Treatments for Overweight


Treatment of Overweight: medical news summaries: The following medical news items are relevant to treatment of Overweight:

Treatments of Overweight discussion: If you are overweight or obese, choose sensible ways to get in shape:

  • Avoid crash diets. Instead, eat less of the foods you usually have. Limit the amount of fat you eat.
  • Increase your physical activity. Aim for at least 30 minutes of exercise most days of the week. (See below for easy suggestions .)
  • Set a reasonable weight-loss goal, such as losing 1 pound a week. Aim for a long-term goal of losing at least 7 percent of your total body weight.

Make wise food choices most of the time

What you eat has a big impact on your health. By making wise food choices, you can help control your body weight, blood pressure, and cholesterol.

  • Take a hard look at the serving sizes of the foods you eat. Reduce serving sizes of main courses (such as meat), desserts, and foods high in fat. Increase the amount of fruits and vegetables.
  • Limit your fat intake to about 25 percent of your total calories. For example, if your food choices add up to about 2,000 calories a day, try to eat no more than 56 grams of fat. Your doctor or a dietitian can help you figure out how much fat to have. You can check food labels for fat content too.
  • You may also wish to reduce the number of calories you have each day. Your doctor or dietitian can help you with a meal plan that emphasizes weight loss.
  • Keep a food and exercise log. Write down what you eat, how much you exercise--anything that helps keep you on track.
  • When you meet your goal, reward yourself with a nonfood item or activity, like watching a movie.

Be physically active every day

Regular exercise tackles several risk factors at once. It helps you lose weight, keeps your cholesterol and blood pressure under control, and helps your body use insulin effectively. People in the DPP who were physically active for 30 minutes a day reduced their risk of type 2 diabetes. Many chose brisk walking for exercise.

If you are not very active, you should start slowly, talking with your doctor first about what kinds of exercise would be safe for you. Make a plan to increase your activity level toward the goal of being active for at least 30 minutes a day most days of the week.

Choose activities you enjoy. Here are some ways to work extra activity into your daily routine:

  • Take the stairs rather than an elevator or escalator.
  • Park at the far end of the lot and walk.
  • Get off the bus a few stops early and walk the rest of the way.
  • Walk or bicycle instead of drive whenever you can.

Almost any of the commercial weight-loss programs can work, but only if they motivate you sufficiently to decrease the amount of calories you eat or increase the amount of calories you burn each day (or both).2

A Responsible and Safe Weight-Loss Program 2

Research consistently shows that regular physical activity, combined with healthy eating habits, is the most efficient and healthful way to control your weight. Whether you are trying to lose weight or maintain it, you should understand the important role of physical activity and include it in your lifestyle. 3

Most available weight-loss medications are "appetite-suppressant" medications. Appetite-suppressant medications promote weight loss by decreasing appetite or increasing the feeling of being full. These medications decrease appetite by increasing serotonin or catecholamine--two brain chemicals that affect mood and appetite.

In 1999, the drug orlistat was approved by the Food and Drug Administration (FDA) as an obesity treatment. Orlistat works by reducing the body's ability to absorb dietary fat by about one third.

Most currently available weight-loss medications are approved by the U.S. Food and Drug Administration (FDA) for short-term use, meaning a few weeks or months. Sibutramine and orlistat are the only weight-loss medications approved for longer-term use in significantly obese patients, although the safety and effectiveness have not been established for use beyond 1 year. (See table 1 for the generic and trade names of prescription weight-loss medications.) While the FDA regulates how a medication can be advertised or promoted by the manufacturer, these regulations do not restrict a doctor's ability to prescribe the medication for different conditions, in different doses, or for different lengths of time. The practice of prescribing medication for periods of time or for conditions not approved is known as "off-label" use. While such use often occurs in the treatment of many conditions, you should feel comfortable about asking your doctor if he or she is using a medication or combination of medications in a manner that is not approved by the FDA. The use of more than one weight-loss medication at a time (combined drug treatment) is an example of an off-label use. Using weight-loss medications other than sibutramine or orlistat for more than a short period of time (i.e., more than "a few weeks") is also considered off-label use.

