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Managing weight loss

1. Through diet

A physician or nutritionist should plan a diet for each individual based on their BMI and risks factors to produce a net-loss calorie intake of 500 to 1,000 kcal/day. This should be alongside the reduction of saturated and total fat to lower the LDL-cholesterol levels.

2. Through physical activity

Although most weight loss occurs because of the reduction in calorie intake, an increase in physical activity remains an important component of weight loss therapy to prevent weight from returning. It also reduces the risks of cardiovascular disease and diabetes significantly beyond that produced by weight reduction alone. Because of the risk of overexertion, all exercise programs should begin slowly and build gradually. Whatever exercise is chosen can either be done in a single session or intermittently over the day. Walking for about 30 minutes or swimming at a slow pace represent a good start. The length of each session and its intensity can slowly be increased. The intention is to burn an additional 100 to 200 calories per day. This should become a daily routine. Walking is safe and easy to do.

3. Behavior therapy

People are encouraged to learn new habits that will overcome barriers to keeping to a diet and/or continuing physical activity. The techniques include relaxation and stress management, problem solving skills and support from peers and trained counsellors.

4. Medication

Appropriate medication such as Acomplia can enhance the behavioral approach to weight loss, helping individuals to retain their motivation by reducing their appetite.

5. Weight loss surgery

In a limited number of cases, weight loss surgery is appropriate where the individual is obese with associated high risk factors. Such surgery is usually a last resort when other efforts at medical therapy have failed. Gastric restriction or gastric bypass are the weight loss options for individuals who are well-motivated and may undertake the operation without serious risk. But there must be intensive follow-up to provide guidance on diet, physical activity, and behavioral and social support otherwise the effort of the surgery will be wasted.