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Nutrition is an important part of maintaining a healthy body weight.

Weight management refers to behaviors, techniques, and physiological processes that contribute to a person's ability to attain and maintain a healthy weight.^[1]^[2] Most weight management techniques encompass long-term lifestyle strategies that promote healthy eating and daily physical activity.^[3] Moreover, weight management involves developing meaningful ways to track weight over time and to identify ideal body weights for different individuals.^[4]

Weight management strategies most often focus on achieving healthy weights through slow but steady weight loss, followed by maintenance of an ideal body weight.^[5] However, weight neutral approaches to health have also been shown to result in positive health outcomes.^[6]^[7]

Understanding the basic science of weight management and strategies for attaining and maintaining a healthy weight is very important because obesity is a risk factor for development of many chronic diseases, like Type 2 diabetes, hypertension and cardiovascular disease.^[1]^[5]^[8]

Key concepts

There are many factors that contribute to a person's weight, including: diet, physical activity, genetics, environmental factors, health care support, medications, and illnesses.^[5]^[9]^[10] 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 above all other factors because they can be affected by conscious behavior modification.^[9]^[11] 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.^[9] 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^[9]^[12]

The calories a person consumes come from both the foods and drinks they eat and drink.^[9] The calories a person expends comes from their basal metabolic rate and their daily physical activity.^[5] When eating a healthy diet mainly composed of vegetables, lean meats, and fruits, the human body is very good at maintaining a neutral energy balance so that calories consumed do not substantially exceed calories expended in a given time period and vice versa.^[5] This energy balance is regulated by hormones like Leptin (suppresses), Ghrelin (stimulates), and Cholecystokinin (suppresses) which either suppress or stimulate appetite.^[5] If attempting to lose weight, the National Heart, Lung, and Blood Institute (NHLBI) recommends a slow and steady approach by eating 500 fewer calories than the number of calories burned or expended each day.^[9]

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.^[5]^[9]^[12]^[11] 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.^[5] Increased portion sizes may also lead to increased energy intake.^[5]

Physical activity

Physical activity is one of the main components of a person's daily energy expenditure.^[13] Physical activity can be related to a person's professional activities, non-work related daily activities, or it can be in the form of physical exercise.^[5] Physical activity can encompass anything from gardening, cleaning, hiking, yoga, and stretching to kickboxing, strength training, or jogging.^[14]^[15] Such physical activity may help a person to maintain a healthy weight and avoid developing noncommunicable diseases like diabetes, heart disease, and dyslipidemia (high cholesterol).^[5] Increasing physical activity is particularly important following a diet to prevent catch-up fat according to the physiological concept of the Summermatter cycle.^[16]

Basal metabolic rate

An energy deficit remains important for sustainable weight loss.^[11] Basal metabolic rate (BMR) is one of the main components of a person's daily energy expenditure.^[13] BMR is defined as the amount of energy that is expended during a given amount of time by a person at rest.^[13] In other words, it is the amount of energy a person's body uses to do things like pump blood, maintain proper brain function, breakdown toxins, and ensure other bodily functions. Technically speaking, BMR is the amount of energy the body expends during the following very specific conditions: right after waking up, while in a resting state, and after fasting for 12–14 hours.^[13] Sometimes the term Resting Metabolic (RMR) is used in place of BMR but RMR is slightly different in that it is not measured under the previously listed stringent conditions and is about 10% more than BMR.^[13]

BMR is directly proportional to a person's lean body mass.^[5]^[13] 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 conditions like burns, fractures, infections, fevers, etc.^[13] BMR can be measured via direct and indirect calorimetry; however, it is possible to estimate a person's BMR using one of several equations that use a person's age, sex, height, and weight to calculate a fairly accurate estimate of a person's BMR.^[13] 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.^[17]

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)^[17]

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)^[17]

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^[17]

The Mifflin St. Jeor Equation was found to be the most accurate predictor of BMR compared to BMR measured by direct and indirect calorimetry.^[17]

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.^[5] 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):^[5]

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

or

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

Though BMI is often used to help assess for excess weight, it is by no means a perfect representation of a person's body fat percentage.^[5] For example, an individual can have a higher than normal BMI but have a normal body fat percentage if they have higher than average muscle mass because excess muscle contributes to a higher weight. The following table shows how different ranges of BMIs are often categorized into underweight, normal weight, overweight, and obese:^[5]

Classification of Overweight and Obesity by Body Mass Index (BMI)
Category^[18]	BMI
Underweight	< 18.5
Normal Weight	18.5 – 24.9
Overweight	25.0 – 29.9
Obesity (Class I)	30.0 – 34.9
Obesity (Class II)	35.0 – 39.9
Obesity (Class III)	≥ 40.0

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 as it pertains to body fat.^[5] Despite not being a perfect representation of healthy and unhealthy weight, BMI is very important value because it helps health professionals identify people who are at higher risk of developing illnesses like diabetes, hypertension, dyslipidemia (high cholesterol), liver disease, and some cancers.^[5] In general, as BMI increases so too does a person's risk of developing those previously stated illnesses.^[5] Additionally, regularly calculating a person's BMI can also be used to help track changes in a person's body mass over time.

