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Over 40% of American adults struggle with obesity, according to the Centers for Disease Control and Prevention (CDC). If you’re among them, you may wonder about options for weight loss.

Obesity is a chronic, progressive, and relapsing disease. It’s influenced by biology, environment, behaviors, medications, and genetics — not simply “eating too much” or “not exercising enough.”

The good news? Safe, effective treatment options exist, and you don’t have to face this alone.

The best weight loss plan is personalized to you, combining the right tools to support your physical, emotional, and metabolic health.

You don’t need to lose half your body weight to see major health benefits. Losing just 5% to 10% of your total body weight may improve and prevent many chronic health conditions, such as:

• Cancer.
• Heart disease.
• High blood pressure.
• Stroke.
• Type 2 diabetes.

Learn more about the different weight loss treatment options.

What Are the Treatment Options for Obesity?

Obesity treatment is based on several key pillars that support people in achieving and maintaining a healthy weight. The four pillars of obesity treatment are:

• Nutrition therapy.
• Physical activity. 
• Behavior changes.
• Surgery or medications.

Nutrition, physical activity, and behavior changes are considered lifestyle modifications. While some people can lose weight and successfully maintain it through lifestyle changes alone, others may lose weight but struggle to keep it off. Some people also might find it difficult to lose weight with lifestyle changes alone.

People in the latter two groups often need additional support to help them achieve and maintain their weight loss goals. That’s where surgery and medication come in. Those tools can complement lifestyle changes, providing the necessary support to help people succeed in their long-term weight management journey.

UPMC offers weight loss services and can help find the best option for you to lose weight, along with effective strategies for lifelong weight management.

What Lifestyle Changes Can Help Me Lose Weight?

Lifestyle interventions involve making changes to your daily life to help you safely lose weight. Lifestyle intervention programs also teach effective strategies for lifelong weight management.

Nutrition therapy 

The cornerstone of successful weight loss is healthy eating and balanced nutrition. A nutritious diet focuses on fresh, whole foods, including plenty of:

• Fruits and vegetables.
• Lean proteins.
• Low-fat dairy.
• Whole grains.

It’s also important to limit highly processed foods, added sugars, and fast food. Many people benefit from learning how to shop for healthier ingredients and explore new recipes that support their weight loss goals while still being enjoyable and satisfying.

Medical nutrition therapy (MNT) is a way to use food and nutrition to help manage obesity and improve overall well-being. MNT is provided by a registered dietitian. The goal is to create a personalized eating plan that fits each person’s needs, preferences, and health goals.

Meal replacement plans are a structured nutrition tool for weight loss. They provide essential nutrients in controlled portions, often lower in calories than regular meals. Meal replacement supports weight loss by controlling hunger and promoting fullness. It helps you to lose up to 5% to 15% of your total body weight.

Options for meal replacement plans include:

• A low-calorie diet — Suitable for people with a body mass index (BMI) over 25. It combines meal replacements and whole foods under a supervised 1,200- to 1,500-calorie plan to help you lose weight effectively.
• A very-low-calorie diet — A medically supervised 800-calorie ketogenic diet for those with a BMI over 30 (or 27 with health conditions).

Physical activity 

Regular physical activity and exercise are crucial for weight loss, particularly for maintaining weight loss over time. They also play a significant role in managing chronic health conditions, such as:

• Heart disease.
• High blood pressure.
• High cholesterol.
• Type 2 diabetes.

Consistent exercise also supports mental well-being and promotes strong bone and muscle health.

Getting at least 150 to 300 minutes of moderate-intensity aerobic exercise each week supports modest weight loss and helps prevent weight regain. This can include daily walks, regular bike rides, trying a new sport, consistent gym workouts, or long hikes on the weekends.

Incorporating strength training two to three times per week is essential to preserve and build muscle mass while losing weight.

Some physical activity is always better than none. Alongside structured exercise, incorporating non-exercise physical activities into your daily routine can provide added benefits. Examples include walking short distances instead of driving, taking the stairs instead of the elevator, and creating a more active work environment by using standing desks.

Behavioral changes

Adopting healthy lifestyle habits is essential for effective weight management. This includes:

• Getting adequate sleep each night.
• Limiting screen time, especially before bed.
• Maintaining a consistent sleep-wake schedule.
• Managing stress effectively.
• Reducing or avoiding alcohol consumption.

 Benefits of lifestyle modifications

• Encourage the development of sustainable, healthy habits.
• Enhance mental well-being and reduce stress.
• Improve overall physical health and energy levels.
• Promote long-term weight loss and weight maintenance.
• Reduce the risk of chronic diseases such as diabetes, heart disease, and high blood pressure.

Challenges with lifestyle modifications 

• Changing behavior takes time, dedication, and persistence.
• Entails keeping up with new behavior habits to continue or maintain weight loss long term.
• Requires changes to daily routines, such as mealtimes and leisure activities.
• Requires learning new skills or improving skills, such as cooking.

What Are Surgeries or Medications to Treat Obesity or Manage Weight?

