Weight management

File:Apples.jpg

Weight management comprises behaviors, techniques, and physiological processes that contribute to a person's ability to attain and maintain a healthy weight.{{Cite web |date=2022-06-03 |title=Healthy Weight |url=https://www.cdc.gov/healthyweight/index.html |access-date=2023-01-17 |website=Centers for Disease Control and Prevention |language=en-us}}{{Cite web |title=Understanding Adult Overweight & Obesity {{!}} NIDDK |url=https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity |access-date=2023-01-17 |website=National Institute of Diabetes and Digestive and Kidney Diseases |language=en-US}} Most weight management techniques encompass long-term lifestyle strategies that promote healthy eating and daily physical activity.{{cite journal | vauthors = Seagle HM, Strain GW, Makris A, Reeves RS | title = Position of the American Dietetic Association: weight management | journal = Journal of the American Dietetic Association | volume = 109 | issue = 2 | pages = 330–346 | date = February 2009 | pmid = 19244669 | doi = 10.1016/j.jada.2008.11.041 | author5 = American Dietetic Association }} Weight management generally includes tracking weight over time and identifying an individual's ideal body weight.{{cite journal | vauthors = Ryan DH, Kahan S | title = Guideline Recommendations for Obesity Management | journal = The Medical Clinics of North America | volume = 102 | issue = 1 | pages = 49–63 | date = January 2018 | pmid = 29156187 | doi = 10.1016/j.mcna.2017.08.006 | series = Obesity Medicine }}

Weight management strategies most often focus on achieving healthy weights through slow but steady weight loss, followed by maintenance of an ideal body weight. However, weight neutral approaches to health have also been shown to result in positive health outcomes.{{cite journal | vauthors = Tylka TL, Annunziato RA, Burgard D, Daníelsdóttir S, Shuman E, Davis C, Calogero RM | title = The weight-inclusive versus weight-normative approach to health: evaluating the evidence for prioritizing well-being over weight loss | journal = Journal of Obesity | volume = 2014 | pages = 983495 | year = 2014 | pmid = 25147734 | pmc = 4132299 | doi = 10.1155/2014/983495 | doi-access = free }}{{cite journal | vauthors = Bacon L, Aphramor L | title = Weight science: evaluating the evidence for a paradigm shift | journal = Nutrition Journal | volume = 10 | pages = 9 | date = January 2011 | pmid = 21261939 | pmc = 3041737 | doi = 10.1186/1475-2891-10-9 | doi-access = free }}

Understanding the basic science of weight management and strategies for attaining and maintaining a healthy weight is important because obesity is a risk factor for development of many chronic diseases, like Type 2 diabetes, hypertension and cardiovascular disease.{{cite journal | vauthors = Klein S, Sheard NF, Pi-Sunyer X, Daly A, Wylie-Rosett J, Kulkarni K, Clark NG | title = Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition | journal = The American Journal of Clinical Nutrition | volume = 80 | issue = 2 | pages = 257–263 | date = August 2004 | pmid = 15277143 | doi = 10.1093/ajcn/80.2.257 | doi-access = free }}

Key factors

There are many factors that contribute to a person's weight, including: diet, physical activity, genetics, environmental factors, health care support, medications, and illnesses.{{Cite book |title=Goldman-Cecil Medicine |vauthors=Goldman L, Schafer AI |publisher=Elsevier |year=2020 |isbn=9780323532662 |edition=26th |location=Philadelphia, PA |pages=1418–1427}}{{Cite web |url= https://www.nhlbi.nih.gov/health/educational/lose_wt/index.htm |title=Maintain a Healthy Weight|work = National Heart, Lung, and Blood Institute (NHLBI) |access-date=2018-11-28}}{{cite journal | vauthors = Mendenhall E, Singer M | title = The global syndemic of obesity, undernutrition, and climate change | language = English | journal = Lancet | volume = 393 | issue = 10173 | pages = 741 | date = February 2019 | pmid = 30765124 | doi = 10.1016/S0140-6736(19)30310-1 | s2cid = 72333975 | doi-access = free }}{{cite journal | vauthors = Katzmarzyk PT, Martin CK, Newton RL, Apolzan JW, Arnold CL, Davis TC, Price-Haywood EG, Denstel KD, Mire EF, Thethi TK, Brantley PJ, Johnson WD, Fonseca V, Gugel J, Kennedy KB, Lavie CJ, Sarpong DF, Springgate B | display-authors = 6 | title = Weight Loss in Underserved Patients - A Cluster-Randomized Trial | journal = The New England Journal of Medicine | volume = 383 | issue = 10 | pages = 909–918 | date = September 2020 | pmid = 32877581 | pmc = 7493523 | doi = 10.1056/NEJMoa2007448 }} Each of these factors affect weight in different ways and to varying degrees, but health professionals most often stress the importance of diet and physical activity because they can be affected by conscious behavior modification.{{cite journal | vauthors = Kim JY | title = Optimal Diet Strategies for Weight Loss and Weight Loss Maintenance | journal = Journal of Obesity & Metabolic Syndrome | volume = 30 | issue = 1 | pages = 20–31 | date = March 2021 | pmid = 33107442 | pmc = 8017325 | doi = 10.7570/jomes20065 }} Attaining a healthy weight involves recognition of general techniques such as portion sizing, self-monitoring, and daily diet consistency.{{Cite web |date=10 May 2022 |title=Obesity in adults: Dietary therapy |url=https://www.uptodate.com/contents/obesity-in-adults-overview-of-management#:~:text=Overweight%20is%20defined%20as%20a,comorbidities)%20(calculator%201).}} Once this healthy weight has been attained, maintaining this stable weight additionally involves physical activity and control of an individual's environment and eating patterns.{{cite journal | vauthors = Flore G, Preti A, Carta MG, Deledda A, Fosci M, Nardi AE, Loviselli A, Velluzzi F | display-authors = 6 | title = Weight Maintenance after Dietary Weight Loss: Systematic Review and Meta-Analysis on the Effectiveness of Behavioural Intensive Intervention | journal = Nutrients | volume = 14 | issue = 6 | pages = 1259 | date = March 2022 | pmid = 35334917 | pmc = 8953094 | doi = 10.3390/nu14061259 | doi-access = free }} Furthermore, healthcare support in the form of primary care medical supervision and following up over time has been shown to be helpful for long-term weight management.{{cite journal | vauthors = Madigan CD, Graham HE, Sturgiss E, Kettle VE, Gokal K, Biddle G, Taylor GM, Daley AJ | display-authors = 6 | title = Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials | journal = BMJ | volume = 377 | pages = e069719 | date = May 2022 | pmid = 35636762 | pmc = 9150078 | doi = 10.1136/bmj-2021-069719 }}

The following is a review of some of the key components of weight management in humans.

