Why is weight control important?

If you are struggling with your weight, you are not alone. In the United States, more than 70 percent of adults are overweight or have obesity. Having this extra weight raises your risk for many health conditions, such as type 2 diabetes, heart disease, kidney disease, and certain cancers.

Reaching and staying at a healthy weight can be challenging. But a having a healthy lifestyle, including healthy eating patterns and regular physical activity, can help you lose weight. It can also lower your chance of developing weight-related health conditions.

What factors affect weight and health?

You gain weight when you take in more calories (through food and drinks) than you use up from physical activity and daily living. But there are many different factors that can affect weight gain, such as:

• The world around you. Your home, community, and workplace all may affect how you make daily lifestyle choices. For example:
  • It is often easier to find food and beverages high in calories, sugar, and fat. For instance, vending machines, cafeterias, and special events may not offer healthy, lower calorie options.
  • Less healthy foods may be cheaper than healthier foods.
  • Many people are getting less physical activity because they are spending more time using smartphones and other devices.
• Families. Overweight and obesity tend to run in families. Overweight and obesity tend to run in families. This suggests that genes may play a role in weight gain. Families may also share eating and lifestyle habits. For example, some families may often have foods and drinks that are high in calories, sugar, and fat. And some families may tend to be less active and spend more time doing things like sitting and watching TV or using computers.
• Not enough sleep. People who don't get enough sleep may eat more calories and snack more.
• Emotions. Some people eat when they feel bored, sad, or stressed, even if they are not hungry.
• Medicines and health conditions. Taking certain medicines, such as steroids and certain antidepressants, can lead to weight gain. Some chronic health problems can also cause you to gain weight. A few examples are Cushing's syndrome and polycystic ovary syndrome (PCOS).

How can I get to and stay at a healthy weight?

Getting to and staying at a healthy weight involves finding a balance of food and activity. To lose weight, you need to take in fewer calories than you use up. Some ways to do this are:

• Eating more nutrient-rich foods, such as foods with lots of vitamins, minerals, and fiber.
• Eating and drinking less of the foods and beverages that have lots of calories, salt, sugar, and fat.
• Limiting alcohol.
• Finding healthier ways to cook, such as using healthier oils to cook with and baking or grilling instead of frying foods.
• Getting more physical activity. The general recommendation is for adults to get 150 minutes of physical activity each week, including:
  • Aerobic activity, which is also called cardio. It uses your large muscle groups (chest, legs, and back) to speed up your heart rate and breathing.
  • Muscle-strengthening activity, which is also called strength training. It works your muscles by making you push or pull against something.

You may decide to do these lifestyle changes on your own, or you may decide to try a weight-loss diet or program. Before you start, it's important to check with your health care provider first. Your provider can tell you what a healthy weight is for you, help you set goals, and give you tips on how to lose weight.

If making lifestyle changes or doing a weight-loss program are not enough to help you lose weight, your provider may prescribe medicines. The prescription medicines to treat overweight and obesity work in different ways. Some may help you feel less hungry or full sooner. Others may make it harder for your body to absorb fat from the foods you eat.

Another treatment is weight loss surgery. Your provider may recommend the surgery if you have severe obesity or serious obesity-related health problems and you have not been able to lose enough weight.

People who have overweight or obesity*, compared to those with healthy weight, are at increased risk for many serious diseases and health conditions. These include:

• All-causes of death (mortality).
• High blood pressure (hypertension).
• High LDL cholesterol, low HDL cholesterol, or high levels of triglycerides (dyslipidemia).
• Type 2 diabetes.
• Coronary heart disease.
• Stroke.
• Gallbladder disease.
• Osteoarthritis (a breakdown of cartilage and bone within a joint).
• Sleep apnea and breathing problems.
• Many types of cancer.
• Low quality of life.
• Mental illness such as clinical depression, anxiety, and other mental disorders
• Body pain and difficulty with physical functioning

*Overweight is defined as a body mass index (BMI) of 25 or higher. Obesity is defined as a BMI of 30 or higher. See the BMI calculator for people 20 years and older and the BMI calculator for people ages 2 through 19.

BMI is an estimate of body fat and a good measure of your risk for diseases that can occur with overweight and obesity. For adults, a healthy weight is defined as the appropriate body weight in relation to height. This ratio of weight to height is known as the body mass index (BMI). People who are overweight (BMI of 25–29.9) have too much body weight for their height. People who are obese (BMI of 30 or above) almost always have a large amount of body fat in relation to their height. The higher the BMI, the higher the risk for heart disease, high blood pressure, type 2 diabetes, gallstones, osteoarthritis, sleep apnea, and certain cancers (e.g., colon, breast, endometrial, and gallbladder).