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.^[5]^[13] 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.^[5]^[13] Processing proteins and carbohydrates has more of a thermogenic effect than does processing fats.^[5]

Genetics

Genetics play an important role in weight management and contribute to a person's risk of becoming obese.^[5] In fact, several genes have been found to be associated with elevated Body Mass Index (BMI) and obesity.^[5] That being said, only a small portion of a person's excess weight can be attributed to genetics considering other significant factors as discussed in this section.^[5]

There are some rare genetic disorders that do cause significant weight gain like Prader-Willi Syndrome.^[5]

Medications

Certain medications can cause either weight loss or weight gain.^[5] For example, antipsychotic medications, steroid hormones, and certain anti-diabetic medications may lead to added weight.^[5]These side effects are often listed for each medication and should be considered when attempting to manage a person's weight.^[5]

Metanalysis has shown that phentermine and topiramate, pramlintide, naltrexone, bupropion, and liraglutide have been shown to induce weight loss; this provides new insights into anti-obesity drugs and future research on obesity management and treatment.^[19] Semaglutide is another approved^{[by whom?]} anti-obesity drug that is also used for blood sugar control.^[20] However, use of approved anti-obesity drugs is dependent on side affects and profiles. For example, those with cardiovascular disease should not use phentermine.^[20] Liraglutide and semaglutide are contraindicated for those at increased risk for medullary thyroid cancer or type 2 multiple endocrine neoplasia.^[20] A healthcare practitioner's decision to prescribe anti-obesity medications is subject to knowledge of established clinical guidelines, resources, and patient histories.^[20]

Diseases

There are several medical conditions that are associated with either weight loss or weight gain. Medical conditions associated with weight gain include hypothyroidism, Cushing's syndrome, Polycystic Ovary Syndrome (PCOS), and congestive heart failure.^[5]^[21] On the other hand, unintentional weight loss can be due to disease and medical conditions such as cancer, gastrointestinal illness, psychiatric disorders, infections, endocrine disorders, and neurologic disorders. Common gastrointestinal disorders associated with weight loss are malabsorption due to Celiac disease or chronic pancreatitis. Depression and eating disorders such as anorexia nervosa are a common cause of 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.

File:Cushing's Syndrome.webp

This photo represents symptoms of Cushing's syndrome- a medical condition 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.^[22] 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 and contribute to the development of PCOS.^[22] 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.^[22]

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.^[23] In individuals with higher body mass index concerning for obesity, there are increased hormones, proinflammatory markers, and glycerol, which contribute to insulin resistance.^[23] The combined effects of impaired pancreatic β-islet cells and insulin resistance increase one’s likelihood of developing diabetes.^[23]

The importance of weight management in type 2 diabetes mellitus has been well studied. In individuals who have blood sugar levels considered to be in the prediabetic range, weight loss was demonstrated to have many benefits including improving glycemic control, reducing the risk of developing type 2 diabetes, and in some individuals even delaying or reversing its progression.^{[citation needed]}

Social determinants of health that factor into barriers to weight management include food deserts, low health literacy, lack of safe spaces to exercise outside, and lack of access to affordable health food.^[24] However, the extent to which differences in genes may help explain disparities in obesity among different racial and ethnic groups warrants further investigation.^[24]

Strategies

Increasing protein intake

A high protein diet relative to a low-fat or high-carbohydrate diet may increase thermogenesis and decrease appetite leading to a decrease in weight,^[25] especially early in a diet (3–6 months) when rapid weight loss is observed.^[26] However these advantages are reduced later in the diet (12–24 months) during the slow weight loss phase.^[26]

Modifying plate size

Some studies have suggested that using smaller plates might help people to consume smaller portion sizes,^[27] but this has since been shown to be ineffective.^[28]

Modifying portion sizes, however, may be helpful in influencing energy intake.^[29] People who are presented with larger portions do not report to have a higher level of satiety, which suggests that hunger and satiety signals are ignored when a large portion of food is placed in front of them.^[29] In particular, one study showed that 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.^[29] Increased portion sizes have occurred simultaneously with the increase in obesity rates; hence, large portion sizes can be one of the factors contributing to the current increase in average body weight in the US.^[29] 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 rather than smaller size alternatives.^[30]

