A reasonable goal for weight reduction in a patient who has a BMI ranging from 27-35 kg/m2 is to lose ½-1 pound a week by reducing their daily caloric intake by 300-500 kcal/day. Overweight individuals can achieve significant weight loss by reducing their caloric intake by 300-500 kcal per day. Patients with Class 2 or 3 obesity (BMI>35kg/m2) should reduce their daily caloric intake by 500-1000 kcal/day with the expectation of losing 1-2 pounds/week (10% of current weight in 6 months).
Current guidelines for a healthy adult diet, irrespective of attempts at weight loss, recommend keeping total fat intake under 35% of calories. Commercial weight loss programs such as Weight Watchers have been studied in clinical trials and may be helpful for some patients compared to individual weight loss attempts because of the associated group support. Low-carbohydrate diets may achieve more weight loss at 6 months than low-fat diets, but there is no significant difference in weight loss between the two diets at 1 or 2 years. Average weight loss at 2 years among the different diets was comparable, mainly attributable to the caloric restriction in the diets, not the varying proportions of fat, protein, and carbohydrates.
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