on the prevention of vascular disease, and it was stopped early for futility.292 Inadequate aver- age weight loss in the active treatment group and statin therapy in the control group might explain the negative findings. 