How can I lose weight?

Motivation is crucial
No weight-loss plan will work unless you have a serious desire to lose weight. You may not feel that being overweight or obese is a problem to you, and have little motivation or desire to lose weight. That is fine, so long as you understand the health risks.

Current food intake
It is helpful to know exactly how much you currently eat. An estimate is often inaccurate. Therefore, a detailed diary of every amount of food and drink that you have over an average week is more helpful. You can discuss this with a nurse or dietician. The number of calories that you eat in a typical week can then be calculated. The simple fact is that, to lose weight, you must eat less than your current food intake.

Eat a healthy balanced diet
Another leaflet in this series called 'Healthy Eating' gives more details. Briefly a healthy diet means:
AT LEAST five portions of a variety of fruit and vegetables per day.
THE BULK OF MOST MEALS should be starch-based foods (such as cereals, wholegrain bread, potatoes, rice, pasta), plus fruit and vegetables.
NOT MUCH fatty food such as fatty meats, cheeses, full-cream milk, fried food, butter, etc. Use low fat, mono-, or poly-unsaturated spreads.
INCLUDE 2-3 portions of fish per week. At least one of which should be 'oily' (such as herring, mackerel, sardines, kippers, pilchards, salmon, or fresh tuna).
If you eat meat it is best to eat lean meat, or poultry such as chicken.
If you do fry, choose a vegetable oil such as sunflower, rapeseed or olive oil.
Try not to add salt to food, and avoid foods that are salty.

It is best to eat three healthy meals each day, including breakfast. Eat each meal slowly. Don't skip meals. Skipping meals will just make you feel more hungry, make you think more about food, and you are more likely to overeat in the evening. Do not snack between meals. Cut back on alcohol if you drink a lot.

Physical actvity
If you are able, aim to do at least 60-90 minutes of moderate physical activity on at least five days a week. (All adults should aim for at least 30 minutes on five days a week. However, 60-90 minutes is recommended if you are overweight or obese and are aiming to lose weight.) Moderate physical activity includes: brisk walking, jogging, dancing, swimming, badminton, tennis, etc. In addition, try to do more in your daily routines. For example, use stairs instead of lifts, walk or cycle to work or school, etc. See separate leaflet called 'Physical Activity for Health' for details.

Be realistic
Some people aim to get down to a 'perfect' weight. However, if this target is too low, you may become fed up about poor progress, and give up. As mentioned, in most cases most health benefits come from losing the first 5-10% of your weight (often about 5-10 kg). Also, to diet for 3-4 months is the most that many people can manage. It is difficult to remain motivated after this. To lose 5 kg is considered good. To lose 10 kg is excellent. (10 kg is about one and a half stone.)

Lose weight gradually
It is best not to lose weight too fast. If you lose more than a kilogram per week, you may lose muscle tissue rather than fat. It is best to lose an average of ½-1 kg per week (about 1-2 lb per week). To do this you need to eat 500-1000 calories per day less than you did before your diet. You will lose 6-12 kg if you keep this up for three months. Don't be disheartened by minor increases or levelling off in weight for a few days. Look for the overall trend over several months.

Depression or other mental health problems
These may cause you to eat for comfort, or to binge eat. This may lead to weight gain, which may make you more depressed, and so on. See a doctor if you feel that you have depression or another mental health problem. Treatment often helps.

Other general points
The first kilogram is the easiest to lose. This is because you lose water from your body at first as well as fat. It is important to be aware that the initial kilogram or so may seem to fall off, but then the weight loss commonly slows down. Regular weighing, advice, and encouragement by a nurse or dietician is often helpful.

Special diets which are often advertised are not usually helpful. This is because after losing weight, if your old eating habits remain, the weight often goes straight back on. It is usually not a special diet that is needed, but changing to a normal healthy balanced diet - for good.

Medical treatments
Medicines to help with weight loss are an option in some cases. They may help, but they are not wonder-drugs, and you still need to eat less. Doctors are given guidelines on when to prescribe these medicines.

Counselling is sometimes useful, but may not be available in all areas. This may be done 'one-to-one', or in a group setting. The kind of topics discussed may include:
how to choose meals that are lower in fat and calories.
how to recognise and resist cues that may make you want to eat when you are not hungry.
tips on how to reduce the number and size of meals.
how to eat more slowly.
how to separate eating from other activities, such as eating in front of the TV.

Surgery is an option if you are very obese. Results are usually good.

Keeping the weight off

Many people lose weight but, at the end of the 'diet', the weight goes back on. To keep the weight off, it is vital that you have a permanent change in your attitudes and lifestyle. This usually means
keeping to a healthy diet.
exercising regularly, if possible.
possibly, a change for the whole household. It is difficult for one member of a household to shop and eat differently to the rest. It is best that the whole household eat a healthy diet.
It does not mean less enjoyment of food. However, it may take a while to learn to enjoy different foods, meals, and recipes.

Some people need more support to keep to a reduced weight than when they were actually dieting and losing weight. A local support group may be useful for this.