Eating more soup

Soups have a significant effect on satiety. Studies have demonstrated that when compared to solid foods, soup ingestion decreases the amount of energy intake.^[31] When soup is consumed before a meal, there is a 20% decrease in the number of calories consumed during the meal.^[32]

Choosing low-calorie foods

The majority of guidelines agree that a calorie deficit, particularly 500-750 kcal daily, can be recommended to those wanting to lose weight.^[5]^[11] A moderate decrease in caloric intake will lead to a slow weight loss, which is often more beneficial for long term weight management vs rapid weight loss.^[8] For example, choosing a black coffee instead of a full fat latte will save calories that will add up in the long run. Low fat meats reduce the total amount of calories and cholesterol consumed.^[33] For example, traditional beef patties have 19.2% fat and 272 kcal per 100 g of meat. On the other hand, lean beef patties have 9.8%fat and 196 kcal.^[33]

Eating more dairy

Studies have shown that a diet high in dairy decreases total body fat.^[34] This occurs because a high amount of dietary calcium increases the amount of energy and fat excreted from the body.^[35] Other studies specifically show that dairy sources of calcium demonstrate greater weight loss than supplemental calcium intake.^[36] This may be due to the other bioactive components present in milk, which may aid in metabolic efficiency and fat loss.^[36] The accuracy of this statement remains controversial. Since most natural dairy products contain fat content, there is a common understanding that this may cause weight gain. In addition, dairy contains some key ingredients such as whey protein and combinations protein/calcium that have a positive effect on satiety, increases energy loss, and finally assists weight loss.^[37]

Incorporating more vegetables into meals

Fruits and vegetables have been shown to increase satiety and decrease hunger.^[38] These foods have a low energy density, which is mainly due to the high water content and partly due to the fiber content.^[38] The reduction of energy density has been shown to enhance satiety. The water adds weight, without adding calories and the fiber slows gastric emptying. Both of these factors contribute to the satiating effect of vegetables and fruits. Studies have also shown that fiber decreases hunger and also decreases total energy intake.^[38] Using apple cider vinegar with salads is also considered to help reduce fat.^[39]

Increasing fiber intake

Dietary fiber has been suggested to aid weight management by inducing satiety,^[5] decreasing absorption of macronutrients and promoting secretion of gut hormones.^[40] Dietary fiber consists of non-digestible carbohydrates and lignin, which are a structural component in plants.^[41] Fiber recommendations range from 10 – 13 grams/1000 calories, with slightly higher recommendations for men.^[42]

Fruits and vegetables contain a natural source of fiber that can lead to improved satiety. — Fruits and vegetables contain fiber which has been shown to improve satiety and help with weight loss.

Due to the high volume or water content of fiber-rich foods, fiber displaces available calories and nutrients from the diet.^[43] Consumption of viscous fibers delays gastric emptying, which may cause an extended feeling of fullness.^[44] 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.^[45] In addition, hormone secretion is affected during fiber ingestion.^[46] Insulin response is reduced and cholecystokinin (CCK) in the small intestine is increased.^[40] Insulin regulates blood glucose levels while CCK adjusts gastric emptying, pancreatic secretion and gall bladder contraction.^[40] There is direct correlation between CCK and satiety after foods of different fiber contents are consumed.^[47] Fiber may have the added benefit of helping consumers decrease food intake throughout the day. However, the results of trials examining this possibility have been conflicting. In general, large intakes of dietary fiber at breakfast are associated with less food intake at a lunch.^[48]

Increasing resistant starch intake

Resistant starch is a type of non-digestible, fermentable fiber that is resistant to amylase digestion in the small intestine, and 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.^[49] Resistant starch dilutes energy density of food intake, has a bulking effect similar to non-fermentable fiber, and increases the expression of PYY and GLP-1 in the gut.^[49]^[50]^[51]^[52] The increase in gut hormones can affect long-term energy balance by affecting neuronal pathways in the brain^[53]^[54] as well as improved overall health of the intestines.^[55]

Increasing caffeine intake

Caffeine and black coffee have been associated with increased energy expenditure and subsequent weight loss.^[56] Caffeine belongs to a class of compounds called methylxanthines, and is present in coffee, tea, cocoa, chocolate and some cola drinks.^[57] Caffeine induces a thermogenic effect in the body by increasing sympathetic nervous system activity, which is an important regulator of energy expenditure.^[58]^[59]^[60]

