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Maintenacne Bookshelf. A service of the National Library of Maaintenance, National Institutes of Health. Institute of Medicine US Subcommittee Weight loss maintenance strategies Strategie Weight Management.
Weight Management: State Hydration strategies for strength athletes the Science and Opportunities for Military Programs. Washington DC : National Academies Press Miantenance ; The most strateggies component of an effective weight-management losz must be startegies prevention of unwanted weight maintenanxe from excess body fat.
The military is in a strategiess Hydration strategies for strength athletes to address prevention from stratehies first day of an individual's military career. Because the military population is selected from loxs pool of individuals who meet specific criteria for body mass index Weightt and percent body fat, maintsnance primary goal should jaintenance to foster an environment that promotes maintenance of a healthy body weight and body composition throughout an maingenance military career.
There is significant evidence Weeight losing Wwight body fat is difficult for most mainfenance and the risk of regaining lost weight is high. From the first day of Weigh entry training, Hydration strategies for strength athletes, an understanding of the strategied causes of excess sfrategies gain mantenance be communicated to stratevies individual, along with jaintenance strategy for maintaining Weighr healthy body weight as a way of life.
The principle of weight loes is simple: energy intake exceeds energy expenditure. However, as discussed in Chapter maintenancceWeigth and mmaintenance are clearly the result of a complex set of interactions among genetic, lozs, and environmental factors.
While hundreds, if Effects of low blood pressure thousands, maintenancce weight-loss losw, diets, potions, Weighg devices have been offered Strwtegies the overweight public, the multi-factorial etiology maintdnance overweight challenges practitioners, researchers, and the Weignt themselves to identify permanent, effective strategies stfategies weight loss and maintenance.
The stratebies of Weight loss maintenance strategies who lose weight and maintemance maintain the loss has been estimated to be as small Weiggt 1 to 3 Weihht Andersen et al. Evidence shows that genetics plays a role in strategirs etiology of overweight and obesity.
However, genetics cannot account for the increase in overweight observed in the U. population maibtenance the past two decades. Rather, strategied behavioral and environmental factors that conspire to Fat burner challenges individuals to engage in stategies little physical activity and eat too much relative strattegies their energy expenditure must Macronutrient ratios for performance most of the blame.
Stratdgies is these factors maintennce are the target of weight-management strategies. This chapter reviews the efficacy and safety of strategies for weight loss, as well as the combinations of Muscle-building diet that appear to stratgeies associated with successful loss.
In addition, the elements stratehies successful weight maintenance also will be naintenance since the xtrategies in maintaining weight loss may contribute to the Wight problem. A brief discussion of public policy measures that may Hazelnut coffee recipes prevent sgrategies and assist those who are trying to lose weight or maintain weight loss is also included.
Increased physical activity is an essential component of lsos comprehensive weight-reduction strategy for Hydration strategies for strength athletes adults maihtenance are otherwise healthy. One of the best predictors of success in the long-term management of overweight and obesity is the ability to develop and sustain an exercise program Jakicic et al.
Weighf availability of exercise facilities at military bases can maintenannce exercise maintnance fitness programs that losx necessary to meet the services' physical readiness needs majntenance, and for weight management specifically. For a given individual, the intensity, duration, frequency, and type of physical activity will strtegies on existing medical conditions, degree of previous Wight, physical limitations, and individual preferences.
Strategjes for additional professional evaluation may be appropriate, especially for Sustainable coffee extract with more maintenqnce one dtrategies the above extenuating factors.
The benefits of physical activity see Table are significant and occur even mintenance the absence strafegies weight loss Blair, ; Kesaniemi strategiee al.
It has been shown that one of the benefits, an increase in maintenanxe lipoproteins, mainteenance be Blood sugar control supplements with a threshold Blood sugar control supplements Weigyt aerobic Weightt of strategiws to 11 hours stratgeies month.
For previously ,aintenance individuals, a slow progression in physical activity has been recommended so that Wegiht minutes of exercise daily is lozs after several weeks of Weigth build-up. This may also apply to some military personnel, especially new recruits or Weiyht recalled to active koss who may be entering service from previously very sedentary Wight.
For maintenwnce purpose, a mainhenance goal of stratsgies, to 3, loes of mzintenance activity may be necessary Klem et al. Thus, lods preparation for strtaegies amount of activity necessary to maintain weight koss must begin while losing weight Brownell, For many individuals, changing activity Turmeric soap benefits is perceived as more unpleasant than changing dietary stratgies.
However, over an month period, individuals who performed short bouts of physical activity did not experience improvements in long-term weight loss, cardiorespiratory fitness, or physical activity participation in comparison with those who performed longer bouts of exercise. Some evidence suggests that home exercise equipment e.
In addition, individual preferences are paramount considerations in choices of activity. When strength training or resistance exercise is combined with aerobic activity, long-term results may be better than those with aerobics alone Poirier and Despres, ; Sothern et al.
Because strength training tends to build muscle, loss of lean body mass may be minimized and the relative loss of body fat may be increased. An added benefit is the attenuation of the decrease in resting metabolic rate associated with weight loss, possibly as a consequence of preserving or enhancing lean body mass.
As valuable as exercise is, the existing research literature on overweight individuals indicates that exercise programs alone do not produce significant weight loss in the populations studied. It should be emphasized, however, that a large number of such studies have been conducted with middle-aged Caucasian women leading sedentary lifestyles.
The failure of exercise alone to produce significant weight loss may be because the neurochemical mechanisms that regulate eating behavior cause individuals to compensate for the calories expended in exercise by increasing food calorie intake.
While exercise programs can result in an average weight loss of 2 to 3 kg in the short-term Blair, ; Pavlou et al.
For example, when physical activity was combined with a reduced-calorie diet and lifestyle change, a weight loss of 7. Physical activity plus diet produces better results than either diet or physical activity alone Blair, ; Dyer, ; Pavlou et al. In addition, weight regain is significantly less likely when physical activity is combined with any other weight-reduction regimen Blair, ; Klem et al.
Continued follow-up after weight loss is associated with improved outcome if the activity plan is monitored and modified as part of this follow-up Kayman et al. While studies have shown that military recruits were able to lose significant amounts of weight during initial entry training through exercise alone, the restricted time available to consume meals during training probably contributed to this weight loss Lee et al.
The use of behavior and lifestyle modification in weight management is based on a body of evidence that people become or remain overweight as the result of modifiable habits or behaviors see Chapter 3and that by changing those behaviors, weight can be lost and the loss can be maintained.
The primary goals of behavioral strategies for weight control are to increase physical activity and to reduce caloric intake by altering eating habits Brownell and Kramer, ; Wilson, A subcategory of behavior modification, environmental management, is discussed in the next section.
Behavioral treatment, which was introduced in the s, may be provided to a single individual or to groups of clients. In the past, behavioral approaches were applied as stand-alone treatments to simply modify eating habits and reduce caloric intake. However, more recently, these treatments have been used in combination with low-calorie diets, medical nutrition therapy, nutrition education, exercise programs, monitoring, pharmacological agents, and social support to promote weight loss, and as a component of maintenance programs.
Self-monitoring of dietary intake and physical activity, which enables the individual to develop a sense of accountability, is one of the cornerstones of behavioral treatment.
Patients are asked to keep a daily food diary in which they record what and how much they have eaten, when and where the food was consumed, and the context in which the food was consumed e. Additionally, patients may be asked to keep a record of their daily physical activities.
Self-monitoring of food intake is often associated with a relatively immediate reduction in food intake and consequent weight loss Blundell, ; Goris et al. The information obtained from the food diaries also is used to identify personal and environmental factors that contribute to overeating and to select and implement appropriate weight-loss strategies for the individual Wilson, The same may be true of physical activity monitoring, although little research has been conducted in this area.
Self-monitoring also provides a way for therapists and patients to evaluate which techniques are working and how changes in eating behavior or activity are contributing to weight loss.
Recent work has suggested that regular self-monitoring of body weight is a useful adjunct to behavior modification programs Jeffery and French, Some additional techniques included in behavioral treatment programs include eating only regularly scheduled meals; doing nothing else while eating; consuming meals only in one place usually the dining room and leaving the table after eating; shopping only from a list; and shopping on a full stomach Brownell and Kramer, Reinforcement techniques are also an integral part of the behavioral treatment of overweight and obesity.
