Existing clinical guidance strongly recommends face-to-face or tele- phone-delivered weight-loss maintenance programs that provide regular contact (at least monthly) with a trained interventionist to help participants engage in high levels of physical activity (200 to 300 minutes/ week), monitor body weight regularly (at least weekly), and consume a reduced-calorie diet.S4.1-10 US Food and Drug Administration (FDA) approved and bariatric adjunctive to complementary lifestyle in- terventions, additionally reduce weight and may have a role in weight loss for select patients. The present guideline document focuses primarily on lifestyle inter- ventions for overweight and obesity, as outlined in the 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults.S4.1-10 Weight loss interventions should be cautiously implemented and individualized, especially in older adults, to avoid det- rimental effects, such as loss of lean body/muscle mass and nutritional deficiencies.S4.1-13 S4.1-15 Recommendation-Specific Supportive Text 1. Clinically meaningful weight loss ( 5% initial weight) is associated with moderate improvement in BP, low-density lipoprotein cholesterol (LDL-C), triglyceride, and glucose levels among individuals Weight loss reduces or delays the development of T2DM in persons with High-intensity ( 14 sessions in 6 months) comprehensive weight-loss interven- tions provided by a trained interventionist work However, other modalities, such as elec- tronically delivered weight-loss programs with per- sonalized feedback and some commercial-based programs, have also shown moderate results. 2. Comprehensive lifestyle intervention consists of a structured program, which includes regular self- monitoring of food intake, physical activity, and weight. Increased physical activity, preferably aerobic physical activity (eg, brisk walking) for 150 minutes/ week (equal to 30 minutes/day on most days of the week), is recommended for initial weight loss.S4.1-10 Higher levels of physical activity, approximately 200 to 300 minutes/week, are recommended to main- tain weight loss or minimize weight regain after 1 year. 