Who should lose weight? Health experts generally agree that adults can benefit
from weight loss if they are moderately to severely overweight (see the following
weight-for-height chart below). Health experts also agree that adults who are
overweight and have weight-related medical problems or a family history of such
problems can benefit from weight loss. Some weight-related health problems include
diabetes, heart disease, high blood pressure, high cholesterol levels, or high
blood sugar levels. Even a small weight loss of 10 to 20 pounds can improve
your health, for example by lowering your blood pressure and cholesterol levels.
You do not need to lose weight if your weight is within the healthy range on
the weight-for-height chart, you have gained less than 10 pounds since you reached
your adult height, and you are otherwise healthy.
How We Lose Weight
Your body weight is controlled by the number of calories you eat and
the number of calories you use each day. So, to lose weight you need to
take in fewer calories than you use. You can do this by becoming more
physically active or by eating less. Following a weight-loss program
that helps you to become more physically active and decrease the amount
of calories that you eat is most likely to lead to successful weight
loss. The weight-loss program should also help you keep the weight off
by making changes in your physical activity and eating habits that you
will be able to follow for the rest of your life.
Types of Weight-Loss Programs
To lose weight and keep it off, you should be aware of the
different types of programs available and the important parts of a good
program. Knowing this information should help you select or design a
weight-loss program that will work for you. The three types of
weight-loss programs include: do-it-yourself programs, non-clinical
programs, and clinical programs.
Any effort to lose weight by yourself or with a group of
like-minded others through support groups, worksite or community-based
programs fits in the "do-it-yourself" category. Individuals using a
do-it-yourself program rely on their own judgment, group support, and
products such as diet books for advice (Note: Not all diet books are
reliable sources of weight-loss information).
These programs may or may not be commercially operated, such as
through a privately-owned, weight-loss chain. They often use books and
pamphlets that are prepared by health-care providers. These programs
use counselors (who usually are not health-care providers and may or
may not have training) to provide services to you. Some programs
require participants to use the program's food or supplements.
This type of program may or may not be commercially owned.
Services are provided in a health-care setting, such as a hospital, by
licensed health professionals, such as physicians, nurses, dietitians,
and/or psychologists. In some clinical programs, a health professional
works alone; in others, a group of health professionals works together
to provide services to patients. Clinical programs may offer you
services such as nutrition education, medical care, behavior change
therapy, and physical activity.
Clinical programs may also use other weight-loss methods, such
as very low-calorie diets, prescription weight-loss drugs, and surgery,
to treat severely overweight patients. These treatments are described
below: Very low-calorie diets (VLCDs) are commercially prepared
formulas that provide no more than 800 calories per day and replace all
usual food intake. VLCDs help individuals lose weight more quickly than
is usually possible with low-calorie diets. Because VLCDs can cause
side effects, obesity experts recommend that only people who are
severely overweight (see weight-for-height chart) use these diets, and
only with proper medical care. A fact sheet on VLCDs is available from
the Weight-control Information Network (WIN).
Prescribed weight-loss drugs should be used only if you are
likely to have health problems caused by your weight. You should not
use drugs to improve your appearance. Prescribed weight-loss drugs,
when combined with a healthy diet and regular physical activity, may
help some obese adults lose weight. However, before these medications
can be widely recommended, more research is needed to determine their
long-term safety and effectiveness. Whatever the results, prescription
weight-loss drugs should be used only as part of an overall program
that includes long-term changes in your eating and physical activity
habits. A fact sheet on prescription medications for the treatment of
obesity is available from WIN.
You may consider gastric surgery to promote weight loss if you
are more than 80 pounds overweight. The surgery, sometimes called
bariatric surgery, causes weight loss in one of two ways: 1) by
limiting the amount of food your stomach can hold by closing off or
removing parts of the stomach or 2) by causing food to be poorly
digested by bypassing the stomach or part of the intestines. After
surgery, patients usually lose weight quickly. While some weight is
often regained, many patients are successful in keeping off most of
their weight. In some cases, the surgery can lead to problems that
require follow-up operations. Surgery may also reduce the amount of
vitamins and minerals in your body and cause gallstones. For additional
information, a fact sheet on gastric surgery is available from WIN.
If you are considering a weight-loss program and you have
medical problems, or if you are severely overweight, programs run by
trained health professionals may be best for you. These professionals
are more likely to monitor you for possible side effects of weight loss
and to talk to your doctor when necessary.
Whether you decide to use the do-it-yourself, non-clinical, or
clinical approach, the program should help you lose weight and keep it
off by teaching you healthy eating and physical activity habits that
you will be able to follow for the rest of your life.
