From the Guidelines
To lose those extra 20 pounds, focus on creating a sustainable calorie deficit through both diet and exercise, aiming for a weight loss of 1-2 pounds per week, as recommended by the 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults 1.
Key Recommendations
- Reduce daily caloric intake by 300-500 calories by limiting processed foods, sugary drinks, and alcohol while increasing protein intake (aim for 0.8-1g per pound of target body weight) and fiber-rich vegetables.
- Incorporate both cardio and strength training into your routine, trying 150 minutes of moderate cardio weekly (like brisk walking, cycling, or swimming) plus 2-3 strength training sessions targeting major muscle groups.
- At 46, maintaining muscle mass becomes increasingly important as it helps boost metabolism.
- Track your food intake using an app for the first few weeks to understand your consumption patterns.
- Stay hydrated by drinking at least 8 glasses of water daily, which can help control hunger.
- Aim for 7-8 hours of quality sleep nightly, as poor sleep disrupts hunger hormones.
Importance of Lifestyle Changes
- Lifestyle changes, including education, reduced energy and fat intake, regular physical activity, and regular participant contact, can produce long-term weight loss on the order of 5–7% of starting weight, as stated in the nutrition recommendations and interventions for diabetes--2006 by the American Diabetes Association 1.
- Physical activity and behavior modification are important components of weight loss programs and are most helpful in maintenance of weight loss.
Considerations
- Weight loss medications may be considered in the treatment of overweight, but should be used under the guidance of a healthcare professional.
- Bariatric surgery may be an option for adults with a BMI ≥ 40 kg/m² or BMI ≥ 35 kg/m² with obesity-related comorbid conditions who are motivated to lose weight and have not responded to behavioral treatment with or without pharmacotherapy, as recommended by the 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults 1.
From the FDA Drug Label
Directions read the enclosed brochure for other important information diet and exercise are the starting points for any weight loss program. Try these first before adding orlistat. for overweight adults 18 years and older: take 1 capsule with each meal containing fat do not take more than 3 capsules daily use with a reduced-calorie, low-fat diet and exercise program until you reach your weight loss goal Use for weight loss in overweight adults, 18 years and older, when used along with a reduced-calorie and low-fat diet
For a 46-year-old male with an extra 20 lbs, the advice is to start with diet and exercise as the primary approach to weight loss. If this is not sufficient, orlistat can be considered as an addition to a reduced-calorie, low-fat diet and exercise program. It is essential to check with your doctor before starting any exercise program and to use orlistat as directed, taking 1 capsule with each meal containing fat, up to a maximum of 3 capsules daily 2. Additionally, it is recommended to take a multivitamin once a day, at bedtime, when using orlistat 2.
- Key points:
- Start with diet and exercise
- Consider orlistat as an addition to a reduced-calorie, low-fat diet and exercise program
- Check with your doctor before starting any exercise program
- Use orlistat as directed, with a maximum of 3 capsules daily
- Take a multivitamin once a day, at bedtime, when using orlistat 2 2
From the Research
Weight Loss Options
- For a 46-year-old male with an extra 20 lbs, lifestyle modification is recommended as the cornerstone of obesity management 3.
- However, many patients do not achieve long-lasting benefits due to difficulty with adherence as well as physiological and neurohormonal adaptation of the body in response to weight loss 3.
- Fortunately, several drug therapies, including orlistat, lorcaserin, liraglutide, phentermine/topiramate, and naltrexone/bupropion, are available for long-term weight management 3, 4.
Effectiveness of Liraglutide
- Liraglutide has been shown to be effective in weight loss, with a greater effectiveness compared to orlistat in a real-world setting 5.
- Liraglutide also improves several obesity-associated metabolic and cardiovascular risk factors, including fasting plasma glucose, systolic blood pressure, low-density lipoprotein-cholesterol, and alanine transaminase 5.
- Additionally, liraglutide reduces systolic blood pressure in patients with type 2 diabetes mellitus, with a weighted mean difference of -5.39 mmHg 6.
Benefits of Liraglutide
- Liraglutide has beneficial effects on cardiovascular protection and may improve prognosis in patients with type 2 diabetes mellitus 6.
- It also has positive effects on blood pressure and lipid profile, and is approved as an anti-obesity drug at a higher dose (3.0 mg/day) 7.
- Liraglutide improves glycemic control by enhancing insulin secretion from the beta-pancreatic cells and inhibiting glucagon release, and also slows gastric emptying, increases postprandial satiety, and reduces appetite and food consumption 7.