See also ABDOMINAL ADIPOSITY; BODY MASS INDEX
(BMI); BODY SHAPE AND CARDIOVASCULAR DISEASE;
UPPER ARM CIRCUMFERENCE.
weight loss and weight management The
approaches and methods to lose excessive weight
and maintain healthy weight after weight loss.
Two thirds of Americans weigh more than is
healthy, with a corresponding increase in weight-
related health conditions such as HYPERTENSION
(high BLOOD PRESSURE), type 2 DIABETES,
OSTEOARTHRITIS, ATHEROSCLEROSIS, and CORONARY
ARTERY DISEASE(CAD). Americans also spend tens of
billions of dollars each year on diet programs,
books, diet aids, and other weight-loss products.
Yet the premise of weight loss and weight man-
agement is fairly simple: eat less and exercise
more as a matter of lifestyle.
Losing WeightA weight loss approach that balances decreased
food intake and increased exercise can provide
steady, sustainable results. Health experts recom-
mend a rate of nonsurgical weight loss that targets
no more than a 10 percent drop in weight over no
less than six months for optimal success in keep-
ing the weight off long term. Short-term weight
loss goals help monitor progress and establish a
sense of success. Methods for weight loss include
lifestyle modifications,BEHAVIOR MODIFICATION THER-
APY, medication therapy, and BARIATRIC SURGERY.
Lifestyle modifications: eating habits and exer-
cise Lifestyle is the cornerstone of weight man-
agement. Many people achieve greater success
with their weight loss efforts when they join pro-
grams that incorporate nutritional control (such as
prepared meals or stringent menus) and struc-
tured physical exercise (such as group classes).
However, fad diets that promise rapid weight loss
generally do not produce sustainable results.
It is important for people who need to lose
weight to understand portion sizes, NUTRIENT DEN-
SITY, NUTRITIONAL NEEDS, and nutritional food
choices that are also palatable. This understanding
is essential for incorporating healthy EATING HABITS
into long-term lifestyle modifications. Unless
under a doctor’s supervision and guidance, daily
CALORIE intake should never drop below 1,200
calories for women and 1,600 calories for men.
Calorie intake below these levels activates the
body’s starvation mechanisms, which result in
slower METABOLISMand efforts to conserve energy
(calories). Daily exercise is essential to increase
the body’s energy expenditure. During weight loss
efforts, increased activity and decreased food con-
sumption combine for the most efficient results.30 MINUTES A DAY = 15 POUNDS A YEAR
One pound of fat is the equivalent of 3,500 calo-
ries. Physical exercise at the minimum recom-
mended level of 30 minutes daily typically
consumes 150 calories a day. This adds up to
nearly 1^1 ⁄ 2 pounds a month, or 15 pounds a year,
lost through exercise alone.Behavior modification therapyBehavior modi-
fication therapy may incorporate techniques such
as taking smaller portions with the understanding
that one can have more if still hungry, extending
consumption of a meal over a certain period of
time to encourage a slower pace of eating, eating
only at the table without reading or watching tele-
vision, keeping a food and exercise journal, sched-
uling exercise “appointments,” and shopping after
eating and only from a list.
Medication therapy Prescription APPETITEsup-
pressants can help people follow portion size and
eating recommendations to reduce the amount of
calories they consume. Medications tend to
become less effective over time. Researchers are
uncertain whether this is an issue of physiologic
tolerance (the body becomes resistant to the med-
ication’s effect) or a matter of becoming accus-
tomed to the medication and more able to
overcome its effect. Medication may be an appro-
priate treatment for people who have a BODY MASS
INDEX(BMI) between 30 and 34.9 (class 1 OBESITY)
and who have been unsuccessful with efforts to
lose weight. The medications to suppress appetite
may have significant side effects or DRUGinterac-
tions.
Over-the-counter (OTC) diet medications often
contain CAFFEINEor a decongestant such as pseu-
doephedrine. These drugs may mildly suppress the
appetite though their long-term use may result in
side effects such as agitation and PALPITATIONS. OTC
diet products generally provide no greater benefit
than diet and exercise alone.weight loss and weight management 309