Although BMI can be used for most men and women, it does have some limits:

• It may overestimate body fat in athletes and others who have a muscular build.
• It may underestimate body fat in older persons and others who have lost muscle.

BMI for children and teens, 2 to 20 years old, is determined by using a BMI table that compares their weight and height along with growth charts. The growth charts use a child's BMI, age, and gender to produce a BMI percentile. A child or teen who is between the 85th and 95th percentile on the growth chart is considered overweight. A child or teen who is at the 95th percentile or above is considered obese.

Being overweight can put you at greater risk for health problems. Losing even a small amount of weight (5 to 10 percent of your total body weight) can reduce and sometimes reverse the risk.

Losing weight also may help you have more energy, less joint pain, and a better night’s sleep. Setting goals can help you lose weight and keep it off in a healthy way. Try these steps for creating weight loss goals that help you stay focused and motivated.

Think Long-Term

Goals can help you work toward a healthier lifestyle. Aim to develop lifestyle habits that will help you keep your weight in a healthy range now and in the future. Research shows that a short-term diet that you go on and then go off is not the answer to long-term weight loss and management. Healthy weight loss means having a lifestyle that includes long-term changes in eating and exercise habits.

Take It Slow

Studies show that people who lose weight gradually and steadily are more successful at keeping weight off. Health experts recommend 1 to 2 pounds a week over the long run for healthy weight loss. That’s better than trying to lose a lot of weight all at once.

Set Small Goals

Break down a long-term goal into a series of smaller, short-term goals to make your plan more manageable and keep you accountable over the long haul. For example, if your goal is to lose 10 pounds in three months, you might have separate goals for each month. Perhaps aim for 4 pounds in the first month and 3 pounds in each of the next two months because early weight loss often is faster.

See the Big Picture

Eating healthier and being more physically active is good for your health, even if you don’t lose weight. Try setting goals beyond weight loss, focusing on how your body feels better and what it can do. Think about the other things healthy eating and physical activity might do for you, like learning how to cook healthier, trying new foods, and having more energy.

Track Your Progress

Keep track of progress toward your weight loss goals. Keep track of progress toward your weight loss goals. There are lots of tracking tools available that can be used online or on your smartphone.

Adjust Goals as Needed

Relying on healthful eating and physical activity most days of the week can help you achieve your weight loss goals in a healthy way. Holidays, vacations, and special events can mean setbacks on your weight loss journey. Losing weight involves using up more calories than you take in. One way to do that is to increase your physical activity. Here are some rough estimates of how much exercise it takes to burn off the calories of some favorite treats:

• Snack-sized bag of chips: 1 hour and 30 minutes of strength training
• Medium order of fries: Biking 1 hour and 35 minutes
• Energy bar: Climbing stairs for 25 minutes
• Large vanilla latte with whipped cream: Jogging for 50 minutes
• Large frozen yogurt with no toppings: 1 hour and 5 minutes on an elliptical machine

Healthy weight isn’t about following a diet or program. Instead, it involves a lifestyle with healthy eating patterns, regular physical activity, and stress management.

People with gradual, steady weight loss (about 1 to 2 pounds per week) are more likely to keep the weight off than people who lose weight quickly.

Sleep, age, genetics, diseases, medications, and environments may also contribute to weight management. If you are concerned about your weight or have questions about your medications, talk with your health care provider.

Getting Started

Losing weight takes a well-thought-out plan. Here’s how to get started.

Step 1: Make a commitment

Whether you have a family history of heart disease, want to see your kids get married, or want to feel better in your clothes, write down why you want to lose weight. Writing it down can confirm your commitment. Post these reasons where they serve as a daily reminder of why you want to make this change.

Step 2: Take stock of where you are

Write down everything you eat and drink for a few days in a food and beverage diary. Being more aware of what you eat and drink will help you avoid mindless consumption. Tracking physical activity, sleep, and emotions can also help you understand current habits and stressors. This can also help identify areas where you can start making changes.

Next, examine your lifestyle. Identify things that might pose challenges to your weight loss efforts. For example, does your work or travel schedule make it hard to get enough physical activity? Do you find yourself eating sugary foods because that’s what you buy for your kids? Do your coworkers often bring high-calorie items, such as doughnuts, to the workplace? Think through things you can do to help overcome these challenges.

If you have a chronic condition or a disability, ask your health care provider for resources to support healthy weight. This may include referral to a registered dietitian and other clinical or community programs, federally approved medications or devices, or surgery. Ask for a follow-up appointment to monitor changes in your weight or any related health conditions.

Step 3: Set realistic goals

Set short-term goals and reward your efforts along the way. Maybe your long-term goal is to lose 40 pounds and to control your high blood pressure. Short-term goals might be to drink water instead of sugary beverages, take a 15-minute evening walk, or have a vegetable with supper.

