The best way to lose weight is to use more calories than you take in. You can do this by following a healthy eating plan and being more active. Before you start a weight-loss program, talk to your doctor.
Safe weight-loss programs that work well:
- Set a goal of slow and steady weight loss — 1 to 2 pounds per week
- Offer low-calorie eating plans with a wide range of healthy foods
- Encourage you to be more physically active
- Teach you about healthy eating and physical activity
- Adapt to your likes and dislikes and cultural background
- Help you keep weight off after you lose it
The U.S. Department of Health and Human Services (HHS) and Department of Agriculture (USDA) offer tips for healthy eating in Dietary Guidelines for All Americans.
- Focus on fruits. Eat a variety of fruits — fresh, frozen, canned, or dried — rather than fruit juice for most of your fruit choices. For a 2,000-calorie diet, you will need 2 cups of fruit each day. An example of 2 cups is 1 small banana, 1 large orange, and 1/4 cup of dried apricots or peaches.
- Vary your veggies. Eat more:
- dark green veggies, such as broccoli, kale, and other dark leafy greens
- orange veggies, such as carrots, sweet potatoes, pumpkin, and winter squash
- beans and peas, such as pinto beans, kidney beans, black beans, garbanzo beans, split peas, and lentils
- Get your calcium-rich foods. Each day, drink 3 cups of low-fat or fat-free milk. Or, you can get an equivalent amount of low-fat yogurt and/or low-fat cheese each day. 1.5 ounces of cheese equals 1 cup of milk. If you don’t or can’t consume milk, choose lactose-free milk products and/or calcium-fortified foods and drinks.
- Make half your grains whole. Eat at least 3 ounces of whole-grain cereals, breads, crackers, rice, or pasta each day. One ounce is about 1 slice of bread, 1 cup of breakfast cereal, or 1/2 cup of cooked rice or pasta. Look to see that grains such as wheat, rice, oats, or corn are referred to as “whole” in the list of ingredients.
- Go lean with protein. Choose lean meats and poultry. Bake it, broil it, or grill it. Vary your protein choices with more fish, beans, peas, nuts, and seeds.
- Limit saturated fats. Get less than 10 percent of your calories from saturated fatty acids. Most fats should come from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils. When choosing and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free.
- Limit salt. Get less than 2,300 mg of sodium (about 1 teaspoon of salt) each day.
The new 2008 Physical Activity Guidelines for Americans state that an active lifestyle can lower your risk of early death from a variety of causes. There is strong evidence that regular physical activity can also lower your risk of:
- Heart disease
- High blood pressure
- Unhealthy cholesterol levels
- Type 2 diabetes
- Metabolic syndrome
- Colon cancer
- Breast cancer
Regular activity can help prevent unhealthy weight gain and also help with weight loss, when combined with lower calorie intake. If you are overweight or obese, losing weight can lower your risk for many diseases. Being overweight or obese increases your risk of heart disease, high blood pressure, stroke, type 2 diabetes, breathing problems, osteoarthritis, gallbladder disease, sleep apnea (breathing problems while sleeping), and some cancers.
Regular physical activity can also improve your cardiorespiratory (heart, lungs, and blood vessels) and muscular fitness. For older adults, activity can improve mental function.
Physical activity may also help:
- Improve functional health for older adults
- Reduce waistline size
- Lower risk of hip fracture
- Lower risk of lung cancer
- Lower risk of endometrial cancer
- Maintain weight after weight loss
- Increase bone density
- Improve sleep quality
Health benefits are gained by doing the following each week:
During moderate-intensity activities you should notice an increase in your heart rate, but you should still be able to talk comfortably. An example of a moderate-intensity activity is walking on a level surface at a brisk pace (about 3 to 4 miles per hour). Other examples include ballroom dancing, leisurely bicycling, moderate housework, and waiting tables.
If your heart rate increases a lot and you are breathing so hard that it is difficult to carry on a conversation, you are probably doing vigorous-intensity activity. Examples of vigorous-intensity activities include jogging, bicycling fast or uphill, singles tennis, and pushing a hand mower.
- 2 hours and 30 minutes of moderate-intensity aerobic physical activity
- 1 hour and 15 minutes of vigorous-intensity aerobic physical activity
- A combination of moderate and vigorous-intensity aerobic physical activity
- Muscle-strengthening activities on 2 or more days
This physical activity should be in addition to your routine activities of daily living, such as cleaning or spending a few minutes walking from the parking lot to your office.
If you want to lose a substantial (more than 5 percent of body weight) amount of weight, you need a high amount of physical activity unless you also lower calorie intake. This is also the case if you are trying to keep the weight off. Many people need to do more than 300 minutes of moderate-intensity activity a week to meet weight-control goals.
|If you normally…||Try this instead!|
|Park as close as possible to the store||Park farther away|
|Let the dog out back||Take the dog for a walk|
|Take the elevator||Take the stairs|
|Have lunch delivered||Walk to pick up lunch|
|Relax while the kids play||Get involved in their activity|
The Food and Drug Administration has approved two medicines for long-term treatment of obesity:
- Sibutramine (si-BYOO-tra-meen) suppresses your appetite.
- Orlistat (OR-li-stat) keeps your body from absorbing fat from the food you eat.
These medicines are for people who:
- Have a BMI of 30 or higher
- Have a BMI of 27 or higher and weight-related health problems or health risks
If you take these medicines, you will need to follow a healthy eating and physical activity plan at the same time.
Before taking these medicines, talk with your doctor about the benefits and the side effects.
- Sibutramine can raise your blood pressure and heart rate. You should not take this medicine if you have a history of high blood pressure, heart problems, or strokes. Other side effects include dry mouth, headache, constipation, anxiety, and trouble sleeping.
- Orlistat may cause diarrhea, cramping, gas, and leakage of oily stool. Eating a low-fat diet can help prevent these side effects. This medicine may also prevent your body from absorbing some vitamins. Talk with your doctor about whether you should take a vitamin supplement.
Weight loss surgeries — also called bariatric (bair-ee-AT-rik) surgeries — can help treat obesity. You should only consider surgical treatment for weight loss if you:
- Have a BMI of 40 or higher
- Have a BMI of 35 or higher and weight-related health problems
- Have not had success with other weight-loss methods
Common types of weight loss surgeries are:
- Roux-en-Y (ROO-en-WEYE) gastric bypass. The surgeon uses surgical staples to create a small stomach pouch. This limits the amount of food you can eat. The pouch is attached to the middle part of the small intestine. Food bypasses the upper part of the small intestine and stomach, reducing the amount of calories and nutrients your body absorbs.
- Laparoscopic (LAP-uh-ruh-SKAWP-ik) gastric banding. A band is placed around the upper stomach to create a small pouch and narrow passage into the rest of the stomach. This limits the amount of food you can eat. The size of the band can be adjusted. A surgeon can remove the band if needed.
- Biliopancreatic (bil-ee-oh-pan-kree-at-ik) diversion (BPD) or BPD with duodenal (doo-AW-duh-nul) switch (BPD/DS). In BPD, a large part of the stomach is removed, leaving a small pouch. The pouch is connected to the last part of the small intestine, bypassing other parts of the small intestine. In BPD/DS, less of the stomach and small intestine are removed. This surgery reduces the amount of food you can eat and the amount of calories and nutrients your body absorbs from food. This surgery is used less often than other types of surgery because of the high risk of malnutrition.
If you are thinking about weight-loss surgery, talk with your doctor about changes you will need to make after the surgery. You will need to:
- Follow your doctor’s directions as you heal
- Make lasting changes in the way you eat
- Follow a healthy eating plan and be physically active
- Take vitamins and minerals if needed
You should also talk to your doctor about risks and side effects of weight loss surgery. Side effects may include:
- Leaking from staples
- Blood clots in the leg veins that travel to your lungs (pulmonary embolism)
- Dumping syndrome, in which food moves from your stomach to your intestines too quickly
- Not getting enough vitamins and minerals from food