(From the Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults: Evidence Report, 1998)
- Weight loss to lower elevated blood pressure in
overweight and obese persons with high blood pressure.
- Weight loss to lower elevated levels of total
cholesterol, LDL-cholesterol, and triglycerides, and to raise low levels of
HDL-cholesterol, in overweight and obese persons with dyslipidemia.
- Weight loss to lower elevated blood glucose levels in
overweight and obese persons with type 2 diabetes.
- Use the BMI to assess overweight and obesity. Body weight
alone can be used to follow weight loss and to determine the effectiveness of
- Use the BMI to classify overweight and obesity and to
estimate relative risk of disease compared to normal weight.
- The waist circumference should be used to assess
abdominal fat content.
- The initial goal of weight-loss therapy should be to
reduce body weight by about 10 percent from baseline. With success, and if
warranted, further weight loss can be attempted.
- Weight loss should be about 1 to 2 pounds per week for a
period of 6 months, with the subsequent strategy based on the amount of weight
- Low-calorie diets (LCD) for weight loss in overweight and
obese persons. Reducing fat as part of an LCD is a practical way to reduce
- Reducing dietary fat alone without reducing calories is
not sufficient for weight loss. However, reducing dietary fat, along with
reducing dietary carbohydrates, can help reduce calories.
- A diet that is individually planned to help create a
deficit of 500 to 1,000 kcal/day should be an intregal part of any program
aimed at achieving a weight loss of 1 to 2 pounds per week.
- Physical activity should be part of a comprehensive
weight loss therapy and weight control program because it (1) modestly
contributes to weight loss in overweight and obese adults, (2) may decrease
abdominal fat, (3) increases cardiorespiratory fitness, and (4) may help with
maintenance of weight loss.
- Physical activity should be an integral part of weight-loss therapy and weight maintenance. Initially, moderate levels of physical
activity for 30 to 45 minutes, 3 to 5 days a week, should be encouraged. All
adults should set a long-term goal to accumulate at least 30 minutes or more of
moderate-intensity physical activity on most, and preferably all, days of the
- The combination of a reduced-calorie diet and increased
physical activity is recommended, because it produces weight loss that also
may result in decreases in abdominal fat and increases in cardiorespiratory
- Behavior therapy is a useful adjunct when incorporated
into treatment for weight loss and weight maintenance.
- Weight-loss and weight-maintenance therapy should employ
the combination of LCDs, increased physical activity, and behavior therapy.
- After successful weight loss, the likelihood of weight-loss maintenance is enhanced by a program consisting of dietary therapy,
physical activity, and behavior therapy, which should be continued indefinitely.
Drug therapy also can be used. However, drug safety and efficacy beyond 1 year
of total treatment have not been established.
- A weight maintenance program should be a priority after
the initial 6 months of weight-loss therapy.
Healthy Weight Tip
The combination of a reduced-calorie diet and increased physical activity is recommended, because it produces weight loss that also may result in decreases in abdominal fat and increases in cardiorespiratory fitness.