Article 90: Following Weight Loss Measures and Developing a Weight Loss Plan

Anyone who is obese can lose weight. However, whether the weight loss can be maintained in the long term is uncertain. Pessimists believe that some people are born fat, and there is nothing we can do about it; others believe those exaggerated advertisements that claim that a certain product can make people lose weight effortlessly, and then they can be fat again once and for all.

In fact, treating obesity is like mastering a foreign language; anyone with a certain level of ability, who receives certain guidance, and is prepared to invest certain effort can achieve their goal.

Weight loss must be guided by science, and the measures should be comprehensive. Those trying to lose weight should follow these six steps: ① Daily calorie intake should be lower than calorie expenditure, creating a negative energy balance. Based on this, with sustained effort (at least six months to one year), a new energy balance should be gradually established. However, it is important to avoid excessive dieting to prevent insufficient intake of various nutrients. ② Weight loss should not be too rapid or drastic; it should be gradual, with a monthly weight loss not exceeding 2 kg. ③ The diet provided for weight loss should be acceptable to the overweight person in terms of dietary habits, local customs, color, aroma, taste, and price to ensure long-term adherence and avoid inconsistent efforts. ④ Through behavioral guidance, help overweight people change various unhealthy eating and lifestyle habits that easily lead to obesity. The diets and eating habits that overweight people prefer are often the causes of their obesity. Therefore, it is important to patiently explain this to them. ⑤ Incorporate regular aerobic activities (such as walking, running, cycling, dancing, etc.) into their basic lifestyle. ⑥ Seek full support from the external environment. The core of the above can be summarized into three key points, or twelve words: a balanced diet, daily exercise, and behavioral changes.

Most obese people have a strong desire to lose weight, but turning this desire into reality is not easy, and maintaining the weight loss requires long-term, arduous effort. Weight loss is a systematic project; it cannot be achieved on a whim or through blind experimentation, and there are no magic bullets. Otherwise, haste makes waste; the faster the weight loss, the faster it will rebound. Therefore, before starting any weight loss program, careful consideration and a realistic, feasible plan are essential.

The first step in developing a weight loss plan is to establish weight loss goals that are appropriate for your individual circumstances, namely: ① How much weight should you lose? ② How long should it take to achieve this? ③ What are the main weight loss methods you will use?

To ensure your weight loss plan is truly effective and achieves results on schedule, you need to learn the necessary skills and make a commitment to yourself. Those trying to lose weight must diligently learn the methods, learn to apply them in different situations, and adapt them flexibly to their own circumstances. A commitment to yourself means that once you've made a plan, you must be determined to complete it, persevere, and have patience and willpower. The plan is like a mirror reflecting your commitment, requiring constant self-reflection. Conversely, without a steadfast commitment and diligent execution throughout the weight loss process, even the best plan is just empty talk.

A balanced diet is the foundation of all weight loss plans. Once patients have grasped basic nutritional knowledge, they can freely choose foods, cook them properly, and eat in moderation to achieve the goal of maintaining health through a balanced diet. Overcoming unhealthy eating and lifestyle habits helps patients establish a healthy lifestyle.

Exercise aimed at increasing aerobic activity is an important part of physical fitness management. While exercise has little immediate effect on weight loss, it is crucial for long-term weight control. External support, including the attitudes of doctors, teachers, family, friends, and even strangers-such as ridicule versus sincere help-has a world of difference in its impact on obese individuals.

Even with a well-defined weight loss plan, including clear goals and specific measures, success isn't guaranteed. After a period of practice, you'll find that your weight loss goals, plans, methods, and approaches all need modification. The reason and basis for these modifications should be the evaluation results of your weight loss efforts.

Sometimes, such evaluation results confirm that the original plan is feasible. For example, you may find that the adjusted diet has an ideal weight loss effect, and it is necessary to continue for a period of time. This feedback is called positive feedback. However, in most cases, the evaluation finds that the specific measures are not satisfactory or there are areas for improvement. In this case, the feedback is negative feedback.

Choosing the right weight loss method is crucial to a weight loss plan. However, in the actual treatment of obesity, there are no absolute rules regarding which method should be the primary approach and which should be the secondary approach; the choice should be made flexibly based on the patient's specific situation.

(1) Pathological obesity: Secondary obesity caused by endocrine disorders such as Cushing's syndrome, hypothyroidism, and islet cell tumors should be treated aggressively. Iatrogenic obesity, such as obesity caused by the use of glucocorticoids, chlorpromazine, isoniazid, etc., should be treated with different measures such as discontinuation or dosage reduction depending on the specific situation. Although there is currently no good treatment for obesity caused by diseases of the hypothalamus, in some cases, the use of food reduction therapy can reduce appetite and play a certain therapeutic role.

(2) Simple obesity: The treatment of simple obesity mainly starts with solving the problem of energy supply and consumption balance. At the same time, it is combined with diet therapy, exercise therapy, behavior therapy, drug therapy, etc., to change the bad living habits and environment of patients and their families, and strengthen patient education. These measures can often achieve good results.

Different treatment methods are selected based on the degree of obesity, which is the most commonly used basic approach in clinical practice. ① For obesity of 10%–20%, treatment can be conducted at home, primarily using behavioral therapy, supplemented by diet therapy and exercise therapy, and traditional Chinese medicine may also be considered. ② For obesity of 20%–40%, treatment can be conducted at home, primarily using behavioral therapy, supplemented by diet therapy and exercise therapy, and traditional Chinese medicine may also be considered. If treatment is conducted on an outpatient basis, diet therapy is the primary method, supplemented by behavioral therapy and exercise therapy, and traditional Chinese medicine may also be considered. ③ For obesity of 40%–70%, treatment can be conducted on an outpatient basis, primarily using diet therapy, supplemented by behavioral therapy and exercise therapy, and traditional Chinese medicine may also be considered. If hospitalization is required, diet therapy is the primary method, supplemented by behavioral therapy and exercise therapy. ④ For obesity of 70%–100%, hospitalization is generally required, primarily using diet therapy, supplemented by behavioral therapy, exercise therapy, and medication.

During pregnancy, obesity should be prevented and treated early, with prevention being the primary focus. Pregnant women should eat a balanced diet with a variety of components to meet all essential nutrients and energy needs without causing excess calories. Pregnant women should not be picky eaters; three meals a day are sufficient, provided they include adequate amounts of animal protein, legumes, and fresh vegetables, without the need for extra snacks. For pregnant women who already had a significant weight gain before pregnancy or who have gained significant weight during pregnancy, it is advisable to appropriately limit food intake, especially avoiding excessive sugar consumption. At this time, all other weight loss methods are not permitted.