From the Guidelines
The most effective approach to weight loss is a combination of calorie restriction and regular physical activity, with a goal of reducing daily calorie intake by 500-750 calories and engaging in at least 150 minutes of moderate-intensity exercise per week, as supported by the most recent evidence from 2021 1.
Key Strategies for Weight Loss
- Reducing daily calorie intake by 500-750 calories to create a caloric deficit
- Engaging in at least 150 minutes of moderate-intensity exercise per week
- Incorporating more whole foods and reducing ultra-processed items
- Drinking water before meals to reduce hunger and enhance metabolism
Importance of Sustainable Weight Loss
- The most successful weight loss programs are those that can be maintained long-term
- Gradually introducing changes to establish baseline habits is crucial for sustainable weight loss
- Comprehensive lifestyle interventions, including dietary changes and increased physical activity, have been shown to reduce the incidence of type 2 diabetes by 58% 1
Recent Evidence
- A 2021 study published in Diabetes Care found that significant weight loss can be attained with lifestyle programs that achieve a 500–750 kcal/day energy deficit, and that clinical benefits typically begin upon achieving 3–5% weight loss 1
- The study also found that dietary interventions may differ by macronutrient goals and food choices, as long as they create the necessary energy deficit to promote weight loss
Recommendations
- Prescribe a diet to achieve reduced calorie intake for obese or overweight individuals who would benefit from weight loss, as part of a comprehensive lifestyle intervention 1
- Counsel overweight and obese adults with cardiovascular risk factors that lifestyle changes that produce even modest, sustained weight loss of 3%–5% produce clinically meaningful health benefits 1
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 Directions read the enclosed brochure for other important information diet and exercise are the starting points for any weight loss program. The most recent information provided from the drug labels is that diet and exercise are the starting points for any weight loss program, and orlistat can be used along with a reduced-calorie, low-fat diet for weight loss in overweight adults, 18 years and older 2 2.
- Key points for a weight loss program with orlistat include:
- Using orlistat with a reduced-calorie, low-fat diet
- Starting with diet and exercise before adding orlistat
- Continuing with diet and exercise after stopping orlistat to maintain weight loss
From the Research
Recent Findings on Weight Loss
- Weight loss interventions involving diet and physical activity typically result in 8-10% weight loss within 6-12 months after initiating treatment 3.
- Physical activity is a key component of weight loss interventions, with effects additive to dietary restriction alone, and is important for prevention of weight regain and maintenance of significant weight loss 3.
- An energy deficit is the most important factor in weight loss, and a low-calorie diet with a low fat or carbohydrate content has been recommended, although individualized strategies should be chosen based on patient preferences 4.
Dietary Strategies for Weight Loss
- Evidence-based dietary strategies for weight management include a low-calorie diet with a low fat or carbohydrate content, and some macronutrient composition-based diets such as the ketogenic diet or high-protein diet may be considered in some cases 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.
- Various dietary approaches, including low-fat diets, low-carbohydrate diets, high-protein diets, and Mediterranean diet, have been recommended to treat obesity in adults, but the optimal dietary weight loss strategy remains controversial 5.
Pharmacological Interventions for Weight Loss
- Orlistat and liraglutide are two drugs that have been shown to be effective in patients with overweight or obesity who have failed to lose weight after lifestyle modification, with liraglutide showing greater effectiveness in weight loss compared to orlistat 6.
- Liraglutide has been shown to improve several obesity-associated metabolic and cardiovascular risk factors, including weight loss, fasting plasma glucose, systolic BP, low-density lipoprotein-cholesterol, and alanine transaminase 6.
Lifestyle Modifications for Weight Loss
- Lifestyle modifications, including a moderately reduced-calorie diet, increased physical activity, and behavior strategies, are first-line therapy for patients with overweight or obesity 7.
- The goal of weight loss interventions should be a modest weight loss of 5% to 10% that can be maintained long term, and 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 7.