Successful weight-loss treatments include setting goals and making lifestyle changes, such as eating fewer calories and being physically active. Medicines and weight-loss surgery also are options for some people if lifestyle changes aren't enough.
Setting realistic weight-loss goals is an important first step to losing weight.
Lifestyle changes can help you and your family achieve long-term weight-loss success. Example of lifestyle changes include:
Over time, these changes will become part of your everyday life.
Cutting back on calories (energy IN) will help you lose weight. To lose 1 to 2 pounds a week, adults should cut back their calorie intake by 500 to 1,000 calories a day.
These calorie levels are a guide and may need to be adjusted. If you eat 1,600 calories a day but don't lose weight, then you may want to cut back to 1,200 calories. If you're hungry on either diet, then you may want to add 100 to 200 calories a day.
Very low-calorie diets with fewer than 800 calories a day shouldn't be used unless your doctor is monitoring you.
For overweight children and teens, it's important to slow the rate of weight gain. However, reduced-calorie diets aren't advised unless you talk with a health care provider.
A healthy eating plan gives your body the nutrients it needs every day. It has enough calories for good health, but not so many that you gain weight.
A healthy eating plan is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. Following a healthy eating plan will lower your risk for heart disease and other conditions.
Healthy foods include:
Canola and olive oils, and soft margarines made from these oils, are heart healthy. However, you should use them in small amounts because they're high in calories.
You also can include unsalted nuts, like walnuts and almonds, in your diet as long as you limit the amount you eat (nuts also are high in calories).
The National Heart, Lung, and Blood Institute's "Aim for a Healthy Weight" patient booklet provides more information about following a healthy eating plan.
Foods to limit. Foods that are high in saturated and trans fats and cholesterol raise blood cholesterol levels and also might be high in calories. Fats and cholesterol raise your risk for heart disease, so they should be limited.
Saturated fat is found mainly in:
Trans fat is found mainly in:
Cholesterol mainly is found in:
Limiting foods and drinks with added sugars, like high-fructose corn syrup, is important. Added sugars will give you extra calories without nutrients like vitamins and minerals. Added sugars are found in many desserts, canned fruit packed in syrup, fruit drinks, and nondiet drinks.
Check the list of ingredients on food packages for added sugars like high-fructose corn syrup. Drinks that contain alcohol also will add calories, so it's a good idea to limit your alcohol intake.
Portion size. A portion is the amount of food that you choose to eat for a meal or snack. It's different from a serving, which is a measured amount of food and is noted on the Nutrition Facts label on food packages.
Anyone who has eaten out lately is likely to notice how big the portions are. In fact, over the past 40 years, portion sizes have grown significantly. These growing portion sizes have changed what we think of as a normal portion.
Cutting back on portion size is a good way to eat fewer calories and balance your energy IN. Learn how today's portions compare with those from 20 years ago at the National Heart, Lung, and Blood Institute's Portion Distortion Web pages.
Food weight. Studies have shown that we all tend to eat a constant "weight" of food. Ounce for ounce, our food intake is fairly consistent. Knowing this, you can lose weight if you eat foods that are lower in calories and fat for a given amount of food.
For example, replacing a full-fat food product that weighs 2 ounces with a low-fat product that weighs the same helps you cut back on calories. Another helpful practice is to eat foods that contain a lot of water, such as vegetables, fruits, and soups.
Being physically active and eating fewer calories will help you lose weight and keep weight off over time. Physical activity also will benefit you in other ways. It will:
The four main types of physical activity are aerobic, muscle-strengthening, bone strengthening, and stretching. You can do physical activity with light, moderate, or vigorous intensity. The level of intensity depends on how hard you have to work to do the activity.
People vary in the amount of physical activity they need to control their weight. Many people can maintain their weight by doing 150 to 300 minutes (2 hours and 30 minutes to 5 hours) of moderate-intensity activity per week, such as brisk walking.
People who want to lose a large amount of weight (more than 5 percent of their body weight) may need to do more than 300 minutes of moderate-intensity activity per week. This also may be true for people who want to keep off weight that they've lost.
You don't have to do the activity all at once. You can break it up into short periods of at least 10 minutes each.
If you have a heart problem or chronic disease, such as heart disease, diabetes, or high blood pressure, talk with your doctor about what types of physical activity are safe for you. You also should talk with your doctor about safe physical activities if you have symptoms such as chest pain or dizziness.
