Obesity in adults: Dietary therapy
- George A Bray, MD
George A Bray, MD
- Boyd Professor Emeritus, Pennington Biomedical Research Center/Louisiana State University
- Professor of Medicine Emeritus, Louisiana State University Health Science Center
- Section Editors
- F Xavier Pi-Sunyer, MD, MPH
F Xavier Pi-Sunyer, MD, MPH
- Section Editor — Obesity
- Professor of Medicine
- Columbia University College of Physicians and Surgeons
- Timothy O Lipman, MD
Timothy O Lipman, MD
- Section Editor — Nutrition
- GI-Hepatology-Nutrition Section
- Washington DC Veterans Affairs Medical Center
The optimal management of overweight and obesity requires a combination of diet, exercise, and behavioral modification. In addition, some patients eventually require pharmacologic therapy or bariatric surgery. The risk of overweight to the subject should be evaluated before beginning any treatment program. Selection of treatment can then be made using a risk-benefit assessment (figure 1). The choice of therapy is dependent on several factors including the degree of overweight or obesity and patient preference.
This topic will review the dietary therapy of obesity. Other aspects of treatment are discussed separately. (See "Obesity in adults: Health hazards" and "Obesity in adults: Overview of management" and "Obesity in adults: Drug therapy" and "Obesity in adults: Behavioral therapy".)
GOALS OF WEIGHT LOSS
It is important to set goals when discussing a dietary weight loss program with an individual patient. An initial weight loss goal of 5 to 7 percent of body weight is realistic for most individuals.
●The first goal for any overweight individual is to prevent further weight gain and keep body weight stable (within 5 pounds of its current level).
●The goal of the clinician is to identify and review with the patient a realistic weight loss goal. Most patients have a weight loss goal of 30 percent or more below current weight, which is unrealistic .
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- GOALS OF WEIGHT LOSS
- DIETARY ENERGY
- Rate of weight loss
- Maintenance of weight loss
- TYPES OF DIETS
- Balanced low-calorie diets
- - Portion-controlled diets
- Low-fat diets
- Low-carbohydrate diets
- High-protein diets
- Mediterranean diet
- Very-low-calorie diets
- Choice of diet
- - Weight loss diets
- Side effects
- - Weight maintenance diets
- Role of dietary counseling
- Prolonged caloric restriction and longevity
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS