What is the best way to reduce body weight in a healthy way?

Healthy Weight Loss Strategy

The most effective approach to healthy weight loss is creating a caloric deficit of 500-750 kcal/day through reduced caloric intake combined with 150-300 minutes weekly of moderate-intensity physical activity, targeting a gradual loss of 1-2 pounds per week for the first 6 months. 1, 2

Core Principle: Energy Balance

The fundamental mechanism is straightforward: weight loss requires energy expenditure to exceed energy intake. 1, 2 All effective dietary approaches work by creating this energy deficit, regardless of their specific macronutrient composition. 3

Specific Caloric Targets

• Women: Aim for 1200-1500 kcal/day (500 kcal deficit) 3
• Men: Aim for 1500-1800 kcal/day (750 kcal deficit) 3
• Weight prevention: Reduce by only 50-100 kcal/day 1, 2
• Active weight loss: Reduce by 500+ kcal/day 1

A 5-10% reduction in body weight produces clinically meaningful health benefits, including improved blood pressure (3/2 mmHg reduction), hemoglobin A1c decrease (0.6-1.0%), and improved lipid profiles. 2

Dietary Composition Strategy

Focus on food quality over macronutrient ratios. 4 The American Heart Association emphasizes that diet quality drives diet quantity. 4

Foods to Emphasize:

• Vegetables, fruits, legumes, and whole grains 1
• Lean meats and low-fat dairy products 1
• Plant-based foods to displace calorie-dense options 1

Foods to Limit:

• Fried foods, cookies, cakes, candy, ice cream 1, 2
• Sugar-sweetened beverages 1, 4
• Processed meats and ultra-processed foods 4
• Foods high in saturated fat (<7% of total energy), trans fat (<1%), cholesterol (<300 mg/day), and sodium (≤1,500 mg/day) 4

Validated Dietary Approaches:

All of the following produce equivalent weight loss when caloric deficit is maintained: Mediterranean diet, low-carbohydrate diet, low-fat diet, high-protein diet, vegetarian diet, and low-glycemic-load diet. 3 Choose based on personal preference and adherence potential, not superiority claims.

Physical Activity Requirements

Current guidelines of 30 minutes daily are insufficient for weight loss. 4 The evidence demands more:

• Initial target: 30-40 minutes of moderate-intensity activity, 3-5 days/week 3
• Weight loss phase: 150-300 minutes/week of moderate-intensity aerobic activity 2
• Weight maintenance: 60-90 minutes daily (200-300 minutes/week minimum) 4, 2
• Resistance training: 2-3 times weekly to preserve lean muscle mass 4, 2

Moderate-intensity activities include brisk walking, dancing, leisurely bicycling, and recreational sports. 1 Exercise alone produces only 2-3 kg weight loss on average, but is critical for maintaining weight loss long-term. 2

Behavioral Modification Components

Structured behavior modification with daily self-monitoring is essential. 4

• Track food intake, physical activity, and weight daily 1, 4
• Weigh yourself weekly 4
• Use portion control with measured servings or meal replacements 4
• High-protein meal replacements (shakes/bars for 1-2 meals daily) improve weight loss by 1.44 kg compared to diet alone 2
• Reduce screen time and sedentary behaviors 4
• Decrease portion sizes systematically 1
• Limit between-meal snacks 1

Program Structure and Timeline

Intensive intervention is required for success. 2

• Frequency: At least 14 sessions over 6 months (ideally biweekly to monthly contact) 4, 2
• Maximal weight loss: Occurs between 6-12 months 2
• Maintenance phase: Continue for up to 24 months 2
• Expected outcomes: 8 kg loss at 6 months, maintained at 12 months with continued contact 4
• Long-term reality: Expect gradual regain of 1-2 kg/year without ongoing intervention 4

Critical Warnings

Avoid very-low-calorie diets (<800 kcal/day) outside medical supervision as they produce rapid weight loss but typically result in weight regain upon cessation. 3

Very-low-carbohydrate diets (<130 g/day) are not recommended long-term due to unknown effects and elimination of important food sources including fruits, vegetables, whole grains, and legumes. 1, 3

Rapid weight loss programs are inferior to gradual approaches. Programs producing 1-2 pounds per week are at least as efficacious as rapid weight loss diets over the long term and may be more effective in promoting sustainable behavioral changes. 1

Medication Consideration

If BMI ≥30 kg/m² (or ≥27 kg/m² with weight-related complications) and lifestyle modifications fail after 3-6 months, consider anti-obesity medication such as GLP-1 receptor agonists. 4 Review current medications for weight-promoting effects. 4

Timing Strategy

Meal timing matters. An 8-hour eating window with 14+ hours of overnight fasting improves fat loss and cardiometabolic parameters, with an early window (8:00 AM-4:00 PM) providing optimal metabolic benefits. 3

Target BMI Range

Maintain BMI between 18.5-25.0 kg/m² for optimal health. 1, 2 For Asian populations, overweight begins at BMI ≥23.0 kg/m² due to higher body fat percentages at lower BMI values. 1, 2