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Patient education: Weight loss treatments (The Basics)

Patient education: Weight loss treatments (The Basics)

How do I know if I am overweight? — Doctors use a special measure called "body mass index," or BMI, to decide who is underweight, at a healthy weight, or overweight.

Your BMI will tell you which category you are in based on your weight and height (figure 1):

If your BMI is between 25 and 29.9, you are overweight

If your BMI is 30 or greater, you have obesity

Should I see a doctor or nurse? — If you are overweight or have obesity, see your doctor or nurse. They might have suggestions on healthy ways to lose weight.

People with obesity are more likely than people of normal weight to get diabetes, heart disease, cancer, and lots of other health problems. People with obesity also live less time than people of normal weight. That's why it's important to try to keep your weight in the normal range.

What's the best way to lose weight on my own? — To lose weight, you have to eat fewer calories and move more.

Studies have compared different diets such as the Atkins diet, the Zone diet, and the Weight Watchers diet. No single diet is better than any other. Any diet that reduces the number of calories you eat can help you lose weight – as long as you stick with it. You should pick the diet or eating pattern that works best for you.

Physical activity works the same way. You can walk, dance, garden, or even just move your arms while sitting. What's important is that you increase the number of calories you burn by moving more. And you have to keep doing the extra activity.

If you go on a diet for a short time, or increase your activity for a while, you might lose weight. But you will regain the weight if you go back to your old habits. Weight loss is about changing your habits for the long term.

The best way to start is to make small changes and stick with them. Then, little by little, you can add new changes that you also stick with.

Are there medical treatments that can help me lose weight? — There are medicines and surgery to help with weight loss. But these treatments are only for people who have not been able to lose weight through diet and exercise. What's more, weight loss treatments do not take the place of diet and exercise. People who have those treatments must also change how they eat and how active they are.

How do weight loss medicines work? — Weight loss medicines work by reducing your appetite or by changing the way you digest food. They are appropriate only for people who:

Have a BMI of 30 or greater; or

Have a BMI between 27 and 29.9 and also have weight-related medical problems, such as diabetes, heart disease, or high blood pressure

Can I try herbal or non-prescription medicines to lose weight? — Many herbal weight loss medicines are unsafe or do not work. Check with your doctor or pharmacist before you take any herbal weight loss medicines. There is also an over-the-counter (non-prescription) version of a prescription medicine called orlistat (brand name: Alli). It is probably safe to try, but it can cause unwanted side effects, such as cramps, burping, and gas.

Some weight loss medicines are sold over the internet. However, they can contain harmful ingredients and be unsafe.

How do weight loss procedures work? — Weight loss surgical procedures work by making your stomach smaller. Some types of surgery also change the path food takes through your gut (intestines) so that fewer calories and nutrients get absorbed.

Weight loss surgery is appropriate only for people who:

Have a BMI greater than 40; or

Have a BMI of 35 to 39.9 and also have medical problems, such as diabetes, heart disease, or high blood pressure

Have a BMI of 30 or greater and have diabetes that cannot be controlled in other ways

How do I decide if weight loss treatment is right for me? — If your doctor suggests weight loss treatment, ask these questions:

About how much weight can I expect to lose and how long will that take? – This depends on the treatment. There are several different types of surgeries to help with weight loss. The amount of weight loss and how long it takes to lose weight is different for each one.

What are the risks of treatment for someone like me? – All weight loss medicines can have side effects. All weight loss surgeries can lead to infection, bleeding, the need for other operations, and even death. To reduce the risk of these problems with surgery, make sure your surgeon is very experienced and that you are treated at a certified "Center of Excellence."

What changes will I need to make to my diet and lifestyle? – Weight loss treatments are not "short-cuts" that get you out of making lifestyle changes. People must also change how they eat and how active they are. No single weight loss treatment works on its own. Sometimes people can get surgery only after they prove they can make lifestyle changes – by losing some weight on their own first.

Will I be able to process food normally? – Some types of weight loss surgeries leave people unable to get all the nutrients they need from food. People who have this problem must take vitamin and mineral supplements for the rest of their lives.

More on this topic

Patient education: My child is overweight (The Basics)
Patient education: Health risks of obesity (The Basics)
Patient education: Weight loss surgery (The Basics)

Patient education: Losing weight (Beyond the Basics)
Patient education: Weight loss surgery and procedures (Beyond the Basics)

This topic retrieved from UpToDate on: Mar 03, 2022.
This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms ©2022 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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