Weight Loss for the Obese

Weight loss for the obese requires a different approach than that required for the overweight. Rapid weight loss should be supervised by a medical professional. Obese people with cardiac problems should consult closely with a doctor before undergoing any program of physical fitness. Surgical weight loss methods can lead to greater results, but carry additional challenges.

Diet

• Diet is arguably the most important pillar of weight loss strategy for the obese and one of the most difficult to manage. Many methods advocate serious calorie restrictions, sometimes involving keeping consumption as low as 1,200 calories per day or below. Calorie restriction should not be attempted without professional supervision, as it can easily lead to crippling fatigue and malnutrition. A balanced diet rich in protein and vitamins, while cutting out foods with negligible nutritional value, is safer, but may have slower results. The amount consumed should be proportional to the amount of exercise you are performing.

Exercise

• Obese people are more vulnerable to injury through exercise. Contracting with a personal trainer can reduce this risk, as most injuries occur due to errors in form. Cardiovascular exercise induces hunger, so managing diet becomes more challenging. Many exercise machines are not designed for the obese, so alternative exercises are often necessary. Aquatic exercises are excellent alternatives because the buoyancy reduces the pressure on vulnerable joints. According to research conducted at the University of Michigan and presented at the 2008 American Physiological Society Intersociety Meeting, one 90-minute workout per day can increase metabolism by up to 700 calories per day in obese people, even if the exercise is light.

Surgery

• Surgery is a radical option that requires massive lifestyle and dietary changes. Gastric bypass surgery is highly effective at inducing weight loss. Surgeons alter the stomach and digestive system so that the stomach pouch can only store food up to the size of a walnut at once. An incision is made in the small intestine, which is then reattached to the pouch, so that food bypasses most of the stomach. This reduces caloric absorption from food. The caloric restriction makes it challenging to exercise strenuously, and a very specific dietary plan must be followed to make this treatment successful. Laproscopic adjustable gastric banding, also known as "lap banding," is similar in that it restricts stomach size, but differs in that it does not reroute the intestine, which keeps calorie absorption the same as an ordinary stomach.

Drugs

• Prescription weight loss drugs can lead to significant weight loss if taken as directed. Meridia is a psychoactive drug that can make you feel more full than you actually are. Xenica reduces the ability of the stomach and intestines to absorb fat from food. Both of these drugs work best if you stick to a healthy diet. Each has significant side effects, and not everyone can tolerate them. Beginning a drug program is a long-term commitment, as halting treatment can easily lead to regaining all of the weight you lost due to their effects.