What are the most effective methods for achieving weight loss?

From the Guidelines

The most effective way to lose weight is to create a calorie deficit through a combination of dietary changes and increased physical activity, with a focus on achieving a 500-750 kcal/day energy deficit, as recommended by the 2024 standards of care in diabetes. To achieve this, reduce your calorie intake by 500-1000 calories per day to lose 1-2 pounds weekly, focusing on whole foods like vegetables, lean proteins, fruits, and whole grains while limiting processed foods, added sugars, and refined carbohydrates 1. Aim for 150-300 minutes of moderate-intensity exercise weekly, combining cardio (walking, swimming, cycling) with strength training 2-3 times weekly to preserve muscle mass. Prioritize protein intake (0.7-1 gram per pound of body weight daily) to maintain muscle and increase satiety. Ensure adequate sleep (7-9 hours nightly) and manage stress, as both affect hunger hormones.

Some key points to consider when creating a weight loss plan include:

• Intensive behavioral interventions, including 16 sessions during an initial 6 months, can be effective in achieving significant weight loss 1
• Nutrition recommendations should be individualized to the person’s preferences and nutritional needs, with a focus on creating an energy deficit, regardless of macronutrient composition 1
• Consider 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
• For those who achieve weight loss goals, long-term weight maintenance programs are recommended, with monthly contact and support, ongoing monitoring of body weight, and encouragement of regular physical activity 1

It's also important to note that some individuals may benefit from medications like semaglutide (Wegovy, 2.4mg weekly injection) or tirzepatide (Zepbound, up to 15mg weekly injection) under medical supervision, which can produce 15-20% weight loss when combined with lifestyle changes. However, these medications should only be considered for those with significant obesity, and under the guidance of a healthcare professional.

In terms of specific lifestyle changes, consider the following:

• Reduce daily calorie intake by 500-1000 calories to achieve a weight loss of 1-2 pounds per week
• Aim for 150-300 minutes of moderate-intensity exercise per week
• Prioritize protein intake to maintain muscle and increase satiety
• Ensure adequate sleep and manage stress to support weight loss efforts.

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 most effective way to lose weight mentioned in the drug labels is to use orlistat along with a reduced-calorie and low-fat diet 2. This approach is intended for weight loss in overweight adults, 18 years and older 2. Key elements of this weight loss method include:

• Using orlistat as a weight loss aid
• Following a reduced-calorie diet
• Following a low-fat diet

From the Research

Effective Weight Loss Strategies

• A moderately reduced-calorie diet, increased physical activity, and behavior strategies are the most effective ways to lose weight 3
• The goal should be a modest weight loss of 5% to 10% that can be maintained long term 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

Lifestyle Interventions

• High-intensity, comprehensive lifestyle intervention, consisting of a reduced-calorie diet, increased physical activity, and behavior therapy, can lead to approximately 8 kg (approximately 8% of initial weight) weight loss 4
• A 1-year weight loss maintenance program with at least monthly counseling with a trained interventionist can help prevent weight regain 4
• Lifestyle interventions can be delivered in-person, or through community- and commercial-based programs, as well as delivered by telephone, Internet, and smartphone platforms, although in-person interventions usually produce larger weight losses 4

Medications for Weight Loss

• Liraglutide has been shown to be more effective than orlistat in weight loss, with a greater percentage of patients losing at least 5% of their baseline weight 5, 6
• Liraglutide can also improve several obesity-associated metabolic and cardiovascular risk factors, such as fasting plasma glucose, systolic BP, low-density lipoprotein-cholesterol, and alanine transaminase 5
• Lorcaserin has also been associated with weight reduction, although the average weight loss is lower compared to liraglutide 6

Dietary Strategies

• An energy deficit is the most important factor in weight loss, and a low-calorie diet with a low fat or carbohydrate content can be effective 7
• Some macronutrient composition-based diets, such as the ketogenic diet or high-protein diet, may be considered in some cases, although the potential risks and long-term effectiveness remain unknown 7
• Meal timing is also an important factor in weight management, and higher-calorie breakfasts in combination with overnight fasting may help to prevent obesity 7