Why a modest loss matters
Overweight and obesity raise the risk of many health problems, especially with extra fat around the waist.3 Nearly 9 in 10 people with type 2 diabetes have overweight or obesity.4 The good news is that the benefit starts early: losing 5% of your body weight over 6 months may be a good first goal,19 and if you already have high blood pressure or diabetes, losing weight may help.20
What a first goal looks like
What modest weight loss can do
| Weight lost | What it may do |
|---|---|
| 3% to 5% | Reduce fat in the liver.6 |
| 5% to 7% | Prevent or delay type 2 diabetes in people at risk.5 |
| 5% to 10% | Lower blood sugar, blood pressure and triglycerides.26 |
Percent of starting body weight, as described by NIDDK. Losing weight quickly raises the risk of gallstones, so ask how to lose it safely.9
What a lifestyle program achieved
In the NIH Diabetes Prevention Program, adults at high risk aimed to lose 7% of their weight and exercise 150 minutes a week, and lowered their chance of type 2 diabetes by 58% compared with placebo.31 The benefit continued for at least 15 years.32
Lower chance of type 2 diabetes after about 3 years
Diabetes Prevention Program, compared with placebo
Results from a research trial in these participants, not a description of a ProperHealth or Clarkson service.
What affects weight
Habits matter: high-calorie, sugary and fatty foods, sugary drinks and long hours sitting can lead to weight gain.13 So do things people rarely connect with weight: too little sleep raises hunger,14 some medicines contribute to weight gain,15 and conditions such as PCOS or an underactive thyroid can too.16 Genes and surroundings play a part.1718
Many things affect weight
Sleep and medicines
Programs, medicines and surgery
Safe, successful programs share common parts: regular counseling, an eating plan, at least 150 minutes of activity a week and regular monitoring.21
What a safe, successful program includes
Typical components, as described by NIDDK.
For some adults, prescription medicines add 3% to 12% more weight loss at a year,25 but they do not replace healthy habits24 and some weight usually returns after stopping.27 Surgery may be recommended with a BMI of 35 or higher.22
Prescription weight medicines: what to know
| Question | What NIDDK says |
|---|---|
| Who may be offered one? | Adults with a BMI of 30 or more, or 27 or more with problems such as high blood pressure or type 2 diabetes.23 |
| How much do they add? | On average, 3% to 12% more weight loss at 1 year than a lifestyle program alone.25 |
| Do they replace habits? | No. They work best with a lifestyle program.24 |
| What happens on stopping? | Some weight usually comes back.27 |
Not in pregnancy or when planning one.28 Never take one only to change how you look.30
Weight-loss supplements
The proven ways to lose weight are healthful food, fewer calories and physical activity; there is little scientific evidence that weight-loss supplements work.34 The FDA warns that many diet pills, supplements and teas are likely to contain dangerous hidden ingredients.38
Weight-loss supplements: what the evidence shows
A historical perspective: Dr. Majid Ali
“They know that some foods create brisk sugar spikes while others do not.”
— Dr. Majid Ali, 30 December 2014
Dr. Ali objected to the idea that "calories are calories" and treated weight as a sign of metabolic problems, not a failure of willpower. Parts of that are consistent with current sources: sugary foods and drinks are among the habits linked to weight gain,13 and sleep, medicines, health conditions and genes all affect weight.14151617
He also proposed single causes of obesity and framed his plans as reversing diabetes and chronic disease. The sources used here do not support those claims: many factors affect weight,18 and weight loss may prevent or delay diabetes in people at risk5 without any eating plan being a cure.
What to do this week
Work out your 5%
At 200 pounds, it is 10 pounds over 6 months.19
Check your medicines
Some medicines can contribute to weight gain; ask before changing any.15
Protect your sleep
Too little sleep raises hunger.14
Move most days
Work up to 150 minutes a week, such as brisk walking.21
Skip weight-loss supplements
When to get help now
Each warning sign cites the official guidance behind it. The wording still needs pharmacist sign-off.
- Chest pain or fainting, or a racing or irregular heartbeat with dizziness or shortness of breath, after a weight-loss pill, tea or supplement — call 911.4041
- Thoughts of harming yourself — call or text 988, or 911 if you are in danger.42
- Unexplained weight loss you are not trying for — book an appointment promptly.43
- Binge eating with a feeling of loss of control, or making yourself vomit or using laxatives to control weight — talk to a clinician; help is available.4445
- Severe upper-belly pain lasting several hours, especially after rapid weight loss — see a doctor right away.46
Every numbered marker links to the exact passage it rests on. Check the sources.