Weight Loss: What Are Your Options?
The prevalence of obesity has increased steadily in Western cultures over the past century, particularly during the last several decades. In fact, most health professionals agree that we are in the midst of an obesity epidemic in the United States. Being overweight is closely linked to many very serious health conditions, most particularly risk factors for heart disease and stroke , including high blood pressure , high cholesterol , high triglycerides , low levels of HDL (high-density lipoprotein—the "good" cholesterol), and type 2 diabetes . Fortunately, even modest reductions in weight can help improve these conditions. Plus, practicing the behavioral changes of a healthier diet and regular exercise may actually reduce these risk factors whether weight loss occurs or not.
Energy Balance: The Simple Principle of Weight LossScientists often explain weight loss quite simply in terms of the energy balance equation: energy in versus energy out. To lose weight, you must consume fewer calories than you burn or, in reverse, you must burn more calories than you consume.This is, of course, easier said than done. But no matter what weight loss methods you may employ—diet, exercise, medications, supplements, surgery, therapy, group support—the principle of energy balance is unavoidable. In fact, experts from both traditional and nontraditional disciplines agree that to achieve and maintain weight loss you must make changes in your diet and activity level to favorably affect the balance of the energy equation.
Using Strategies to Get StartedGetting started is often the most difficult part of losing weight. Any changes you make in your eating and exercising behaviors must become habitual, which takes time. In addition, carrying extra weight, no matter how much, can affect how you feel about yourself psychologically, sometimes making it more difficult to take the necessary steps to begin to change.The following five strategies are crucial to successful weight loss and can help to overcome some of these barriers:
- Set and commit to realistic goals and monitor your progress toward achieving these goals
- Slowly modify your eating and exercise behaviors, as well as habits influencing both
- Examine and restructure unrealistic, negative thoughts, or expectations
- Reduce stress
- Develop a network of social support and information
Looking at Weight Loss AidsThere is a great deal of interest in whether prescription medications or supplements can facilitate weight loss. Some medications suppress appetite by interfering with brain chemicals that affect mood and appetite. Others reduce fat absorption from the gut. Here are examples of medications that may be recommended for weight loss:
- Phentermine—can be taken alone or in combination with another medication
Setting Realistic GoalsIt is clear that losing weight is not simple. Changing your diet and being more physically active are the building blocks for successful weight loss. Depending on your health status, medications and supplements may be an option for you. As you think about a health weight loss plan for you, consider these suggestions:
- Remember that even modest changes can make a big difference.
- Work with a therapist. A therapist can help you to explore the deeper individual and cultural issues you may have about food, eating, and body image. Use this information to gain a greater degree of self-understanding, acceptance, and compassion.
- If you are interested in trying medications or supplement, have realistic ideas about what these can do for you. There is no substitute for making long-term lifestyle changes.
National Heart, Lung, and Blood Institute
National Institute of Diabetes and Digestive and Kidney Diseases
Dietitians of Canada
Health Canada Food and Nutrition
Diets for weight loss. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 30, 2014. Accessed March 11, 2014.
Obesity in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 7, 2014. Accessed March 11, 2014.
Prescription medications for the treatment of obesity. National Institute of Diabetes and Digestive and Kidney Disorders. Available at: http://win.niddk.nih.gov/publications/prescription.htm. Updated October 25, 2013. Accessed March 11, 2014.
Rucker D, Padwal R, Li SK, Curioni C, Lau DC. Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ. 2007;335(7631):1194-1199.
Weight loss medications for obesity in adults. Available at: http://www.ebscohost.com/dynamed. Updated February 19, 2014. Accessed March 11, 2014.
7/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Seo DC, Sa J. A meta-analysis of psycho-behavioral obesity interventions among US multiethnic and minority adults. Prev Med. 2008;47:573-582.
10/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: US Food and Drug Administration. Meridia (sibutramine): market withdrawal due to risk of serious cardiovascular events. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm228830.htm. Updated Sepember 9, 2013. Accessed March 11, 2014.
- Reviewer: Michael Woods, MD
- Review Date: 03/2014
- Update Date: 03/11/2014