Lifestyle Modification: The Cornerstone of All Weight-Loss Treatments

Experts stress that the choices made concerning weight-loss treatment should be additive, not sequential.
Lifestyle Modification

Many people believe that when it comes to seeking treatment for excess weight, a series of step-wise choices are made. If a lifestyle modification program that includes diet and exercise does not produce the desired results, the option to switch to an obesity medication may be explored. If the obesity is severe, bariatric surgery may be considered.

However, experts stress that the choices made concerning weight-loss treatment should be additive, not sequential. Lifestyle modification is the recommended cornerstone of all weight-loss treatments, whether as the means to an end or in conjunction with more intensive treatment options.

Lifestyle Modification
Lifestyle modification is a weight management approach that teaches the skills necessary for lasting weight loss. As described by obesity expert Gary Foster, this type of approach goes beyond deciding what eating and activity behaviors need to be changed; it provides methods, skills and techniques to be able to learn how to make the changes.1

Weight-Loss Medications
The clinical guidelines for the prescription of weight-loss medications state that drugs should be used as an adjunct to a lifestyle modification program. Unfortunately, weight-loss medications are often prescribed as a stand-alone treatment for obesity. A randomized clinical trial published in the New England Journal of Medicine demonstrated the limitation of this practice. Based on the superior results found in the group of study participants that participated in a group-based behavior change program along with an obesity drug, the researchers concluded that weight-loss medications should only be used in combination with a lifestyle modification program.2

Bariatric Surgery
There are several types of surgery that are available as weight-loss treatments. In Europe, a popular surgery involves the insertion of a balloon filled with saline (salt water) to reduce the stomach's capacity and limit the amount of food that can be eaten. Researchers in France followed patients who had received a gastric balloon for one year following the balloon's removal. Based on their findings, they concluded that "concurrent behavior modification is needed for durable weight loss."3

In the United States, more invasive forms of bariatric surgery are the norm. These procedures involve surgically reducing the size of the stomach (with or without a rerouting of the small intestine). Irrespective of the type of surgery performed, experts agree that a comprehensive weight management program, including nutrition information and behavioral modification, is critical to long-term success.4

The Bottom Line
Lasting weight loss requires balancing the number of calories consumed in food with the number of calories expended in physical activity to maintain a reduced weight. To attain this balance, lifestyle modification – including making wise food choices, being physically active and having positive thinking skills – is needed. This holds true for every form of weight-loss treatment.

This content is reviewed regularly. Last updated June 20, 2012.

view footnotes


Check out our Science Library or read more about Science and Weight Watchers.


1 Foster GD, Makris AP, Bailer BA. Behavioral treatment of obesity. Am J Clin Nutr. 2005 Jul;82(1 Suppl):230S-235S.

2 Wadden TA, Berkowitz RI, Womble LG, Sarwer DB, Phelan S, Cato RK, Hesson LA, Osei SY, Kaplan R, Stunkard AJ. Randomized trial of lifestyle modification and pharmacotherapy for obesity. N Engl J Med. 2005 Nov 17;353(20):2111-20.

3 Herve J, Wahlen CH, Schaeken A, Dallemagne B, Dewandre JM, Markiewicz S, Monami B, Weerts J, Jehaes C. What becomes of patients one year after the intragastric balloon has been removed. Obes Surg. 2005 Jun-Jul;15(6):864-70.

4 Andris DA. Surgical treatment for obesity: ensuring success. J Wound Ostomy Continence Nurs. 2005 Nov-Dec;32(6):393-401.