Increasing green tea intake

Green tea has been associated with decreasing blood glucose,^[61] inhibiting hepatic and body fat accumulation,^[61]^[62] and stimulating thermogenesis^[63] due to the catechins that are present. Catechins are polyphenols that are a major component of green tea extract.^[64] Green tea has also been shown to increase energy expenditure and fat oxidation in humans, independent of the caffeine content.^[63]^[65] In a human study conducted, 690 mg of catechins daily for 12 weeks reduced body fat, suggesting that green tea might be useful in the prevention of chronic disease, particularly obesity.^[66] Moreover, catechins in the brain play a major role in satiety.^[67]

Increasing physical activity

Along with making dietary changes, maintaining a consistent level of or increasing physical activity can also promote weight loss efficiency.^[5] One method of increasing daily activity is taking more steps daily.^[5]

Popular 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.^[68]^[69]^[70]^[71]^[72]^[73]^[74] Nonetheless, a low-saturated fat diet complemented with high fiber can be helpful for those who are found to be obese based on BMI.^[11] Furthermore, a low-carbohydrate diet can have the added benefits of blood sugar control in those with Type 2 Diabetes Mellitus.^[11] Compared to a typical diet, low-carbohydrate, low-fat, and moderate macronutrient diets can all positively impact weight loss.^[74] However, weight regain is common, and the outcome of a diet can vary widely depending on the individual.^[11]^[69]^[72]^[75] 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.^[5] Patients may choose to have a conversation with their healthcare provider in order to choose the best diet that fits their lifestyle.^[11]

Apart from low-fat and low-carbohydrate diets, other diets that have been discussed in medical literature are listed below:

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.^[11] This diet was originally shown to decrease or control blood pressure when compared to the typical U.S. diet.^[76]^[77] DASH offers an intervention to manage elevated blood pressures and prevent cardiovascular disease non-pharmacologically.^[77]^[78]^[79]^[80] In addition, combining the DASH diet with a reduced sodium intake will further decrease blood pressure, but is not required for therapeutic effect.^[76] This is because it has been proven to be effective at a wide range of sodium intake levels.^[76] 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.^[81] According to the National Heart, Lung, and Blood Institute of the U.S., those who wish to follow this program should aim for an intake of:

7-8 daily servings of grains
4-5 daily servings of vegetables
4-5 daily servings of fruits
2-3 daily servings of fat free dairy
2 or less daily servings of meat, poultry, or fish
4-5 weekly servings of nuts, seeds, and dry beans
5 or less weekly sweets ^[82]

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.^[83] It has been shown to be effective for long term weight loss with added cardiovascular health benefits.^[11]^[84] For example, the Mediterranean diet can lead to decreased triglyceride and lipid levels as well as improved blood pressure readings.^[73] It can also improve blood sugar levels in those diagnosed with Type 2 Diabetes Mellitus.^[73]

Ketogenic Diet

The ketogenic or "keto" diet involves intake of less than 50 g of carbohydrates daily along with increased fat and protein amounts.^[85] One type of ketogenic or low carbohydrate diet is the "Atkins" Diet, which does not restrict protein and fat amounts.^[11] However, there are other ketogenic diets that place restrictions on the total amount of daily proteins and fats.^[11] Although additional studies are necessary to assess the diet's impact, ketogenic diets have been shown to be therapeutic for those who have Type 2 Diabetes Mellitus and PCOS.^[11] Those with certain conditions such as Type 1 Diabetes Mellitus, kidney failure, or evidence of arrhythmias should not pursue this diet.^[11]

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.^[86] In other words, fiber and unsaturated fat intake is increased and consumption of higher calorie meats and saturated fats is decreased.^[86] This diet has been helpful in decreasing the progression to chronic diseases such as cardiovascular diseases and diabetes.^[86] When compared to carnivore diets, the plant-based diet results in greater weight loss and body composition changes.^[86]

Intermittent Fasting

Intermittent fasting (IF) involves consistent fasting blocks of time where no to little calories are consumed and recently this has garnered more interest.^[11] By measuring a certain time window where calories are eaten, those who are prone to late-night snacking may maintain control of caloric intake.^[11] Intermittent fasting has been shown to improve fasting blood glucose levels and insulin resistance with a concurrent reduction in BMI.^[87] This diet could be considered by those diagnosed with pre-diabetes or insulin resistance.^[87]

Those who are prone to becoming hypoglycemic should be cautious before attempting fasting as symptoms such as dizziness and weakness can occur.^[11]