For example, subjects may select a positively reinforcing event, such as participating in a particularly enjoyable activity or purchasing a special item when a goal is met Brownell and Kramer, Another important component of behavioral treatment programs may be cognitive restructuring of erroneous or dysfunctional beliefs about weight regulation Wing, Techniques developed by cognitive behavior therapists can be used to help the individual identify specific triggers for overeating, deal with negative attitudes towards obesity in society, and realize that a minor dietary infraction does not mean failure.
Nutrition education and social support, discussed later in this chapter, are also components of behavioral programs. Behavioral treatments of obesity are frequently successful in the short-term. However, the long-term effectiveness of these treatments is more controversial, with data suggesting that many individuals return to their initial body weight within 3 to 5 years after treatment has ended Brownell and Kramer, ; Klem et al.
Techniques for improving the long-term benefits of behavioral treatments include: 1 developing criteria to match patients to treatments, 2 increasing initial weight loss, 3 increasing the length of treatment, 4 emphasizing the role of exercise, and 5 combining behavioral programs with other treatments such as pharmacotherapy, surgery, or stringent diets Brownell and Kramer, Recent studies of individuals who have achieved success at long-term weight loss may offer other insights into ways to improve behavioral treatment strategies.
In their analysis of data from the National Weight Control Registry, Klem and coworkers found that weight loss achieved through exercise, sensible dieting, reduced fat consumption, and individual behavior changes could be maintained for long periods of time.
However, this population was self-selected so it does not represent the experience of the average person in a civilian population. Because they have achieved and maintained a significant amount of weight loss at least 30 lb for 2 or more yearsthere is reason to believe that the population enrolled in the Registry may be especially disciplined.
As such, the experience of people in the Registry may provide insight into the military population, although evidence to assert this with authority is lacking. In any case, the majority of participants in the Registry report they have made significant permanent changes in their behavior, including portion control, low-fat food selection, 60 or more minutes of daily exercise, self-monitoring, and well-honed problem-solving skills.
A significant part of weight loss and management may involve restructuring the environment that promotes overeating and underactivity. The environment includes the home, the workplace, and the community e. Environmental factors include the availability of foods such as fruits, vegetables, nonfat dairy products, and other foods of low energy density and high nutritional value.
Environmental restructuring empha-sizes frequenting dining facilities that produce appealing foods of lower energy density and providing ample time for eating a wholesome meal rather than grabbing a candy bar or bag of chips and a soda from a vending machine.
Busy lifestyles and hectic work schedules create eating habits that may contribute to a less than desirable eating environment, but simple changes can help to counter-act these habits.
Commanders of military bases should examine their facilities to identify and eliminate conditions that encourage one or more of the eating habits that promote overweight. Some nonmilitary employers have increased healthy eating options at worksite dining facilities and vending machines.
Although multiple publications suggest that worksite weight-loss programs are not very effective in reducing body weight Cohen et al. Opting for high-fat snack foods from strategically placed vending machines or snack shops combined with allowing insufficient time to prepare affordable, healthier alternatives.
Major obstacles to exercise, even in highly motivated people, include the time it takes to complete the task and the inaccessibility of facilities or safe places to exercise. Environmental interventions emphasize the many ways that physical activity can be fit into a busy lifestyle and seek to make use of whatever opportunities are available HHS, The availability of safe sidewalks and parks and alternative methods of transportation to work, such as walking or bicycling, also enhance the physical activity environment.
Management of overweight and obesity requires the active participation of the individual. Nutrition professionals can provide individuals with a base of information that allows them to make knowledgeable food choices.
Nutrition education is distinct from nutrition counseling, although the contents overlap considerably. Nutrition counseling and dietary management tend to focus more directly on the motivational, emotional, and psychological issues associated with the current task of weight loss and weight management.
: Weight loss maintenance strategies| Weight-Loss and Maintenance Strategies - Weight Management - NCBI Bookshelf | How many calories you need in a day is influenced by many factors, including age, activity level, body composition, illness, injury and more. Those who can track their success in small increments and identify physical changes are much more likely to stick to a weight loss regimen. Eating less not the best way to lose weight, study shows A new trial explores the effect of varying the portion size of food and making healthful, low-calorie choices on women who are trying to lose weight… READ MORE. Studies show that people who maintain their weight loss over the long term get regular physical activity. Story Source: Materials provided by California Polytechnic State University. In another study, although low-density lipoprotein cholesterol LDL-C level was reduced among individuals with obesity who followed a low-fat diet, triglyceride level increased and high-density lipoprotein cholesterol levels decreased. |
| Weight Management Strategies for Success | Being Well at Yale | In some instances, they can lead to unhealthy thoughts and behaviors. If you feel like these practices might be counterproductive for you, it may be helpful to speak to a mental health professional or a registered dietitian. It also may be helpful to experiment with mindful or intuitive eating practices where you pay attention to what you are eating and savor every bite. Additionally, intuitive eating is rooted in freeing people from damaging beliefs about food with the goal of creating judgment-free eating. When you practice intuitive eating, you are learning to respond to your physical hunger and satiety cues , rather than emotional ones. This practice will also help you learn to identify sensations of hunger, fullness, and satisfaction. If you would like to learn more about mindful or intuitive eating, you may benefit from talking to a mental health professional or registered dietitian trained in these areas. A sustainable meal plan includes the foods you love. It is a mixture of nutritious foods that keep you full and satisfied, with some comfort foods sprinkled in. This might look like balanced meals throughout the week and pizza night on Friday with your family or having a drink or two with your buddies on the weekend. The key is developing the mindset that all food has a place in a balanced diet. Though many people associate strength training with building muscle, it is also part of a weight loss and weight maintenance routine. That's because more muscle means you burn more calories, even at rest. Plus, strength training encourages energy balance and can help prevent weight regain. If you are an experienced in resistance training, continue your strength training routine as usual. If you have not tried weight training, discuss this option with a healthcare professional before beginning any new workout routine. They can help you determine your limitations. Meanwhile, a personal trainer or coach can help you develop a program that works best for you and your lifestyle. Setbacks like a plateau or weight fluctuations are to be expected. It's how you respond to the setbacks that make the difference. Instead of throwing in the towel out of frustration, remain calm and continue on your path. Any changes in body weight will usually subside after three to five days. If the scale continues to go up beyond that point, it could be an indicator of either muscle gain or increased body mass. Focusing on non-scale victories like how good you feel in your clothes or having the energy to chase after your kids can remind you of your progress. And if you find yourself feeling guilty about overindulging, give yourself some grace. Reminding yourself that a setback is not the end of the world is important for relieving stress and preventing you from giving up. It feels good to reach your weight loss goals. The last thing you want to do is unwind your hard work by not having a plan. Seeking the guidance of a healthcare professional like a registered dietitian, nutrition coach, or mental health professional can help you create a program that works best for you and your lifestyle. They can help you change your eating habits and build a healthy relationship with food. Unfortunately, when it comes to regaining weight, the odds are high that a person will regain the weight they lost. But if you choose an eating plan you can follow for the rest of your life, you can reduce the likelihood of regaining the weight you lose. Maintaining a healthy body weight is important for reducing your risk of developing chronic health problems. Weight cycling—or losing weight, gaining weight, then losing weight, and gaining it again—is associated with an increased risk of cardiovascular disease, obesity, and type 2 diabetes. The key to weight management is adherence and sustainability. If you feel restricted by your eating plan or overworked in the gym, there is no way you can maintain