Children should get at least 60 minutes or more of physical activity every day. Most physical activity should be moderate-intensity aerobic activity. Activity should vary and be a good fit for the child's age and physical development.
Many people lead inactive lives and might not be motivated to do more physical activity. When starting a physical activity program, some people may need help and supervision to avoid injury.
If you're obese, or if you haven't been active in the past, start physical activity slowly and build up the intensity a little at a time.
When starting out, one way to be active is to do more everyday activities, such as taking the stairs instead of the elevator and doing household chores and yard work. The next step is to start walking, biking, or swimming at a slow pace, and then build up the amount of time you exercise or the intensity level of the activity.
To lose weight and gain better health, it's important to get moderate-intensity physical activity. Choose activities that you enjoy and that fit into your daily life.
A daily, brisk walk is an easy way to be more active and improve your health. Use a pedometer to count your daily steps and keep track of how much you're walking. Try to increase the number of steps you take each day. Other examples of moderate-intensity physical activity include dancing, gardening, and water aerobics.
For greater health benefits, try to step up your level of activity or the length of time you're active. For example, start walking for 10 to 15 minutes three times a week, and then build up to brisk walking for 60 minutes, 5 days a week.
For more information about physical activity, go to the Department of Health and Human Services "2008 Physical Activity Guidelines for Americans" and the Health Topics Physical Activity and Your Heart article.
Changing your behaviors or habits related to food and physical activity is important for losing weight. The first step is to understand which habits lead you to overeat or have an inactive lifestyle. The next step is to change these habits.
Below are some simple tips to help you adopt healthier habits.
Change your surroundings. You might be more likely to overeat when watching TV, when treats are available at work, or when you're with a certain friend. You also might find it hard to motivate yourself to be physically active. However, you can change these habits.
Keep a record. A record of your food intake and the amount of physical activity that you do each day will help inspire you. You also can keep track of your weight. For example, when the record shows that you've been meeting your physical activity goals, you'll want to keep it up. A record also is an easy way to track how you're doing, especially if you're working with a registered dietitian or nutritionist.
Seek support. Ask for help or encouragement from your friends, family, and health care provider. You can get support in person, through e-mail, or by talking on the phone. You also can join a support group.
Reward success. Reward your success for meeting your weight-loss goals or other achievements with something you would like to do, not with food. Choose rewards that you'll enjoy, such as a movie, music CD, an afternoon off from work, a massage, or personal time.
Weight-loss medicines approved by the Food and Drug Administration (FDA) might be an option for some people.
If you're not successful at losing 1 pound a week after 6 months of using lifestyle changes, medicines may help. You should only use medicines as part of a program that includes diet, physical activity, and behavioral changes.
Weight-loss medicines might be suitable for adults who are obese (a BMI of 30 or greater). People who have BMIs of 27 or greater, and who are at risk for heart disease and other health conditions, also may benefit from weight-loss medicines.
As of October 2010, the weight-loss medicine sibutramine (Meridia®) was taken off the market in the United States. Research showed that the medicine may raise the risk of heart attack and stroke.
Orlistat (Xenical®) causes a weight loss between 5 and 10 pounds, although some people lose more weight. Most of the weight loss occurs within the first 6 months of taking the medicine.
People taking Xenical need regular checkups with their doctors, especially during the first year of taking the medicine. During checkups, your doctor will check your weight, blood pressure, and pulse and may recommend other tests. He or she also will talk with you about any medicine side effects and answer your questions.
The FDA also has approved Alli®, an over-the-counter (OTC) weight-loss aid for adults. Alli is the lower dose form of orlistat. Alli is meant to be used along with a reduced-calorie, low-fat diet and physical activity. In studies, most people taking Alli lost 5 to 10 pounds over 6 months.
Both Xenical and Alli reduce the absorption of fats, fat calories, and vitamins A, D, E, and K to promote weight loss. Both medicines also can cause mild side effects, such as oily and loose stools.
Although rare, some reports of liver disease have occurred with the use of orlistat. More research is needed to find out whether the medicine plays a role in causing liver disease. Talk with your doctor if you’re considering using Xenical or Alli to lose weight. He or she can discuss the risks and benefits with you.
