In preparing a new practical guide to help doctors treat their obese and overweight patients, an NIH panel reviewed relevant treatment strategies designed for weight loss. Their recommendations emphasize the potential effectiveness of weight control using multiple interventions and strategies, as follows:

• Dietary therapy
  • Low calorie diets are recommended for weight loss.
  • Reducing fat as part of a low calorie diet is a practical way to reduce calories.
  • Reducing dietary fat alone without reducing calories is not sufficient for weight loss.
  • Reducing dietary fat along with reducing dietary carbohydrates can facilitate calorie reduction.
  • A diet that is individually planned to help create a deficit of 500 to 1,000 calories/day should be an integral part of any program aimed at achieving a weight loss of 1 – 2 lbs/week.
• Physical activity
  • Physical activity is recommended as part of a comprehensive weight loss therapy and weight control program because it
    • Modestly contributes to weight loss
    • May decrease abdominal fat
    • Increases cardiorespiratory fitness
  • Physical activity should initially be at moderate levels for 30-45 minutes, 3 – 5 days/week.
  • Ultimately, all adults should accumulate at least 30 minutes or more of moderate physical activity on most, and preferably all, days.
• Behavior therapy
  • Behavior therapy is a useful adjunct when incorporated into treatment for weight loss and weight maintenance.
  • No one type of behavior therapy appears better than any other in its effect on weight loss.
  • Behavior therapy is more helpful in short-term weight loss; no additional benefits are found 3 – 5 years later.
• Pharmacotherapy
  • There is strong evidence that drug therapy, in combination with diet and physical activity, results in weight loss when used for 6 months to a year.
  • Weight loss drugs approved by the FDA may be used as part of a comprehensive weight loss program.
  • Continual assessment of drug therapy for efficacy and safety is necessary. If the drug is helping the patient to lose or maintain weight loss, and there are no serious adverse effects, it can be continued.
• Weight loss surgery
  • Weight loss surgery is an option for carefully selected patients with clinically severe obesity when less invasive methods of weight loss have failed and the patient is at high risk for obesity-associated illness or death.

Further, the panel recommended that dietary therapy, physical activity, and behavior therapy be used in combination for the greatest success. The panel recommends these methods to foster long-term weight control and prevention of weight gain as well.

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