The word "diet" probably brings to mind meals of lettuce and
cottage cheese. By definition, "diet" refers to what a person eats or
drinks during the course of a day. A diet that limits portions to a
very small size or that excludes certain foods entirely to promote
weight loss may not be effective over the long term. Rather, you are
likely to miss certain foods and find it difficult to follow this type
of diet for a long time. Instead, it is often helpful to gradually
change the types and amounts of food you eat and maintain these changes
for the rest of your life. The ideal diet is one that takes into
account your likes and dislikes and includes a wide variety of foods
with enough calories and nutrients for good health.
How much you eat and what you eat play a major role in how much
you weigh. So, when planning your diet, you should consider: What
calorie level is appropriate? Is the diet you are considering
nutritionally balanced? Will the diet be practical and easy to follow?
Will you be able to maintain this eating plan for the rest of your
life? The following information will help you answer these questions.
Low-calorie Diets. Most weight-loss diets provide 1,000 to 1,500
calories per day. However, the number of calories that is right for you
depends on your weight and activity level. At these calorie levels,
diets are referred to as low-calorie diets. Self-help diet books and
clinical and non-clinical weight-loss programs often include
low-calorie diet plans.
The calorie level of your diet should allow for a weight loss
of no more than 1 pound per week (after the first week or two when
weight loss may be more rapid because of initial water loss). If you
can estimate how many calories you eat in a day, you can design a diet
plan that will help you lose no more than 1 pound per week. You may
need to work with a trained health professional, such as a registered
dietitian. Or, you can use a standardized low-calorie diet plan with a
fixed calorie level.
The selected calorie level, however, may not produce the recommended rate of weight loss, and you may need to eat more or less.
Make sure that your diet contains all the essential nutrients
for good health. Using the Food Guide Pyramid and the Nutrition Facts
Label that is found on most processed food products can help you choose
a healthful diet. The Pyramid shows you the kinds and amounts of food
that you need each day for good health. The Nutrition Facts Label will
help you select foods that meet your daily nutritional needs. A
healthful diet should include: Adequate vitamins and minerals. Eating a
wide variety of foods from all the food groups on the Food Guide
Pyramid will help you get the vitamins and minerals you need. If you
eat less than 1,200 calories per day, you may benefit from taking a
daily vitamin and mineral supplement.
Adequate protein. The average woman 25 years of age and older should get 50
grams of protein each day, and the average man 25 years of age and older should
get 63 grams of protein each day. Adequate protein is important because it prevents
muscle tissue from breaking down and repairs all body tissues such as skin and
teeth. To get adequate protein in your diet, make sure you eat 2-3 servings
(see Figure 2) from the Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts Group
on the Food Guide Pyramid every day. These foods are all good sources of protein.
Source: U.S. Department of Agriculture / U.S. Department of
Health and Human Services
Note: A range of servings is given for each food group. The smaller number is
for people who consume about 1,600 calories a day, such as sedentary women.
The larger number is for those who consume about 2,800 calories a day, such
as active men.
Adequate carbohydrates. At least 100 grams of carbohydrates per day are needed
to prevent fatigue and dangerous fluid imbalances. To make sure you get enough
carbohydrates, eat 6-11 servings (see Figure 2) from the Bread, Cereal, Rice,
and Pasta Group on the Food Guide Pyramid every day.
A daily fiber intake of 20 to 30 grams. Adequate fiber helps with proper bowel
function. If you were to eat 1 cup of bran cereal, 1/2 cup of carrots, 1/2 cup
of kidney beans, a medium-sized pear, and a medium-sized apple together in 1
day, you would get about 30 grams of fiber.
No more than 30 percent of calories, on average, from fat per day, with less
than 10 percent of calories from saturated fat (such as fat from meat, butter,
and eggs). Limiting fat to these levels reduces your risk for heart disease
and may help you lose weight. In addition, you should limit the amount of cholesterol
in your diet. Cholesterol is a fat-like substance found in animal products such
as meat and eggs. Your diet should include no more than 300 milligrams of cholesterol
per day (one egg contains about 215 milligrams of cholesterol, and 3.5 ounces
of cooked hamburger contain 100 milligrams of cholesterol).
At least 8 to 10 glasses, 8 ounces each, of water or water-based beverages,
per day. You need more water if you exercise a lot.
These nutrients should come from a variety of low-calorie, nutrient-rich foods.
One way to get variety -- and with it, an enjoyable and nutritious diet -- is
to choose foods each day from the Food Guide Pyramid (see Figure 1).
