General principles of managing excess body weight

Management strategies for excess body weight need to be maintained long term to reduce the risk of atherosclerotic cardiovascular disease. While many people can achieve weight loss in the short term, few maintain this loss over a prolonged period (more than 2 years). Management must be flexible and tailored to the individual. Set achievable goals (eg maintenance of 5 to 10% loss of initial body weight, reduction in waist circumference, reduced BP) and record progress. Consider referral to other health professionals (eg dietitian, exercise physiologist, psychologist) or a multidisciplinary obesity clinic for expert advice.

Behavioural interventions that provide coping skills, stimulus control, goal setting and self-monitoring, along with cognitive behavioural interventions to modify aversive thinking patterns, result in greater weight loss than placebo and improve the weight loss achieved by diet alone.

To help prevent weight regain after weight loss, develop an individualised maintenance program focusing on physical activity and diet, and provide regular follow-up.

For patient handouts and advice on weight management, see the Royal Australian College of General Practitioners Ten top tips for weight control.