From the Guidelines
The best way to lose weight is to create a calorie deficit of 500-750 kcal/day through a combination of reduced calorie intake and increased physical activity, as this approach has been shown to be beneficial for weight loss and can be maintained long-term. This can be achieved by consuming a diet that is individualized to the person's preferences and nutritional needs, with a focus on nutrient-dense whole foods like vegetables, fruits, lean proteins, and whole grains, while limiting processed foods, added sugars, and refined carbohydrates 1.
Key Recommendations
- Aim to consume 500-1000 fewer calories than you burn daily, which typically results in 1-2 pounds of weight loss per week—a sustainable rate that helps maintain muscle mass
- Incorporate both cardio (150+ minutes of moderate activity weekly) and strength training (at least twice weekly) to burn calories and preserve muscle
- Stay hydrated by drinking water before meals, which can reduce hunger, and get 7-9 hours of quality sleep nightly to regulate hunger hormones
- Track your food intake and physical activity using a journal or app to maintain accountability
Importance of Individualized Approach
The choice of calorie-restricted diet can be individualized to the patient's preferences and health status, and referral to a nutrition professional is recommended if a specialized diet for CVD risk reduction, diabetes, or other medical conditions is also prescribed 1. Additionally, consideration should be given to systemic, structural, and socioeconomic factors that may impact nutrition patterns and food choices, such as food insecurity and hunger, access to healthful food options, cultural circumstances, and other social determinants of health 1.
Long-term Weight Maintenance
For those who achieve weight loss goals, long-term weight maintenance programs are recommended, which provide monthly contact and support, recommend ongoing monitoring of body weight and other self-monitoring strategies, and encourage regular physical activity 1. This approach can help maintain weight loss over time and reduce the risk of weight regain.
From the FDA Drug Label
Use for weight loss in overweight adults, 18 years and older, when used along with a reduced-calorie and low-fat diet Purpose Weight loss aid
The best way to lose weight is to use orlistat along with a reduced-calorie and low-fat diet 2. This approach is supported by the drug label as an effective method for weight loss in overweight adults, 18 years and older. Key elements of this approach include:
- Reduced-calorie diet
- Low-fat diet
- Orlistat as a weight loss aid 2
From the Research
Effective Weight Loss Strategies
- A moderately reduced-calorie diet, increased physical activity, and behavior strategies are the most effective weight loss interventions 3
- Adults should engage in at least 150 to 300 min/week of moderate-intensity or 75 to 150 min/week of vigorous-intensity aerobic physical activity for substantial health benefits 3
- Effective behavior strategies include motivational interviewing, cognitive behavior therapy, removal of environmental trigger foods, self-distraction, and planning ahead 3
Dietary Strategies for Weight Loss
- An energy deficit is the most important factor in weight loss, and a low-calorie diet with a low fat or carbohydrate content may be recommended 4
- Some macronutrient composition-based diets, such as the ketogenic diet or high-protein diet, could be considered in some cases, although potential risks and long-term effectiveness remain unknown 4
- Meal timing is also an important factor in weight management, and higher-calorie breakfasts in combination with overnight fasting may help to prevent obesity 4
Bariatric Surgery and Weight Loss
- Bariatric surgery, such as sleeve gastrectomy, can lead to substantial weight loss and improvements in comorbidities, but outcomes vary across procedures and populations 5, 6
- Roux-en-Y gastric bypass may have greater weight loss and better long-term glycemic control compared to sleeve gastrectomy 6
- Anti-obesity medications may be underutilized following bariatric surgery, and their use should be considered earlier and more frequently in patients with insufficient weight loss or weight regain 7