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 therapy.
- 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 lost.
- 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 calories.
- 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 week.
- 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 fitness.
- 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.
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Editor: Susan K. Boyer, RN
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