Focus on two or three goals at a time. Effective goals are —

• Specific
• Realistic
• Forgiving (less than perfect)

For example, “exercise more” is not specific. But “I will walk 15 minutes, 3 days a week for the first week,” is specific and realistic.

Setting unrealistic goals, such as losing 20 pounds in 2 weeks, can leave you feeling defeated and frustrated.

Being realistic also means expecting occasional setbacks. When setbacks happen, get back on track as quickly as possible. Also think about how to prevent setbacks in similar future situations.

Keep in mind everyone is different—what works for someone else might not be right for you. Try a variety of activities such as walking, swimming, tennis, or group exercise classes. See what you enjoy most and can fit into your life. These activities will be easier to stick with over the long term.

Step 4: Identify resources for information and support

Find family members or friends who will support your weight loss efforts. Coworkers or neighbors with similar goals might share healthy recipes and plan group physical activities. Joining a weight loss group or visiting a health care professional such as a registered dietitian may also help.

Step 5: Continually monitor your progress

Revisit the goals you set in Step 3 and evaluate your progress regularly. Evaluate which parts of your plan are working well and which ones need tweaking. Then rewrite your goals and plan accordingly.

If you consistently achieve a particular goal, add a new goal to help you continue your pathway to success.

Reward yourself for your successes! Recognize when you’re meeting your goals and be proud of your progress. Use non-food rewards, such as a bouquet of fresh flowers, a sports outing with friends, or a relaxing bath. Rewards help keep you motivated on the path to better health.

Regular physical activity is one of the most important things you can do for your health. If you’re ready to get the immediate benefits of better sleep, reduced anxiety, and lower blood pressure, here are ways to get started:

• Look for ways to reduce time sitting and increase time moving. For example, make it a tradition to walk before or after dinner.
• Set aside specific times to make physical activity part of your daily or weekly routine. 
• Start with activities, locations, and times you enjoy. For example, you might like morning walks in your neighborhood; others might prefer an online class after work.
• Try activities with others in your household for motivation and mutual encouragement.
• Start slowly and work your way up to more time or more challenging activities.
• Use free apps and websites to find fun ways to be physically active or new places to put some variety in your activity routine.
• Federal guidelines recommend at least 150 minutes of moderate-intensity physical activity a week for adults. You might split that into 30 minutes, 5 days a week.

For many people, walking is a great way to become more active.

People with chronic conditions may want to talk to their doctor about the right types and amounts of physical activity. Examples of chronic conditions are heart problems, arthritis, diabetes, or high blood pressure.

Ways to Overcome Obstacles to Physical Activity

As you start thinking about ways to become more active, the obstacles might seem hard to overcome. Try these strategies:

Physical activity is an important part of your weight management program. Most weight loss occurs because of decreased calorie intake. Sustained physical activity is most helpful in the prevention of weight regain. In addition, exercise has a benefit of reducing risks of cardiovascular disease and diabetes, beyond that produced by weight reduction alone. Start exercising slowly, and gradually increase the intensity. Trying too hard at first can lead to injury.

Examples of moderate-intensity amounts of physical activity

Common Chores

• Washing and waxing a car for 45–60 minutes
• Washing windows or floors for 45–60 minutes
• Gardening for 30–45 minutes
• Wheeling self in wheelchair for 30–40 minutes
• Pushing a stroller 1.5 miles in 30 minutes
• Raking leaves for 30 minutes
• Walking 2 miles in 30 minutes (15 min/mile)
• Shoveling snow for 15 minutes
• Stairwalking for 15 minutes

Sporting Activities

• Playing volleyball for 45–60 minutes
• Playing touch football for 45 minutes
• Walking 1.75 miles in 35 minutes (20 min/mile)
• Basketball (shooting baskets) for 30 minutes
• Bicycling 5 miles in 30 minutes
• Dancing fast (social) for 30 minutes
• Water aerobics for 30 minutes
• Swimming laps for 20 minutes
• Basketball (playing game) for 15–20 minutes
• Bicycling 4 miles in 15 minutes
• Jumping rope for 15 minutes
• Running 1.5 miles in 15 minutes (10 min/mile)

Your exercise can be done all at one time, or intermittently throughout the day. Activities to get you started could include walking or swimming at a slow pace. You can start out by walking 30 minutes for 3 days a week and build to 45 minutes of more intense walking, at least 5 days a week. With this plan, you can burn 100 to 200 calories more per day. All adults should set a long-term goal to accumulate at least 30 minutes or more of moderate-intensity physical activity on most, and preferably all, days of the week. This regimen can be adapted to other forms of physical activity, but walking is particularly attractive because of its safety and accessibility. Also, try to increase "everyday" activity such as by taking the stairs instead of the elevator. Reducing sedentary time is a good strategy to increase activity by undertaking frequent, less strenuous activities. With time, you may be able to engage in more strenuous activities. Competitive sports, such as tennis and volleyball, can provide an enjoyable form of exercise for many, but care must be taken to avoid injury.