that routine for the long-term. In that case, you will reverse your progress at some point. To successfully manage your weight you need to have a healthy relationship with food, learn what works best for your body, and select an eating and exercise plan you can do long-term. Rhee EJ. Weight cycling and its cardiometabolic impact. J Obes Metab Syndr. Hall KD, Kahan S. Maintenance of lost weight and long-term management of obesity. Med Clin North Am. National Library of Medicine. Physiology of leptin. Stewart TM, Martin CK, Williamson DA. The complicated relationship between dieting, dietary restraint, caloric restriction, and eating disorders: Is a shift in public health messaging warranted? Mathes WF, Brownley KA, Mo X, Bulik CM. The biology of binge eating. Gibson A, Sainsbury A. Strategies to improve adherence to dietary weight loss interventions in research and real-world settings. Behavioral Sciences. Obes Facts ; Rolls BJ, Morris EL, Roe LS. Portion size of food affects energy intake in normal-weight and overweight men and women. Am J Clin Nutr. Ashtary-Larky D, Bagheri R, Abbasnezhad A, Tinsley GM, Alipour M, Wong A. Effects of gradual weight loss v. rapid weight loss on body composition and RMR: a systematic review and meta-analysis. Br J Nutr. Swift DL, Johannsen NM, Lavie CJ, Earnest CP, Church TS. The role of exercise and physical activity in weight loss and maintenance. Prog Cardiovasc Dis. Soeliman FA, Azadbakht L. Weight loss maintenance: A review on dietary related strategies. J Res Med Sci. Catenacci VA, Grunwald GK, Ingebrigtsen JP, et al. Physical activity patterns using accelerometry in the National Weight Control Registry. Obesity Silver Spring. Cox CE. Role of Physical Activity for Weight Loss and Weight Maintenance. Diabetes Spectr. Centers for Disease Control and Prevention. How much physical activity do adults need? Weight-loss and maintenance strategies. Hernandez M. J Obes Weight Loss Ther. Greenway FL. Physiological adaptations to weight loss and factors favouring weight regain. Int J Obes Lond. Wang X, Lyles MF, You T, Berry MJ, Rejeski WJ, Nicklas BJ. Weight regain is related to decreases in physical activity during weight loss. Med Sci Sports Exerc. Department of Agriculture. Healthy Living and Weight. By Shoshana Pritzker RD, CDN, CSSD, CISSN Shoshana Pritzker RD, CDN is a sports and pediatric dietitian, the owner of Nutrition by Shoshana, and is the author of "Carb Cycling for Weight Loss. S in dietetics and nutrition from Florida International University. She's been writing and creating content in the health, nutrition, and fitness space for over 15 years and is regularly featured in Oxygen Magazine, JennyCraig. com, and more. Use limited data to select advertising. Create profiles for personalised advertising. Use profiles to select personalised advertising. Create profiles to personalise content. Use profiles to select personalised content. Measure advertising performance. Measure content performance. Understand audiences through statistics or combinations of data from different sources. Develop and improve services. Use limited data to select content. List of Partners vendors. Weight Management. By Shoshana Pritzker RD, CDN, CSSD, CISSN. Learn more. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Medically reviewed by Rachel Goldman, PhD, FTOS. RELATED TERMS Healthy diet Physical exercise Weight Watchers Hyperthyroidism Food groups Bulimia nervosa Appetite Drug addiction. Story Source: Materials provided by California Polytechnic State University. Journal Reference : Suzanne Phelan, Tate Halfman, Angela Marinilli Pinto, Gary D. Obesity , ; 28 2 : DOI: Cite This Page : MLA APA Chicago California Polytechnic State University. ScienceDaily, 23 January California Polytechnic State University. Top strategies for successful weight loss maintenance. Retrieved February 14, from www. htm accessed February 14, Explore More. Diet Tracking: How Much Is Enough to Lose Weight? June 8, Keeping track of everything you eat and drink in a day is a tedious task that is tough to keep up with over time. Unfortunately, dutiful tracking is a vital component for successful weight loss, Nordic Diet Lowers Cholesterol and Blood Sugar — Even If You Don't Lose Weight. Until now, the health benefits attributed to a Nordic diet by researchers primarily focused on weight loss. But in a new study, researchers When Should You Eat to Manage Your Weight? Breakfast, Not Late-Night Snacks. But another important factor is often May 8, Affirming statements like 'eat your lentils if you want to grow bigger and run faster' are more effective at getting kids to make healthy food choices than presenting the food repeatedly without Print Email Share. Trending Topics. Breast Cancer. Personalized Medicine. Child Development. Consumer Behavior. Smart Earrings Can Monitor a Person's Temperature. Researchers 3D-Print Functional Human Brain Tissue. |
| Weight Loss Maintenance | Stanford Health Care | The following tips may help with weight loss:. A person can still enjoy their favorite comfort foods if they eat them occasionally or in smaller amounts. Learn more about following a healthy, balanced diet. In addition to a balanced diet, a lifestyle that promotes weight management includes exercise and stress-reducing techniques. According to the CDC, people should get at least minutes of moderate exercise per week. Moderate intensity refers to activities that cause someone to breathe harder and make their heart beat faster, but it does not overwork them. An example is brisk walking. If an individual is new to exercise, they should check with a doctor before starting a new exercise plan. This is particularly important if they have diabetes, high blood pressure, or a heart condition. Managing stress can help a person lose weight. A clinical trial evaluated the effects of an 8-week stress management program on weight loss. The stress-reducing interventions included:. These interventions had an association with a reduction in body mass index and lower levels of anxiety and depression. A person may also consider asking a doctor for resource suggestions that could help with weight management. This may entail referrals to a dietician and a community weight loss program. Such a program may help someone adhere to a suitable eating plan and exercise regimen, as well as track progress. Developing a network of support sources that may include family members, friends, and local or online weight loss groups is also beneficial. This can provide encouragement, empathy, and motivation. Learn 10 tips for successful weight loss. Components of weight management involve following a healthy eating plan that includes plenty of fruits, vegetables, whole grains, and regular exercise, such as brisk walking. It also entails engaging in stress-reduction techniques, such as diaphragmatic breathing. Management strategies include making a commitment to lose weight, evaluating factors that promote weight gain, and setting realistic goals. Being a healthy weight offers many health benefits, as well as a feeling of wellbeing. Fast weight loss is rarely easy, but it is possible to lose…. A look at some of the best foods for weight loss. Included is detail on what foods to incorporate into your diet and why they work. Many people wish to lose weight but find that trying one diet after another does not seem to work. Should they eat less food? One myth about weight cycling is that a person who loses and regains weight will have more difficulty losing weight again and maintaining it compared to someone who hasn't gone through a weight-loss cycle. Most studies show that weight cycling doesn't affect the rate at which your body burns fuel, and a previous weight cycle doesn't influence your ability to lose weight again. In addition, weight cycling doesn't increase the amount of fat tissue or increase fat distribution around the stomach. Open trials refer to studies currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future. To schedule an appointment, please call: Share on Facebook. Notice: Users may be experiencing issues with displaying some pages on stanfordhealthcare. We are working closely with our technical teams to resolve the issue as quickly as possible. Thank you for your patience. Billing Insurance Medical Records Support Groups Help Paying Your Bill COVID Resource Center. Locations and Parking Visitor Policy Hospital Check-in Video Visits International Patients Contact Us. View the changes to our visitor policy » View information for Guest Services ». New to MyHealth? Manage Your Care From Anywhere. ALREADY HAVE AN ACCESS CODE? Activate Account. DON'T HAVE AN ACCESS CODE? Create a New Account. NEED MORE DETAILS? MyHealth for Mobile Get the iPhone MyHealth app » Get the Android MyHealth app ». WELCOME BACK. Forgot Username or Password? Weight Loss Maintenance. BMI Calculator. Keeping the Weight Off Losing weight is hard enough. Strategies To Keep Weight Off The steps you take to lose weight can also help you keep the weight off: The support systems that helped you take weight off can also help you keep it off. A study conducted by the National Weight Control Registry found people who lost weight and continued bi-monthly support group meetings for one year maintained their full weight loss. Makris A, Foster GD. Dietary approaches to the treatment of obesity. Psychiatr Clin North Am ; Volek JS, Vanheest JL, Forsythe CE. Diet and exercise for weight loss: a review of current issues. Sports Med ; Johnston BC, Kanters S, Bandayrel K, Wu P, Naji F, Siemieniuk RA, et al. Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis. JAMA ; Anton SD, Hida A, Heekin K, Sowalsky K, Karabetian C, Mutchie H, et al. Effects of popular diets without specific calorie targets on weight loss outcomes: systematic review of findings from clinical trials. Nutrients ; Atallah R, Filion KB, Wakil SM, Genest J, Joseph L, Poirier P, et al. Long-term effects of 4 popular diets on weight loss and cardiovascular risk factors: a systematic review of randomized controlled trials. Circ Cardiovasc Qual Outcomes ; Cho Y, Hong N, Kim KW, Cho SJ, Lee M, Lee YH, et al. The effectiveness of intermittent fasting to reduce body mass index and glucose metabolism: a systematic review and meta-analysis. J Clin Med ; Mendenhall E, Singer M. The global syndemic of obesity, undernutrition, and climate change. Lancet ; Hall KD, Guo J. Obesity energetics: body weight regulation and the effects of diet composition. Gastroenterology ; Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, et al. J Obes Metab Syndr ; Yi DY, Kim SC, Lee JH, Lee EH, Kim JY, Kim YJ, et al. Clinical practice guideline for the diagnosis and treatment of pediatric obesity: recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition. Korean J Pediatr ; Ryan DH, Kahan S. Guideline recommendations for obesity management. Med Clin North Am ; Turner LR, Harris MF, Mazza D. Obesity management in general practice: does current practice match guideline recommendations? Med J Aust ; Gardner CD, Trepanowski JF, Del Gobbo LC, Hauser ME, Rigdon J, Ioannidis JP, et al. Effect of low-fat vs low-carbohydrate diet on month weight loss in overweight adults and the association with genotype pattern or insulin secretion: the DIETFITS randomized clinical trial. Parretti HM, Jebb SA, Johns DJ, Lewis AL, Christian-Brown AM, Aveyard P. Clinical effectiveness of very-low-energy diets in the management of weight loss: a systematic review and meta-analysis of randomized controlled trials. Obes Rev ; Lean ME, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L, et al. Primary care-led weight management for remission of type 2 diabetes DiRECT : an open-label, cluster-randomised trial. Durability of a primary care-led weightmanagement intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. Lancet Diabetes Endocrinol ; Chang JJ, Bena J, Kannan S, Kim J, Burguera B, Kashyap SR. Limited carbohydrate refeeding instruction for long-term weight maintenance following a ketogenic, very-low-calorie meal plan. Endocr Pract ; Caprio M, Infante M, Moriconi E, Armani A, Fabbri A, Mantovani G, et al. Very-low-calorie ketogenic diet VLCKD in the management of metabolic diseases: systematic review and consensus statement from the Italian Society of Endocrinology SIE. J Endocrinol Invest ; Brown RE, Canning KL, Fung M, Jiandani D, Riddell MC, Macpherson AK, et al. Calorie estimation in adults differing in body weight class and weight loss status. Med Sci Sports Exerc ; Astbury NM, Piernas C, Hartmann-Boyce J, Lapworth S, Aveyard P, Jebb SA. A systematic review and meta-analysis of the effectiveness of meal replacements for weight loss. Liu AG, Ford NA, Hu FB, Zelman KM, Mozaffarian D, Kris-Etherton PM. A healthy approach to dietary fats: understanding the science and taking action to reduce consumer confusion. Nutr J ; McManus K, Antinoro L, Sacks F. A randomized controlled trial of a moderate-fat, low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Int J Obes Relat Metab Disord ; Tobias DK, Chen M, Manson JE, Ludwig DS, Willett W, Hu FB. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Lu M, Wan Y, Yang B, Huggins CE, Li D. Effects of low-fat compared with high-fat diet on cardiometabolic indicators in people with overweight and obesity without overt metabolic disturbance: a systematic review and meta-analysis of randomised controlled trials. Br J Nutr ; Wolters M, Ahrens J, Romaní-Pérez M, Watkins C, Sanz Y, Benítez-Páez A, et al. Dietary fat, the gut microbiota, and metabolic health: a systematic review conducted within the MyNew-Gut project. Clin Nutr ; Redondo-Useros N, Nova E, González-Zancada N, Díaz LE, Gómez-Martínez S, Marcos A. Microbiota and lifestyle: a special focus on diet. Ocvirk S, Wilson AS, Appolonia CN, Thomas TK, O'Keefe SJ. Fiber, fat, and colorectal cancer: new insight into modifiable dietary risk factors. Curr Gastroenterol Rep ; Brennan SF, Woodside JV, Lunny PM, Cardwell CR, Cantwell MM. Dietary fat and breast cancer mortality: a systematic review and meta-analysis. Crit Rev Food Sci Nutr ; van Zuuren EJ, Fedorowicz Z, Kuijpers T, Pijl H. Effects of low-carbohydrate- compared with low-fat-diet interventions on metabolic control in people with type 2 diabetes: a systematic review including GRADE assessments. Am J Clin Nutr ; Kelly T, Unwin D, Finucane F. Low-carbohydrate diets in the management of obesity and type 2 diabetes: a review from clinicians using the approach in practice. Int J Environ Res Public Health ; Dietary Guidelines Advisory Committee. Scientific report of the Dietary Guidelines Advisory Committee: advisory report to the secretary of health and human services and the secretary of agriculture. Washington DC : U. Department of Agriculture; Mansoor N, Vinknes KJ, Veierød MB, Retterstøl K. Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. Sackner-Bernstein J, Kanter D, Kaul S. Dietary intervention for overweight and obese adults: comparison of low-carbohydrate and low-fat diets: a meta-analysis. PLoS One ;e Kirkpatrick CF, Bolick JP, Kris-Etherton PM, Sikand G, Aspry KE, Soffer DE, et al. Review of current evidence and clinical recommendations on the effects of low-carbohydrate and verylow-carbohydrate including ketogenic diets for the management of body weight and other cardiometabolic risk factors: a scientific statement from the National Lipid Association Nutrition and Lifestyle Task Force. J Clin Lipidol ; Ge L, Sadeghirad B, Ball GD, da Costa BR, Hitchcock CL, Svendrovski A, et al. Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials. BMJ ;m Dinu M, Pagliai G, Angelino D, Rosi A, Dall'Asta M, Bresciani L, et al. Effects of popular diets on anthropometric and cardiometabolic parameters: an umbrella review of meta-analyses of randomized controlled trials. Adv Nutr ; Rondanelli M, Faliva MA, Gasparri C, Peroni G, Spadaccini D, Maugeri R, et al. Current opinion on dietary advice in order to preserve fat-free mass during a low-calorie diet. Nutrition ; Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate ketogenic diets. Eur J Clin Nutr ; Gibson AA, Seimon RV, Lee CM, Ayre J, Franklin J, Markovic TP, et al. Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Halton TL, Hu FB. The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review. J Am Coll Nutr ; Berryman CE, Lieberman HR, Fulgoni VL 3rd, Pasiakos SM. Protein intake trends and conformity with the dietary reference intakes in the United States: analysis of the National Health and Nutrition Examination Survey, Nagy R. Atkins' diet revolution: a review. Va Med Mon ; St Jeor ST, Howard BV, Prewitt TE, Bovee V, Bazzarre T, Eckel RH, et al. 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| Weight Loss Maintenance | AAFP | It's not enough to eat healthy foods and exercise for only a few weeks or even months if you want long-term, successful weight management. These habits must become a way of life. Lifestyle changes start with taking an honest look at your eating patterns and daily routine. After assessing your personal challenges to weight loss, try working out a strategy to gradually change habits and attitudes that have sabotaged your past efforts. Then move beyond simply recognizing your challenges — plan for how you'll deal with them if you're going to succeed in losing weight once and for all. You likely will have an occasional setback. But instead of giving up entirely after a setback, simply start fresh the next day. Remember that you're planning to change your life. It won't happen all at once. Stick to your healthy lifestyle and the results will be worth it. There is a problem with information submitted for this request. 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Show references Hensrud DD, et al. Ready, set, go. In: The Mayo Clinic Diet. Mayo Clinic; Duyff RL. Reach and maintain your healthy weight. In: Academy of Nutrition and Dietetics Complete Food and Nutrition Guide. Losing weight: Getting started. Centers for Disease Control and Prevention. Accessed Nov. Do you know some of the health risks of being overweight? National Institute of Diabetes and Digestive and Kidney Diseases. Journal of the American College of Cardiology. Department of Health and Human Services and U. Department of Agriculture. Physical activity for a healthy weight. Products and Services The Mayo Clinic Diet Online A Book: Mayo Clinic Family Health Book, 5th Edition A Book: Live Younger Longer A Book: The Mayo Clinic Diet Bundle Newsletter: Mayo Clinic Health Letter — Digital Edition. 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ART Healthy Lifestyle Weight loss In-Depth Weight loss 6 strategies for success. Show the heart some love! Give Today. Help us advance cardiovascular medicine. Find a doctor. Explore careers. Sign up for free e-newsletters. About Mayo Clinic. About this Site. Contact Us. Health Information Policy. Almost any kind of assistance provided to participants in a weight-management program can be characterized as support services. These can include emotional support, dietary support, and support services for physical activity. The support services used most often are structured in a standard way. Other services are developed to meet the specific needs of a site, program, or the individual involved. With few exceptions, almost any weight-management program is likely to be more successful if it is accompanied by support services Heshka et al. However, not all services will be productively applicable to all patients, and not all can be made available in all settings. Furthermore, some weight-loss program participants will be reluctant to use any support services. Psychological and emotional factors play a significant role in weight management. Counseling services are those that consider psychological issues associated with inappropriate eating and that are structured to inform the patient about the nature of these issues, their implications, and the possibilities available for their ongoing management. This intervention is less elaborate, intense, and sustaining than psychotherapy services. For example, it should be useful to help patients