Introduction to Healthy Weight Loss

Calories are the measure of how much energy is in food. Calories are also how we measure how much energy our bodies use every day. When your body has extra calories, it stores them in the form of fat. When you take in less calories then your body burns, you use up some of those stored calories in the fat. That said, if you take in fewer calories than you burn, you lose weight, and if you take in more calories than you burn, you gain weight. The easiest and best way to tip this balance in your favor is to control how many calories you eat through diet and to increase the amount of calories you burn through exercise. This is the essence of a healthy weight loss program.

Diets for healthy weight loss

There are several diets out there. Some work a little differently than others in different people. Some people have an easier time staying on one diet verses another. Because everyone is different, you should discuss these diets with your doctor before starting. In general, you just need to eat fewer calories than your body burns to lose weight. There are several formulas and online calculators to determine how many calories a person should eat.

Exercise

Exercise is good for virtually everyone and essential to a healthy weight loss plan. However, it is easier said than done. You do not have to become an Olympic athlete. You just need to kick your body’s metabolism into gear. You can start with simple walking and progress from there. People with certain medical conditions may not be able to participate in certain exercises. You should discuss this with your doctor before starting an exercise program.

Medicines

All medicines have the risks of side effects. For some people, these risks are too great to ever use certain drugs. Although it would be nice, there are no drugs that magically take the weight off quickly without any effort. In fact, using medicines only gives about a 10 lb weight loss in 1 year. They act as aids in your healthy weight loss plan and do help some people. They can also be expensive. The safer and cheaper strategy of diet and exercise should be tried first. Drug therapy can be considered if a person’s BMI is more than 30 or more than 27 and the person has certain medical conditions. (For more on BMI, see below.)

Surgery

This does seem to be a quick fix, but there are risks and benefits to any surgery. Liposuction is where the fat under the skin is suctioned out surgically. However, it does not provide all the same health benefits as dieting and exercise. There is also stomach surgery, or “gastric bypass”. This can be considered in a person with a BMI more than 40 or a person with a BMI more than 35 and certain medical conditions. For someone to be considered, he or she needs to have tried other methods of weight loss first. By having the surgery you are basically forced to diet by not being able to fit as much food in your stomach. Theses surgeries do seem to produce some of the health benefits of dieting, but there are also risks involved.

Other Methods

There are other methods that many people use. Some are based more on medical science than others. Things like mesotherapy and hypnosis are medical weight loss methods that have been scientifically investigated. Weight loss supplements and natural weight loss products are often marketed with exaggerated claims, but several products may have some theoretical if not actual benefit. These products are not regulated by the FDA and may even be dangerous for some people or in combination with certain medicines. Make sure you have a healthy weight loss plan and not one based on false promises in order to sell you a product.

How to measure obesity

The Body Mass Index (BMI) is used to measure how overweight an adult person is. You can calculate your BMI by taking your weight in kilograms and dividing it by your height in square meters, or you can use this online calculator asdf that will calculate this for you. Once you have your BMI, you find what class you are in using the table below. In general, the best BMI to have is 22.

Class:	Underweight	Normal	Overweight	Obesity	Severe Obesity
BMI:	Less than 18.5	18.5-24.9	25-29.9	30-30.9	More than 30.9

Note: Obesity is determined differently in children. A child’s BMI is compared to a previously determined set of national percentiles. If a child’s BMI is in the 95th percentile or above, he/she is overweight.

Waist size is also considered when evaluating how overweight some one is. If a man’s waist is more than 40 inches (102 cm) or if a woman’s waist is more than 35 inches (88 cm), then he or she is at an increase risk of disease or death.

A good BMI and appropriate waist size should be your goals for healthy weight loss.

Benefits of Weight Loss

Believe it or not, life insurance companies were the first to suggest that losing weight would decrease a person’s risk of disease or death. While this is certainly true for overweight people, there are other benefits. You would have decreased risk of diabetes, cardiovascular disease, and osteoarthritis.In patients at higher risk, a 5-10% weight loss can reduce the risk factors for diabetes and cardiovascular disease. Even if you try to lose weight but cannot, your risk of dying is actually decreased for having tried. You look and feel better if you go from being overweight to a healthy weight.

Keeping it off

Healthy weight loss takes a commitment to a change in lifestyle. Exercise is absolutely necessary to maintain a healthy weight. All the fat you used to have burned calories by being excess tissue. With it gone, there is less of your fat tissue to burn calories. This also means that the daily calories you eat from now on will have to be less than what you ate before losing weight. All you really have to do is continue the changes you made to lose weight in the first place.

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It is important you discuss any weight loss or exercise plan with your doctor in order for it to be an individualized healthy weight loss program. Only you and your physician can decide what is best for you. Some people have certain conditions that prevent them from doing all exercises, and goal body weights may be different for different people. You need to discuss all these things with your physician before starting any weight loss or exercise program.

This article was written by John Vickery, MD.

References

“Overview of therapy for obesity in adults” UpToDate version 15.3
http://www.nhlbisupport.com/bmi/bmicalc.htm
Ann Intern Med 2005;142:525-531
“Drug therapy of obesity” UpToDate version 15.3