Table 1

Prescription Weight-Loss Medications
Generic Name Trade Name(s)
Dexfenfluramine Redux (withdrawn)
Diethylpropion Tenuate, Tenuate dospan
Fenfluramine Pondimin (withdrawn)
Mazindol Sanorex, Mazanor
Orlistat Xenical
Phendimetrazine Bontril, Plegine, Prelu-2, X-Trozine
Phentermine Adipex-P, Fastin, Ionamin, Oby-trim
Sibutramine Meridia

Combined drug treatment using fenfluramine and phentermine ("fen/phen") is no longer available due to the withdrawal of fenfluramine from the market. Little information is available about the safety or effectiveness of other drug combinations for weight loss, including fluoxetine/phentermine, phendimetrazine/phentermine, Xenical/sibutramine, herbal combinations, or others. Until more information on their safety or effectiveness is available, using combinations of medications for weight loss is not recommended except as part of a research study. 4

Regular physical activity, combined with healthy eating habits, is the most efficient and healthful way to control your weight. It is also an important part of a healthy lifestyle. Some simple ways to increase your family's physical activity include the following:

  • Be a role model for your children. If your children see that you are physically active and have fun, they are more likely to be active and stay active for the rest of their lives.

  • Plan family activities that provide everyone with exercise and enjoyment, like walking, dancing, biking, or swimming. For example, schedule a walk with your family after dinner instead of watching TV. Make sure that you plan activities that can be done in a safe environment.

  • Be sensitive to your child's needs. Overweight children may feel uncomfortable about participating in certain activities. It is important to help your child find physical activities that they enjoy and that aren't embarrassing or too difficult.

  • Reduce the amount of time you and your family spend in sedentary activities, such as watching TV or playing video games.

  • Become more active throughout your day and encourage your family to do so as well. For example, walk up the stairs instead of taking the elevator, or do some activity during a work or school break-get up and stretch or walk around.

The point is not to make physical activity an unwelcome chore, but to make the most of the opportunities you and your family have to be active5

Teaching healthy eating practices early will help children approach eating with the right attitude-that food should be enjoyed and is necessary for growth, development, and for energy to keep the body running. The best way to begin is to learn more about children's nutritional needs by reading or talking with a health professional and then to offer them some healthy options, allowing your children to choose what and how much they eat. The pamphlet "Dietary Guidelines for Americans" is a good source of dietary advice for healthy Americans ages 2 years and older. This pamphlet is available from WIN. 5

Children should never be placed on a restrictive diet to lose weight, unless a doctor supervises one for medical reasons. Limiting what children eat may be harmful to their health and interfere with their growth and development. 5

The key to reaching and staying at a healthy (or healthier) body weight is to balance healthful eating with regular physical activity. The Surgeon General suggests the following steps to better health.

  • Aim for a healthy weight. If you are overweight or obese, losing just 10 percent of your body weight can improve your health. Lose weight gradually ó 1/2 to 2 pounds per week. Do not go on fad diets. These can often hurt your health. Ask your doctor about the best weight loss plan for you.

  • Be active. Be physically active for at least 30 minutes on most days of the week. Regular exercise is very important in weight control and has many other health benefits.

    Some examples of good ways to exercise include walking, yard work, housework, and dancing. More vigorous exercise can raise your HDL ("good cholesterol") level and make your heart stronger. This kind of activity is called "aerobic" and includes jogging, swimming, jumping rope, or brisk walking or bicycling. Be sure to build up your activity level gradually over a period of several weeks. Check with your doctor before starting a vigorous exercise program.

  • Eat well. Eat smaller portions, eat more foods that are lower in fat and calories, and follow the Dietary Guidelines for Americans. These guidelines call for eating plenty of fruits, vegetables, and whole grains. Try to eat five servings of fruits and vegetables every day. Choose foods that are low in saturated fat and eat fewer foods that are high in sugar or salt.

If you are overweight or obese, talk with your doctor or health care provider about ways to improve your health. If you already have health problems related to obesity, such as high blood pressure or diabetes, follow the treatment plan prescribed by your doctor. 6

There is no "best" way to lose weight. Don't forget to talk with your doctor about setting up a weight loss plan. 7

Some general guidelines for losing weight safely are:

  • Eat fewer calories. The best formula for losing weight is to decrease the number of calories you get while increasing your physical activity every day. Depending on how active you are, you may need between 1,500 ó 2,500 calories a day. A safe plan is to eat 300 to 500 fewer calories a day to lose 1 to 2 pounds a week.

