Low Calorie Diet
Evidence Statement: LCDs can reduce total body weight by an average of 8 percent over 3 to 12 months. Evidence Category A.
decrease in abdominal fat
Evidence Statement: LCDs resulting in weight loss effect a decrease in abdominal fat. Evidence Category A.
increasing physical activity
Evidence Statement: No improvement in cardiorespiratory fitness as measured by VO2 max appears to occur in overweight or obese adults who lose weight on LCDs without increasing physical activity. Evidence Category B.
Very Low Calorie Diet
Evidence Statement: VLCDs produce greater initial weight loss than LCDs. However, the long-term (> 1 year) weight loss is not different from that of the LCD. Evidence Category A.
lower fat diets
Evidence Statement: Although lower fat diets without targeted caloric reduction help promote weight loss by producing a reduced caloric intake, lower-fat diets coupled with total caloric reduction produce greater weight loss than lower fat diets alone. Evidence Category A.
Lower fat diets
Evidence Statement: Lower fat diets produce weight loss primarily by decreasing caloric intake. Evidence Category B.
Reducing fat as part of an LCD
RECOMMENDATION: LCDs are recommended for weight loss in overweight and obese persons. Evidence Category A. Reducing fat as part of an LCD is a practical way to reduce calories. Evidence Category A.
Physical activity
Evidence Statement: Physical activity, i.e., aerobic exercise, in overweight and obese adults results in modest weight loss independent of the effect of caloric reduction through diet. Evidence Category A..
Physical activity
Evidence Statement: Physical activity in overweight and obese adults modestly reduces abdominal fat. Evidence Category B.
Physical activity in overweight
Evidence Statement: Physical activity in overweight and obese adults increases cardiorespiratory fitness independent of weight loss. Evidence Category A.
Physical activity …
RECOMMENDATION: Physical activity is recommended as part of a comprehensive weight loss therapy and weight maintenance program because it: (1) modestly contributes to weight loss in overweight and obese adults (Evidence Category A)
Physical activity
(2) may decrease abdominal fat (Evidence Category B), (3) increases cardiorespiratory fitness (Evidence Category A), and (4) may help with maintenance of weight loss (Evidence Category C).
The combination of a reduced calorie diet and increased physical activity
Evidence Statement: The combination of a reduced calorie diet and increased physical activity produces greater weight loss than diet alone or physical activity alone. Evidence Category A.
The combination of a reduced calorie diet and increased physical activity
Evidence Statement: The combination of a reduced calorie diet and increased physical activity produces greater reductions in abdominal fat than either diet alone or physical activity alone, although it has not been shown to be independent of weight loss. Evidence Category B..
A combination of a reduced calorie diet and increased physical activity
Evidence Statement: A combination of a reduced calorie diet and increased physical activity improves cardiorespiratory fitness as measured by VO2 max when compared to diet alone. Evidence Category A.
The combination of a reduced calorie diet and increased physical activity
RECOMMENDATION: The combination of a reduced calorie diet and increased physical activity is recommended, since it produces weight loss, decreases abdominal fat, and increases cardiorespiratory fitness. Evidence Category A.
Behavior therapy
Evidence Statement: Behavior therapy, when used in combination with other weight loss approaches, provides additional benefits in assisting patients to lose weight short term (1 year). Evidence Category B
3 to 5 years
No additional benefits are found at 3 to 5 years in the absence of continued intervention. Evidence Category B.
multimodal strategies
Evidence Statement: No one behavior therapy appeared superior to any other in its effect on weight loss; rather, multimodal strategies appeared to work best and those interventions with the greatest intensity appeared to be associated with the greatest weight loss. Evidence Category A.
Long-term follow-up
Evidence Statement: Long-term follow-up of patients undergoing behavior therapy shows a return to baseline weight in the great majority of subjects in the absence of continued behavioral intervention. Evidence Category B.
weight maintenance
RECOMMENDATION: Behavior therapy is a useful adjunct when incorporated into treatment for weight loss and weight maintenance. Evidence Category B.
setting expectations
RECOMMENDATION: The possibility that a standard approach to weight loss will work differently in diverse patient populations must be considered when setting expectations about treatment outcomes. Evidence Category B.
Pharmacotherapy
Evidence Statement: Pharmacotherapy, which has generally been studied along with lifestyle modification including diet and physical activity, using dexfenfluramine, sibutramine, orlistat, or phentermine/fenfluramine, results in weight loss in obese adults when used for 6 months to 1 ear. Evidence Category B.
comprehensive weight loss program
RECOMMENDATION: Weight loss drugs may only be used as part of a comprehensive weight loss program including diet and physical activity for patients with a BMI of ≥30 with no concomitant obesity related risk factors or diseases, or for patients with a BMI of ≥27 with concomitant obesity related risk factors or diseases. Evidence Category B.
Surgical interventions
Evidence Statement: Surgical interventions in adults with a BMI ≥ 40 or a BMI ≥ 35 with comorbid conditions result in substantial weight loss. Evidence Category B.
BMI ≥40 or ≥35 with comorbid conditions
RECOMMENDATION: Surgical intervention is an option for carefully selected patients with clinically severe obesity (a BMI ≥40 or ≥35 with comorbid conditions) when less invasive methods of weight loss have failed and the patient is at high risk for obesity-associated morbidity and mortality. Evidence Category B.