Recommendations for Achieving a Healthy Weight

Key Recommendations

  • Lose weight to lower elevated blood pressure in overweight and obese persons with high blood pressure.
  • Lose weight 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.
  • Lose weight 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 a regimen.
  • The BMI should be used 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 should be to reduce body weight by about 10 percent from baseline. With success, 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 for weight loss in overweight and obese persons - reducing fat as part of a healthy diet is a practical way to reduce calories.
  • Reducing dietary fat alone without reducing calories is not good enough 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 a part of any program aimed at achieving a weight loss of 1 to 2 pounds per week.
  • Physical activity should be part of 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 a 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, regardless of weight, should set a long-term goal to exercise at least 30 minutes or more 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 overall fitness.
  • Behavior therapy is when incorporated into treatment for weight loss and weight maintenance.
  • Weight loss and weight maintenance therapy should employ the combination of 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.

(Source: "Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: Evidence Report," NHLBI Expert Panel. National Heart, Lung, and Blood Institute, 1998.)