The basic principles of scientific weight loss: a comprehensive strategy encompassing diet control, exercise therapy, and medical intervention.

Obesity can cause a series of physiological, biochemical, pathological, neurohumoral, and functional changes in the human body, reducing people's working ability and even significantly shortening lifespan (some estimates suggest it can reduce average lifespan by 10-12 years). When combined with diabetes, hypertension, and coronary heart disease, it can cause obvious symptoms, leading to serious consequences and posing a serious threat to human health. Obesity is very common and its incidence is on the rise, further increasing its threat to human health. In industrialized countries, the incidence rate is 7.8-6.4%. In the United States, the incidence rate among residents over 30 years old reaches 20%, and among women over 30 years old who are more than 10% overweight, it is as high as 50%. Some reports show that data from Chinese cities are roughly equivalent to those from other countries. From my country and other countries with different levels of development, it can be seen that with the improvement of people's material living standards, the incidence of obesity is also increasing, making it an increasingly important health and wellness issue facing us.

There have been various attempts and studies in the prevention and treatment of obesity, but different opinions still exist, and therefore a comprehensive set of measures is lacking. However, for established obesity, the focus of treatment should be on altering the patient's energy metabolism, that is, by reducing the energy provided by nutrients or by increasing energy expenditure; usually, these two measures are carried out simultaneously. When formulating measures, it should be based on previous dietary habits, work situation, triggering factors, and the presence or absence of complications. (I) Dietary Control: For the prevention and treatment of obesity, rich experience has been accumulated through strengthening dietary management, controlling nutrient intake, and adopting dietary regulation methods. Examples include short-term fasting therapy, intermittent fasting therapy, and various weight-loss diets. Although there is no complete consensus on the means and methods of dietary management, animal experiments and clinical observations generally favor low-calorie, low-carbohydrate diets or diets that simultaneously provide high protein, attempting to achieve the goal through energy control.

A low-calorie diet can put the body in a negative energy balance, thereby achieving the goal of consuming stored body fat. Of course, while consuming fat, it will cause a deficiency in protein and non-fat components, thus often requiring an increase in protein intake. A low-sugar diet is adopted mainly because sugar is easily absorbed, promoting enhanced fat synthesis and inhibiting fat breakdown. This effect can be weakened by consuming starchy foods or foods rich in dietary fiber. Regarding fat, some have previously advocated for reducing the intake of fat-rich foods, but animal experiments have found that glycerol from fat breakdown can control obesity, thus some advocate increasing the proportion of fat-based calories. Of course, if accompanied by coronary heart disease, arteriosclerosis, hypertension, or hyperlipidemia, fat intake should be controlled.

1. Mild obesity: Primarily restrict carbohydrate intake and reduce calorie consumption. Especially limit sweets, pastries, peanuts, and beer; increase fruit and vegetable intake. Aim for a daily weight loss of 0.5–1.0 kg. 2. Moderate obesity: Strict dietary control is necessary. Calculate daily calorie requirements based on ideal weight and activity level. Daily calorie intake should be controlled below 1200 kcal, with a weight loss of 0.5–1.0 kg per week. If ineffective after two weeks, reduce calorie intake to 800–1000 kcal per day. 3. Severe obesity: Initially treat with a low-calorie diet (400–600 kcal/day). If ineffective, use starvation therapy and intermittent starvation therapy. Starvation therapy begins with 1–2 weeks of continuous fasting, providing only water, vitamins, and essential minerals.

The patient initially experiences hunger, followed by mild ketoacidosis, decreased blood pressure, and fatigue, requiring monitored feeding. During the initial fasting period, weight loss is rapid, exceeding 0.5 kg per day. This can be followed by continuation of a low-calorie or intermittent fasting method to consolidate the results. Alternatively, intermittent fasting may be used from the outset, involving two days of intermittent fasting per week on a low-calorie diet. After two weeks of this method, a weight loss of 7.3 kg can be achieved. However, some oppose fasting therapy, arguing that while it may reduce weight quickly, it often leads to protein depletion, increasing the risk of ketoacidosis, hypotension, irritability, nervousness, and vomiting. Therefore, the benefits and risks should be carefully weighed before its use.

(II) Exercise Therapy: This is a widely accepted weight loss method. Physical labor or exercise promotes fat breakdown, conserves amino acids, and promotes muscle protein synthesis. Muscle activity requires energy, primarily provided by carbohydrates and fats. Normally, carbohydrates provide energy, but with greater exercise, the additional energy must be provided by stored fat. This is a superior treatment method compared to starvation therapy. Physical exercise is flexible and consistent. For example, walking at a normal pace for one hour can burn 300-360 kcal, and with consistent practice for one month, weight loss of approximately 3 kg is possible. The standard for exercise therapy is an energy expenditure of 300-500 kcal per session. Exercise intensity is measured by heart rate: 130 beats/min for those aged 30-40, 120 beats/min for those aged 40-50, and no more than 112 beats/min for those over 60. Exercise intensity should be increased gradually, limited by physiological tolerance. Those with cardiovascular complications should use this method with extreme caution.

(III) Drug Treatment: 1. Medications that affect or suppress appetite, such as amphetamines and biguanides. 2. Consumption-inducing drugs: such as thyroid preparations. 3. Traditional Chinese Medicine: such as Fangfeng Tongsheng San. (IV) Surgical Treatment: Jejunoileal bypass surgery has been used to reduce nutrient absorption, but it often does not achieve the desired therapeutic effect. If obesity is caused by temporary overeating, dieting can be used to reduce food intake and restore the original standard weight. This is effective for temporary obesity.