= Energy balance =

The science behind weight management is complex, but one of the key concepts that governs weight management is Energy Balance. Energy Balance is the phrase used to describe the difference between the number of calories a person consumes and the number of calories that same person expends (a.k.a. burns) in a given time period. There are three possible scenarios when it comes to the energy balance equation:

Calories consumed (food, drink) = Calories expended (basal metabolic rate, physical activity, thermogenic effect of food, acute illness)
Outcome: Weight remains unchanged
Calories consumed > Calories expended
Also known as Positive Energy Balance
Outcome: Weight increases
Calories consumed < Calories expended
Also known as Negative Energy Balance
Outcome: Weight decreases

The calories a person consumes come from food and drink intake. The calories a person expends comes from their basal metabolic rate and their daily physical activity. The human body is very good at maintaining a neutral energy balance, particularly with a diet composed of fruits, vegetables, and meats so that calories consumed do not substantially exceed calories expended in a given time period and vice versa. This energy balance is regulated by hormones like Leptin (suppresses), Ghrelin (stimulates), and Cholecystokinin (suppresses) which either suppress or stimulate appetite.

File:Energy drink and fast food cheeseburger calorie comparison.jpg

= Diet =

The quantity of food and drink consumed by an individual may play a role in weight management, as may the types of food and drink a person consumes. For example, intake of sweetened drinks such as sodas or juices can lead to increased energy intake that is not neutralized by a decrease in accompanying food intake. Increased portion sizes may also lead to increased energy intake. Food categories such as intake of proteins, carbohydrates, and fats are all important to consider when managing weight. It is also important to have control and understand how certain foods may affect the human body.{{Cite web |last=Dahl |first=Cynthia DeMarco & Heather Alexander |title=Macronutrients 101: What to know about protein, carbs and fats |url=https://www.mdanderson.org/cancerwise/macronutrients-101--what-to-know-about-protein--carbs-and-fats.h00-159774078.html |access-date=2025-04-08 |website=MD Anderson Cancer Center |language=en}}

= Physical activity =

File:Exercise Treadmill Convey Motion.jpg

Physical activity can be related to a person's professional activities, non-work related daily activities like walking or cycling, or it can be in the form of activities such as recreation or team sports. The specific type of activity can be tailored to populations such as children, pregnant women, and elderly adults. Tailored activity to one's fitness level also encourages the body to heal properly and prevent any injuries as a result of exercise.{{Cite book |url= |title=Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine |date=2022 |publisher=Elsevier | vauthors = Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, Braunwald E |isbn=9780323824675 |edition=12th |location=Philadelphia, PA |pages=442–470 |oclc=1286711171}}

Physical inactivity leads to less energy expenditure and is a factor that impacts obesity rates in both children and adults.{{Cite book |url=https://www.worldcat.org/oclc/1159444603 |title=Sleisenger and Fordtran's Gastrointestinal and Liver Disease |date=2020 |publisher=Elsevier | vauthors = Feldman M, Friedman LS, Brandt LJ |isbn=978-0-323-71094-7 |edition=11th |location=Philadelphia, PA |pages=92–100 |oclc=1159444603}} Physical inactivity has become a worldwide concern since inactivity also elevates the risk of heart disease. With a regular active lifestyle it can reduce the risk for noncommunicable diseases like diabetes, heart disease, and dyslipidemia (high cholesterol). Physical activity not only reduces the risk of noncommunicable diseases, but it also can benefit the body such as improving sleep patterns, reducing both anxiety and depression, and of course, helps weight loss and weight management.{{Cite web |last=CDC |date=2025-03-24 |title=Physical Activity and Your Weight and Health |url=https://www.cdc.gov/healthy-weight-growth/physical-activity/index.html |access-date=2025-04-08 |website=Healthy Weight and Growth |language=en-us}}

= Basal metabolic rate =

Basal metabolic rate (BMR) is one of the main components of a person's daily energy expenditure. It is defined as the amount of energy that is expended during a given amount of time by a person at rest. This energy at rest is used to pump blood throughout the body, maintain proper brain function, break down toxins, and ensure other bodily functions. Technically speaking, BMR is the energy the body expends during the following specific conditions: immediately after waking up, while in a resting state, and after fasting for 12–14 hours. Sometimes the term Resting Metabolic (RMR) is used in place of BMR, but RMR is not solely measured under the previously listed stringent conditions and it is about 10% more than BMR.{{Cite book|title=Conn's Current Therapy 2018| vauthors = Kellerman RD, Bope ET |publisher=Elsevier, Inc.|year=2018|isbn=978-0-323-52769-9|location=Philadelphia, PA|pages=336–345}}

The BMR is directly proportional to a person's lean body mass. In other words, the more lean body mass a person has, the higher their BMR. BMR is also affected by acute illnesses and increases with burns, fractures, infections, fevers, etc. It can be measured via direct and indirect calorimetry. However, it is also possible to approximately estimate BMR using several equations that factor in a person's age, sex, height, and weight. Some of the most popular and accurate equations used to calculate BMR are the original Harris-Benedict equations, the revised Harris-Benedict equations, and the Mifflin St. Jeor equation.{{Cite book|title=Textbook of Family Medicine | edition = Ninth | vauthors = Rakel RE, Rakel DP |publisher=Elsevier, Inc.|year=2016|isbn=978-0-323-23990-5|location=Philadelphia, PA|pages=891–911}}

The original Harris-Benedict Equations are as follows:

BMR (Males) in Kcals/day = 66.47 + 13.75 (weight in kg) + 5.0 (height in cm) - 6.76 (age in years)
BMR (Females) in Kcals/day = 655.1 + 9.56 (weight in kg) + 1.85 (height in cm) – 4.68 (age in years)

The revised Harris-Benedict Equations are as follows:

BMR (Males) in Kcals/day = 88.36 + 13.40 (weight in kg) + 4.8 (height in cm) – 5.68 (age in years)
BMR (Females) in Kcals/day = 447.59 + 9.25 (weight in kg) + 3.10 (height in cm) – 4.33 (age in years)

The Mifflin St. Jeor Equation is as follows:

BMR (Males) in Kcals/day = 9.99 (weight in kg) + 6.25 (height in cm) – 4.92 (age in years) + 5
BMR (Females) in Kcals/day = 9.99 (weight in kg) + 6.25 (height in cm) – 4.92 (age in years) – 161

The Mifflin St. Jeor Equation has been found to be the most accurate predictor of BMR compared to BMR measured by direct and indirect calorimetry.

= Body mass index =

Body mass index (BMI) is a value used to get a general sense of a person's overall mass and is calculated using a person's height and weight. It is more often used than weight alone to determine if an individual is underweight, normal weight, overweight, or obese. The following two equations can used to calculate BMI depending on the units used for height (meters vs. inches) and weight (kilograms vs. pounds):

$\mathrm{BMI} = \frac{\text{weight}_\text{kg}}{{\text{height}_\text{m}}^2}$

$\mathrm{BMI} = \frac{\text{weight}_\text{lbs}}{{\text{height}_\text{in}}^2} \times 703$

Though BMI is often used to help assess for excess weight, it is not a perfect representation of a person's body fat percentage. For example, an individual can have a higher than normal BMI but a normal body fat percentage if they have higher than average muscle mass. This is because excess muscle contributes to a higher weight. Since BMI is not a perfect representation of a person's body fat percentage, other measurements like waist circumference are often used to better assess for unhealthy excess weight.

