Conservative management of obesity

The conservative management of obesity has three main goals:

• a mildly hypocaloric diet
• increased exercise
• behaviour modification

NICE have also outlined general strategies to help people achieve and maintain a healthy weight (1)

• Diet
  • base meals on starchy foods such as potatoes, bread, rice and pasta, choosing wholegrain where possible
  • eat plenty of fibre-rich foods - such as oats, beans, peas, lentils, grains, seeds, fruit and vegetables, as well as wholegrain bread, and brown rice and pasta
  • eat at least five portions of a variety of fruit and vegetables each day, in place of foods higher in fat and calories
  • eat a low-fat diet and avoid increasing your fat and/or calorie intake
  • eat as little as possible of:- fried foods- drinks and confectionery high in added sugars- other food and drinks high in fat and sugar, such as some take-away and fast foods
  • eat breakfast
  • watch the portion size of meals and snacks, and how often you are eating
  • for adults, minimise the calories you take in from alcohol
• Activity
  • make enjoyable activities - such as walking, cycling, swimming, aerobics and gardening - part of everyday life
  • minimise sedentary activities, such as sitting for long periods watching television, at a computer or playing video games
  • build activity into the working day - for example, take the stairs instead of the lift, take a walk at lunchtime

NICE have stated that weight loss programmes (including commercial or self-help groups, slimming books or websites) are recommended only if they:

• are based on a balanced healthy diet
• encourage regular physical activity
• expect people to lose no more than 0.5-1 kg (1-2 lb) a week
• programmes that do not meet these criteria are unlikely to help people maintain a healthy weight in the long term
• people with certain medical conditions - such as type 2 diabetes, heart failure or uncontrolled hypertension or angina - should check with their general practice or hospital specialist before starting a weight loss programme (1)

Reference:

1. NICE. Overweight and obesity management. NICE guideline NG246. Published January 2025