Activity Progression Samples

Beginners: standing activities, ironing, cooking, playing a musical instrument, etc.

Light: slow walking, garage work, house cleaning, childcare, etc.

Moderate intensity: faster walking, weeding the garden, cycling, tennis, etc.

High intensity: walking fast with a load uphill, basketball, climbing, soccer, etc.

You also may want to try:

• Flexibility exercises to attain full range of joint motion
• Strength or resistance exercises
• Aerobic conditioning

When it comes to eating, many of us have developed habits. Some are good (“I always eat fruit as a dessert”), and some are not so good (“I always have a sugary drink after work as a reward”).  Even if you’ve had the same eating pattern for years, it’s not too late to make improvements.

Making sudden, radical changes, such as eating nothing but cabbage soup, can lead to short term weight loss. However, such radical changes are neither healthy nor a good idea and won’t be successful in the long run. Permanently improving your eating habits requires a thoughtful approach in which you reflect, replace, and reinforce.

• REFLECT on all of your specific eating habits, both bad and good; and, your common triggers for unhealthy eating.
• REPLACE your unhealthy eating habits with healthier ones.
• REINFORCE your new, healthier eating habits.

Reflect:

• Create a list of your eating and drinking habits. Keep a food and beverage diary for a few days. Write down everything you eat and drink, including sugary drinks and alcohol. Write down the time of day you ate or drank the item. This will help you uncover your habits. For example, you might discover that you always seek a sweet snack to get you through the mid-afternoon energy slump. Use this diary [PDF-105KB] to help. It’s good to note how you were feeling when you decided to eat, especially if you were eating when not hungry. Were you tired? Stressed out?
• Highlight the habits on your list that may be leading you to overeat. Common eating habits that can lead to weight gain are:
  • Eating too fast
  • Always cleaning your plate
  • Eating when not hungry
  • Eating while standing up (may lead to eating mindlessly or too quickly)
  • Always eating dessert
  • Skipping meals (or maybe just breakfast)
• Look at the unhealthy eating habits you’ve highlighted. Be sure you’ve identified all the triggers that cause you to engage in those habits. Identify a few you’d like to work on improving first. Don’t forget to pat yourself on the back for the things you’re doing right. Maybe you usually eat fruit for dessert, or you drink low-fat or fat-free milk. These are good habits! Recognizing your successes will help encourage you to make more changes.
• Create a list of “cues” by reviewing your food diary to become more aware of when and where you’re “triggered” to eat for reasons other than hunger. Note how you are typically feeling at those times. Often an environmental “cue”, or a particular emotional state, is what encourages eating for non-hunger reasons. Common triggers for eating when not hungry are:
  • Opening up the cabinet and seeing your favorite snack food.
  • Sitting at home watching television.
  • Before or after a stressful meeting or situation at work.
  • Coming home after work and having no idea what’s for dinner.
  • Having someone offer you a dish they made “just for you!”
  • Walking past a candy dish on the counter.
  • Sitting in the break room beside the vending machine.
  • Seeing a plate of doughnuts at the morning staff meeting.
  • Swinging through your favorite drive-through every morning.
  • Feeling bored or tired and thinking food might offer a pick-me-up.
• Circle the “cues” on your list that you face on a daily or weekly basis. While the Thanksgiving holiday may be a trigger to overeat, for now focus on cues you face more often. Eventually you want a plan for as many eating cues as you can.
• Ask yourself these questions for each “cue” you’ve circled:
  • Is there anything I can do to avoid the cue or situation? This option works best for cues that don’t involve others. For example, could you choose a different route to work to avoid stopping at a fast food restaurant on the way? Is there another place in the break room where you can sit so you’re not next to the vending machine?
  • For things I can’t avoid, can I do something differently that would be healthier? Obviously, you can’t avoid all situations that trigger your unhealthy eating habits, like staff meetings at work. In these situations, evaluate your options. Could you suggest or bring healthier snacks or beverages? Could you offer to take notes to distract your attention? Could you sit farther away from the food so it won’t be as easy to grab something? Could you plan ahead and eat a healthy snack before the meeting?