You also should talk with your doctor before starting orlistat if you’re taking blood-thinning medicines or being treated for diabetes or thyroid disease. Also, ask your doctor whether you should take a multivitamin due to the possible loss of some vitamins.
In July 2012, the FDA approved two new medicines for chronic (ongoing) weight management. Lorcaserin hydrochloride (Belviq®) and Qsymia™ are approved for adults who have a BMI of 30 or greater. (Qsymia is a combination of two FDA-approved medicines: phentermine and topiramate.)
These medicines also are approved for adults with a BMI of 27 or greater who have at least one weight-related condition, such as high blood pressure, type 2 diabetes, or high blood cholesterol.
Both medicines are meant to be used along with a reduced-calorie diet and physical activity.
Some prescription medicines are used for weight loss, but aren't FDA-approved for treating obesity. They include:
Some OTC products claim to promote weight loss. The FDA doesn't regulate these products because they're considered dietary supplements, not medicines.
However, many of these products have serious side effects and generally aren't recommended. Some of these OTC products include:
Weight-loss surgery might be an option for people who have extreme obesity (BMI of 40 or more) when other treatments have failed.
Weight-loss surgery also is an option for people who have a BMI of 35 or more and life-threatening conditions, such as:
Two common weight-loss surgeries include banded gastroplasty and Roux-en-Y gastric bypass. For gastroplasty, a band or staples are used to create a small pouch at the top of your stomach. This surgery limits the amount of food and liquids the stomach can hold.
For gastric bypass, a small stomach pouch is created with a bypass around part of the small intestine where most of the calories you eat are absorbed. This surgery limits food intake and reduces the calories your body absorbs.
Weight-loss surgery can improve your health and weight. However, the surgery can be risky, depending on your overall health. Gastroplasty has few long-term side effects, but you must limit your food intake dramatically.
Gastric bypass has more side effects. They include nausea (feeling sick to your stomach), bloating, diarrhea, and faintness. These side effects are all part of a condition called dumping syndrome. After gastric bypass, you may need multivitamins and minerals to prevent nutrient deficiencies.
Lifelong medical followup is needed after both surgeries. Your doctor also may recommend a program both before and after surgery to help you with diet, physical activity, and coping skills.
If you think you would benefit from weight-loss surgery, talk with your doctor. Ask whether you're a candidate for the surgery and discuss the risks, benefits, and what to expect.
Maintaining your weight loss over time can be a challenge. For adults, weight loss is a success if you lose at least 10 percent of your initial weight and you don't regain more than 6 or 7 pounds in 2 years. You also must keep a lower waist circumference (at least 2 inches lower than your waist circumference before you lost weight).
After 6 months of keeping off the weight, you can think about losing more if:
The key to losing more weight or maintaining your weight loss is to continue with lifestyle changes. Adopt these changes as a new way of life.
If you want to lose more weight, you may need to eat fewer calories and increase your activity level. For example, if you eat 1,600 calories a day but don't lose weight, you may want to cut back to 1,200 calories. It's also important to make physical activity part of your normal daily routine.
Obesity happens one pound at a time. So does prevention.
Clinical trials are research studies that explore whether a medical strategy, treatment, or device is safe and effective for humans. To find clinical trials that are currently underway for Overweight and Obesity, visit www.clinicaltrials.gov.
November 8, 2013
NIH and the Children's Museum of Manhattan launch innovative program to help families create healthier futures
Through an innovative public-private partnership, the National Institutes of Health and the Children's Museum of Manhattan (CMOM) have created a new health educational curriculum — EatPlayGrow: Creative Activities for a Healthy Start — for children ages 2-5 and their parents
The HBO Documentary Film series The Weight of the Nation for Kids will air in May 2013. The family-friendly film series highlights young people actively improving the health of both themselves and their communities. Watch the series to learn how kids are working to make a difference in their schools and communities. The films stream free on the HBO website.
To learn more about the film series and related public awareness campaign, including how to host a local screening go to www.nih.gov/health/
November 20, 2013
Gary H. Gibbons
New NHLBI Program Trains Scientists to Bring More Science Out of the Lab and into the Patient Care Marketplace
The NHLBI updates Health Topics articles on a biennial cycle based on a thorough review of research findings and new literature. The articles also are updated as needed if important new research is published. The date on each Health Topics article reflects when the content was originally posted or last revised.