Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue or lean mass, namely bone mineral deposits, muscle, tendon, and other connective tissue.
Weight loss can either occur unintentionally due to malnourishment or an underlying disease or arise from a conscious effort to improve an actual or perceived overweight or obese state. “Unexplained” weight loss that is not caused by a reduction in calorific intake or exercise is called cachexia and may be a symptom of a serious medical condition. Intentional weight loss is commonly referred to as slimming.
Intentional weight loss is the loss of total body mass as a result of efforts to improve fitness and health, or to change appearance through slimming. Weight loss in individuals who are overweight or obese can reduce health risks, increase fitness, and may delay the onset of diabetes. It could reduce pain and increase movement in people with osteoarthritis of the knee. Weight loss can lead to a reduction in hypertension (high blood pressure), however, whether this reduces hypertension-related harm is unclear.
Weight loss occurs when the body is expending more energy in work and metabolism than it is absorbing from food or other nutrients. It will then use stored reserves from fat or muscle, gradually leading to weight loss. For athletes seeking to improve performance or to meet required weight classification for participation in a sport, it is not uncommon to seek additional weight loss even if they are already at their ideal body weight.
Others may be driven to lose weight to achieve an appearance they consider more attractive. However, being underweight is associated with health risks such as difficulty fighting off infection, osteoporosis, decreased muscle strength, trouble regulating body temperature and even increased risk of death.
Low-calorie diets are also referred to as balanced percentage diets. Due to their minimal detrimental effects, these types of diets are most commonly recommended by nutritionists. In addition to restricting calorie intake, a balanced diet also regulates macronutrient consumption. From the total number of allotted daily calories, it is recommended that 55% should come from carbohydrates, 15% from protein, and 30% from fats with no more than 10% of total fat coming from saturated forms.
For instance, a recommended 1,200 calorie diet would supply about 660 calories from carbohydrates, 180 from protein, and 360 from fat. Some studies suggest that increased consumption of protein can help ease hunger pangs associated with reduced caloric intake by increasing the feeling of satiety. Calorie restriction in this way has many long-term benefits.
After reaching the desired body weight, the calories consumed per day may be increased gradually, without exceeding 2,000 net (i.e. derived by subtracting calories burned by physical activity from calories consumed). Combined with increased physical activity, low-calorie diets are thought to be most effective long-term, unlike crash diets, which can achieve short-term results, at best. Physical activity could greatly enhance the efficiency of a diet. The healthiest weight loss regimen, therefore, is one that consists of a balanced diet and moderate physical activity.
Weight gain has been associated with excessive consumption of fats, (added) sugars, refined carbohydrates in general, and alcohol consumption. Depression, stress or boredom may also contribute to weight increase, and in these cases, individuals are advised to seek medical help. A 2010 study found that dieters who got a full night’s sleep lost more than twice as much fat as sleep-deprived dieters.
Though hypothesized that supplementation of vitamin D may help, studies do not support this. The majority of dieters regain weight over the long term.
According to the Dietary Guidelines for Americans, those who achieve and manage a healthy weight do so most successfully by being careful to consume just enough calories to meet their needs, and being physically active. According to the U.S. Food and Drug Administration (FDA), healthy individuals seeking to maintain their weight should consume 2,000 calories (8.4 MJ) per day.
The least intrusive weight loss methods, and those most often recommended are adjustments to eating patterns and increased physical activity, generally in the form of exercise. The World Health Organization recommended that people combine a reduction of processed foods high in saturated fats, sugar and salt and caloric content of the diet with an increase in physical activity.
An increase in fiber intake is also recommended for regulating bowel movements. Other methods of weight loss include use of drugs and supplements that decrease appetite, block fat absorption, or reduce stomach volume. Bariatric surgery may be indicated in cases of severe obesity. Two common bariatric surgical procedures are gastric bypass and gastric banding. Both can be effective at limiting the intake of food energy by reducing the size of the stomach, but as with any surgical procedure both come with their own risks that should be considered in consultation with a physician. Dietary supplements, though widely used, are not considered a healthy option for weight loss. Many are available, but very few are effective in the long term.
Virtual gastric band uses hypnosis to make the brain think the stomach is smaller than it really is and hence lower the amount of food ingested. This brings as a consequence weight reduction. This method is complemented with psychological treatment for anxiety management and with hypnopedia. Research has been conducted into the use of hypnosis as a weight management alternative.
In 1996 a study found that cognitive-behavioral therapy (CBT) was more effective for weight reduction if reinforced with hypnosis. Acceptance and Commitment Therapy ACT, a mindfulness approach to weight loss, has also in the last few years been demonstrating its usefulness.
Permanent weight loss
In order for weight loss to be permanent, changes in diet and lifestyle must be permanent as well. Short-term dieting has not been shown to produce either long term weight loss or better health, and may even be counterproductive.
Unintentional weight loss may result from loss of body fats, loss of body fluids, muscle atrophy, or even a combination of these. It is generally regarded as a medical problem when at least 10% of a person’s body weight has been lost in six months or 5% in the last month. Another criterion used for assessing weight that is too low is the body mass index (BMI). However, even lesser amounts of weight loss can be a cause for serious concern in a frail elderly person.
Unintentional weight loss can occur because of an inadequately nutritious diet relative to a person’s energy needs (generally called malnutrition). Disease processes, changes in metabolism, hormonal changes, medications or other treatments, disease- or treatment-related dietary changes, or reduced appetite associated with a disease or treatment can also cause unintentional weight loss. Poor nutrient utilization can lead to weight loss, and can be caused by fistulae in the gastrointestinal tract, diarrhea, drug-nutrient interaction, enzyme depletion and muscle atrophy.
Continuing weight loss may deteriorate into wasting, a vaguely defined condition called cachexia. Cachexia differs from starvation in part because it involves a systemic inflammatory response. It is associated with poorer outcomes. In the advanced stages of progressive disease, metabolism can change so that they lose weight even when they are getting what is normally regarded as adequate nutrition and the body cannot compensate. This leads to a condition called anorexia cachexia syndrome (ACS) and additional nutrition or supplementation is unlikely to help. Symptoms of weight loss from ACS include severe weight loss from muscle rather than body fat, loss of appetite and feeling full after eating small amounts, nausea, anemia, weakness and fatigue.
Serious weight loss may reduce quality of life, impair treatment effectiveness or recovery, worsen disease processes and be a risk factor for high mortality rates. Malnutrition can affect every function of the human body, from the cells to the most complex body functions, including:
– immune response;
– wound healing;
– muscle strength (including respiratory muscles);
– renal capacity and depletion leading to water and electrolyte disturbances;
– thermoregulation; and
In addition, malnutrition can lead to vitamin and other deficiencies and to inactivity, which in turn may pre-dispose to other problems, such as pressure sores.
Unintentional weight loss can be the characteristic leading to diagnosis of diseases such as cancer and type 1 diabetes.
In the UK, up to 5% of the general population is underweight, but more than 10% of those with lung or gastrointestinal diseases and who have recently had surgery. According to data in the UK using the Malnutrition Universal Screening Tool (‘MUST’), which incorporates unintentional weight loss, more than 10% of the population over the age of 65 is at risk of malnutrition. A high proportion (10-60%) of hospital patients are also at risk, along with a similar proportion in care homes.
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