Replace:

• Replace unhealthy habits with new, healthy ones. For example, in reflecting upon your eating habits, you may realize that you eat too fast when you eat alone. So, make a commitment to share a lunch each week with a colleague, or have a neighbor over for dinner one night a week. Another strategy is to put your fork down between bites. Also, minimize distractions, such as watching the news while you eat. Such distractions keep you from paying attention to how quickly and how much you’re eating.
• Eat more slowly. If you eat too quickly, you may “clean your plate” instead of paying attention to whether your hunger is satisfied.
• Eat only when you’re truly hungry instead of when you are tired, anxious, or feeling an emotion besides hunger. If you find yourself eating when you are experiencing an emotion besides hunger, such as boredom or anxiety, try to find a non-eating activity to do instead. You may find a quick walk or phone call with a friend helps you feel better.
• Plan meals ahead of time to ensure that you eat a healthy well-balanced meal.

Reinforce:

• Reinforce your new, healthy habits and be patient with yourself. Habits take time to develop. It doesn’t happen overnight. When you do find yourself engaging in an unhealthy habit, stop as quickly as possible and ask yourself: Why do I do this? When did I start doing this? What changes do I need to make? Be careful not to berate yourself or think that one mistake “blows” a whole day’s worth of healthy habits. You can do it! It just takes one day at a time!

More than two-thirds of adults and one-third of children in the United States are overweight or obese. Obesity or being overweight may increase the risk of many health problems, including type 2 diabetes, heart disease, and certain cancers. If you’re pregnant, excess weight may lead to short- and long-term health problems for you and your child. Achieving a healthy weight, eating a healthy diet, and being physically active can help prevent these weight-related diseases.

Some people, in their efforts to lose weight, turn to unproven dietary supplements (sometimes marketed as “fat burners” or appetite suppressants), which can have harmful side effects. If you’re thinking about starting a new weight-loss program, talk with your health care provider, who can assess your weight and health risks, determine whether you need to lose weight, and provide information that will help you make informed decisions about an effective weight-loss program.

Bottom Line

• Most dietary supplements marketed for rapid weight loss, such as acai and hoodia, don’t work for keeping weight off in the long term, and some are dangerous. For example, ephedra, which was used in weight loss supplements, was banned because of unreasonable risk of injury or illness.
• Researchers have studied the weight loss potential of a variety of dietary supplements, including omega-3s and fish oil; chitosan, a dietary fiber from shellfish; green tea extracts; Chinese herbs; and bitter orange (Citrus aurantium) extract. None have been shown to be effective for weight loss, and each of these has side effects.
• There’s some emerging evidence suggesting that some mind and body approaches, such as yoga and meditation, particularly mindful eating, may be useful as complements to other weight-loss interventions.

Safety

• The U.S. Food and Drug Administration (FDA) banned the sale of dietary supplements containing ephedra, which was marketed for weight loss, because of serious health risks, such as cardiovascular complications and even risk of death. Ephedra is also called ma huang.
• Many ephedra-free supplements are now being sold, but side effects of some of their ingredients are similar to the banned products. Some ephedra-free supplements also have a lot of caffeine or herbs, such as guarana, that contain caffeine. The products can cause increased heart rate and abnormal heart rhythms.
• Many dietary supplements marketed for weight-loss (including ones sold as “fat burners” or appetite suppressants) have not been tested for safety.
• What’s on the label may not be what’s in the bottle. Analyses of dietary supplements, including herbal supplements, sometimes find differences between labeled and actual ingredients. Also, the FDA has found weight-loss products tainted with prescription drug ingredients.
• Dietary supplements for weight loss are sometimes misused by people with eating disorders, such as anorexia nervosa or bulimia nervosa, to lose weight or induce vomiting.
• If you’re considering a dietary supplement for weight loss, remember that “natural” does not necessarily mean “safe.”
• Mind and body practices, such as meditation and yoga, are generally considered safe for healthy people when practiced appropriately under the guidance of a well-trained instructor. If you have any underlying health conditions, talk to your health care provider about any complementary approach you may be interested in using.

Check It Out: Before You Sign Up for Any Weight-Loss Program

Some people lose weight on their own; others like the support of a structured program. Overweight people who are successful at losing weight, and keeping it off, can reduce their risk factors for heart disease. If you decide to join any kind of weight-control program, here are some questions to ask before you join.

• Does the program provide counseling to help you change your eating activity and personal habits?
  The program should teach you how to change permanently those eating habits and lifestyle factors, such as lack of physical activity, that have contributed to weight gain.
• Is the staff made up of a variety of qualified counselors and health professionals such as nutritionists, registered dietitians, doctors, nurses, psychologists, and exercise physiologists?
  You need to be evaluated by a physician if you have any health problems, are currently taking any medicine or plan on taking any medicine, or plan to lose more than 15 to 20 pounds. If your weight-control plan uses a very low-calorie diet (a special liquid formula that replaces all food for 1 to 4 months), an exam and followup visits by a doctor also are needed.
• Is training available on how to deal with times when you may feel stressed and slip back to old habits?
  The program should provide long-term strategies to deal with weight problems you may have in the future. These strategies might include things like setting up a support system and establishing a physical activity routine.
• Is attention paid to keeping the weight off? How long is this phase?
  Choose a program that teaches skills and techniques to make permanent changes in eating habits and levels of physical activity to prevent weight gain.
• Are food choices flexible and suitable? Are weight goals set by the client and the health professional?
  The program should consider your food likes and dislikes and your lifestyle when your weight-loss goals are planned.