The following table shows how different ranges of BMIs are often categorized into underweight, normal weight, overweight, and obese:

File:Obesity-waist circumference.svg

class="wikitable"

|+ Classification of Overweight and Obesity by Body Mass Index (BMI)

! Category{{cite book|url=https://apps.who.int/iris/bitstream/handle/10665/43190/9241593024_eng.pdf|title=The SuRF Report 2|date=2005|publisher=World Health Organization|series=The Surveillance of Risk Factors Report Series (SuRF)|page=22}}

! BMI

Underweight

| style="text-align:center;" | < 18.5

Normal Weight

| style="text-align:center;" | 18.5 – 24.9

Overweight

| style="text-align:center;" | 25.0 – 29.9

Obesity (Class I)

| style="text-align:center;" | 30.0 – 34.9

Obesity (Class II)

| style="text-align:center;" | 35.0 – 39.9

Obesity (Class III)

| style="text-align:center;" | ≥ 40.0

On average, groups of people with "obese" BMIs may have a higher risk of developing illnesses like diabetes, hypertension, dyslipidemia (high cholesterol), liver disease, and some cancers. "Underweight" BMIs may indicate malnutrition or other health problems. However, BMI has limitations when used to describe individual health rather than describing populations of people.

Complicating factors

= Thermogenic effect of food =

The thermogenic effect of food is another component of a person's daily energy expenditure and refers to the amount of energy it takes the body to digest, absorb, and metabolize nutrients in the diet. The amount of energy expended while processing food differs by individual but on average it amounts to about 10% the number of calories consumed during a given time period. Processing proteins and carbohydrates has more of a thermogenic effect than does processing fats.

= Medications =

Certain medications can cause either weight loss or weight gain. Suide effects are often listed for each medication and should be considered when attempting to manage a person's weight. Semaglutide is an anti-obesity drug that is also used for blood sugar control.{{Cite journal | vauthors = Bays HE, Fitch A, Christensen S, Burridge K, Tondt J |date=2022-06-01 |title=Anti-Obesity Medications and Investigational Agents: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022 |journal=Obesity Pillars |volume=2 |pages=100018 |doi=10.1016/j.obpill.2022.100018 |pmid=37990711 |pmc=10662004 |s2cid=248205315 |issn=2667-3681|doi-access=free }}

= Natural supplements =

There are so many different ways to manage weight and a healthy lifestyle. Natural supplements not only help with managing weight but taking natural supplements also helps build muscles, provide energy for the human body, and burn fat. Supplements such as magnesium, green tea, caffeine, vitamins, ginger, and turmeric are just a few of the many supplements that can help with natural weight loss and burn fat.{{Cite web |title=What to know before you buy weight-loss supplements |url=https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/weight-loss/art-20046409 |access-date=2025-04-08 |website=Mayo Clinic |language=en}}{{Cite web |title=Office of Dietary Supplements - Dietary Supplements for Weight Loss |url=https://ods.od.nih.gov/factsheets/WeightLoss-HealthProfessional/ |access-date=2025-04-08 |website=ods.od.nih.gov |language=en}}

= Unhealthy weight loss =

Some unhealthy weight loss illnesses can include cancer, diseases such as liver and kidney disease, diabetes, hyperthyroidism, and eating disorders such as anorexia and bulimia. It is important to know the difference between healthy weight loss and unhealthy weight loss.{{Cite web |title=Eating disorders - Symptoms and causes |url=https://www.mayoclinic.org/diseases-conditions/eating-disorders/symptoms-causes/syc-20353603 |access-date=2025-04-08 |website=Mayo Clinic |language=en}}{{Cite web |last=Moore |first=Sarah |date=2024-06-17 |title=Unexplained Weight Loss: When It Might Signal a Health Problem |url=https://www.news-medical.net/health/Unexplained-Weight-Loss-When-It-Might-Signal-a-Health-Problem.aspx |access-date=2025-04-08 |website=News-Medical |language=en}}

= Diseases =

Medical conditions associated with weight gain include hypothyroidism,{{Cite book |url=https://www.worldcat.org/oclc/1252630759 |title=Cecil Essentials of Medicine |date=2022 | vauthors = Wing EJ, Schiffman FJ, Cecil RL |isbn=978-0-323-72272-8 |edition=10th |location=Philadelphia, PA |pages=626–634 |oclc=1252630759}} Cushing's syndrome, Polycystic Ovary Syndrome (PCOS), and congestive heart failure.Khaodhiar L, McCowen KC, Blackburn GL. Obesity and its comorbid conditions. Clin Cornerstone. 1999;2(3):17-31. doi: 10.1016/s1098-3597(99)90002-9. PMID 10696282. Medical conditions such as cancer, gastrointestinal illness, psychiatric disorders, infections, endocrine disorders, and neurologic disorders may lead to weight loss.

== Commonly associated with weight gain ==

Polycystic ovary syndrome (PCOS), which is characterized by insulin resistance and hyperandrogenism, is a common condition that has been linked to obesity.Barber TM, Hanson P, Weickert MO, Franks S. Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies. Clin Med Insights Reprod Health. 2019 Sep 9;13:1179558119874042. doi: 10.1177/1179558119874042. PMID 31523137; PMCID: PMC6734597. A combination of genetics, lifestyle, and environment appear to contribute to the hormonal changes responsible for weight gain and obesity seen in individuals with PCOS.There appears to be a bidirectional relationship between obesity and PCOS, whereby PCOS increases the risk of obesity and similarly, obesity has been found to exacerbate PCOS hormonal differences and clinical symptoms.{{cite journal | vauthors = Lim SS, Hutchison SK, Van Ryswyk E, Norman RJ, Teede HJ, Moran LJ | title = Lifestyle changes in women with polycystic ovary syndrome | journal = The Cochrane Database of Systematic Reviews | volume = 2019 | issue = 3 | pages = CD007506 | date = March 2019 | pmid = 30921477 | pmc = 6438659 | doi = 10.1002/14651858.CD007506.pub4 | collaboration = Cochrane Gynaecology and Fertility Group }}

Obesity has been linked with pancreatic β-cell dysfunction and insulin resistance. In diabetes, impaired β-islet cells are responsible for the lack of blood glucose control.{{cite journal | vauthors = Al-Goblan AS, Al-Alfi MA, Khan MZ | title = Mechanism linking diabetes mellitus and obesity | journal = Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy| volume = 7 | pages = 587–591 | year = 2014 | pmid = 25506234 | pmc = 4259868 | doi = 10.2147/DMSO.S67400 | doi-access = free }} Individuals with a higher body mass index concerning for obesity may have increased levels of hormones, proinflammatory markers, and glycerol, which can contribute to insulin resistance. The combined effects of impaired pancreatic β-islet cells and insulin resistance increase the likelihood of developing diabetes.