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@@ Line 166: / Line 166: @@
 {{See also|List of diets}}
-As weight loss depends partly on [[calorie]] intake, [[List of diets|different kinds]] of [[Calorie restriction|calorie-reduced]] diets, such as those emphasizing particular macronutrients ([[low-fat diet|low-fat]], [[low-carbohydrate diet|low-carbohydrate]], etc.), have been shown to be equally effective as weight loss tools.<ref name=Strychar>{{cite journal | vauthors = Strychar I | title = Diet in the management of weight loss | journal = CMAJ | volume = 174 | issue = 1 | pages = 56–63 | date = January 2006 | pmid = 16389240 | pmc = 1319349 | doi = 10.1503/cmaj.045037 }}</ref><ref name="Thom2017">{{cite journal | vauthors = Thom G, Lean M | title = Is There an Optimal Diet for Weight Management and Metabolic Health? | journal = Gastroenterology | volume = 152 | issue = 7 | pages = 1739–1751 | date = May 2017 | pmid = 28214525 | doi = 10.1053/j.gastro.2017.01.056 | url = http://eprints.gla.ac.uk/137779/7/137779.pdf | type = Review }}</ref><ref name="JAMA Dieting Patient Page">{{cite journal | vauthors = Guth E | title = JAMA patient page. Healthy weight loss | journal = JAMA | volume = 312 | issue = 9 | pages = 974 | date = September 2014 | pmid = 25182116 | doi = 10.1001/jama.2014.10929 | doi-access = free }}</ref><ref name = sacks>{{cite journal | 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 | display-authors = 6 | 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 | date = February 2009 | pmid = 19246357 | pmc = 2763382 | doi = 10.1056/NEJMoa0804748 }}</ref><ref name="Wadden2012">{{cite journal | vauthors = Wadden TA, Webb VL, Moran CH, Bailer BA | title = Lifestyle modification for obesity: new developments in diet, physical activity, and behavior therapy | journal = Circulation | volume = 125 | issue = 9 | pages = 1157–1170 | date = March 2012 | pmid = 22392863 | pmc = 3313649 | doi = 10.1161/CIRCULATIONAHA.111.039453 | type = Narrative review }}</ref><ref name=":5">{{Cite journal |last=Mancini |first=Joseph G. |last2=Filion |first2=Kristian B. |last3=Atallah |first3=Renée |last4=Eisenberg |first4=Mark J. |date=2016-04-01 |title=Systematic Review of the Mediterranean Diet for Long-Term Weight Loss |url=https://www.amjmed.com/article/S0002-9343(15)30027-9/abstract |journal=The American Journal of Medicine |language=English |volume=129 |issue=4 |pages=407–415.e4 |doi=10.1016/j.amjmed.2015.11.028 |issn=0002-9343}}</ref><ref name=":6">{{Cite journal |last=Ge |first=Long |last2=Sadeghirad |first2=Behnam |last3=Ball |first3=Geoff D C |last4=da Costa |first4=Bruno R |last5=Hitchcock |first5=Christine L |last6=Svendrovski |first6=Anton |last7=Kiflen |first7=Ruhi |last8=Quadri |first8=Kalimullah |last9=Kwon |first9=Henry Y |last10=Karamouzian |first10=Mohammad |last11=Adams-Webber |first11=Thomasin |last12=Ahmed |first12=Waleed |last13=Damanhoury |first13=Samah |last14=Zeraatkar |first14=Dena |last15=Nikolakopoulou |first15=Adriani |date=2020-04-01 |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 |url=https://www.bmj.com/lookup/doi/10.1136/bmj.m696 |journal=BMJ |language=en |pages=m696 |doi=10.1136/bmj.m696 |issn=1756-1833 |pmc=PMC7190064 |pmid=32238384}}</ref> Nonetheless, a low-saturated fat diet complemented with high fiber can be helpful for those who are found to be obese based on BMI.<ref name=":2" /> Furthermore, a low-carbohydrate diet can have the added benefits of blood sugar control in those with [[Type 2 diabetes|Type 2 Diabetes Mellitus.]]<ref name=":2" /> Compared to a typical diet, low-carbohydrate, low-fat, and moderate macronutrient diets can all positively impact weight loss.<ref name=":6" /> However, weight regain is common, and the outcome of a diet can vary widely depending on the individual.<ref name=":2" /><ref name="Thom2017" /><ref name="Wadden2012" /><ref name="Anderson 579–584">{{cite journal | vauthors = Anderson JW, Konz EC, Frederich RC, Wood CL | 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 | date = November 2001 | pmid = 11684524 | doi = 10.1093/ajcn/74.5.579 | doi-access = free }}</ref> 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.<ref name="Goldman_2016" /> Patients may choose to have a conversation with their healthcare provider in order to choose the best diet that fits their lifestyle.<ref name=":2" />