There are other questions you can ask about how well a weight-loss program works. Because many programs don't gather this information, you may not get answers. But it's still important to ask them:

• What percentage of people complete the program?
• What is the average weight loss among people who finish the program?
• What percentage of people have problems or side effects? What are they?
• Are there fees or costs for additional items, such as dietary supplements?

Remember, quick weight loss methods don't provide lasting results. Weight-loss methods that rely on diet aids like drinks, prepackaged foods, or diet pills don't work in the long run. Whether you lose weight on your own or with a group, remember that the most important changes are long term. No matter how much weight you have to lose, modest goals and a slow course will increase your chances of both losing the weight and keeping it off.

FDA-regulated medical devices can help patients lose or manage their weight. The FDA categorizes devices as weight-loss or weight-management devices based on the amount of weight a person is expected to lose.

Overweight and Obesity

Overweight and obesity are defined as excessive fat accumulation that presents a risk to health. Obesity is a major public health concern in the United States and has been linked to many health problems such as heart disease, stroke, diabetes, high blood pressure, sleep disorders, and breathing problems. Obesity is defined by body mass index (BMI) , which is calculated from a person's weight and height. A BMI of 30 kg/m² or more is considered obese. A person is considered overweight with a BMI of 25.0 - 29.9 kg/m². Being overweight may increase the risk for many of the same health problems that are associated with obesity.

Therapies for weight-loss or weight-management range from healthy eating and exercise, to prescription medicine, medical devices and surgery. Healthy eating and exercise are typically recommended to help a person who is overweight lose excess weight.

Weight-Loss Devices

Currently, there are three types of FDA-regulated devices intended for weight-loss:

• Gastric Band - bands are placed around the top portion of the stomach leaving only a small portion available for food.
  • Lap-Band Adjustable Gastric Banding System
• Gastric Balloon Systems - inflatable balloons are placed in the stomach to take up space and delay gastric emptying.
  • ORBERA Intragastric Balloon System
  • Obalon Balloon System
  • TransPyloric Shuttle/TransPyloric Shuttle Delivery Device
  • Spatz3 Adjustable Balloon System
• Endoscopic suturing devices for altering gastric anatomy - suturing devices are advanced down the throat to the stomach and used to place permanent suture ("stitches") that reduce the stomach's volume.
  • Apollo Endoscopic Sleeve Gastroplasty and Revise Systems

Weight-Management Devices

Currently, there are two types of FDA-regulated devices intended to aid in weight management:

• Oral Removable Palatal Space Occupying Device - worn during meals to limit bite size
  • Sensor Monitored Alimentary Restriction Therapy (SMART) Device
• Ingested, Transient, Space Occupying Device - an ingested material that transiently occupies space in the stomach
  •  Plenity

Factors to Consider Before Use of Weight-Loss or Weight-Management Devices

Before prescribing medicine or recommending devices or surgery, most doctors will request their patients demonstrate healthy lifestyles that include better nutrition and increased physical activity. Even after prescription medicine, device or surgical treatments, patients will need to maintain a healthy lifestyle for the rest of their lives. Despite treatments and lifestyle changes, some patients may not be able to lose weight or maintain weight-loss.

For some weight-loss devices, patients should be evaluated and treated for eating disorders before considering device use as part of their obesity treatment. An undiagnosed and untreated eating disorder can have serious health consequences for patients.  Some devices are not for (contraindicated in) patients that have a history of eating disorders. Medical professionals may also find it appropriate to closely monitor patients with certain weight-loss devices during treatment for evidence of an eating disorder.

How to Report a Problem

If you experience an injury or problem when using a weight-loss or weight-management device, we encourage you to file a voluntary report by phone at 1-800-FDA-1088 or online at MedWatch, the FDA Safety Information and Adverse Event Reporting program.

Reports of Problems

In February 2017, August 2017, June 2018, and April 2020, the FDA issued letters to health care providers based on reports of patient problems related to liquid-filled gastric balloon systems, including death. Other problems included a hole in the stomach (gastric perforation); sudden inflammation of the pancreas, which typically causes a sudden and severe stomach ache (acute pancreatitis); and balloons filling with air and enlarging, causing discomfort (spontaneous hyperinflation).

The FDA continues to monitor these problems and recommends health care providers closely monitor patients who have liquid-filled gastric balloons for complications. The FDA also recommends health care providers instruct patients on symptoms that could be signs of serious or even life-threatening problems—and explain to patients what to do if these symptoms happen.