In individuals with blood sugar levels in the prediabetic range, weight loss was demonstrated to have many benefits including improved glycemic control and a reduced risk of developing type 2 diabetes.{{Cite book |url=https://www.worldcat.org/oclc/1118693594 |title=Goldman-Cecil Medicine |date=2020 | vauthors = Crandall JP, Shamoon H |isbn=978-0-323-53266-2 |edition=26th |location=Philadelphia, PA |pages=1490–1510 |oclc=1118693594}}

== Commonly associated with weight loss ==

Common gastrointestinal disorders associated with weight loss are malabsorption due to Celiac disease or chronic pancreatitis. Depression and eating disorders such as anorexia nervosa can also contribute to weight loss. Infectious causes of weight loss include HIV/AIDS.

While Type 1 diabetes has been found to cause weight loss, type 2 diabetes has been associated with weight gain. Other endocrine causes of weight loss include hyperthyroidism and chronic adrenal insufficiency.

Intentional weight loss

=Diets=

As weight loss depends partly on calorie intake, different kinds of calorie-reduced diets, such as those emphasizing particular macronutrients (low-fat, low-carbohydrate, etc.), have been shown to be equally effective as weight loss tools.{{cite journal |vauthors=Strychar I |date=January 2006 |title=Diet in the management of weight loss |journal=CMAJ |volume=174 |issue=1 |pages=56–63 |doi=10.1503/cmaj.045037 |pmc=1319349 |pmid=16389240}}{{cite journal |vauthors=Thom G, Lean M |date=May 2017 |title=Is There an Optimal Diet for Weight Management and Metabolic Health? |journal=Gastroenterology |type=Review |volume=152 |issue=7 |pages=1739–1751 |doi=10.1053/j.gastro.2017.01.056 |pmid=28214525|url=http://eprints.gla.ac.uk/137779/7/137779.pdf }}{{cite journal |vauthors=Guth E |date=September 2014 |title=JAMA patient page. Healthy weight loss |journal=JAMA |volume=312 |issue=9 |pages=974 |doi=10.1001/jama.2014.10929 |pmid=25182116 |doi-access=free}}{{cite journal |display-authors=6 |vauthors=Sacks FM, Bray GA, Carey VJ, Smith SR, Ryan DH, Anton SD, McManus K, Champagne CM, Bishop LM, Laranjo N, Leboff MS, Rood JC, de Jonge L, Greenway FL, Loria CM, Obarzanek E, Williamson DA |date=February 2009 |title=Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates |journal=The New England Journal of Medicine |volume=360 |issue=9 |pages=859–873 |doi=10.1056/NEJMoa0804748 |pmc=2763382 |pmid=19246357}}{{cite journal |vauthors=Wadden TA, Webb VL, Moran CH, Bailer BA |date=March 2012 |title=Lifestyle modification for obesity: new developments in diet, physical activity, and behavior therapy |journal=Circulation |type=Narrative review |volume=125 |issue=9 |pages=1157–1170 |doi=10.1161/CIRCULATIONAHA.111.039453 |pmc=3313649 |pmid=22392863}}{{cite journal |vauthors=Mancini JG, Filion KB, Atallah R, Eisenberg MJ |date=April 2016 |title=Systematic Review of the Mediterranean Diet for Long-Term Weight Loss |journal=The American Journal of Medicine |language=English |volume=129 |issue=4 |pages=407–415.e4 |doi=10.1016/j.amjmed.2015.11.028 |pmid=26721635|doi-access=free }}{{cite journal |display-authors=6 |vauthors=Ge L, Sadeghirad B, Ball GD, da Costa BR, Hitchcock CL, Svendrovski A, Kiflen R, Quadri K, Kwon HY, Karamouzian M, Adams-Webber T, Ahmed W, Damanhoury S, Zeraatkar D, Nikolakopoulou A, Tsuyuki RT, Tian J, Yang K, Guyatt GH, Johnston BC |date=April 2020 |title=Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials |journal=BMJ |volume=369 |pages=m696 |doi=10.1136/bmj.m696 |pmc=7190064 |pmid=32238384}} Nonetheless, a diet low in saturated fat complemented with high fiber can be helpful for those who are found to be obese based on BMI. A low-carbohydrate diet can have the added benefits of blood sugar control in those with Type 2 Diabetes Mellitus. A low-carbohydrate diet can also improve weight loss, HDL, and cholesterol in certain individuals.{{cite journal |vauthors=Chawla S, Tessarolo Silva F, Amaral Medeiros S, Mekary RA, Radenkovic D |date=December 2020 |title=The Effect of Low-Fat and Low-Carbohydrate Diets on Weight Loss and Lipid Levels: A Systematic Review and Meta-Analysis |journal=Nutrients |volume=12 |issue=12 |pages=3774 |doi=10.3390/nu12123774 |pmc=7763365 |pmid=33317019|doi-access=free }} Compared to a typical diet, low-carbohydrate, low-fat, and moderate macronutrient diets can all positively impact weight loss. However, weight regain is common, and the outcome of a diet can vary widely depending on the individual.{{cite journal |vauthors=Anderson JW, Konz EC, Frederich RC, Wood CL |date=November 2001 |title=Long-term weight-loss maintenance: a meta-analysis of US studies |journal=The American Journal of Clinical Nutrition |volume=74 |issue=5 |pages=579–584 |doi=10.1093/ajcn/74.5.579 |pmid=11684524 |doi-access=free}} Rather than focusing on the nuances of each diet type, molding one diet in a way that the person can continuously adhere in the long-term could be beneficial for weight loss.