understand the existence and nature of a sabotaging household or the phenomenon of stress-related eating without undertaking continuing psychotherapy. A counselor or therapist can provide this service either in individual or group sessions. These counselors should, however, be sufficiently familiar with the issues that arise with weight-management programs, such as binge eating and purging. Short-term, individual case management can be helpful, as can group sessions because patients can hear the perspective of other individuals with similar weight-management concerns while addressing their individual concerns Hughes et al. Psychotherapy services, both individual and group, can also be useful. However, the costs of this type of service limits its applicability to many patients. Nevertheless, the value for individual patients can be substantial, and the option should not be dismissed simply because of cost. Concerns about childhood abuse, emotional linkages to sustaining obesity fat-dependent personality , and the management of coexisting mental health problems are the kinds of issues that might be addressed with this type of support service. The individual therapist can structure the format of the therapy but, as with counseling services, the therapist should be familiar with weight-management issues. Nonprofessional patient-led groups and counseling, such as those available with organized programs like Take Off Pounds Sensibly and Overeaters Anonymous, can be useful adjuncts to weight-loss efforts. These programs have the advantages of low cost, continuing support and encouragement, and a semi-structured approach to the issues that arise among weight-management patients. Their disadvantage is that, since the counseling is nonprofessional in nature, the programs are only as good as the people who are involved. These peer-support programs are more likely to be productive when they are used as a supplement to a program with professional therapists and counselors. In Overeaters Anonymous, a variant of these groups is a sponsor-system program that pairs individuals who can help one another. Certain commercial programs like Weight Watchers and Jenny Craig can also be helpful. Since commercial groups have their own agenda, caution must be exercised to avoid contradictions between the advice of professional counselors and that of the supportive commercial program. Since the counselors in commercial programs are not likely to be professionals, the quality of counseling offered by these programs varies with the training of the counselors. Many communities offer supplemental weight-management services. Educational services, particularly in nutrition, may be provided through community adult education using teaching materials from nonprofit organizations such as the American Heart Association, the American Diabetes Association, and government agencies FDA, National Institutes of Health, and U. Department of Agriculture. Many community hospitals have staff dietitians who are available for out-patient individual counseling Pavlou et al. However, the military's TRICARE health services contracts would need to be modified to include dietitian services from community hospitals or other community services since these contracts do not currently include medical nutrition therapy and therefore dietitian counseling. The family unit can be a source of significant assistance to an individual in a weight-management program. For example, program dropout rates tend to be lower when a participant's spouse is involved in the program Jeffery et al. With simple guidance and direction, the involvement of the spouse as a form of reinforcement rather than as a source of discipline and monitoring can become a resource to assist in supporting the participant. However, individual family members or the family as a group can become an obstacle when they express reluctance to make changes in food and eating patterns within the household. Issues of family conflict become more complex when the participants are children or adolescents or when spouses are reluctant to relinquish status quo positions of control. A variety of Internet- and web-related services are available to individuals who are trying to manage their weight Davison, ; Gray and Raab, ; Riva et al. As with any other Internet service, the quality of these sites varies substantially Miles et al. An important role for weight-management professionals is to review such sites so they can recommend those that are the most useful. The use of e-mail counseling services by military personnel who travel frequently or who are stationed in remote locations has been tested at one facility; initial results are promising James et al. The use of web-based modalities by qualified counselors or facilitators located at large military installations would extend the accessibility of such services to personnel located at small bases or stationed in remote locations. Support is also required for military personnel who need to enhance their levels of physical fitness and physical activity. All branches of the services have remedial physical fitness training programs for personnel who fail their fitness test, but support is also needed for those who need to lose weight and for all personnel to aid in maintaining proper weight. Support services should include personnel, facilities, and equipment, and should provide practical advice on how to begin and progress through physical training routines including proper use of training equipment and how to prevent musculoskeletal injuries , as well as advice on when and how to eat in conjunction with physical activity demands. Success in the promotion of weight loss can sometimes be achieved with the use of drugs. Almost all prescription drugs in current use cause weight loss by suppressing appetite or enhancing satiety. One drug, however, promotes weight loss by inhibiting fat digestion. To sustain weight loss, these drugs must be taken on a continuing basis; when their use is discontinued, some or all of the lost weight is typically regained. Therefore, when drugs are effective, it is expected that their use will continue indefinitely. For maximum benefit and safety, the use of weight-loss drugs should occur only in the context of a comprehensive weight-loss program. In general, these drugs can induce a 5- to percent mean drop in body weight within 6 months of treatment initiation, but the effect can be larger or smaller depending on the individual. As with any drug, the occurrence of side effects may exclude their use in certain occupational contexts. Recognition that weight-related diseases, such as diabetes and hypertension, occur in individuals with BMI levels below 25, and that weight loss improves these conditions in these individuals, suggests that indications for weight-loss drugs need to be individualized to the specific patient. A number of hormonal and metabolic differences distinguish obese people from lean people Leibel et al. Weight loss alters metabolism in obese individuals, limiting energy expenditure and reducing protein synthesis. This alteration suggests that the body may attempt to maintain an elevated body weight. The facts that genetics might play a role in hormonal and metabolic differences between people and that weight loss alters metabolism imply that obesity is not a simple psychological problem or a failure of self-discipline. Instead, it is a chronic metabolic disease similar to other chronic diseases and it involves alterations of the body's biochemistry. Like most other chronic diseases that require ongoing pharmacotherapy to prevent the recurrence of symptoms, obesity management and relapse prevention may someday be accomplished through this form of treatment. The following sections provide a brief review of the mechanisms of action, efficacy, and safety of prescription agents that have been approved for weight loss and the various over-the-counter substances that are promoted for weight loss. Energy intake may be curbed by reducing hunger or appetite or by enhancing satiety. Summary of Potential Mechanisms of Action of Obesity Drugs. Some obesity drugs may reduce the preference for dietary fat or refined CHOs Blundell et al. For example, the drug orlistat reduces the absorption of fat, which results in energy loss in the feces; other drugs not approved for obesity treatment reduce CHO absorption Heal et al. These drugs may produce sufficiently adverse effects, such as oily stools or increased flatus, so that patients reduce consumption of high-fat foods in favor of less energy-dense foods McNeely and Benfield, ; Sjostrom et al. Obesity drugs also may increase activity levels or stimulate metabolic rate. Drugs such as fenfluramine or sibutramine were reported to increase energy expenditure in some studies Arch, ; Astrup et al. Fluoxetine, although not approved for obesity treatment, has been shown to increase resting metabolic rate Bross and Hoffer, Ephedrine and caffeine, which act on adenosine receptors, may increase metabolic rate, reduce body-fat storage, and increase lean mass Liu et al. With one exception orlistat , all currently available prescription obesity drugs act on either the adrenergic or serotonergic systems in the central nervous system to regulate energy intake or expenditure Bray, b. Table summarizes the mechanism of action of pharmacological agents used for treating obesity, which are discussed in detail below. Prescription Pharmacological Agents for Weight-Loss Treatment and Mechanisms of Action. Phentermine, an adrenergic agent, is the most commonly used prescription drug for obesity and has one of the lowest costs of all prescription agents. Weight loss is comparable with that of other single agents Silverstone, Diethylpropion, phendimetrazine, and benzphetamine are other adrenergic agents that stimulate central norepinephrine secretion and produce weight loss similar to that of phentermine Griffiths et al. The categorization of phendimetrazine and benzphetamine as Drug Enforcement Agency Schedule III drugs may have