• Weight loss to lower elevated blood pressure in overweight and obese persons with high blood pressure.
• Weight loss to lower elevated levels of total cholesterol, LDL-cholesterol, and triglycerides, and to raise low levels of HDL-cholesterol, in overweight and obese persons with dyslipidemia.
• Weight loss to lower elevated blood glucose levels in overweight and obese persons with type 2 diabetes.
• Use the BMI to assess overweight and obesity. Body weight alone can be used to follow weight loss and to determine the effectiveness of therapy.
• Use the BMI to classify overweight and obesity and to estimate relative risk of disease compared to normal weight.
• The waist circumference should be used to assess abdominal fat content.
• The initial goal of weight-loss therapy should be to reduce body weight by about 10 percent from baseline. With success, and if warranted, further weight loss can be attempted.
• Weight loss should be about 1 to 2 pounds per week for a period of 6 months, with the subsequent strategy based on the amount of weight lost.
• Low-calorie diets (LCD) for weight loss in overweight and obese persons. Reducing fat as part of an LCD is a practical way to reduce calories.
• Reducing dietary fat alone without reducing calories is not sufficient for weight loss. However, reducing dietary fat, along with reducing dietary carbohydrates, can help reduce calories.
• A diet that is individually planned to help create a deficit of 500 to 1,000 kcal/day should be an intregal part of any program aimed at achieving a weight loss of 1 to 2 pounds per week.
• Physical activity should be part of a comprehensive weight loss therapy and weight control program because it (1) modestly contributes to weight loss in overweight and obese adults, (2) may decrease abdominal fat, (3) increases cardiorespiratory fitness, and (4) may help with maintenance of weight loss.
• Physical activity should be an integral part of weight-loss therapy and weight maintenance. Initially, moderate levels of physical activity for 30 to 45 minutes, 3 to 5 days a week, should be encouraged. All adults should set a long-term goal to accumulate at least 30 minutes or more of moderate-intensity physical activity on most, and preferably all, days of the week.
• The combination of a reduced-calorie diet and increased physical activity is recommended, because it produces weight loss that also may result in decreases in abdominal fat and increases in cardiorespiratory fitness.
• Behavior therapy is a useful adjunct when incorporated into treatment for weight loss and weight maintenance.
• Weight-loss and weight-maintenance therapy should employ the combination of LCDs, increased physical activity, and behavior therapy.
• After successful weight loss, the likelihood of weight-loss maintenance is enhanced by a program consisting of dietary therapy, physical activity, and behavior therapy, which should be continued indefinitely. Drug therapy also can be used. However, drug safety and efficacy beyond 1 year of total treatment have not been established.
• A weight maintenance program should be a priority after the initial 6 months of weight-loss therapy.

Talking to a family member or friend about losing weight can be hard. Use these tips to start the conversation.

Start by saying, “I care about you.”

• “You're important to me, and I want you to be around for a long time.”
• “I want you to have more energy and not worry about your health. That’s why I want to help you reach a healthy weight.”
• “I’m here for you. Let’s make healthy changes together.”

Share what has worked for others.

Here are some ideas for losing weight in a healthy way:

• Set manageable goals — start by trying to lose about 1 to 2 pounds each week.
• Start a food diary to keep track of what and how much you eat and drink.
• Eat a healthy breakfast every day.
• Serve yourself smaller portions.
• Drink water instead of sugary drinks like soda or energy drinks.
• Do something active every day — take the stairs, go for a walk at lunch, or enjoy a family bike ride.
• Join a walking club or support group to keep you motivated.

If you have friends, family members, or co-workers who have lost weight by eating healthy and getting active, ask them to share what worked for them.

Do more than talk.

Find ways to get active and eat healthy together. Here are some ideas:

• Go food shopping together. Use the Nutrition Facts label to find foods and drinks that are low in added sugars and saturated fats.
• If you go out to eat, split a meal or save half to take home.
• Go for a walk every day or take an exercise class together.
• Celebrate your loved one’s weight loss — but avoid using food as a reward.

Losing weight can be challenging. Talk to your doctor or nurse about how to lose weight in a way that’s right for you.

What do I ask the doctor?

When you visit the doctor, it helps to have questions ready ahead of time. You can also ask a family member or friend to go with you to take notes.

Consider taking this list of questions to your next appointment.

• How does my weight affect my health?
• Do I have a health problem that’s affecting my weight?
• How can losing weight improve my health?
• What’s a healthy weight for me?
• How much weight should I aim to lose?
• How long will it take me to lose weight?

You may also want to ask about healthy ways to lose weight. For example:

• What are healthy ways to lose weight and avoid gaining it back?
• How can I change my eating habits?
• What kinds of physical activity are best for me to meet my weight goals?
• Are there any kinds of physical activity I need to avoid because of my health conditions?
• Could a weight loss program help me?
• What type of weight loss program would you recommend for me?