 Bariatric surgery

Bariatric surgery involves permanently altering parts of your digestive system to help limit the amount of food you can eat and make it more difficult to regain weight. It may be an option for:

• People with a BMI of 40 or higher.
• People with a BMI of 35 or higher who also have obesity-related conditions such as type 2 diabetes, high blood pressure, high cholesterol, or sleep apnea.

When combined with lifestyle changes, bariatric surgery can result in a 20% to 40% loss of your total body weight.

There are two main types of bariatric surgery:

• Gastric bypass — This three-step process involves making a small pouch from your stomach and changing how your intestines connect to it. This is the most involved surgery and results in the most significant weight loss.
• Gastric sleeve — A surgeon removes most of your stomach, so the remaining sleeve-sized stomach holds less food at a time.

The amount of weight people lose from bariatric surgery varies. If you choose to undergo surgery, learn more about each option and discuss the risks and benefits with your doctor.

 Advantages of bariatric surgery

• Covered by most insurance plans.
• Highly effective, leading to more weight loss compared to other treatments.
• Long-lasting with a very low risk of regaining much weight.
• Usually a one-time intervention.

Challenges with bariatric surgery

Like every other surgery, bariatric surgery involves risks like anesthesia and recovery time. Bariatric surgery also involves:

• Adapting to eating only small meals and chewing food well post-surgery.
• Making lifestyle modifications to achieve the most weight loss and maintain it.
• Taking vitamin supplements for the long term.

 Weight management or anti-obesity medications 

You may have heard of various weight loss medications and feel uncertain about which one might be right for you. Here’s what you need to know to better understand your options.

Food and Drug Administration (FDA)-approved anti-obesity medications are available for people with a BMI of 30 or higher without other health conditions. They may also be prescribed for those with a BMI of 27 or higher who have obesity-related conditions such as type 2 diabetes, high blood pressure, high cholesterol, or sleep apnea. These medications work better when you combine them with lifestyle modifications.

Pill medications help you to lose up to 5% to 10% of your body weight. Potential oral medications for weight loss include:

• Phentermine.
• Qysmia (combination of phentermine and topiramate).
• Contrave (combination of naltrexone and bupropion).

These medications may not be appropriate for everyone, such as people with certain existing medical conditions. Talk to your doctor for more information.

Injectable medications for weight management

There are currently three FDA-approved injectable medications for weight management. When combined with healthy lifestyle changes, these treatments can support weight loss of up to 15% to 20% of total body weight. You may have heard these medications marketed as glucagon‐like peptide‐1 (GLP‐1) receptor agonists.

• Liraglutide — Available under the brand names Saxenda® (for weight management) and Victoza® (for type 2 diabetes). This medication is administered as a daily injection.
• Semaglutide — Available as Wegovy® (approved for weight management and for reducing the risk of major cardiovascular events in people with heart disease or stroke) and Ozempic® (approved for type 2 diabetes). An oral version, Rybelsus®, is also available for type 2 diabetes. Wegovy and Ozempic are weekly injections.
• Tirzepatide — Available as Zepbound® (approved for weight management and for treating obstructive sleep apnea) and Mounjaro® (approved for type 2 diabetes). These are weekly injections. Tirzepatide is both a GLP-1 receptor agonist and a gastric inhibitory polypeptide (GIP) receptor agonist. 

How do GLP-1 medications work?

• Reduce hunger and increase fullness — These medications act on areas of the brain that control appetite, helping you feel full sooner and less hungry overall, which leads to eating less.
• Slow stomach emptying — GLP-1s delay how quickly food leaves your stomach, keeping you full longer after meals and reducing how much you eat later.
• Support blood sugar control — They increase insulin production after meals (when blood sugar is high) and reduce the release of glucagon, a hormone that raises blood sugar.
• Curb food noise and emotional eating — GLP-1s help quiet constant thoughts about food and reduce the urge to eat when you’re not truly hungry.

Possible side effects and precautions with GLP-1 medications

Most side effects are gastrointestinal and may include nausea, vomiting, diarrhea, or constipation. These symptoms often improve over time, especially when the medication dose is increased gradually and paired with appropriate nutritional support.

Less common side effects may include burping, bloating, heartburn, headache, fatigue, dizziness, or mild reactions at the injection site.

Though rare, serious side effects can occur. These include:

• Bowel obstruction.
• Gastroparesis — delayed stomach emptying.
• Pancreatitis — inflammation of the pancreas that may require medical attention.

GLP-1 receptor agonists are not suitable for everyone. They should be avoided in people with certain medical conditions. Talk to your doctor for more information.

 Advantages of GLP-1 medications

• Decrease appetite and reduce food cravings, especially when you’re not truly hungry.
• Help manage type 2 diabetes and may lower the risk of developing it.
• Reduce the risk of cardiovascular disease.
• Support improvement in chronic health conditions such as obstructive sleep apnea, non-alcoholic fatty liver disease (NAFLD), and chronic kidney disease.

Challenges with GLP-1 medications

• Lifestyle changes are still necessary for sustainable weight loss.
• Not suitable for people with certain medical conditions.
• Often not covered by insurance, leading to high out-of-pocket costs.
• Ongoing treatment is required.
• Side effects may be difficult to tolerate.
• Weight regain is common after stopping GLP-1 medications.