;DASH diet

The Dietary Approaches to Stop Hypertension (DASH) diet focuses on increasing the consumption of fruits, vegetables, whole grains and low-fat dairy products.{{cite journal |display-authors=6 |vauthors=Svetkey LP, Simons-Morton D, Vollmer WM, Appel LJ, Conlin PR, Ryan DH, Ard J, Kennedy BM |date=February 1999 |title=Effects of dietary patterns on blood pressure: subgroup analysis of the Dietary Approaches to Stop Hypertension (DASH) randomized clinical trial |journal=Archives of Internal Medicine |volume=159 |issue=3 |pages=285–293 |doi=10.1001/archinte.159.3.285 |pmid=9989541}}{{cite journal |display-authors=6 |vauthors=Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N |date=April 1997 |title=A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group |url=http://nrs.harvard.edu/urn-3:HUL.InstRepos:30147220 |journal=The New England Journal of Medicine |volume=336 |issue=16 |pages=1117–1124 |doi=10.1056/NEJM199704173361601 |pmid=9099655 |s2cid=15227903|doi-access=free }} DASH offers an intervention to manage elevated blood pressure and to prevent cardiovascular disease non-pharmacologically.{{cite journal |display-authors=6 |vauthors=Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, Stevens VJ, Vollmer WM, Lin PH, Svetkey LP, Stedman SW, Young DR |date=2003-04-23 |title=Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial |journal=JAMA |volume=289 |issue=16 |pages=2083–2093 |doi=10.1001/jama.289.16.2083 |pmid=12709466 |s2cid=38404996}}{{cite journal |vauthors=Siervo M, Lara J, Chowdhury S, Ashor A, Oggioni C, Mathers JC |date=January 2015 |title=Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis |journal=The British Journal of Nutrition |volume=113 |issue=1 |pages=1–15 |doi=10.1017/S0007114514003341 |pmid=25430608|doi-access=free }}{{cite journal |vauthors=Craddick SR, Elmer PJ, Obarzanek E, Vollmer WM, Svetkey LP, Swain MC |date=November 2003 |title=The DASH diet and blood pressure |journal=Current Atherosclerosis Reports |volume=5 |issue=6 |pages=484–491 |doi=10.1007/s11883-003-0039-5 |pmid=14525682 |s2cid=27229087}} Combining the DASH diet with a reduced sodium intake will further decrease blood pressure, but is not required for therapeutic effect. Indeed, it is effective at a wide range of sodium intake levels. More recent reviews of DASH have continued to advocate its efficacy as an affordable weight loss tool, but stress that diet adherence is key to produce the desired results.{{cite journal |vauthors=Steinberg D, Bennett GG, Svetkey L |date=April 2017 |title=The DASH Diet, 20 Years Later |journal=JAMA |volume=317 |issue=15 |pages=1529–1530 |doi=10.1001/jama.2017.1628 |pmc=5509411 |pmid=28278326}}

File:DIETA MEDITERRANEA ITALIA.JPG

;Mediterranean diet

The Mediterranean diet involves eating fruits, vegetables, whole grains and beans while replacing butter with extra-virgin olive oil and limiting red meats, dairy, sweets, and processed foods.{{Cite web |last=CDC |date=2022-12-06 |title=Healthy Eating for People With Diabetes |url=https://www.cdc.gov/diabetes/library/features/mediterranean-style-eating.html |access-date=2023-01-17 |website=Centers for Disease Control and Prevention |language=en-us}} It is effective for long term weight loss with added cardiovascular health benefits.{{cite journal |vauthors=Sánchez-Sánchez ML, García-Vigara A, Hidalgo-Mora JJ, García-Pérez MÁ, Tarín J, Cano A |date=June 2020 |title=Mediterranean diet and health: A systematic review of epidemiological studies and intervention trials |journal=Maturitas |language=English |volume=136 |pages=25–37 |doi=10.1016/j.maturitas.2020.03.008 |pmid=32386663|s2cid=216280612 }} For example, the Mediterranean diet can lead to decreased triglyceride and lipid levels as well as improved blood pressure readings. It can also improve blood sugar levels in those diagnosed with Type 2 Diabetes Mellitus.

;Ketogenic diet

The ketogenic or "keto" diet involves intake of less than 50 g of carbohydrates daily along with increased fat and protein amounts.{{cite journal |vauthors=Paoli A, Rubini A, Volek JS, Grimaldi KA |date=August 2013 |title=Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets |journal=European Journal of Clinical Nutrition |volume=67 |issue=8 |pages=789–796 |doi=10.1038/ejcn.2013.116 |pmid=23801097|pmc=3826507 }} One type of ketogenic or low carbohydrate diet is the "Atkins" Diet, which does not restrict protein and fat amounts. Other ketogenic diets restrict the total amount of daily proteins and fats.

;Plant-based diet

The plant-based diet is largely based on consumption of beans, grains, fruits, and vegetables and removal of meat, fish, and occasionally dairy and egg products from intake.{{cite journal |vauthors=Tran E, Dale HF, Jensen C, Lied GA |date=2020-09-30 |title=Effects of Plant-Based Diets on Weight Status: A Systematic Review |journal= Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy|language=English |volume=13 |pages=3433–3448 |doi=10.2147/DMSO.S272802 |pmc=7533223 |pmid=33061504 |doi-access=free }} In other words, fiber and unsaturated fat intake is increased and consumption of higher calorie meats and saturated fats is decreased. This diet has been shown to reduce BMI and introduce positive body composition changes when compared to a carnivore diet.{{cite journal |vauthors=Tran E, Dale HF, Jensen C, Lied GA |date=2020-09-30 |title=Effects of Plant-Based Diets on Weight Status: A Systematic Review |journal= Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy|language=English |volume=13 |pages=3433–3448 |doi=10.2147/DMSO.S272802 |pmc=7533223 |pmid=33061504 |doi-access=free }} Plant-based diets provide a lot of fiber in the meals which allows the body to lose weight and keep that weight off. Removing fried foods such as french fries, donuts, potato chips, and fried chicken, and sticking to an all plant-based diet comes with a lot of positive and healthy benefits.{{Cite journal |last=Tuso |first=Philip J. |last2=Ismail |first2=Mohamed H. |last3=Ha |first3=Benjamin P. |last4=Bartolotto |first4=Carole |date=2013 |title=Nutritional update for physicians: plant-based diets |url=https://pmc.ncbi.nlm.nih.gov/articles/PMC3662288/ |journal=The Permanente Journal |volume=17 |issue=2 |pages=61–66 |doi=10.7812/TPP/12-085 |issn=1552-5775 |pmc=3662288 |pmid=23704846}}

;Intermittent fasting

Intermittent fasting (IF) involves consistent fasting blocks of time where fewer or no calories are consumed. Intermittent fasting has been shown to improve fasting blood glucose levels and insulin resistance with a concurrent reduction in BMI.{{cite journal |display-authors=6 |vauthors=Cho Y, Hong N, Kim KW, Cho SJ, Lee M, Lee YH, Lee YH, Kang ES, Cha BS, Lee BW |date=October 2019 |title=The Effectiveness of Intermittent Fasting to Reduce Body Mass Index and Glucose Metabolism: A Systematic Review and Meta-Analysis |journal=Journal of Clinical Medicine |volume=8 |issue=10 |pages=1645 |doi=10.3390/jcm8101645 |pmc=6832593 |pmid=31601019|doi-access=free }}

= Strategies =

File:Dinner meal - MyPlate 20210810-FNS-UNC-0017.jpg

== Modifying plate size ==

Some studies have suggested that using smaller plates might help people to consume smaller portion sizes.{{cite journal | vauthors = Rolls BJ, Morris EL, Roe LS | title = Portion size of food affects energy intake in normal-weight and overweight men and women | journal = The American Journal of Clinical Nutrition | volume = 76 | issue = 6 | pages = 1207–13 | date = December 2002 | pmid = 12450884 | doi = 10.1093/ajcn/76.6.1207 | doi-access = free }}

