January 7, 2019

What’s the Best Way to Lose Body Fat (and Keep It Off)?

It helps to take a long-range view

Woman stretching before going on a walk with her husband

Your clothes haven’t been happy with your weight for a while. And neither have you.


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What’s the best strategy for losing weight and getting into better shape?

Losing weight is not that difficult. The complicated part is maintaining weight loss long-term,” says endocrinologist Bartolome Burguera, MD, PhD.

Obesity is a major health problem that’s on the rise. And, unfortunately, current treatments are not effective, he says.

“One reason is that we’re using short-term treatments, like diets, for a chronic disease,” he says. “It’s imperative to treat obesity with a long-term plan.”

Is lack of willpower an issue?

The failure of medical treatments for obesity has nothing to do with willpower, says Dr. Burguera. Multiple body mechanisms influence your appetite.

“Treatment for obesity should address nutrition, physical activity, optimal sleep and stress management,” he adds. “People often need appetite suppression through FDA-approved anti-obesity medications, too.”

Can the keto diet help you lose body fat?

When combined with overall lifestyle intervention, the ketogenic (keto”) diet can produce significant short-term weight loss, says Dr. Burguera.


On this very low-calorie diet, you’re less hungry because you achieve ketosis. That’s a state in which your body burns stored fat because sugar calories aren’t available.

The keto diet may be recommended when:

  • Your body mass index is 30 or above.
  • You have weight-related health problems.
  • Other weight-loss interventions haven’t helped.

If you have type 2 diabetes, very low-calorie meal plans can improve hyperglycemia and insulin sensitivity, too.

But it’s not a long-term solution. “Ketosis is difficult to maintain because you severely limit calories, and eliminate sugar and alcohol,” explains Dr. Burguera.

Plus, your body converts extra calories — even from protein — to glucose, which can throw you off ketosis and make you hungrier.

Do high-protein or fasting diets help?

High-protein diets, done under a doctor’s supervision, can also bring rapid, substantial weight loss. But the weight loss won’t stick unless you significantly increase physical activity or take anti-obesity medication, says Dr. Burguera.

Some studies also suggest that intermittent fasting aids weight loss. “People seem to eat fewer calories, and higher growth hormone and lower insulin levels may increase body fat breakdown,” he says.


Your basal metabolic rate — the amount of energy your body burns simply by existing (when you’re resting and not moving) also seems to rise slightly. So more calories get burned.

Finally, intermittent fasting may reduce insulin resistance in type 2 diabetes. “But more solid scientific evidence is needed to fully document its long-term benefits,” Dr. Burguera maintains.

What does a long-term weight loss plan look like?

OK, you’re committed to making lifestyle changes for the long haul. Which strategies are best? Dr. Burguera recommends the following:

  1. Consider doing a keto diet for two to three months, and then introduce a Mediterranean diet.
  2. Eat slowly, and drink mostly water.
  3. Increase your level of physical activity.
  4. Sleep six to seven hours every night.
  5. Learn to manage stress, and get help for depression.
  6. Consider seeing a dietitian and/or psychologist.
  7. If your appetite is out-of-control, ask your doctor about FDA-approved weight-loss medications.
  8. Consider lifestyle support groups and shared medical appointments.

What are shared medical appointments?

“Many people find participating in shared medical appointments very helpful for weight loss,” says Dr. Burguera.

In these group visits, doctors focus on obesity itself, instead of the health issues it causes. Besides education and individualized care, patients enjoy the support of others who are on the same journey.

So if you want to smile when you look in the mirror (and have your clothes smile back at you), consider a long-term approach to weight loss. You’ll be glad you did.

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