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	1. Introduction
	2. Rationale for Dietary Treatment
	3. Evaluating Obesity
	3.1 Assess Body Fat Burden and Health Status
	3.2 Measure Body Mass Index (BMI) as an Indirect Measure of Body Fat Burden
	3.3 Measure Waist Circumference to Quantify Risks Related to Body Fat Distribution
	3.4 Document Other Risk Factors and Comorbidities that Increase Risk and Have Other Implications for Therapy
	3.5 Determine if the Patient is a Candidate for Weight Loss
	4. Choose Treatment Options
	4.1 Assess the Patient’s Readiness and Willingness to Lose Weight
	4.2 Decide if Dietary Treatment is the Appropriate Option
	4.3 Decide if Drugs will be Useful Adjunctive Therapy to the Reducing Diet
	4.4 Rule Surgical Options in or Out
	5. Set Goals
	5.1 Clarify Reasonable Goals
	5.2 Adopt Realistic Goals that Include Health Objectives
	5.3 Define Successful Outcomes for Weight Reduction with the Patient
	5.4 Define Success in Broader Terms than Weight Loss Alone
	5.5 Set a “Healthier Weight” Target with the Patient
	5.6 A Reasonable Target: 10% Loss of Body Weight over 6 Months
	5.7 Set a Increased Physical Activity Goal
	5.8 Individualize the Diet and Treatment Program
	6. Plan the Weight Reduction (Energy Deficit Phase) of Weight Control
	6.1 General Principles
	6.2 Size of Caloric Deficit Needed to Lose Weight
	6.3 Goal of the Energy Deficit Phase
	7. Troubleshoot Diet Failures
	7.1 Keep Food Records: Food Intake Varies from Day to Day and it is Easy to Forget to Diet Everyday
	7.2 Remind Patients that Self-reports of Energy Intake are Underestimated, in part because People are Unaware of How much they Eat
	7.3 Remind Patients to Stay Active: Self-reports of Energy Output Tend to be Overestimated
	7.3.1 Compensatory Decreases in Energy Output occur on Most Reducing Diets
	7.4 Remind Patients that Shifts in Water Balance May Obscure True Decreases in Body Fat and Overestimate Fat-related Weight Loss
	7.4.1 Remind Patients that Fat Loss and Weight Loss do not Always Track over the Short Run, Although they do over the Long Run
	8. Set the Caloric Level of the Reducing Diet
	8.1 Low Calorie Diets LCD (1000-1200 Calories for Females, 1200-1600 Calories for Males)
	8.2 Very Low Calorie Diets (VLCD) < 800 or 400-500 Calories
	8.2.1 Uses and Candidates for Therapy
	8.2.2 Formulations Available
	8.2.3 Use
	8.2.4 Safety
	8.2.5 Effectiveness
	8.3 Total Fasting
	9. Consider the Composition of the Reducing Diet
	9.1 Macronutrient Distribution
	9.2 Protein
	9.2.1 Protein Needs During Weight Reduction
	9.2.2 High Protein Weight Loss Diets
	9.3 Fat
	9.3.1 Fat Needs During Weight Reduction
	9.3.2 Moderate to Low Fat Balanced Deficit Reducing Diets
	9.3.3 Very Low Fat Reducing Diets (<20% Fat Calories)
	9.3.4 High Fat Diets for Weight Reduction (55-65% Fat)
	9.4 Carbohydrates the Glycemic Index
	9.4.1 Carbohydrate Needs in Weight Reduction
	9.4.2 Low Carbohydrate Diets (<100 gm Carbohydrate)
	9.4.3 Low Glycemic Index Diets
	9.5 Water
	9.5.1 Water needs on reducing diets vary
	9.6 Electrolytes
	9.7 Vitamins and Minerals
	9.7.1 Needs During Weight Reduction
	9.7.2 Calcium Supplementation and Weight Loss
	9.7.3 Dietary Supplements and Weight Loss
	9.8 Fiber
	9.8.1 Fiber Needs on Reducing Diets
	9.9 Alcohol
	9.10 Energy Density
	10.1 Dietetic Advice and Individualized Eating Plans
	10.1.1 Available programs
	10.1.2 Candidates
	10.1.3 Advantages
	10.1.4 Disadvantages
	10.1.5 Safety and Effectiveness of Therapy
	10.2 Commercial Weight Loss Programs
	10.2.1 Available programs
	10.2.2 Candidates
	10.2.3 Appropriate use
	10.2.4 Advantages
	10.2.5 Disadvantages
	10.2.6 Effectiveness and Safety
	10.3 Formulas and Meal Replacements
	10.3.1 Available products
	10.3.2 Candidates
	10.3.3 Appropriate use
	10.3.4 Advantages
	10.3.5 Disadvantages
	10.3.6 Effectiveness and Safety
	10.4 Prepared Delivered Meals
	10.5 Weight Loss Books and Manuals
	10.6 Web-Based Treatment Programs and Resources
	10.6.1 Programs Available
	10.6.2 Candidates
	10.6.3 Advantages
	10.6.4 Disadvantages
	10.6.5 Safety and Effectiveness
	10.7 Voluntary Self-Help Programs
	11. Summary of Weight Loss Phase
	12. Consolidate Losses in the Weight Maintenance Phase
	12.1 Nutrient Needs
	12.1.2 Carbohydrate
	12.1.3 Energy Density
	12.1.3 Fat
	12.1.4 Dietary Fiber
	12.1.5 Lessons from Long Term Maintainers: Importance of Increased Physical Activity
	13. Adopt a Long Term Eating Pattern to Maintain Weight: Adequate Nutrients within Calorie Needs
	14. Conclusions: Is Dieting Worth It?