You can also add your own questions after learning how to aim for a healthy weight.

If you’ve recently lost excess weight, congratulations! It’s an accomplishment that will likely benefit your health now and in the future. Now that you’ve lost weight, let’s talk about some ways to maintain that success.

The following tips are some of the common characteristics among people who have successfully lost weight and maintained that loss over time.

Watch Your Diet

• Follow a healthy and realistic eating pattern. You have embarked on a healthier lifestyle, now the challenge is maintaining the positive eating habits you’ve developed along the way. In studies of people who have lost weight and kept it off for at least a year, most continued to eat a diet lower in calories as compared to their pre-weight loss diet.

• Keep your eating patterns consistent. Follow a healthy eating pattern regardless of changes in your routine. Plan ahead for weekends, vacations, and special occasions. By making a plan, it is more likely you’ll have healthy foods on hand for when your routine changes.
• Eat breakfast every day. Eating breakfast is a common trait among people who have lost weight and kept it off. Eating a healthful breakfast may help you avoid getting “over-hungry” and then overeating later in the day.

Be Active

• Get daily physical activity. People who have lost weight and kept it off typically engage in 60—90 minutes of moderate intensity physical activity most days of the week while not exceeding calorie needs. This doesn’t necessarily mean 60—90 minutes at one time. It might mean 20—30 minutes of physical activity three times a day. For example, a brisk walk in the morning, at lunch time, and in the evening. Some people may need to talk to their healthcare provider before participating in this level of physical activity.

Stay on Course

• Monitor your diet and activity. Keeping a food and physical activity journal can help you track your progress and spot trends. For example, you might notice that your weight creeps up during periods when you have a lot of business travel or when you have to work overtime. Recognizing this tendency can be a signal to try different behaviors, such as packing your own healthful food for the plane and making time to use your hotel’s exercise facility when you are traveling. Or if working overtime, maybe you can use your breaks for quick walks around the building.
• Monitor your weight. Check your weight regularly. When managing your weight loss, it’s a good idea to keep track of your weight so you can plan accordingly and adjust your diet and exercise plan as necessary. If you have gained a few pounds, get back on track quickly.
• Get support from family, friends, and others. People who have successfully lost weight and kept it off often rely on support from others to help them stay on course and get over any “bumps.” Sometimes having a friend or partner who is also losing weight or maintaining a weight loss can help you stay motivated.

A healthy weight can be a different number for different people. Your age, height, body frame, gender, and other factors are considered in deciding what your ideal weight is.

If you are overweight or obese (body weight at least 20% higher than it should be), you might be at risk for serious health problems. There are steps you can take to lose weight and get to a healthy weight for you.

Set Reachable Goals

Aiming to lose a lot of weight can be overwhelming. Try setting smaller, more manageable weight loss goals. Instead of trying to lose 15 pounds, set a goal of losing 5 pounds. When you reach that goal, go for another 5 pounds, and so on, until you are at your target weight.

Small Successes Matter

Losing just 5–10% of your weight through more physical activity and healthier eating can lead to important health benefits. If you now weigh 250 pounds, losing 5–10% of your weight would mean losing about 13–25 pounds. Losing this percentage of your weight can lower your risk for diabetes, heart disease, stroke, and some types of cancer. You also are likely to have more energy, feel less out of breath, and have fewer aches and pains.

Take It Slow

Extreme diets and over-the-top workouts usually don’t lead to lasting weight loss. They are too difficult to keep up long term. People who lose weight and keep it off usually have a slow and steady weight loss from following a healthier lifestyle. Slowly change your eating habits and increase physical activity. Don’t expect to drop extra weight too quickly. Health experts recommend weight loss of about 2 pounds per week for most adults.

Celebrate Milestones

A 5–10% weight loss is good for your health, but it may not feel like it’s enough. You might have a negative body image or don’t feel comfortable in your own skin. Maybe you have been focused on the number on the scale and it’s not quite where you want to be. Creating a positive environment to stay motivated to lose weight can be hard. Celebrating milestones along the way can help.

When you reach a first 5-pound loss, for example, reward yourself with a pedicure or massage, go see a new movie, enjoy a staycation, or find other calorie-free ways to celebrate your achievement. You can reward yourself for non–weight-loss milestones that show you’re improving your overall health. If you notice your pants starting to sag or you have extra space in your shirts, think about buying a new pair of pants or donating your old clothes to charity. It’s time to celebrate when you can bend to tie your shoes more easily, play dodgeball with your kids, or do other everyday activities you once struggled with. Reward yourself by joining a softball league or signing up for a charity run/walk event.