Treatment of Obesity - Changes in Lifestyle

Obesity is one of the largest epidemics in the world, with steady growth in recent decades.

The treatment of obesity requires a combination of three factors: diet, exercise and changes in lifestyle. Eventually it becomes necessary to use drugs to lose weight. In more severe cases, bariatric surgery may be indicated.

In this article we will discuss the major changes in lifestyle that we can implement to aid in weight loss.



Before you initiate a scanning treatment to lose weight, you need to measure BMI and waist circumference of the patient. We know that a waist circumference greater than 88 cm for women and 102 cm for men is associated with a higher prevalence of obesity-related diseases such as hypertension, diabetes and heart disease. Therefore, the higher the BMI and waist circumference is, the more "aggressive" should be the plan for weight loss.


It is important not to create unrealistic expectations in the first place. For most obese patients, stimulated by the media and mislead by advertising of weight loss products, who just dream of weight loss is very difficult to achieve any results in the short / medium term. Many people dream of losing 30-40% of weight, which is unrealistic for almost everyone. For this, we need a strong will, discipline, a multidisciplinary team for guidance in diet, medications, exercise and psychological part that most obese people do not have.

So we focus on just losing weight but can keep it. For example, in people at high risk of developing diabetes, losing just 5% of weight and keeping it is enough to reduce the risk of developing diabetes by 50%. So if you have 100 kg and you can reduce it to 95 kg, without turning to fat, it's a great start. Losing 15% of weight without gaining it back over a long term can be considered an excellent result in terms of prevention of obesity-related diseases. If an individual can reduce their weight from 120 kg to 100 kg, this is an enormous success for the health, even if it remains classified as overweight and not the body that was dreamt of.

The fact is that many people want to lose weight not just for health but also as a demand of a society that increasingly values thin people, sometimes too much. Desire to look like an actress from television or magazine model is unrealistic even for those, who are not obese, create expectations that cannot be met. Another problem that can lead to frustration and abandonment of treatment is to think that losing weight will solve all other routine problems, especially in professional life, family and love.

It's health that should be the main goal. The welfare of the individual with their appearance is important for mental health; however, one should avoid making aesthetic issue more important than physical health.


The weight gain results from a simple mathematical issue: intake of calories is greater than the daily usage of calories. People who are obese come to this state due to an improper diet and insufficient physical activity patterns. Forget the excuses like "gland problems", "thyroid disease" etc ... No matter what the excuse that you've created for your overweight, in the end, the math above determines whether a person gains weight or not. The first step for losing weight is to abandon excuses and correct the errors.

Eating improperly, bad habits and physical inactivity are acquired throughout life. Obese people eat for many reasons not only just satisfying hunger. You can eat excess calories throughout the day due to small snacks just out of habit or lack of what to do, for frustration or seeking rewards (after an intense day of stressful work the individual decides to reward themselves with a tasty but high-calorie meal), for laziness or ignorance of preparing meals with fewer calories etc ... It is therefore important to have a nutritional guidance and a notebook to jot down the pattern of supply. This may sound silly, but it is not. Note well what you ate, where meals were made, what time you ate, what you felt after eating.

• Eat only in certain parts of your house, for example, in the room or the kitchen. This could break the habit of eating at certain places of the house outside the hours of meals, and office, in bed, watching TV etc...
• Create a system of rewards at the end of the day or the week after getting a diet with fewer calories. Rewards can be anything that makes you feel good, either go to the mall, hair cut, nails done, rent a movie, get massages, have sex etc... The support of the family is very important in this system. The reward should not be the loss of weight, but by better habits. Note: Never use food as a reward.
• Find out what feelings or activities trigger the necessity to eat more often. Try to have control over these situations. If possible, eliminate them.
• See what calorie food you consume more. Stop buying it. If you have the habit of eating it and have it at home, it becomes almost impossible not to consume it. The best way not to eat something with many calories is not to have easy access to it.
• After each bite, take a sip of water. This will cause the stomach to fill up more quickly, reducing the amount of food needed to satisfy it.
• Never fill the pan. Put less food than you think is necessary. Often we eat more than we need to just not to leave leftover food.
• Eat slowly, chew your food well and take short breaks during the meal. Leave time for satiety mechanisms of the body to become active.
• Make a longer interval between food and dessert. See if you really need it or if the candy is just a habit or a form of reward.
• Along with the dietary guidelines (which will be explained in part 2 of this issue), the above described changes can cause you to cut up to 1,000 calories per day.

Losing weight is easier than maintaining weight loss; therefore, changes in lifestyle are essential to stay lean. Among these changes, a regular physical activity is the most important thing. If there is no medical contraindication, every individual must exercise regularly.

A big mistake of people trying to lose weight is thinking they can do so only by reducing calorie intake. The increase in daily caloric expenditure through exercise makes weight loss much easier. Exercise just as proper nutrition is a matter of habit.

At least 150 minutes of light to moderate exercise per week (30 minutes 5 times a week) such as walking faster, are a good start. It is worth remembering that the activity works best if done smoothly. Ideally it is good to maintain the heart rate higher than the basal continuously. Walk and stop, as some people do in day-to-day work, does not work as well as an uninterrupted a 30-minute walk.

This does not mean, however, that the work cannot be implemented with some changes to healthier habits. Give preference to the stairs instead of the elevator, park your car further from the entrance, go by bike if possible, try to go in person to talk to people instead of using the internal telephone, try to walk while talking on the phone etc...

The ideal physical activity, however, is to join aerobics with weight training. A pound of muscle burns more calories than 2.5 x 1 kg of fat at rest. So when we gain muscle mass we increase our intake of calories baseline. If you think that up to 75% of calories consumed during a day at rest is done through the basal metabolism of our body, but the more muscle you have, the more calories you will be able to burn, even sleeping. Physical activity, therefore, increases caloric expenditure during the actual activity and during rest, making loss and maintenance of weight easier.

The older a person gets, the more important it is to prevent the reduction of calorie expenditure with the natural fall of metabolism.


Effective treatment of obesity depends on several factors, and changes in lifestyle may be more important than diet and medical treatment. There is no miracle formula. No effort or willpower - no results. Avoid treatments that promise quick and effortless weight loss. It does not exist. If you want to spend money, you'd better go to a gym and start exercising.