The main treatment for being overweight or obese is a change in lifestyle. In most cases, increasing your activity level and decreasing your caloric intake will help you lose weight and reduce your risk of several serious diseases such as heart disease and type 2 diabetes. Studies show that just a modest reduction in your weight of 5 to 10% can help improve your health and reduce the risk of health problems.

To lose weight, you need to consume fewer calories than you use. One way to do this is to reduce your caloric intake. The National Heart Lung and Blood Institute (NHLBI) reviewed the medical research on diets and issued the following guidelines about limiting caloric intake and successful weight loss:

• Reducing caloric intake by 500 - 1,000 calories (also called kilocalories or kcals) per day from the current level will produce recommended weight loss of 1 - 2 pounds per week.
• In general, doctors should recommend diets of 1,000 - 1,200 kcal/day for most women and 1,200 - 1,600 kcal/day for men.
• Eating a low calorie diet leads to an average weight loss of 8% over 3 - 12 months.
• Eating less fat without reducing calories is not sufficient for weight loss.
• Reduced-calorie diets are more likely to be successful if the patient is educated about food composition, labeling, preparation, and portion size.
• The patient’s preferences should be taken into account when formulating a diet plan.
• Patients should have open communication with their doctor or nutritionist during the period when they are first adjusting to the diet.

Just reducing caloric intake is not necessarily a good idea for weight loss. Instead, doctors recommend that you concentrate on eating healthy foods that are nutrient rich and limit your intake of “empty calories”: foods that may taste good but that do not contain recommended nutrients (soda pop, for example). You should also limit the intake of trans and saturated fats, cholesterol, sodium, and foods with a high glycemic index. Consult your doctor or nutritionist to develop a diet that is right for you.

Increasing your activity level is another part of a successful weight loss plan. If you are trying to lose weight, the American Heart Association recommends that the average person get at 30 to 60 minutes of moderate exercise on most days. Moderate exercise means participating in activities such as jogging, fast walking, or even things like raking leaves or washing windows and floors.

Medications that can help you lose weight are designed for use by people with a BMI of 30 or above and who have tried diet and exercise but have not been able to achieve the desired weight loss. Appetite suppressant drugs help you feel full more quickly and include sibutramine (Meridia), Phendimetrazine (Bontril), and phentermine. Only sibutramine is approved for long-term weight loss. Fat blocking drugs help prevent some of the fat that you eat from being absorbed into the body and include Orlistat (Xenical and Alli). Xenical is a stronger prescription version of the drug and Alli is a reduced-strength over-the-counter version. All of these drugs must be used in combination with diet and exercise in order to be effective.

There are several surgeries that may be able to help people who have failed at all other attempts at losing weight. Weight loss surgery, also called bariatric surgery, is reserved for people whose BMI is at least 40, or people with a BMI of 35 who may also be showing signs of obesity-related diseases. All of the surgeries involve limiting the size of the stomach to reduce caloric intake and each carries some risk of serious complications. The two most popular are laparoscopic gastric banding (LAP BAND) and gastric bypass. The LAP BAND surgery involves placing an inflatable silicone band that is similar to a zip tie or a wristwatch around the patient’s upper stomach to limit its size. Gastric bypass involves reducing the size of the stomach using staples and bypassing a portion of the intestine to limit the amount of calories that are absorbed from food.