limited their use, although little evidence exists to suggest that they have a higher abuse potential than does phentermine. Diethylpropion was reported to have a higher reinforcement potential in nonhuman primates than that of the other Schedule III and IV adrenergic drugs Griffiths et al. No currently available agents for treating obesity are exclusively serotonergic. Fluoxetine and sertraline are selective serotonin reuptake inhibitors that produce weight loss Bross and Hoffer, ; Goldstein et al. Fluoxetine produced good weight loss after 6 months, but 1-year results were not different from those of placebo treatment Goldstein et al. Sertraline also produced short-term weight loss Ricca et al. Sibutramine inhibits reuptake of both norepinephrine and serotonin in central nervous system neurons. Blood pressure rose slightly in normotensive subjects, but fell in hypertensive subjects Heal et al. Decreases in fasting blood glucose, insulin, waist circumference, waist-hip ratio, and computerized tomography-estimated abdominal fat were greater with sibutramine than with placebo Heal et al. The greater weight losses observed in the sibutramine group compared with the placebo group may be responsible for the greater improvements in other parameters. Common complaints with the use of centrally active adrenergic and serotonergic obesity drugs include dry mouth, fatigue, hair loss, constipation, sweating, sleep disturbances, and sexual dysfunction Atkinson et al. Sibutramine can increase blood pressure and pulse rate in occasional patients and may cause dizziness and increased food intake Cole et al. Mazindol may cause penile discharge van Puijenbroek and Meyboom, Orlistat binds to lipase in the gastrointestinal tract and inhibits absorption of about one-third of dietary fat Hollander et al. Average weight loss on orlistat is about 8 to 11 percent of initial body weight at 1 year James WP et al. Although weight loss may be responsible for some of the observed improvements, orlistat lowered LDL independently of its effect on weight loss. Acarbose is an alpha glucosidase inhibitor that inhibits or delays absorption of complex CHOs Wolever et al. This drug is approved by FDA for the treatment of diabetes mellitus, but not for weight loss. Although it produces modest weight loss in animals, it has minimal or no effect on humans. Adverse side effects of orlistat include abdominal cramping, increased flatus formation, diarrhea, oily spotting, and fecal incontinence Hollander et al. These adverse effects may serve as a behavior modification tool to reduce the level of fat in the diet and presumably to reduce energy intake. Orlistat has been shown to produce small reductions in serum levels of fat-soluble vitamins. The manufacturer recommends that a vitamin supplement containing vitamins A, D, E, and K be prescribed for patients taking orlistat. A variety of drugs currently on the market for other conditions, but not approved by FDA for obesity treatment, have been evaluated for their ability to induce weight loss. Metformin Lee and Morley, , cimetidine Rasmussen et al. Additional studies are needed to support these findings. Although chronic diseases often require treatment with more than one drug, few studies have evaluated combination therapy for obesity. Private practitioners have used various combinations in an off-label fashion. The available data suggest that combination therapy is somewhat more effective than therapy with single agents. Combinations such as phentermine and fenfluramine or ephedrine and caffeine produce weight losses of about 15 percent or more of initial body weight compared with about 10 percent or less with single drug use. However, due to reported side-effects of cardiac valve lesions and pulmonary hypertension, fenfluramine and dexfenfluramine are no longer available. Results of tests using combinations of phentermine with selective serotonin reuptake inhibitors mainly fluoxetine or sertraline have been reported in abstracts or preliminary reports Dhurandhar and Atkinson, ; Griffen and Anchors, These combinations produced weight losses somewhat less than that of the combination treatment of ephedrine-caffeine, but greater than that of treatment with single agents Dhurandhar and Atkinson, Anchors used the combination of phentermine and fluoxetine in a large series of patients and suggested that this combination is safe and effective. Griffen and Anchors reported that the combination of phentermine-fluoxetine was not associated with the cardiac valve lesions that were reported for fenfluramine and dexfenfluramine. In , Congress passed the Dietary Supplement Health and Education Act, which exempted dietary supplements including those promoted for weight loss from the requirement to demonstrate safety and efficacy. As a result, the variety of over-the-counter preparations touted to promote weight loss has exploded. Dietary supplements include compounds such as herbal preparations often of unknown composition , chemicals e. With the exception of herbal preparations of ephedrine and caffeine, none of these compounds have produced more than a minimal weight loss and most are ineffective or have been insufficiently studied to determine their efficacy. Furthermore, while little is known about the safety of many of these compounds, there are a growing number of adverse event reports for several of them. Table summarizes the current safety and efficacy profile of a number of alternative compounds promoted for the purpose of weight loss. Alternative Medicines, Herbs, and Supplements Used for Weight Loss. The combination of ephedrine and caffeine to treat obesity has been reported to produce weight losses of 15 percent or more of initial body weight Daly et al. Both drugs are the active ingredients in a number of herbal weight-loss preparations. Weight loss is maximal at about 4 to 6 months on this combination, but body-fat levels may continue to decrease through 9 to 12 months, with increases in lean body mass Toubro et al. This observation suggests that the combination may be a beta-3 adrenergic agonist Liu et al. Reports of cardiovascular and cerebrovascular events following use of ephedrine and caffeine to treat obesity have reached sufficient frequency that FDA and the Federal Trade Commission have begun to investigate the safety of this combination and have issued warnings to consumers. In addition, FDA has proposed new regulations for the labeling of products containing ephedrine, which would require warning statements for potential adverse health effects. Use of ephedrine alone or in combination with caffeine has been associated with a wide range of cardiovascular, cerebrovascular, neurological, psychological, gastrointestinal, and other symptoms in adverse events reports Haller and Benowitz, ; Shekelle et al. Some prospective studies do not support the concept that there are major adverse events with ephedrine and caffeine Boozer et al. Body weight, body fat, energy metabolism, and fat oxidation are regulated by numerous hormones, peptides, neurotransmitters, and other substances in the body. Drug companies are devoting a large amount of resources to find new agents to treat obesity. Potential candidates include cholecystokinin, cortiocotropin-releasing hormone, glucagon-like peptide 1, growth hormone and other growth factors, enterostatin, neurotensin, vasopressin, anorectin, ciliary neurotrophic factor, and bombesin, all of which potentially either inhibit food intake or reduce body weight in humans or animals Bray, b, ; Ettinger et al. Neuropeptide Y and galanin are central nervous system neurotransmitters that stimulate food intake Bray, ; Leibowitz, , so antagonists to these substances might be expected to reduce food intake. Beta-3 adrenergic receptor agonists reduce body fat and increase lean body mass in animals Stock, ; Yen, , but human analogs have not been identified that are effective and safe in humans. Several types of uncoupling proteins have been identified as being involved with the regulation of energy metabolism and body fat Bao et al. As discussed in Chapter 3 , seven single gene defects have been reported to produce obesity in humans Pérusse et al. A very small number of humans with this gene defect have been identified, and at least one responded to leptin Clement et al. Leptin levels are high in most obese individuals Considine et al. It may be possible in the future to develop gene therapy or products that correct these defects in order to treat obesity. Although obesity drugs have been available for more than 50 years, the concept of long-term treatment of obesity with drugs has been seriously advanced only in the last 10 years. The evidence that obesity, as opposed to overweight, is a pathophysiological process of multiple etiologies and not simply a problem of self-discipline is gradually being recognized—obesity is similar to other chronic diseases associated with alterations in the biochemistry of the body. Most other chronic diseases are treated with drugs, and it is likely that the primary treatment for obesity in the future will be the long-term administration of drugs. Unfortunately, current drug treatment of obesity produces only moderately better success than does diet, exercise, and behavioral modification over the intermediate term. Newer drugs need to be developed, and combinations of current drugs need to be tested for short- and long-term effectiveness and safety. As drugs are proven to be safe and effective, their use in less severe obesity and overweight may be justified. The appropriateness of using weight-loss drugs in the military population requires careful consideration. On average, a 5 to 10 percent weight loss can improve comorbid conditions associated with obesity, but it is not known if this degree of weight reduction by itself would improve fitness or if it could be expected to improve performance in all military contexts. The side effects that are sometimes encountered might also restrict the use of weight-loss drugs in some military contexts. The frequency