Modifying portion sizes may impact energy intake.{{cite journal | vauthors = Ello-Martin JA, Ledikwe JH, Rolls BJ | title = The influence of food portion size and energy density on energy intake: implications for weight management | journal = The American Journal of Clinical Nutrition | volume = 82 | issue = 1 Suppl | pages = 236S–241S | date = July 2005 | pmid = 16002828 | doi = 10.1093/ajcn/82.1.236S | doi-access = free }} Those who are presented with larger portion sizes do not report to have high levels of satiety. In other words, hunger and satiety signals could be ignored with large portion sizes. In a study focused on portion sizes, participants consumed 31% less calories with the small portion sized of a 6-inch submarine sandwich compared with the large portion size of a 12-inch submarine sandwich. Increased portions have occurred simultaneously with the increase in obesity rates. Large portion sizes could be one of the factors contributing to the current increase in average body weight in the US. Evidence from a systematic review of 72 randomized controlled trials indicates that people consistently eat more food when offered larger portion, package, or tableware sizes as opposed to smaller size alternatives.{{cite journal | vauthors = Hollands GJ, Shemilt I, Marteau TM, Jebb SA, Lewis HB, Wei Y, Higgins JP, Ogilvie D | display-authors = 6 | title = Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco | journal = The Cochrane Database of Systematic Reviews | issue = 9 | pages = CD011045 | date = September 2015 | volume = 2018 | pmid = 26368271 | pmc = 4579823 | doi = 10.1002/14651858.CD011045.pub2 | department = Cochrane Public Health Group }}{{Open Access}}

== Choosing low-calorie foods ==

The majority of guidelines agree that a calorie deficit, particularly 500-750 kcal daily, can be recommended to those who want to lose weight. A moderate decrease in caloric intake will lead to a slow weight loss, which is often more beneficial than a rapid weight loss for long term weight management. For example, low fat meats reduce the total amount of calories and cholesterol consumed.{{cite journal |vauthors=Chizzolini R, Zanardi E, Dorigoni V, Ghidini S |date=April 1999 |title=Calorific value and cholesterol content of normal and low-fat meat and meat products. |journal=Trends in Food Science & Technology |volume=10 |issue=4–5 |pages=119–128 |doi=10.1016/S0924-2244(99)00034-5}}

== Increasing protein intake ==

A high protein diet relative to a low-fat or high-carbohydrate diet may increase thermogenesis and decrease appetite leading to weight reduction,{{cite journal |vauthors=Paddon-Jones D, Westman E, Mattes RD, Wolfe RR, Astrup A, Westerterp-Plantenga M |date=May 2008 |title=Protein, weight management, and satiety |journal=The American Journal of Clinical Nutrition |volume=87 |issue=5 |pages=1558S–1561S |doi=10.1093/ajcn/87.5.1558S |pmid=18469287|doi-access=free }} particularly 3-6 months into a diet when rapid weight loss is observed.{{cite journal |vauthors=Magkos F |date=September 2020 |title=The role of dietary protein in obesity |journal=Reviews in Endocrine & Metabolic Disorders |volume=21 |issue=3 |pages=329–340 |doi=10.1007/s11154-020-09576-3 |pmid=32740867 |s2cid=220888114}} However, these advantages may be reduced later at 12–24 months into a diet during the slow weight loss phase.

== Eating more soup ==

Studies have demonstrated that when compared to solid foods, soup ingestion decreases the amount of energy intake and increases feelings of satiety.{{cite journal | vauthors = Mattes R | title = Soup and satiety | journal = Physiology & Behavior | volume = 83 | issue = 5 | pages = 739–47 | date = January 2005 | pmid = 15639159 | doi = 10.1016/j.physbeh.2004.09.021 | s2cid = 2637690 }} When soup is consumed before a meal, there is a 20% decrease in the number of calories consumed during said meal.{{cite journal | vauthors = Flood JE, Rolls BJ | title = Soup preloads in a variety of forms reduce meal energy intake | journal = Appetite | volume = 49 | issue = 3 | pages = 626–34 | date = November 2007 | pmid = 17574705 | pmc = 2128765 | doi = 10.1016/j.appet.2007.04.002 }}

== Eating more dairy ==

File:Glass of milk on tablecloth.jpg

Studies have shown that a diet high in dairy decreases total body fat.{{cite journal | vauthors = Zemel MB, Richards J, Milstead A, Campbell P | title = Effects of calcium and dairy on body composition and weight loss in African-American adults | journal = Obesity Research | volume = 13 | issue = 7 | pages = 1218–1225 | date = July 2005 | pmid = 16076991 | doi = 10.1038/oby.2005.144 }} This occurs because a high amount of dietary calcium increases the amount of energy and fat excreted from the body.{{cite journal | vauthors = Jacobsen R, Lorenzen JK, Toubro S, Krog-Mikkelsen I, Astrup A | title = Effect of short-term high dietary calcium intake on 24-h energy expenditure, fat oxidation, and fecal fat excretion | journal = International Journal of Obesity | volume = 29 | issue = 3 | pages = 292–301 | date = March 2005 | pmid = 15672116 | doi = 10.1038/sj.ijo.0802785 | s2cid = 19841675 | doi-access = free }} Other studies have noted that dairy sources of calcium lead to greater weight loss than supplemental calcium intake.{{cite journal | vauthors = Zemel MB, Thompson W, Milstead A, Morris K, Campbell P | title = Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults | journal = Obesity Research | volume = 12 | issue = 4 | pages = 582–590 | date = April 2004 | pmid = 15090625 | doi = 10.1038/oby.2004.67 }} This could be due to the bioactive components of dairy sources, especially when combined with a lower calorie diet.{{cite journal | vauthors = Stonehouse W, Wycherley T, Luscombe-Marsh N, Taylor P, Brinkworth G, Riley M | title = Dairy Intake Enhances Body Weight and Composition Changes during Energy Restriction in 18-50-Year-Old Adults-A Meta-Analysis of Randomized Controlled Trials | journal = Nutrients | volume = 8 | issue = 7 | pages = 394 | date = July 2016 | pmid = 27376321 | pmc = 4963870 | doi = 10.3390/nu8070394 | doi-access = free }} Since most natural dairy products contain fat content, there is a common understanding that this may cause weight gain. However, dairy contains ingredients such as whey protein and certain combinations of protein/calcium nutrients that induce a positive effect on satiety, increase energy loss, and assists weight loss.{{cite journal | vauthors = Egger G, Egger S | title = Weight management - Facts and fallacies | journal = Australian Family Physician | volume = 38 | issue = 11 | pages = 921–923 | date = November 2009 | pmid = 19893844 | doi = }}

== Eating more vegetables ==

Fruits and vegetables have been shown to increase satiety and decrease hunger signals.{{cite journal | vauthors = Rolls BJ, Ello-Martin JA, Tohill BC | title = What can intervention studies tell us about the relationship between fruit and vegetable consumption and weight management? | journal = Nutrition Reviews | volume = 62 | issue = 1 | pages = 1–17 | date = January 2004 | pmid = 14995052 | doi = 10.1111/j.1753-4887.2004.tb00001.x | url = | doi-access = free }} These food groups have a low energy density, mainly due to the high water content and partly due to the fiber content. The reduction of energy density has been shown to enhance satiety. The water content adds satisfying weight without excess calories and fiber slows gastric emptying. Studies have also shown that fiber decreases hunger and also decreases total energy intake.

