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weight management

Alternative Names
obesity management, weight control, weight loss, dieting

Definition
Weight management is a plan devised to help an overweight person avoid adding more kilograms, lose weight safely, and maintain a lower, healthier body weight. These plans often include exercise, dietary changes, behavioural therapy, and, sometimes, medication or surgery.

What is the information for this topic?
One way to measure weight is the body mass index (BMI). This is a calculation of a person's weight divided by height. It also takes into account how body fat is distributed. The so-called apple-shape of a wider waistline is more dangerous to health than having a pear-shaped body.

A BMI of:
  • less than 20% is underweight
  • 20 to 25 means that a person falls into a normal range for weight
  • 25 to 30 means that a person is overweight
  • 30 or higher means that a person is obese
  • 40 or higher means that a person is morbidly obese
People who are overweight or obese often struggle with social prejudice and discrimination. They have a higher risk for many health problems, including: Generally, the more overweight a person is, the greater the risk to health and the higher the likelihood of an early death. But while excess weight clearly has long-term consequences, other risk factors, such as smoking and family history, play a big role in health, too.

Anyone who takes in more kilojoules than the body burns off can expect to put on weight. But experts do not fully understand what causes obesity. It is a chronic health problem thought to involve many factors, such as:
  • Social and cultural pressures
  • Behaviour
  • Metabolism, or how the body stores and uses kilojoules
  • Genes
It is best to discuss any weight management plan with a doctor or dietician. Certain medications and diets or yo-yo dieting-that is, repeated cycles of taking off weight and putting it on-can endanger a person's health.

A good weight management plan can help anyone who is overweight. It may be medically advised when:
  • A person's BMI is 30 or higher
  • A person's BMI is 25 to 29.9 and other health problems or risks are present, such as heart disease or a waistline of 100cm or more in a man or 88cm or more in a woman
The first goal is usually to lower body weight by 10% within 6 months. If this goal is achieved, further weight loss can be attempted. Strategies to maintain weight loss are also important. Losing weight is of little help if it is all gained back.

Various methods of weight management can help a person take off unnecessary and unhealthy kilograms. Many of these combine:
  • Cutting kilojoules by making healthy dietary choices, especially by cutting down on fats
  • Regular activity to help burn off kilojoules. For weight loss, walking for 30 minutes on 3 days a week is recommended to start. If you can't manage 30, start with 5-10 minutes and build up from there. Gradually build to 45 minutes or more of exercise at least 5 days a week.
  • Behavioural therapy. This helps people learn good habits and stick with the treatment plan. Self-monitoring, social support, and stress management are examples of this type of therapy.
Weight loss drugs are sometimes used if other treatments fail. There are various types of drugs in use, such as Xenical. Severely obese people with a BMI greater than 40 may be candidates for surgery. This is normally done only if a person fails to respond to other methods. Most surgery involves making the stomach smaller (to make a person feel full sooner) or bypassing it completely.

Drugs used to treat obesity have possible side effects. These can range from diarrhoea to addiction, depending on the drug used. Close supervision is important, and the person must still follow other treatments, such as a proper diet. Surgery carries a risk of bleeding and infection. People may also have problems in absorbing certain nutrients from food after surgery.

Weight management therapy may continue for life. The eventual goal is to change a person's lifestyle to a healthier, more active one that results in a normal weight.

BMI calculator

Author: Terry Mason, MPH
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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