If you are an obese person and you want to lose weight, I recommend that you should see your GP if you live in the UK or your family Doctor if you live in North America.
They should recommend the following:
•what type of diet you should be following
•how much exercise you will need to do
•whether you need further testing or treatments for obesity-related conditions
•whether you need treatment for an underlying cause of obesity, such as polycystic ovary syndrome
Your GP or family Doctor may refer you to other services, such as local weight loss groups. These could be provided by the NHS if you live in England or may be commercial services you pay for if you live in North America.
If it’s appropriate, your GP or family doctor may recommend exercise on prescription, where you are referred to a local active health team for a number of sessions under the supervision of a qualified trainer. Depending on where you live, the exercise programme may be free or at a reduced cost.
While there is no single rule, most obese people are told they have to reduce the energy intake from their diet by 600 calories a day.
The best way to achieve this is to swap unhealthy and high energy food choices such as fast food, processed food and sugary drinks (including alcohol) for healthier choices.
A healthy diet should consist of :
•plenty of fruit and vegetables
•plenty of potatoes, bread, rice, pasta and other starchy foods (ideally you should choose wholegrain varieties)
•some milk and dairy foods
•some meat, fish, eggs, beans and other non-dairy sources of protein
•just small amounts of food and drinks that are high in fat and sugar
Also avoid food that contains high levels of salt as this can raise your blood pressure, which can be dangerous in already obese people.
You will also need to check calorie information for each type of food and drink you consume to make sure you do not go over your daily limit.
Some restaurants, cafés and fast food outlets provide calorie information per portion, but providing this information is not compulsory. Be careful – some foods can quickly take you over the limit, such as burgers, fried chicken and some curries or Chinese dishes.
Avoid fad diets
You should avoid fad diets that recommend unsafe practices such as fasting (going without food for long periods of time) or cutting out entire food groups such as meat, fish, wheat or dairy products.
These are not sustainable, can make you feel ill, and may cause unpleasant side effects such as bad breath, diarrhoea and headaches.
This is not to say that all commercial diet programmes are unsafe. Many are based on sound medical and scientific principles and can work well in some people. A responsible diet programme should:
•educate you about issues such as portion size, making changes to behaviour and healthy eating
•not be overly restrictive in terms of the type of food you can eat
•be based on achieving gradual sustainable weight loss rather than short-term rapid weight loss, which is unlikely to last
Very low calorie diet
A very low calorie diet (VLCD) is where you consume less than 1,000 calories a day. An example of a VLCD would be:
•a bowl of cornflakes for breakfast
•a single jaffa cake as a mid-morning snack
•a chicken salad sandwich for lunch
•a low calorie lasagne for an evening meal
•a pear for an after-dinner treat
This plan also assumes that you will be drinking water or diet drinks throughout the day, as most other popular drinks such as tea and coffee contain calories.
Remember, excessive amounts of fizzy diet drinks can damage your teeth – they may not contain sugar, but they do contain high levels of certain acids which are very erosive to your teeth.
While a VLCD can be an effective method of losing weight for some obese people, it is not a suitable or safe method for everyone. It would usually only be recommended if rapid weight loss was required to reduce the risk of an obesity-related complication, such as heart disease, or if you have failed to lose weight despite conventional treatment.
You should only ever undertake a VLCD under the supervision of a suitably qualified healthcare professional.
For more information on diet and weight loss, see:
•start losing weight
•healthy food swaps
•eight tips for healthy eating
Reducing the amount of calories in your diet will stop you putting on more weight. But if you want to lose weight, you have to combine a calorie-controlled diet with regular exercise.
Your GP, family doctor or weight loss adviser will be able to provide an exercise plan suited to your circumstances, which will probably recommend so many hours of moderate-intensity physical activity a week.
Moderate-intensity physical activity is any activity that increases your heart and breathing rate and may make you sweat, but you are still able to hold a normal conversation.
•fast walking or walking up the stairs of a very high building.
•using a step-trainer or similar at the gym
Choose physical activities that you enjoy, as you are more likely to continue doing them.
You should aim to start gradually – possibly 15 to 20 minutes of exercise five times a week – and then build on it.
For more information on exercise, see:
•health and fitness
•get active your way
•get running with Couch to 5K
•the 10,000 step challenge
More than 120 different types of anti-obesity medication have been tested in clinical trials, but only one has proved to be both safe and effective. This medication is called orlistat.
Orlistat works by blocking the action of a protein used to digest fat. The undigested fat is not absorbed into your body and is passed out with your faeces (stools).
Orlistat will stop around one-third of the fat from the food you eat from being digested.
This will help you avoid gaining weight, but it will not necessarily cause you to lose weight. It is therefore still important to stick to your recommended diet and exercise plan.
One orlistat capsule is taken with each main meal (a maximum of three capsules a day). You can take the capsule either before, during, or up to one hour after each meal.
If you miss a meal or the meal does not contain any fat, you may not need to take the orlistat capsule. Your GP should explain this to you, or you can check the patient information leaflet that comes with your medication.
You must have made a significant effort to lose weight through diet, exercise or changing your lifestyle before taking orlistat. Even then, orlistat is only prescribed if you are on a low calorie diet and you have:
•a body mass index (BMI) of 28 or more and other conditions related to weight, such as high blood pressure (hypertension)
•a BMI of 30 or more
Treatment with orlistat must be combined with a low-fat diet and other weight loss strategies, such as doing more exercise. If you are prescribed orlistat, you will also be offered advice and support about diet, exercise and making lifestyle changes.
Treatment with orlistat should only continue beyond three months if you have lost 5% of your body weight. Orlistat usually starts to affect how you digest fat within one to two days. If orlistat has not worked after three months, it is unlikely to be an effective treatment for you.
If you have type 2 diabetes (a condition caused by too much glucose in the blood), it may take you longer to lose weight using orlistat. Your target weight loss after three months may therefore be slightly lower.
If orlistat is successful after three months, your prescription may be continued for up to a year. After that, your GP or family doctor will review your condition and decide whether you should continue with orlistat or not.
Side effects of orlistat include:
•fatty or oily stools
•needing the toilet urgently
•passing stools more frequently
•oily discharge from your rectum (you may have oily spots on your underwear)
•upper respiratory tract infections, such as a cold or sore throat
Side effects are much less likely if you stick to a low fat diet.
Women taking the oral contraceptive pill are advised to use an additional method of contraception, such as a condom, if they experience severe diarrhoea while taking orlistat.
This is because the contraceptive pill may not be absorbed by your body if you have diarrhoea, and so may not be effective.
Orlistat is not suitable for pregnant or breastfeeding women.
If you are morbidly obese then you may need surgery to assist you losing weight like gastric bypass surgery.
If you have any questions please let me know.