  • Lose weight slowly. It is best to aim for losing 1/2 to 2 pounds a week. By improving eating and exercise habits, you will develop a healthier lifestyle. And, this will help you to control your weight over time. You will also lower your chances of getting heart disease, high blood pressure and diabetes. "Crash" diets may take off pounds faster, but can cause you to gain back even more pounds than you lost after you stop the diet.

  • Exercise. Get active for at least 30 minutes every day. You don't have to train for a marathon to be active! Brisk walking, gardening, riding a bicycle, tennis and dancing all count as exercise. You can also break up the 30 minutes into three 10-minute periods. To get even more active every day, you can do things like park farther away from the mall in the parking lot and take the stairs instead of the elevator. The idea is to use up more calories than you eat each day. This will keep the calories from being stored as fat in your body.

  • Eat less fat and sugar. This will help lower the number of calories you eat each day. Select foods whose labels say low, light or reduced to describe calories or fat, including milk products and cheese. Eat lean types of meat, poultry, and fish. Eat less sugar and fewer sweets (don't forget that soda and juice can have lots of sugar). Drink less or no alcohol.

  • Eat a wide variety of foods, including starches and dairy products. This helps your body to get the nutrients and vitamins it needs to be healthy. Include plenty of vegetables, fruits, grain products and whole grains each day. Don't skip dairy products ó there are many good tasting low, no, and reduced fat milks, yogurts, cheeses, ice creams, and other products to choose from. Proper calcium intake is needed for all women to prevent bone loss.

    Starch is an important source of energy that all bodies need, even when a person is trying to lose weight. It is found in foods like potatoes, rice, pasta, bread, beans, and some vegetables. Foods high in starch can become high in fat and calories when you eat them in large amounts, or when they are made with rich sauces, oils, or other high-fat toppings like butter, sour cream, or mayonnaise. Stick to starchy foods that are high in fiber, like whole grains, beans, and peas.

  • Practice portion control. Eat smaller amounts of food at each meal. Let go of belonging to the "clean plate club." Don't feel like you have to eat everything on your plate, even when eating out. You can also try eating more small meals throughout the day, rather than three large meals.

  • Get support. It can be hard to start a weight loss program, particularly if you are out of shape and not used to exercising. Ask your family and friends for support. Try to find an exercise buddy. Make your activity fun and social ó go on a walk or hike with a friend or learn a new sport like tennis or ice-skating.

  • Treat yourself (once in a while). When trying to lose weight, we all feel tempted to "cheat" by eating a favorite, rich food like cake or cookies. But, sometimes it can be helpful to eat a small amount of a favorite food. This may keep you from craving it and overeating if you do "cheat."


There are many types of diet pills and herbal, or natural, supplements that you can buy over-the-counter at a drug or discount store, or on-line. You can't assume that a product that is called "natural" or "herbal" is safe. It may also hurt you if you are on other medications. It is best to always check with your doctor before using any herbal or natural weight-loss product.

Diet pills you can buy over-the-counter don't make much of a difference in how much weight you lose, how fast you lose it, or how long you keep the weight off. Some diet pills can raise your blood pressure. Also, cough or cold medicines often have the same drug used in diet pills. If you take both products together, you may get too much of the same drug and have harmful side effects. For some people, diet pills prescribed by a doctor can be helpful. If you do use these, be sure to follow your doctor's directions.

In 1997, The Food and Drug Administration (FDA) removed the weight-loss drug called Fen-Phen (fenfluramine and dexfenfluramine) from the market because this drug was found to cause heart valve disease. Today, there are weight loss products containing herbal fen-phen, which do not contain fenfluramine or dexfenfluramine, on the market. These products, not regulated by the FDA, often contain ephedra and have caused side effects in people using them. Always talk with your health care provider before taking any over-the-counter weight loss product, even it if is herbal or "natural." 7

1. excerpt from Am I at Risk for Type 2 Diabetes: NIDDK
2. excerpt from Choosing a Safe and Successful Weight-Loss Program: NIDDK
3. excerpt from Physical Activity and Weight Control: NIDDK
4. excerpt from Prescription Medications for the Treatment of Obesity: NIDDK
5. excerpt from Helping Your Overweight Child: NIDDK
6. excerpt from Obesity: NWHIC
7. excerpt from Weight Loss: NWHIC

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