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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.

Do-it-yourself 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).

Non-clinical programs

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.

Clinical programs

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.