Treatment Guidelines from The Medical Letter
Diet, Drugs and Surgery for Weight Loss
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Revised 5/6/08: Adjustable Gastric Banding paragraph, 1st sentence has been changed from "Use of a laparoscopically adjustable gastric band placed around..." to "Use of an adjustable gastric band placed laparoscopically around..." In the second sentence, the words through a subcutaneous reservoir have been added.

Definitions of overweight and obesity are now based on the body mass index (BMI). The BMI is calculated by dividing the weight in kilograms by the square of the height in meters (kg/m2). Adults with a BMI of ≥25 are considered overweight; those with a BMI of >30 are considered obese.


For any diet to be effective, caloric expenditure must exceed caloric intake. One pound of fat is equivalent to 3500 Kcalories; adults can lose 1-2 lbs per week by consuming 500-1000 fewer Kcalories per day.

TYPES OF DIETS — Table 1 lists 5 popular diets. Manipulation of the proportions of protein, fat and carbohydrate in the diet is an old approach to making one type of diet more attractive than another. Most diet plans also include a component of lifestyle and behavior modification.

COMPARATIVE TRIALS —Two trials of low-carbohydrate vs. conventional diets ... more      

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