Recommendations (From the Expert Panel on the Identification,
Evaluation, and Treatment of Overweight and Obesity in Adults)
- 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
- 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 since it produces weight loss that may also
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 LCD's, 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 can also 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.
Continue to Part 1 to find out
how to assess your risk.