Types of Diets
Fixed-menu diet. A fixed-menu diet provides a list of all the
foods you will eat. This kind of diet can be easy to follow because the
foods are selected for you. But, you get very few different food
choices which may make the diet boring and hard to follow away from
home. In addition, fixed-menu diets do not teach the food selection
skills necessary for keeping weight off. If you start with a fixed-menu
diet, you should switch eventually to a plan that helps you learn to
make meal choices on your own, such as an exchange-type diet.
Exchange-type diet. An exchange-type diet is a meal plan with a
set number of servings from each of several food groups. Within each
group, foods are about equal in calories and can be interchanged as you
wish. For example, the "starch" category could include one slice of
bread or 1/2 cup of oatmeal; each is about equal in nutritional value
and calories. If your meal plan calls for two starch choices at
breakfast, you could choose to eat two slices of bread, or one slice of
bread and 1/2 cup of oatmeal. With the exchange-type diet plans, you
have more day-to-day variety and you can easily follow the diet away
from home. The most important advantage is that exchange-type diet
plans teach the food selection skills you need to keep your weight off.
Prepackaged-meal diet. These diets require you to buy
prepackaged meals. Such meals may help you learn appropriate portion
sizes. However, they can be costly. Before beginning this type of
program, find out whether you will need to buy the meals and how much
the meals cost. You should also find out whether the program will teach
you how to select and prepare food, skills that are needed to sustain
Formula diet. Formula diets are weight-loss plans that replace
one or more meals with a liquid formula. Most formula diets are
balanced diets containing a mix of protein, carbohydrate, and usually a
small amount of fat. Formula diets are usually sold as liquid or a
powder to be mixed with liquid. Although formula diets are easy to use
and do promote short-term weight loss, most people regain the weight as
soon as they stop using the formula. In addition, formula diets do not
teach you how to make healthy food choices, a necessary skill for
keeping your weight off.
Questionable diets. You should avoid any diet that suggests you
eat a certain nutrient, food, or combination of foods to promote easy
weight loss. Some of these diets may work in the short term because
they are low in calories. However, they are often not well balanced and
may cause nutrient deficiencies. In addition, they do not teach eating
habits that are important for long-term weight management.
Flexible diets. Some programs or books suggest monitoring fat
only, calories only, or a combination of the two, with the individual
making the choice of both the type and amount of food eaten. This
flexible type of approach works well for many people, and teaches them
how to control what they eat. One drawback of flexible diets is that
some don't consider the total diet. For example, programs that monitor
fat only often allow people to take in unlimited amounts of excess
calories from sugars, and therefore don't lead to weight loss.
It is important to choose an eating plan that you can live
with. The plan should also teach you how to select and prepare healthy
foods, as well as how to maintain your new weight. Remember that many
people tend to regain lost weight. Eating a healthful and nutritious
diet to maintain your new weight, combined with regular physical
activity, helps to prevent weight regain.
Regular physical activity is important to help you lose weight
and build an overall healthy lifestyle. Physical activity increases the
number of calories your body uses and promotes the loss of body fat
instead of muscle and other nonfat tissue. Research shows that people
who include physical activity in their weight-loss programs are more
likely to keep their weight off than people who only change their diet.
In addition to promoting weight control, physical activity improves
your strength and flexibility, lowers your risk of heart disease, helps
control blood pressure and diabetes, can promote a sense of well-being,
and can decrease stress.
Any type of physical activity you choose to do -- vigorous
activities such as running or aerobic dancing or moderate-intensity
activities such as walking or household work -- will increase the
number of calories your body uses. The key to successful weight control
and improved overall health is making physical activity a part of your
For the greatest overall health benefits, experts recommend
that you do 20 to 30 minutes of vigorous physical activity (see the
following Activities Chart) three or more times a week and some type of
muscle strengthening activity, such as weight resistance, and
stretching at least twice a week. However, if you are unable to do this
level of activity, you can improve your health by performing 30 minutes
or more of moderate-intensity physical activity (see the Activities
Chart) over the course of a day, at least five times a week. When
including physical activity in your weight-loss program, you should
choose a variety of activities that can be done regularly and are
enjoyable for you. Also, if you have not been physically active, you
should see your doctor before you start, especially if you are older
than 40 years of age, very overweight, or have medical problems. A fact
sheet on physical activity and weight control is available from WIN.
Behavior change focuses on learning eating and physical activity
behaviors that will help you lose weight and keep it off. The first
step is to look at your eating and physical activity habits, thus
uncovering behaviors (such as television watching) that lead you to
overeat or be inactive. Next you'll need to learn how to change those
Getting support from others is a good way to help you maintain
your new eating and physical activity habits. Changing your eating and
physical activity behaviors increases your chances of losing weight and
keeping it off. For additional information on behavior change, you may
wish to ask a weight-loss counselor or refer to books on this topic,
which are available in local libraries.