+As weight loss depends partly on [[calorie]] intake, [[List of diets|different kinds]] of [[Calorie restriction|calorie-reduced]] diets, such as those emphasizing particular macronutrients ([[low-fat diet|low-fat]], [[low-carbohydrate diet|low-carbohydrate]], etc.), have been shown to be equally effective as weight loss tools.<ref name="Strychar">{{cite journal | vauthors = Strychar I | title = Diet in the management of weight loss | journal = CMAJ | volume = 174 | issue = 1 | pages = 56–63 | date = January 2006 | pmid = 16389240 | pmc = 1319349 | doi = 10.1503/cmaj.045037 }}</ref><ref name="Thom2017">{{cite journal | vauthors = Thom G, Lean M | title = Is There an Optimal Diet for Weight Management and Metabolic Health? | journal = Gastroenterology | volume = 152 | issue = 7 | pages = 1739–1751 | date = May 2017 | pmid = 28214525 | doi = 10.1053/j.gastro.2017.01.056 | url = http://eprints.gla.ac.uk/137779/7/137779.pdf | type = Review }}</ref><ref name="JAMA Dieting Patient Page">{{cite journal | vauthors = Guth E | title = JAMA patient page. Healthy weight loss | journal = JAMA | volume = 312 | issue = 9 | pages = 974 | date = September 2014 | pmid = 25182116 | doi = 10.1001/jama.2014.10929 | doi-access = free }}</ref><ref name="sacks">{{cite journal | 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 | display-authors = 6 | 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 | date = February 2009 | pmid = 19246357 | pmc = 2763382 | doi = 10.1056/NEJMoa0804748 }}</ref><ref name="Wadden2012">{{cite journal | vauthors = Wadden TA, Webb VL, Moran CH, Bailer BA | title = Lifestyle modification for obesity: new developments in diet, physical activity, and behavior therapy | journal = Circulation | volume = 125 | issue = 9 | pages = 1157–1170 | date = March 2012 | pmid = 22392863 | pmc = 3313649 | doi = 10.1161/CIRCULATIONAHA.111.039453 | type = Narrative review }}</ref><ref name=":5">{{Cite journal |last=Mancini |first=Joseph G. |last2=Filion |first2=Kristian B. |last3=Atallah |first3=Renée |last4=Eisenberg |first4=Mark J. |date=2016-04-01 |title=Systematic Review of the Mediterranean Diet for Long-Term Weight Loss |url=https://www.amjmed.com/article/S0002-9343(15)30027-9/abstract |journal=The American Journal of Medicine |language=English |volume=129 |issue=4 |pages=407–415.e4 |doi=10.1016/j.amjmed.2015.11.028 |issn=0002-9343}}</ref><ref name=":6">{{Cite journal |last=Ge |first=Long |last2=Sadeghirad |first2=Behnam |last3=Ball |first3=Geoff D C |last4=da Costa |first4=Bruno R |last5=Hitchcock |first5=Christine L |last6=Svendrovski |first6=Anton |last7=Kiflen |first7=Ruhi |last8=Quadri |first8=Kalimullah |last9=Kwon |first9=Henry Y |last10=Karamouzian |first10=Mohammad |last11=Adams-Webber |first11=Thomasin |last12=Ahmed |first12=Waleed |last13=Damanhoury |first13=Samah |last14=Zeraatkar |first14=Dena |last15=Nikolakopoulou |first15=Adriani |date=2020-04-01 |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 |url=https://www.bmj.com/lookup/doi/10.1136/bmj.m696 |journal=BMJ |language=en |pages=m696 |doi=10.1136/bmj.m696 |issn=1756-1833 |pmc=PMC7190064 |pmid=32238384}}</ref> Nonetheless, a low-saturated fat diet complemented with high fiber can be helpful for those who are found to be obese based on BMI.<ref name=":2" /> Furthermore, a low-carbohydrate diet can have the added benefits of blood sugar control in those with [[Type 2 diabetes|Type 2 Diabetes Mellitus.]]<ref name=":2" /> Compared to a typical diet, low-carbohydrate, low-fat, and moderate macronutrient diets can all positively impact weight loss.<ref name=":6" /> However, weight regain is common, and the outcome of a diet can vary widely depending on the individual.<ref name=":2" /><ref name="Thom2017" /><ref name="Wadden2012" /><ref name="Anderson 579–584">{{cite journal | vauthors = Anderson JW, Konz EC, Frederich RC, Wood CL | 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 | date = November 2001 | pmid = 11684524 | doi = 10.1093/ajcn/74.5.579 | doi-access = free }}</ref> 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.<ref name="Goldman_2016" /> Patients may choose to have a conversation with their healthcare provider in order to choose the best diet that fits their lifestyle.<ref name=":2" />
 Apart from low-fat and low-carbohydrate diets, other diets that have been discussed in medical literature are listed below:
 === DASH Diet ===
