Weight management is a plan to help an overweight or obese person reach and stay at a healthy body weight. Body mass index (abbreviated as BMI) is used to evaluate weight. This number is determined by dividing an individual's weight in kilograms by an individual's height in meters squared.
Anyone who takes in more calories than the body burns can expect to put on weight. Overweight and obesity are complex conditions with various factors that interact. These factors fit into the following groups: behavioralculturalgeneticmetabolicphysiologicalsocial
Impact of overweight or obesityOverweight and obesity put a person at risk for other health problems, such as: back painbreathing problemscoronary heart diseasediabetesgallbladder diseasehigh blood pressure osteoarthritissome types of cancerstroke
Obesity can even lead to an early death. The risk grows as the degree of obesity increases.
Weight management planThe first goal should be a 10% weight loss over a 6-month period. The rate of weight loss should be 1 to 2 pounds a week, because faster weight loss does not improve the long-term results.
After the first 6 months, additional weight management goals can be discussed with the healthcare professional. Some people may need to keep losing weight, while others may be ready to maintain their weight loss. No one treatment works for everyone.
NIH recommends these guidelines for the healthcare professional: make changes to the treatment plan based on the person's preferences and responsesschedule regular office visits to track weight loss progressset weight loss goals with the individualunderstand how the treatment fits into other health care and self-care needs of the person
A successful weight management plan includes: behavior therapydietary therapyregular physical activity
The plan may also include medicine or surgery.
Dietary therapyDietary therapy works best when it meets the needs of the individual. In general, NIH recommends these guidelines. A diet of 1,000 to 1,200 calories a day is appropriate for most women.A diet of 1,600 calories a day is recommended for most men.A diet of 1,600 calories a day may be right for women who exercise regularly or weigh over 165 pounds.If the person does not lose weight on the 1,600-calorie diet, a diet of 1,200 calories a day may be recommended.The healthcare professional may recommend adding 100 to 200 calories a day if the person is hungry.Specific recommendations should be given to be sure that the person gets all essential nutrients.
Physical activityTo begin treating obesity, NIH recommends moderate levels of physical activity. The activity should last 30 to 45 minutes a day, 3 to 5 days a week. The activity should be started slowly and gradually increase in intensity. Some moderate physical activities are: bicycling 5 miles in 30 minutesdoing water aerobics for 30 minutesgardening for 30 to 45 minutesraking leaves for 30 minuteswalking 2 miles in 30 minutes
SleepA number of studies have shown that reduced hours of sleep are associated with being overweight or obese. Teens should average 8 to 9 hours of sleep per night.
Behavior therapyBehavior therapy is used to overcome barriers to diet or physical activity. A good behavior therapy plan has these features: focuses on what mattersincludes seeing the healthcare professional oftenincludes self-monitoring, with appropriate rewardsis a partnership with the healthcare professional sets reasonable goalstakes the person's attitudes, beliefs, and history into account
Medicine and surgeryPeople often try natural medications (herbs, vitamins or supplements) for appetite suppression. The Natural Medicines Comprehensive Database (NMCD) rates the following as "possibly effective" for weight loss: caffeine, calcium, conjugated linoleic acid, diacylglycerol, fish oil, whey protein.
Rated as "ineffective" for weight loss are: blue-green algae, garcinia, glycerol, guar gum, inulin.
Rated as "likely ineffective" for weight loss: tiratricol.
Those natural medicines rated by the NMCD as having "insufficient evidence" for using for weight loss include: 5-HTP, 7-keto-DHEA, bean pod, bitter orange, bladderwrack, carob, chitosan, chromium, cola nut, DHEA, glucomannan, green tea, guarana, guggul, licorice, magnolia, mate, phellodendron, pyruvate, soy, and willow bark.
For short term (i.e., a few weeks only) appetite suppression, the following prescription drugs can be used under the supervision of a healthcare professional: diethylpropion (i.e., Tenuate), phentermine (i.e., Adipex-P), mazindol, phendimetrazine, or benzphetmine.
The Food and Drug Administration, or FDA, has approved only two medicines for long-term use for weight loss. They are: orlistat (i.e., Xenical), and sibutramine (i.e., Meridia).
These medicines may be prescribed for people with a BMI of 27 to 29.9 who have two or more diseases. NIH suggests these two medicines can also be used by people with a BMI of 30 or higher.
Bariatric surgery is a procedure in which the size of the stomach is reduced in order to change the way food is absorbed. In the past, it was reserved for people with extreme (morbid) obesity, but now is sometimes used for people with more moderate degrees of obesity for whom other approaches have not worked. It requires a lifelong commitment to a very disciplined approach to eating.
ToolsNIH provides tools to aid in weight management, such as: dietary informationguide to behavior changeguide to physical activityweekly food and activity diaryweight and goal records
ContraindicationsNIH states that these groups of people should be excluded from weight loss treatment: people who have serious illnesses that might be worsened by calorie restrictionpeople who have a serious uncontrolled psychiatric illness, such as major depressionwomen who are pregnant or breastfeeding
NIH also recommends that certain individuals be referred to specialists for weight loss as needed. These include people with a history of eating disorders, such as anorexia nervosa or bulimia. People who are currently abusing drugs should also be referred to a specialist.
Weight maintenanceAfter the person has reached his or her weight loss goal, weight maintenance needs to be lifelong. The person should have regular treatment to continue with these measures: behavior therapydietary therapysleepregular physical activity
Ongoing therapy can be given in a number of ways. The methods recommended by NIH include: e-mail remindersgroup meetingsregular visits with the healthcare professional telephone communications
After successful treatment for obesity, the person can monitor his or her weight. Regular visits with the healthcare professional will also be needed. NIH recommends an appointment at 6 months and again one year after the start of the weight management plan. The professional will check the person's weight, BMI, and waist measurement during these visits. Any new or worsening symptoms should be reported.