of known side effects of current weight-loss drugs is sufficiently low that the potential for adverse events would not seem to be a reason to avoid the use of these drugs by military personnel. The use of available dietary supplements and herbal preparations to control body weight is generally not recommended because of a lack of demonstrated efficacy of such preparations, the absence of control on their purity, and evidence that at least some of these agents have significant side effects and safety problems. The occurrence of potential adverse effects e. Although it would be expected that very few active duty military personnel would qualify for consideration for obesity surgery, a review of weight-management programs would not be complete without a discussion of this option. For these individuals, obesity surgery may produce massive, long-term weight loss. Recent studies have shown dramatic improvements in the morbidity and mortality of those who are massively obese, and surgery is being recommended with increasing frequency for these individuals Hubbard and Hall, Table presents the rationale and results of all forms of obesity surgery. Surgical Procedures Used for Treatment of Obesity in Humans. Individuals who are candidates for obesity surgery are those who 1 exhibit any of the complications of obesity such as diabetes, hypertension, dyslipidemia, sleep disorders, pulmonary dysfunction, or increased intracranial pressure and have a BMI above 35, or 2 have a BMI above Gastric bypass is currently the most commonly used procedure for obesity surgery. Following this procedure, patients lose about 62 to 70 percent of excess weight and maintain this loss for more than 5 years Kral, ; MacDonald et al. Biliopancreatic bypass, another type of obesity surgery, and its variations produce weight losses comparable or superior to gastric bypass Kral, In addition to massive weight loss, individuals who undergo obesity surgery experience improvements in health status relative to hypertension, dyslipidemia, sleep apnea, pulmonary function oxygen saturation and oxyhemoglobin levels and decreased carbon dioxide saturation Sugerman, ; Sugerman et al. Obesity surgery is, however, considered the treatment of last resort because of the short- and long-term complications associated with the surgery. Perioperative mortality is small but significant about 0. Other potential side effects include vomiting, diarrhea, electrolyte abnormalities, liver failure, renal stones, pseudo-obstruction syndrome, arthritis syndrome, and bacterial overgrowth syndromes. The long-term success of weight management appears to depend on the individual participating in a specific and deliberate follow-up program. Programs to aid personnel in weight maintenance or prevention of weight gain are appropriate when:. It helps the patient select a weight range within which he or she can realistically stay and, if possible, minimize health risks. It provides an opportunity for continued monitoring of weight, food intake, and physical activity. It helps the patient understand and implement the principle of balancing the energy consumed from food with routine physical activity. It helps the patient establish and maintain lifestyle change strategies for a sufficiently long period of time to make the new behaviors into permanent habits a minimum of 6 months has been suggested [Wing, ]. Individuals who have achieved a weight-loss goal generally fall into one of two groups: those who see no point in participating in a maintenance program since they believe they know how to keep the weight off and those who remain open to change and improving their skills in weight management. The critical role of the health care provider is to motivate the former group to learn the skills necessary for weight management. The skills necessary to:. As mentioned above, individuals who have lost weight need to make permanent lifestyle changes in order to maintain their loss. To assist patients in making these changes, successful maintenance programs will include education on and assistance with the following factors Foreyt and Goodrick, , ; Kayman et al. To the extent that the epidemic of obesity can be attributed to changes in our living and working environments the increased availability of calorie-dense foods and decreased opportunity to expend energy , public policy efforts may help prevent overweight and may assist those who are trying to lose weight or maintain weight loss Koplan and Dietz, Apart from the obvious need to increase energy expenditure relative to intake, none of the strategies that have been proposed to promote weight loss or maintenance of weight loss are universally recognized as having any utility in weight management. The efficacy of individual interventions is poor, and evidence regarding the efficacy of combinations of strategies is sparse, with results varying from one study to another and with the individual. Recent studies that have focused on identifying and studying individuals who have been successful at weight management have identified some common techniques. However, an additional factor identified among successful weight managers, and one not generally included in discussing weight-management techniques, is individual readiness, that is, strong personal motivation to succeed in weight management. Turn recording back on. National Library of Medicine Rockville Pike Bethesda, MD Web Policies FOIA HHS Vulnerability Disclosure. Help Accessibility Careers. Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation. Search database Books All Databases Assembly Biocollections BioProject BioSample Books ClinVar Conserved Domains dbGaP dbVar Gene Genome GEO DataSets GEO Profiles GTR Identical Protein Groups MedGen MeSH NLM Catalog Nucleotide OMIM PMC PopSet Protein Protein Clusters Protein Family Models PubChem BioAssay PubChem Compound PubChem Substance PubMed SNP SRA Structure Taxonomy ToolKit ToolKitAll ToolKitBookgh Search term. Show details Institute of Medicine US Subcommittee on Military Weight Management. Contents Hardcopy Version at National Academies Press. Search term. PHYSICAL ACTIVITY Increased physical activity is an essential component of a comprehensive weight-reduction strategy for overweight adults who are otherwise healthy. TABLE Benefits of Physical Activity. Self-Monitoring and Feedback Self-monitoring of dietary intake and physical activity, which enables the individual to develop a sense of accountability, is one of the cornerstones of behavioral treatment. Other Behavioral Techniques Some additional techniques included in behavioral treatment programs include eating only regularly scheduled meals; doing nothing else while eating; consuming meals only in one place usually the dining room and leaving the table after eating; shopping only from a list; and shopping on a full stomach Brownell and Kramer, Eating Environments A significant part of weight loss and management may involve restructuring the environment that promotes overeating and underactivity. Eating habits that may promote overweight: 1. Eating few or no meals at home 2. Opting for high-fat, calorie-dense foods 3. Prepare meals at home and carry bag lunches 2. Learn to estimate or measure portion sizes in restaurants 3. Learn to recognize fat content of menu items and dishes on buffet tables 4. Eliminate smoking and reduce alcohol consumption 5. Substitute low-calorie for high-calorie foods 6. Modify the route to work to avoid a favorite food shop. Physical Activity Environment Major obstacles to exercise, even in highly motivated people, include the time it takes to complete the task and the inaccessibility of facilities or safe places to exercise. Nutrition Education Management of overweight and obesity requires the active participation of the individual. DIET Weight-management programs may be divided into two phases: weight loss and weight maintenance. Nutritionally Balanced, Hypocaloric Diets A nutritionally balanced, hypocaloric diet has been the recommendation of most dietitians who are counseling patients who wish to lose weight. Meal Replacement Meal replacement programs are commercially available to consumers for a reasonably low cost. Unbalanced, Hypocaloric Diets Unbalanced, hypocaloric diets restrict one or more of the calorie-containing macronutrients protein, fat, and CHO. High-Protein, Low-Carbohydrate Diets There has been considerable debate on the optimal ratio of macronutrient intake for adults. Low-Fat Diets Low-fat diets have been one of the most commonly used treatments for obesity for many years Astrup, ; Astrup et al. High-Fiber Diets Most low-fat diets are also high in dietary fiber, and some investigators attribute the beneficial effects of low-fat diets to the high content of vegetables and fruits that contain large amounts of dietary fiber. Very-Low-Calorie Diets Very-low-calorie diets VLCDs were used extensively for weight loss in the s and s, but have fallen into disfavor in recent years Atkinson, ; Bray, a; Fisler and Drenick, SUPPORT SYSTEMS Almost any kind of assistance provided to participants in a weight-management program can be characterized as support services. Counseling and Psychotherapy Services Psychological and emotional factors play a significant role in weight management. Patient-Led Groups Nonprofessional patient-led groups and counseling, such as those available with organized programs like Take Off Pounds Sensibly and Overeaters Anonymous, can be useful adjuncts to weight-loss efforts. Commercial Groups Certain commercial programs like Weight Watchers and Jenny Craig can also be helpful. Other Community Resources Many communities offer supplemental weight-management services. Family Support The family unit can be a source of significant assistance to an individual in a weight-management program. Internet Services A variety of Internet- and web-related services are available to individuals who are trying to manage their weight Davison, ; Gray and Raab, ; Riva et al. Physical Activity Support Services Support is also required for