== Increasing fiber intake ==

Fruits and vegetables are two sources of fiber as discussed above. Dietary fiber has been suggested to aid weight management by inducing satiety, decreasing absorption of macronutrients and promoting secretion of gut hormones.{{cite journal | vauthors = Slavin JL | title = Dietary fiber and body weight | journal = Nutrition | location = Burbank, Los Angeles County, Calif. | volume = 21 | issue = 3 | pages = 411–8 | date = March 2005 | pmid = 15797686 | doi = 10.1016/j.nut.2004.08.018 }} Dietary fiber consists of non-digestible carbohydrates and lignin, which are a structural component in plants.{{cite book | author = Institute of Medicine of the National Academies | title = Dietary reference intakes. Proposed definition of dietary fiber | publisher = National Academies Press | location = Washington, DC | date = 2001 }}

File:Foods.jpg

Due to the high volume or water content of fiber-rich foods, fiber displaces available calories and nutrients from the diet.{{cite journal | vauthors = Saris WH | title = Glycemic carbohydrate and body weight regulation | journal = Nutrition Reviews | volume = 61 | issue = 5 Pt 2 | pages = S10–6 | date = May 2003 | pmid = 12828187 | doi = 10.1301/nr.2003.may.S10-S16 | s2cid = 43180717 | url = https://cris.maastrichtuniversity.nl/ws/files/971643/guid-e01e4d17-f194-44a0-a669-f90b50a67b6a-ASSET1.0.pdf }} Consumption of viscous fibers delays gastric emptying, which may cause an extended feeling of fullness.{{cite journal | vauthors = Schneeman BO | title = Gastrointestinal physiology and functions | journal = The British Journal of Nutrition | volume = 88 | issue = Suppl 2 | pages = S159–63 | date = November 2002 | pmid = 12495458 | doi = 10.1079/BJN2002681 | doi-access = free }} Satiety is also induced by increasing chewing, which limits food intake by promoting the secretion of saliva and gastric juice, resulting in an expansion of the stomach.{{cite journal | vauthors = Heaton KW | title = Food fibre as an obstacle to energy intake | journal = Lancet | volume = 2 | issue = 7843 | pages = 1418–21 | date = December 1973 | pmid = 4128728 | doi = 10.1016/s0140-6736(73)92806-7 }} In addition, hormone secretion is affected during fiber ingestion.{{cite journal | vauthors = Korner J, Leibel RL | title = To eat or not to eat - how the gut talks to the brain | journal = The New England Journal of Medicine | volume = 349 | issue = 10 | pages = 926–8 | date = September 2003 | pmid = 12954739 | doi = 10.1056/NEJMp038114 }} Insulin response is reduced and cholecystokinin (CCK) in the small intestine is increased. Insulin regulates blood glucose levels while CCK adjusts gastric emptying, pancreatic secretion, and gall bladder contraction. There is a direct correlation between CCK and satiety after foods of different fiber contents are consumed.{{cite journal | vauthors = Holt SH, Brand-Miller JC, Stitt PA | title = The effects of equal-energy portions of different breads on blood glucose levels, feelings of fullness and subsequent food intake | journal = Journal of the American Dietetic Association | volume = 101 | issue = 7 | pages = 767–73 | date = July 2001 | pmid = 11478473 | doi = 10.1016/S0002-8223(01)00192-4 }}

In general, large intakes of dietary fiber at breakfast have been associated with less food intake at lunchtime.{{cite journal |vauthors=Levine AS, Tallman JR, Grace MK, Parker SA, Billington CJ, Levitt MD |date=December 1989 |title=Effect of breakfast cereals on short-term food intake |journal=The American Journal of Clinical Nutrition |volume=50 |issue=6 |pages=1303–7 |doi=10.1093/ajcn/50.6.1303 |pmid=2556910|doi-access=free }} Fiber may have the added benefit of helping consumers reduce food intake throughout the day, but results of studies examining this possibility have been conflicting.

== Increasing resistant starch intake ==

Resistant starch is a type of non-digestible, fermentable fiber resistant to amylase digestion in the small intestine. It is broken down to short-chain fatty acids by microflora in the large intestine. It is commonly found in cooked and cooled potatoes, green bananas, beans and legumes.{{cite journal | vauthors = Nugent AP | title = Health properties of resistant starch. | journal = Nutrition Bulletin | date = March 2005 | volume = 30 | issue = 1 | pages = 27–54 | doi = 10.1111/j.1467-3010.2005.00481.x | doi-access = free }} The short chain fatty acids can lead to further oxidation of fat and a higher energy expenditure.{{cite journal | vauthors = Canfora EE, Meex RC, Venema K, Blaak EE | title = Gut microbial metabolites in obesity, NAFLD and T2DM | journal = Nature Reviews. Endocrinology | volume = 15 | issue = 5 | pages = 261–273 | date = May 2019 | pmid = 30670819 | doi = 10.1038/s41574-019-0156-z | s2cid = 58948657 | url = https://cris.maastrichtuniversity.nl/en/publications/0811560e-31d3-4d94-be36-21c5d4247ec5 }} Resistant starch dilutes energy density of food intake, maintains a bulking effect similar to non-fermentable fiber, and increases the expression of gut hormones PYY and GLP-1.{{cite journal | vauthors = Englyst HN, Kingman SM, Cummings JH | title = Classification and measurement of nutritionally important starch fractions | journal = European Journal of Clinical Nutrition | volume = 46 | issue = Suppl 2 | pages = S33–50 | date = October 1992 | pmid = 1330528 | doi = | url = }}{{cite journal | vauthors = Higgins JA | title = Resistant starch: metabolic effects and potential health benefits | journal = Journal of AOAC International | volume = 87 | issue = 3 | pages = 761–8 | date = 2004 | pmid = 15287677 | doi = 10.1093/jaoac/87.3.761 | doi-access = free }}{{cite journal | vauthors = Zhou J, Hegsted M, McCutcheon KL, Keenan MJ, Xi X, Raggio AM, Martin RJ | title = Peptide YY and proglucagon mRNA expression patterns and regulation in the gut | journal = Obesity | location = Silver Spring, Md. | volume = 14 | issue = 4 | pages = 683–9 | date = April 2006 | pmid = 16741270 | doi = 10.1038/oby.2006.77 | s2cid = 20183780 | doi-access = free }} The increase in gut hormone expression affects neuronal pathways in the brain that contribute to long-term energy balance{{cite journal | vauthors = Abbott CR, Monteiro M, Small CJ, Sajedi A, Smith KL, Parkinson JR, Ghatei MA, Bloom SR | title = The inhibitory effects of peripheral administration of peptide YY(3-36) and glucagon-like peptide-1 on food intake are attenuated by ablation of the vagal-brainstem-hypothalamic pathway | journal = Brain Research | volume = 1044 | issue = 1 | pages = 127–31 | date = May 2005 | pmid = 15862798 | doi = 10.1016/j.brainres.2005.03.011 | s2cid = 13546829 }}{{cite journal | vauthors = Badman MK, Flier JS | title = The gut and energy balance: visceral allies in the obesity wars | journal = Science | volume = 307 | issue = 5717 | pages = 1909–14 | date = March 2005 | pmid = 15790843 | doi = 10.1126/science.1109951 | bibcode = 2005Sci...307.1909B | s2cid = 7681272 }} and improved overall health of the intestines.{{cite journal | vauthors = Davie JR | title = Inhibition of histone deacetylase activity by butyrate | journal = The Journal of Nutrition | volume = 133 | issue = 7 Suppl | pages = 2485S–2493S | date = July 2003 | pmid = 12840228 | doi = 10.1093/jn/133.7.2485S | doi-access = free }}