What Works for You?
A variety of options exist to help you lose weight and keep it
off. The key to successful weight loss is making changes in your eating
and physical activity habits that you will be able to maintain for the
rest of your life.
- Binge Eating Disorder. NIH Publication No. 94-3589. This fact sheet describes
the symptoms, causes, complications, and treatment of binge eating disorder,
along with a profile of those at risk for the disorder. 1993. Available
- Dieting and Gallstones. NIH Publication No. 94-3677. This fact sheet describes
what gallstones are, how weight loss may cause them, and how to lessen the
risk of developing them. 1993. Available from WIN.
- Gastric Surgery for Severe Obesity. NIH Publication No. 96-4006. This fact
sheet describes the different types of surgery available to treat severe obesity.
It explains how gastric surgery promotes weight loss and the benefits and
risks of each procedure. 1996. Available from WIN.
- Physical Activity and Weight Control. NIH Publication No. 96-4031. This
booklet explains how physical activity helps promote weight control and other
ways it benefits one's health. It also describes the different types of physical
activity and provides tips on how to become more physically active. Revised
1997. Available from WIN.
- Prescription Medications for the Treatment of Obesity. NIH Publication
No. 97-4191. This fact sheet presents information on appetite suppressant
medications. These medications may help some obese patients lose more weight
than with non-drug treatments. The types of medications and the risks and
benefits associated with the use of these medications are described. Revised
1997. Available from WIN.
- Very Low-Calorie Diets. NIH Publication No. 95-3894. Information on who
should use a very low-calorie diet (VLCD) and the health benefits and possible
adverse effects of VLCDs is provided in this fact sheet. 1995. Available from
- Weight Cycling. NIH Publication No. 95-3901. Based on research, this fact
sheet describes the health effects of weight cycling, also known as "yo-yo"
dieting, and how it affects obese individuals' future weight-loss efforts.
1995. Available from WIN.
- "Are You Eating Right?" Consumer Reports. October 1992, pp. 644-55. This
article summarizes advice from 68 nutrition experts, including a discussion
on weight control and health risks of obesity. Available from WIN.
- "Losing Weight: What Works. What Doesn't" and "Rating the Diets." Consumer
Reports. June 1993, pp. 347-57. These articles report on a survey of readers'
experiences with weight-loss diets, discuss research related to weight control,
and outline pros and cons of different diet programs. Available in public
- "The Facts About Weight-Loss Products and Programs." DHHS Publication No.
(FDA) 92-1189. This pamphlet provides basic facts about the weight-loss industry
and what the consumer should expect from a diet program and/or product. Available
from the Food and Drug Administration, Office of Consumer Affairs, HFE-88,
Rockville, MD 20857.
- "Nutrition and Your Health: Dietary Guidelines for Americans, Fourth Edition."
Home and Garden Bulletin No. 232. 1995. This booklet answers some of the basic
questions about healthy eating and the link between poor nutrition and disease.
It stresses the importance of a balanced diet and a healthy lifestyle. Available
- A Report of the Surgeon General: Physical Activity and Health. 1996. Produced
by the Centers for Disease Control and Prevention, this report compiles decades
of research concerning physical activity and health. It addresses the nationwide
health problems associated with physical inactivity and outlines the benefits
of becoming more physically active. Available for $19.00 from the U.S. Government
Printing Office, Superintendent of Documents, Washington, DC 20402; (202)
512-1800. Stock Number 017-023-00196-5.
Weight-control Information Network 1 WIN Way Bethesda, MD 20892-3665 (202)
828-1028 FAX: (202) 828-1028 Email: WIN@info.niddk.nih.gov Internet: http://www.niddk.nih.gov/health/nutrit/win.htm
Toll-free number: (877) 946-4627
The Weight-control Information Network (WIN) is a service of the
National Institute of Diabetes and Digestive and Kidney Diseases, part
of the National Institutes of Health, under the U.S. Public Health
Service. Authorized by Congress (Public Law 103-43), WIN assembles and
disseminates to health professionals and the general public information
on weight control, obesity, and nutritional disorders. WIN responds to
requests for information; develops, reviews, and distributes
publications; and develops communication strategies to encourage
individuals to achieve and maintain a healthy weight.
Publications produced by WIN are reviewed for scientific
accuracy, content, and readability. Materials produced by other sources
are also reviewed for scientific accuracy and are distributed, along
with WIN publications, to answer requests.
NIH Publication No. 98-3700 - January 1998: e-text posted 9 April 1998: updated May 2000