What are the recommendations for achieving weight loss?

From the Guidelines

For effective weight loss, aim for a calorie deficit of 500-750 calories per day through a combination of dietary changes and increased physical activity, as recommended by the most recent guidelines 1. To achieve this, focus on consuming whole foods including lean proteins, vegetables, fruits, whole grains, and healthy fats while limiting processed foods, added sugars, and refined carbohydrates. Some key points to consider:

• Portion control is essential—use smaller plates and practice mindful eating.
• Aim for 150-300 minutes of moderate-intensity exercise weekly, combining cardio with strength training 2-3 times per week to preserve muscle mass.
• Start with 30-minute sessions and gradually increase duration and intensity.
• Stay hydrated by drinking 8-10 cups of water daily, which helps control hunger and supports metabolism.
• Track your food intake and physical activity using a journal or app to maintain accountability.
• For sustainable results, target a weight loss of 1-2 pounds per week. This approach works because creating a calorie deficit forces your body to use stored fat for energy, while exercise increases calorie expenditure and builds metabolism-boosting muscle. The combination of dietary changes and physical activity leads to more sustainable weight loss than either approach alone, as supported by recent studies 1. Additionally, long-term weight maintenance programs are recommended for those who achieve weight loss goals, providing monthly contact and support, recommending ongoing monitoring of body weight and other self-monitoring strategies, and encouraging regular physical activity 1.

From the FDA Drug Label

Diet and exercise are the starting points for any weight loss program. Try these first before adding orlistat. 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

The recommended approach to weight loss is to:

• Start with diet and exercise before adding orlistat
• Use orlistat with a reduced-calorie, low-fat diet and exercise program
• Consider orlistat for weight loss in overweight adults 18 years and older 2 2

From the Research

Weight Loss Recommendations

• The obesity control guidelines strongly recommend lifestyle interventions along with medical treatment for patients who are overweight 3.
• Pharmacotherapy in combination with behavior-based interventions can result in significant weight loss and improved cardiometabolism 3.
• Anti-obesity medications such as orlistat, phentermine/topiramate, naltrexone/bupropion, and liraglutide have been approved by the FDA for chronic weight management 3.
• However, these medications can be costly and may have adverse effects in some individuals, and therefore, drug therapy should be initiated in obese individuals after weighing its benefits and risks 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 has been recommended 4.
• Some macronutrient composition-based diets, such as the ketogenic diet or high-protein diet, could be considered in some cases, although the 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.
• There is no single best strategy for weight management, and strategies for weight loss and its maintenance should be individualized based on patient preferences 4.

Effectiveness of Anti-Obesity Medications

• Liraglutide 3 mg has been shown to be effective in reducing weight and improving cardiometabolic parameters in real-world settings 5, 6.
• Orlistat has not been shown to be effective in reducing weight in some studies 5, 6.
• Semaglutide 2.4 mg weekly has recently emerged as a promising treatment for obesity, producing an average weight loss of 15% at 1 year 7.
• Tirzepatide and cagrilintide/semaglutide combination are also showing promise for even greater weight loss efficacy 7.