-The [[DASH diet|Dietary Approaches to Stop Hypertension (DASH) Diet]] focuses on increasing the consumption of fruits, vegetables, whole grains and low-fat dairy products.<ref name=":2" /> This diet was originally shown to decrease or control blood pressure when compared to the typical U.S. diet.<ref name=":0">{{cite journal | vauthors = Svetkey LP, Simons-Morton D, Vollmer WM, Appel LJ, Conlin PR, Ryan DH, Ard J, Kennedy BM | display-authors = 6 | 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 | date = February 1999 | pmid = 9989541 | doi = 10.1001/archinte.159.3.285 }}</ref><ref name="nrs.harvard.edu">{{cite journal | 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 | display-authors = 6 | title = A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group | journal = The New England Journal of Medicine | volume = 336 | issue = 16 | pages = 1117–1124 | date = April 1997 | pmid = 9099655 | doi = 10.1056/NEJM199704173361601 | s2cid = 15227903 | url = http://nrs.harvard.edu/urn-3:HUL.InstRepos:30147220 }}</ref> DASH offers an intervention to manage elevated blood pressures and prevent cardiovascular disease non-pharmacologically.<ref name="nrs.harvard.edu"/><ref>{{cite journal | 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 | display-authors = 6 | 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 | date = 2003-04-23 | pmid = 12709466 | doi = 10.1001/jama.289.16.2083 | s2cid = 38404996 }}</ref><ref>{{cite journal | vauthors = Siervo M, Lara J, Chowdhury S, Ashor A, Oggioni C, Mathers JC | 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 | date = January 2015 | pmid = 25430608 | doi = 10.1017/S0007114514003341 }}</ref><ref>{{cite journal | vauthors = Craddick SR, Elmer PJ, Obarzanek E, Vollmer WM, Svetkey LP, Swain MC | title = The DASH diet and blood pressure | journal = Current Atherosclerosis Reports | volume = 5 | issue = 6 | pages = 484–491 | date = November 2003 | pmid = 14525682 | doi = 10.1007/s11883-003-0039-5 | s2cid = 27229087 }}</ref> In addition, combining the DASH diet with a reduced sodium intake will further decrease blood pressure, but is not required for therapeutic effect.<ref name=":0" /> This is because it has been proven to be effective at a wide range of sodium intake levels.<ref name=":0" /> 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.<ref>{{cite journal | vauthors = Steinberg D, Bennett GG, Svetkey L | title = The DASH Diet, 20 Years Later | journal = JAMA | volume = 317 | issue = 15 | pages = 1529–1530 | date = April 2017 | pmid = 28278326 | pmc = 5509411 | doi = 10.1001/jama.2017.1628 }}</ref>  According to the National Heart, Lung, and Blood Institute of the U.S., those who wish to follow this program should aim for an intake of:
+The [[DASH diet|Dietary Approaches to Stop Hypertension (DASH) diet]] focuses on increasing the consumption of fruits, vegetables, whole grains and low-fat dairy products.<ref name=":2" /> This diet was originally shown to decrease or control blood pressure when compared to the typical U.S. diet.<ref name=":0">{{cite journal | vauthors = Svetkey LP, Simons-Morton D, Vollmer WM, Appel LJ, Conlin PR, Ryan DH, Ard J, Kennedy BM | display-authors = 6 | 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 | date = February 1999 | pmid = 9989541 | doi = 10.1001/archinte.159.3.285 }}</ref><ref name="nrs.harvard.edu">{{cite journal | 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 | display-authors = 6 | title = A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group | journal = The New England Journal of Medicine | volume = 336 | issue = 16 | pages = 1117–1124 | date = April 1997 | pmid = 9099655 | doi = 10.1056/NEJM199704173361601 | s2cid = 15227903 | url = http://nrs.harvard.edu/urn-3:HUL.InstRepos:30147220 }}</ref> DASH offers an intervention to manage elevated blood pressures and prevent cardiovascular disease non-pharmacologically.<ref name="nrs.harvard.edu"/><ref>{{cite journal | 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 | display-authors = 6 | 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 | date = 2003-04-23 | pmid = 12709466 | doi = 10.1001/jama.289.16.2083 | s2cid = 38404996 }}</ref><ref>{{cite journal | vauthors = Siervo M, Lara J, Chowdhury S, Ashor A, Oggioni C, Mathers JC | 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 | date = January 2015 | pmid = 25430608 | doi = 10.1017/S0007114514003341 }}</ref><ref>{{cite journal | vauthors = Craddick SR, Elmer PJ, Obarzanek E, Vollmer WM, Svetkey LP, Swain MC | title = The DASH diet and blood pressure | journal = Current Atherosclerosis Reports | volume = 5 | issue = 6 | pages = 484–491 | date = November 2003 | pmid = 14525682 | doi = 10.1007/s11883-003-0039-5 | s2cid = 27229087 }}</ref> In addition, combining the DASH diet with a reduced sodium intake will further decrease blood pressure, but is not required for therapeutic effect.<ref name=":0" /> This is because it has been proven to be effective at a wide range of sodium intake levels.<ref name=":0" /> 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.<ref>{{cite journal | vauthors = Steinberg D, Bennett GG, Svetkey L | title = The DASH Diet, 20 Years Later | journal = JAMA | volume = 317 | issue = 15 | pages = 1529–1530 | date = April 2017 | pmid = 28278326 | pmc = 5509411 | doi = 10.1001/jama.2017.1628 }}</ref>  According to the National Heart, Lung, and Blood Institute of the U.S., those who wish to follow this program should aim for an intake of:
 * 7-8 daily servings of grains
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 === Mediterranean Diet ===
-The [[Mediterranean diet|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.<ref>{{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}}</ref> It has been shown to be effective for long term weight loss with added cardiovascular health benefits.<ref name=":2" /><ref>{{cite journal | vauthors = Sánchez-Sánchez ML, García-Vigara A, Hidalgo-Mora JJ, García-Pérez MÁ, Tarín J, Cano A | title = Mediterranean diet and health: A systematic review of epidemiological studies and intervention trials | language = English | journal = Maturitas | volume = 136 | pages = 25–37 | date = June 2020 | pmid = 32386663 | doi = 10.1016/j.maturitas.2020.03.008 }}</ref> For example, the Mediterranean Diet can lead to decreased triglyceride and lipid levels as well as improved blood pressure readings.<ref name=":5" /> It can also improve blood sugar levels in those diagnosed with Type 2 Diabetes Mellitus.<ref name=":5" />
+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.<ref>{{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}}</ref> It has been shown to be effective for long term weight loss with added cardiovascular health benefits.<ref name=":2" /><ref>{{cite journal | vauthors = Sánchez-Sánchez ML, García-Vigara A, Hidalgo-Mora JJ, García-Pérez MÁ, Tarín J, Cano A | title = Mediterranean diet and health: A systematic review of epidemiological studies and intervention trials | language = English | journal = Maturitas | volume = 136 | pages = 25–37 | date = June 2020 | pmid = 32386663 | doi = 10.1016/j.maturitas.2020.03.008 }}</ref> For example, the Mediterranean diet can lead to decreased triglyceride and lipid levels as well as improved blood pressure readings.<ref name=":5" /> It can also improve blood sugar levels in those diagnosed with Type 2 Diabetes Mellitus.<ref name=":5" />
 === Ketogenic Diet ===
 The [[Very low-carbohydrate ketogenic diet|ketogenic]] or "keto" diet involves intake of less than 50 g of carbohydrates daily along with increased fat and protein amounts.<ref>{{cite journal | vauthors = Paoli A, Rubini A, Volek JS, Grimaldi KA | 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 | date = August 2013 | pmid = 23801097 | doi = 10.1038/ejcn.2013.116 }}</ref> One type of ketogenic or low carbohydrate diet is the "Atkins" Diet, which does not restrict protein and fat amounts.<ref name=":2" /> However, there are other ketogenic diets that place restrictions on the total amount of daily proteins and fats.<ref name=":2" /> Although additional studies are necessary to assess the diet's impact, ketogenic diets have been shown to be therapeutic for those who have Type 2 Diabetes Mellitus and PCOS.<ref name=":2" /> Those with certain conditions such as [[Type 1 diabetes|Type 1 Diabetes Mellitus]], [[kidney failure]], or evidence of [[Arrhythmia|arrhythmias]] should not pursue this diet.<ref name=":2" />
+=== 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.<ref name=":8">{{Cite journal |last=Tran |first=Elisabeth |last2=Dale |first2=Hanna Fjeldheim |last3=Jensen |first3=Caroline |last4=Lied |first4=Gülen Arslan |date=2020-09-30 |title=Effects of Plant-Based Diets on Weight Status: A Systematic Review |url=https://www.dovepress.com/effects-of-plant-based-diets-on-weight-status-a-systematic-review-peer-reviewed-fulltext-article-DMSO |journal=Diabetes, Metabolic Syndrome and Obesity |language=English |volume=13 |pages=3433–3448 |doi=10.2147/DMSO.S272802 |pmc=PMC7533223 |pmid=33061504}}</ref> In other words, fiber and unsaturated fat intake is increased and consumption of higher calorie meats and saturated fats is decreased.<ref name=":8" /> This diet has been helpful in decreasing the progression to chronic diseases such as cardiovascular diseases and diabetes.<ref name=":8" /> When compared to carnivore diets, the plant-based diet results in greater weight loss and body composition changes.<ref name=":8" />
 === Intermittent Fasting ===