American Journal of Lifestyle Medicine

Abstract: Dietary modifi cation is crit-ical in obesity treatment. Energy intake must fall below energy expenditure, but not so low that excess lean tissue is lost, hunger escalates, diet quality declines, and health is compromised. Reductions in energy consumption of 500 to 1000 kilo-calories per day should result in appro-priate rates of weight loss in most obese patients. Very low-calorie diets are some-times used when excess body weight poses an acute risk, but such diets carry poten-tial for many complications, and their long-term results are often no better than low-calorie diets. Macronutrient composi-tion is not as important as overall energy defi cit in terms of weight loss, so dieters have some fl exibility in choosing combi-nations that suit their preferences and needs, as long as they promote long-term healthy weight management. Diets with extremes of macronutrients are usually defi cient in micronutrients and are dif-fi cult to follow for long periods of time, so they should not be advocated. Resources for implementing dietary recommenda-tions include registered dietitians, selected Web sites, and an assortment of products and services. Patients should be guided to resources that are evidence based and do not make unrealistic promises for weight loss. Prevention of recidivism should be built into the treatment plan