Obesity (Treatments)

A combination of dieting and exercise (when you stick to it) appears to work better than either one alone. Sticking to a weight reduction program is difficult and requires a lot of support from family and friends.

When dieting, your main goal should be to learn new, healthy ways of eating and make them a part of your everyday routine. Work with your doctor and nutritionist to set realistic, safe daily calorie counts that assure both weight loss and good nutrition. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your nutritionist can teach you about healthy food choices, appropriate portion sizes, and new ways to prepare food. Even modest weight loss can improve your health. Most people can lose weight by eating a healthier diet, exercising more, and adopting new behaviors such as keeping a food diary, avoiding food triggers, and thinking positively. The decision to keep fit requires a lifelong commitment of time and effort. Patience is essential.

Several simple behavioral changes can have an impact on your weight loss success:

• Set realistic goals for weight reduction. One should engage in aerobic exercise for at least 30 minutes a day, 3 times a week, and try to increase physical activity in general.
• Eat only at the table. No snacking in front of the TV, in bed, while driving, or while standing in front of the open refrigerator.
• Learn about appropriate portion sizes.
• Choose low-calorie snacks, such as raw vegetables.
• Consider learning meditation or yoga as a way of managing stress, rather than snacking.
• Find ways to socialize and enjoy your friends and family that don't involve a meal or dessert.
• Consider keeping a diet and exercise journal. This may help you identify overeating triggers in your life.
• Find a support group or consider psychotherapy to help support you in the difficult but worthy goal of weight loss.

Key recommendations from the expert panel on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults:

The initial goal of weight-loss therapy should be to reduce body weight by about 10 percent from baseline. For the first six months, weight loss should be approximately one to two pounds per week. If necessary, the patient can continue to lose more weight.

Reducing dietary fat alone without reducing calories is not enough to cause weight loss. However, reducing dietary fat along with reducing dietary carbohydrates can help reduce calories.

Drug therapy can also be used. However, drug safety and efficacy beyond one year of total treatment have not been established.

Selecting a weight loss program

Some people lose weight on their own; others like the support of a structured program. If you decide to join any kind of weight-control program, here are some questions to ask before you join.

• Does the program provide counseling to help you change your eating and personal habits?
• Will this program teach you how to permanently change habits and lifestyle factors that have contributed to weight gain?
• Is the staff made up of a variety of qualified counselors and health professionals such as nutritionists, registered dietitians, doctors, nurses, psychologists and exercise physiologists?

You need an evaluation by a physician if you have any health problems, are currently taking or plan on taking any medicine or plan to lose more than 15 to 20 pounds. If your weight-control plan uses a very low-calorie diet, you need an exam and follow-up visits by a doctor.

• Is training available on how to deal with times when you may feel stressed and slip back to old habits? Is attention paid to keeping the weight off, and how long is this phase?

The program should provide long-term strategies for dealing with weight problems that may come up in the future. These strategies might include things like establishing a support system and establishing a physical activity routine.

• Are food choices flexible and well-suited to the individual? Are weight goals set by the client and the health professional? The program should consider your food likes and dislikes and your lifestyle when your weight-loss goals are planned.
• What percentage of people completes the program?
• What is the average weight loss among people who finish the program?
• What percentage of people has problems or side effects, and what are they?
• Are there fees or costs for additional items, such as dietary supplements?

Quick weight-loss methods do not lead to lasting results. Relying on diet aids like drinks, prepackaged foods or pills don't work over the long term. No matter how much weight you wish to lose, modest goals and a slow pace will increase your chances of losing the weight and keeping it off.

Guide to physical activity

Not only is exercise an integral part of a weight loss and weight maintenance plan, it also reduces the risk of cardiovascular disease and diabetes, beyond that produced by weight reduction alone.

Your exercise can be done all at one time, or intermittently over the day. Initial activities may be walking or swimming at a slow pace. Your regimen can be adapted to other forms of physical activity, but walking is a particularly smart choice because of its safety and accessibility. Increasing activity by undertaking frequent, less strenuous exercises, such as walking up and down the stairs instead of the using the elevator.
You may eventually be able to engage in more strenuous activities such as tennis or any form of group sport.

Guide to behavior change

Over the past few years it has become clear that many people suffer from health issues due to weight. Some people who need to lose weight for their health don't recognize it, while others who don't need to lose weight want to get thinner for cosmetic reasons.

Weight can affect a person's self-esteem. Excess weight is clearly visible and may attract ridicule. The amount of weight loss needed to improve your health may be much less than your total weight-loss goal. Your health can be greatly improved by a loss of 5-10 percent of your starting weight. That doesn't mean you have to stop there, but it does mean that an initial goal of losing 5-10 percent of your starting weight is both realistic and valuable.

Balance your (food) checkbook

Healthy food shopping

National Heart, Lung, and Blood Institute Obesity Guidelines

So, shop for quick low fat food items and fill your kitchen cupboards with a supply of basics like the following:

• Fat free or low-fat milk, yogurt, cheese, and cottage cheese
• Light or diet margarine
• Eggs/Egg substitutes
• Sandwich breads, bagels, pita bread, English muffins
• Soft corn tortillas, low fat flour tortillas
• Low fat, low sodium crackers
• Plain cereal, dry or cooked
• Rice, pasta
• White meat chicken or turkey (remove skin)
• Fish and shellfish (not battered)
• Beef: round, sirloin, chuck arm, loin and extra lean ground beef
• Pork: leg, shoulder, tenderloin
• Dry beans and peas
• Fresh, frozen, canned fruits in light syrup or juice
• Fresh, frozen, or no salt added canned vegetables
• Low fat or nonfat salad dressings
• Mustard and catsup
• Jam, jelly, or honey
• Herbs and spices
• Salsa

SURGERY

Weight-loss surgery may be an option if you are very obese and have not been able to lose weight through diet and exercise. However, these surgeries are not a "quick fix" for obesity. You must still be committed to diet and exercise after the surgery. Talk to your doctor to learn if this is a good option for you.

The two most common weight-loss surgeries are:

• Laparoscopic gastric banding -- the surgeon places a band around the upper part of your stomach, creating a small pouch to hold food. The band limits the amount of food you can eat by making you feel full after eating small amounts of food.
• Gastric bypass surgery -- helps you lose weight by changing how your stomach and small intestine handle the food you eat. After the surgery, you will not be able to eat as much as before, and your body will not absorb all the calories and other nutrients from the food you eat.

Obesity. Last reviewed 12/31/1969
  • Center for Disease Control
  • National Heart, Lung and Blood Institute
  • National Institutes of Health - National Library of Medicine
  • U.S. Department of Health and Human Services
  • National Institute of Diabetes & Digestive & Kidney Diseases.