== Increasing caffeine intake ==

Caffeine and black coffee have been associated with increased energy expenditure and subsequent weight loss.{{cite journal | vauthors = Acheson KJ, Zahorska-Markiewicz B, Pittet P, Anantharaman K, Jéquier E | title = Caffeine and coffee: their influence on metabolic rate and substrate utilization in normal weight and obese individuals | journal = The American Journal of Clinical Nutrition | volume = 33 | issue = 5 | pages = 989–97 | date = May 1980 | pmid = 7369170 | doi = 10.1093/ajcn/33.5.989 }} Caffeine belongs to a class of compounds called methylxanthines and is present in coffee, tea, cocoa, chocolate and some cola drinks.{{cite journal | vauthors = Westerterp-Plantenga M, Diepvens K, Joosen AM, Bérubé-Parent S, Tremblay A | title = Metabolic effects of spices, teas, and caffeine | journal = Physiology & Behavior | volume = 89 | issue = 1 | pages = 85–91 | date = August 2006 | pmid = 16580033 | doi = 10.1016/j.physbeh.2006.01.027 | s2cid = 16414937 }} Caffeine induces a thermogenic effect in the body by increasing sympathetic nervous system activity, which is an important regulator of energy expenditure.{{cite journal | vauthors = Dulloo AG | title = Biomedicine. A sympathetic defense against obesity | journal = Science | volume = 297 | issue = 5582 | pages = 780–1 | date = August 2002 | pmid = 12161638 | doi = 10.1126/science.1074923 | s2cid = 71039869 }}{{cite journal | vauthors = Astrup A, Toubro S, Cannon S, Hein P, Breum L, Madsen J | title = Caffeine: a double-blind, placebo-controlled study of its thermogenic, metabolic, and cardiovascular effects in healthy volunteers | journal = The American Journal of Clinical Nutrition | volume = 51 | issue = 5 | pages = 759–67 | date = May 1990 | pmid = 2333832 | doi = 10.1093/ajcn/51.5.759 | doi-access = free }}{{cite journal | vauthors = Astrup A, Toubro S | title = Thermogenic, metabolic, and cardiovascular responses to ephedrine and caffeine in man | journal = International Journal of Obesity and Related Metabolic Disorders | volume = 17 | issue = Suppl 1 | pages = S41–3 | date = February 1993 | pmid = 8384179 | doi = | url = }}

== Increasing green tea intake ==

File:Health benefits of green tea.png

Catechins are polyphenols that are a major component of green tea extract.{{cite journal |vauthors=Graham HN |date=May 1992 |title=Green tea composition, consumption, and polyphenol chemistry |journal=Preventive Medicine |volume=21 |issue=3 |pages=334–50 |doi=10.1016/0091-7435(92)90041-f |pmid=1614995}} Green tea has been associated with decreasing blood glucose, inhibiting hepatic and body fat accumulation,{{cite journal | vauthors = Matsumoto N, Ishigaki F, Ishigaki A, Iwashina H, Hara Y | title = Reduction of blood glucose levels by tea catechin. | journal = Bioscience, Biotechnology, and Biochemistry | date = April 1993 | volume = 57 | issue = 4 | pages = 525–527 | doi = 10.1271/bbb.57.525 }}{{cite conference | vauthors = Ishigaki A, Tonooka F, Matsumoto N, Hara Y | title = Suppression of the accumulation of body and liver fat by tea catechin. | location = Shizuoka, Japan | conference = Organizing Committee of International Symposium on Tea Science | date = August 1991 | pages = 309–313 }} and stimulating thermogenesis{{cite journal | vauthors = Dulloo AG, Seydoux J, Girardier L, Chantre P, Vandermander J | title = Green tea and thermogenesis: interactions between catechin-polyphenols, caffeine and sympathetic activity | journal = International Journal of Obesity and Related Metabolic Disorders | volume = 24 | issue = 2 | pages = 252–8 | date = February 2000 | pmid = 10702779 | doi = 10.1038/sj.ijo.0801101 | s2cid = 6895328 | url = }} due to the catechins present in formulations. Moreover, catechins in the brain play a major role in satiety.{{cite journal |vauthors=Wellman PJ |date=October 2000 |title=Norepinephrine and the control of food intake |journal=Nutrition (Burbank, Los Angeles County, Calif.) |volume=16 |issue=10 |pages=837–42 |doi=10.1016/s0899-9007(00)00415-9 |pmid=11054588}} Independent of the caffeine content, green tea has also been shown to increase energy expenditure and fat oxidation in humans.{{cite journal | vauthors = Chantre P, Lairon D | title = Recent findings of green tea extract AR25 (Exolise) and its activity for the treatment of obesity | journal = Phytomedicine | volume = 9 | issue = 1 | pages = 3–8 | date = January 2002 | pmid = 11924761 | doi = 10.1078/0944-7113-00078 }}

While green tea intake alone may not significantly reduce weight or BMI, combining intake with other strategies aimed at weight loss could be helpful for both loss and weight maintenance.{{cite journal | vauthors = Jurgens TM, Whelan AM, Killian L, Doucette S, Kirk S, Foy E | title = Green tea for weight loss and weight maintenance in overweight or obese adults | journal = The Cochrane Database of Systematic Reviews | volume = 2012 | issue = 12 | pages = CD008650 | date = December 2012 | pmid = 23235664 | pmc = 8406948 | doi = 10.1002/14651858.CD008650.pub2 | collaboration = Cochrane Metabolic and Endocrine Disorders Group }}