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You are here : 3-RX.com > Medical Encyclopedia > Special Topics > Weight Management
      Category : Health Centers > Weight Control and Management

Weight Management

Alternate Names : Weight Control

Weight management is a plan to help an overweight or obese person reach and stay at a healthy body weight. Body mass index, or BMI, is used to evaluate weight. It is determined by dividing an individual's weight in kilograms by an individual's height in meters squared.

The National Institutes of Health, or NIH, has set BMI standards. If a person's BMI is 25.0 to 29.9 kg/m2, he or she is considered overweight. People are considered obese if their BMI is 30 to 39.9 kg/m2. A BMI of 40 kg/m2 or higher indicates extreme obesity.

What is the information for this topic?

Anyone who takes in more calories than the body burns can expect to put on weight. Overweight and obesity are complex conditions with various factors that interact. These factors fit into the following groups:

  • behavioral
  • cultural
  • genetic
  • metabolic
  • physiological
  • social
  • Impact of overweight or obesity

    Overweight and obesity put a person at risk for other health problems, such as:

  • back pain
  • breathing problems
  • coronary heart disease
  • diabetes
  • gallbladder disease
  • high blood pressure
  • osteoarthritis
  • some types of cancer
  • stroke
  • Obesity can even lead to an early death. The risk grows as the degree of obesity increases.

    Weight management plan

    The first goal should be a 10% weight loss over a 6-month period. The rate of weight loss should be 1 to 2 pounds a week. Faster weight loss does not improve the long-term results. After the first 6 months, additional weight management goals can be discussed with the healthcare provider. Some people may need to keep losing weight. Others may be ready to maintain their weight loss.

    No one treatment works for everyone. NIH recommends these guidelines for the healthcare provider:

  • make changes to the treatment plan based on the person's preferences and responses
  • schedule regular office visits to track weight loss progress
  • set weight loss goals with the individual
  • understand how the treatment fits into other health care and self-care needs of the person
  • A successful weight management plan includes:

  • behavior therapy
  • dietary therapy
  • regular physical activity
  • The plan may also include medicine or surgery.

    Dietary therapy

    Dietary therapy works best when it meets the needs of the individual. In general, NIH recommends these guidelines.

  • A diet of 1,000 to 1,200 calories a day is appropriate for most women.
  • A diet of 1,600 calories a day is recommended for most men.
  • A diet of 1,600 calories a day may be right for women who exercise regularly or weigh over 165 pounds.
  • If the person doesn't lose weight on the 1,600-calorie diet, a diet of 1,200 calories a day may be recommended.
  • The healthcare provider may recommend adding 100 to 200 calories a day if the person is hungry.
  • Specific recommendations should be given to be sure that the person gets all essential nutrients.
  • Physical activity

    To begin treating obesity, NIH recommends moderate levels of physical activity. The activity should last 30 to 45 minutes a day, 3 to 5 days a week. The activity should be started slowly. There should be a gradual increase in intensity. Some moderate physical activities are:

  • bicycling 5 miles in 30 minutes
  • doing water aerobics for 30 minutes
  • gardening for 30 to 45 minutes
  • raking leaves for 30 minutes
  • walking 2 miles in 30 minutes
  • Behavior therapy

    Behavior therapy is used to overcome barriers to diet or physical activity. A good behavior therapy plan has these features:

  • focuses on what matters
  • includes seeing the healthcare provider often
  • includes self-monitoring, with appropriate rewards
  • is a partnership with the healthcare provider
  • sets reasonable goals
  • takes the person's attitudes, beliefs, and history into account
  • Medicine and surgery

    The Food and Drug Administration, or FDA, has approved only two medicines for long-term use for weight loss. They are orlistat, or Xenical, and sibutramine, or Meridia. These medicines may be prescribed for people with a BMI of 27 to 29.9 who have two or more diseases. NIH suggests these two medicines can also be used by people with a BMI of 30 or higher.

    Surgery, which changes the way food is absorbed, is sometimes used to treat obesity. NIH includes surgery as a choice for people with a BMI or 30 or higher and two or more diseases.


    NIH provides tools to aid in weight management, such as:

  • dietary information
  • guide to behavior change
  • guide to physical activity
  • weekly food and activity diary
  • weight and goal records
  • Contraindications

    NIH states that these groups of people should be excluded from weight loss treatment:

  • people who have serious illnesses that might be worsened by calorie restriction
  • people who have a serious uncontrolled psychiatric illness, such as major depression
  • women who are pregnant or breastfeeding
  • NIH also recommends that certain individuals be referred to specialists for weight loss as needed. These include people with a history of eating disorders, such as anorexia nervosa or bulimia. People who are currently abusing drugs should also be referred to a specialist.

    Weight maintenance

    After the person has reached the weight loss goal, weight maintenance needs to be lifelong. The person should have regular treatment to continue with these measures:

  • behavior therapy
  • dietary therapy
  • regular physical activity
  • Ongoing therapy can be given in a number of ways. The methods recommended by NIH include:

  • e-mail reminders
  • group meetings
  • regular visits with the healthcare provider
  • telephone communications
  • After successful treatment for obesity, the person can monitor his or her weight. Regular visits with the healthcare provider will also be needed. NIH recommends an appointment at 6 months and again one year after the start of the weight management plan. The provider will check the person's weight, BMI, and waist measurement during these visits. Any new or worsening symptoms should be reported to the provider.

    Author: Terry Mason, MPH
    Reviewer: Eileen McLaughlin, RN, BSN
    Date Reviewed: 07/03/01

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