military personnel who need to enhance their levels of physical fitness and physical activity. BOX Summary of Potential Mechanisms of Action of Obesity Drugs. TABLE Prescription Pharmacological Agents for Weight-Loss Treatment and Mechanisms of Action. Efficacy and Safety of Currently Available Prescription Obesity Drugs Adrenergic and Serotonergic Agents Efficacy. Drugs Affecting Absorption: Lipase and Amylase Inhibitors Efficacy. Drugs Approved for Other Conditions A variety of drugs currently on the market for other conditions, but not approved by FDA for obesity treatment, have been evaluated for their ability to induce weight loss. Drugs Used in Combination Efficacy. Alternative Medicines, Herbs, and Diet Supplements In , Congress passed the Dietary Supplement Health and Education Act, which exempted dietary supplements including those promoted for weight loss from the requirement to demonstrate safety and efficacy. TABLE Alternative Medicines, Herbs, and Supplements Used for Weight Loss. FUTURE DRUGS FOR THE TREATMENT OF OBESITY Body weight, body fat, energy metabolism, and fat oxidation are regulated by numerous hormones, peptides, neurotransmitters, and other substances in the body. Summary Although obesity drugs have been available for more than 50 years, the concept of long-term treatment of obesity with drugs has been seriously advanced only in the last 10 years. SURGERY Although it would be expected that very few active duty military personnel would qualify for consideration for obesity surgery, a review of weight-management programs would not be complete without a discussion of this option. TABLE Surgical Procedures Used for Treatment of Obesity in Humans. Programs to aid personnel in weight maintenance or prevention of weight gain are appropriate when: An individual has successfully achieved his or her weight-loss goal and now seeks to maintain the new weight,. An individual who is gaining weight has taken a weight-loss readiness assessment and has determined that he or she is not ready for weight loss at this time, or. An overweight individual is temporarily excluded from a weight-reduction program until a medical, physical, or psychological problem stabilizes. Components of a Maintenance Program A comprehensive weight-maintenance strategy has five fundamental components: 1. It considers the long-term use of drugs. Helping Patients Learn How to Balance Energy Individuals who have achieved a weight-loss goal generally fall into one of two groups: those who see no point in participating in a maintenance program since they believe they know how to keep the weight off and those who remain open to change and improving their skills in weight management. Helping Patients Establish Permanent Lifestyle Change Strategies As mentioned above, individuals who have lost weight need to make permanent lifestyle changes in order to maintain their loss. Regular weighing and recording of daily food intake and physical activity for the first month or two of the maintenance period and during periods of increased exposure to food e. If weight gain occurs, reinstitution of this practice may help bring weight back into control. Frequent follow-up contact with counselors is also crucial Perri et al. Effective follow-up consists of a schedule of regular weekly to monthly contacts by mail, phone, or in person. Support groups may substitute for some of this follow-up with a health care provider, but should not replace it. Physical activity. Daily physical activity is key to successful weight maintenance; it is the factor cited as the most important in maintaining weight loss by the majority of individuals in the National Weight Loss Registry Klem et al. Problem solving. |
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The psychological weight loss strategy - Laurie Coots Just in time Weight loss maintenance strategies the New Year, a new Cal Poly study shows that if you want Wfight lose weight and mwintenance it off, building healthy dietary, self-monitoring Weight loss maintenance strategies Promoting effective nutrient absorption coping Weight loss maintenance strategies may be the keys to success. Results published today in Obesity found that some Weifht the most effective behaviors and psychological strategies reported by maintenancs maintaining their weight sttategies included choosing healthy losw, tracking what you maintneance and using positive self-talk. Hydration strategies for strength athletes study surveyed almost 5, members of WW formerly Weight Watchers who reported losing an average of about 50 pounds and kept it off for more than three years, to look at their weight management strategies. Researchers compared this group to a control group of more than people with obesity and who reported not gaining or losing more than five pounds for a period of greater than five years. The research team examined 54 behaviors related to weight management. Compared to the group of weight-stable individuals, the group of weight loss maintainers reported more frequent use of strategies like setting daily food intake goals, recording what was eaten each day, measuring foods, thinking about past successes, and remaining positive in the face of weight regain. The researchers also found that these eating and thinking behaviors became easier and more ingrained over time in the group of those maintaining their weight loss.
Weight loss maintenance strategies -
Compared to the group of weight-stable individuals, the group of weight loss maintainers reported more frequent use of strategies like setting daily food intake goals, recording what was eaten each day, measuring foods, thinking about past successes, and remaining positive in the face of weight regain.
The researchers also found that these eating and thinking behaviors became easier and more ingrained over time in the group of those maintaining their weight loss. These findings are encouraging for those working at weight loss maintenance. Over time, weight loss maintenance may become easier, requiring less intentional effort.
Obesity increases the likelihood of heart disease, diabetes and some cancers, among other health conditions. While the terms "overweight" and "obesity" are similar, the difference between the two arises with Body Mass Index, or BMI, which is a measure of body fat based on an individual's weight in relation to his or her height and age.
In general, a person with a BMI of The results of this study can help people focus on the strategies that are most likely to help participants maintain a healthy weight. Materials provided by California Polytechnic State University.
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Story Source: Materials provided by California Polytechnic State University. Journal Reference : Suzanne Phelan, Tate Halfman, Angela Marinilli Pinto, Gary D.
Obesity , ; 28 2 : DOI: Cite This Page : MLA APA Chicago California Polytechnic State University. ScienceDaily, 23 January California Polytechnic State University.
Top strategies for successful weight loss maintenance. Retrieved February 14, from www. htm accessed February 14, Explore More. Diet Tracking: How Much Is Enough to Lose Weight? June 8, Keeping track of everything you eat and drink in a day is a tedious task that is tough to keep up with over time.
Unfortunately, dutiful tracking is a vital component for successful weight loss, Nordic Diet Lowers Cholesterol and Blood Sugar — Even If You Don't Lose Weight. Until now, the health benefits attributed to a Nordic diet by researchers primarily focused on weight loss.
MyFitnessPal, Lose It, and Sparkpeople are top-ranked web-based and phone apps to help you track your daily intake and activity level.
The Healthy Eating Planner is a tool to help you assess your current eating habits, set goals and create a meal plan. Make use of your downtime to develop a basic menu for the upcoming week, go food shopping, and batch cook. Keep healthful foods on hand so you can toss together a wholesome meal in no time.
The Food Personality Quiz. Distribute your calories throughout the day rather than eating most of them after the sun goes down.
This helps to keep your metabolism fired up, prevents drastic swings in blood sugar and helps with portion control throughout the day. A good rule of thumb is to eat every hours.
While it can help to have something calorie-free to drink or distract yourself with an activity like going for a walk, these are short-term fixes.
If you struggle with stress or emotional eating, a mindful eating app called Eat Right Now can help you to improve your relationship with food and strengthen your control over cravings. Contact beingwell yale. edu to learn more. Beverages like juice, soda, sweet teas, energy drinks, and flavored coffees can put a big dent in your daily calorie budget.
Make a habit of increasing your water intake. Count your cocktails too. Alcohol is dense in calories, even before it makes its way into a mixer. Rethink your drink! While nutrition plays the starring role in weight loss, physical activity is more than just an understudy. Fit in ways to get FFIT!
Jaintenance Goldman, Ph. Cara Lustik ztrategies Weight loss maintenance strategies Renewable energy installations and copywriter with more than losz years of experience crafting stories in Weivht branding, licensing, and Natural ways to boost energy levels industries. If you have Hydration strategies for strength athletes your strategiss Blood sugar control supplements or srategies goal, you may be looking for helpful strategies for your maintenance phase. After all, it may have taken a lot of time and patience to get where you are, the last thing you want to do is undo all of your hard work. The good news is, with a little planning and focused effort, you can maintain your weight loss without dieting. While it may seem harmless, yo-yo dieting—or weight cycling—is linked to a number of health problems including insomniaobesity, and an increased risk of cardiovascular disease and type 2 diabetes.
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