Ok here's the guidelines in a nutshell (help I'm in a nutshell).....
For MOST people the recommended approach is to modify eating and exercise behaviour. This can be done a number of ways at a number of levels depending on the amount of weight you need to lose (which is supposed to be assessed by BMI). Lower levels of overweight are recommended to be addressed by self help, self directed approaches, then moving up through commercial self help programs (think the major programs like weight watchers and Jenny Craig)and to formal psychological/behavioural treatment (which is best delivered in group format, but hard to come by). Next step up is medication, but this should be augmented by psychological/behavioural treatment. Next is surgery which is for consideration in people with a BMI of 30+ (or 27+ with risk factors like uncontrolled diabetes, heart disease etc that mean the weight must be reduced NOW) but lifestyle changes are still fundamental (still looking at psychological/behavioural processes).
SO what does psych/behaviour treatment look like??? Firstly it's about recognition of patterns so food, mood and exercise diaries are recommended. Second, strategies are implemented to adjust food intake and increase exercise, these include appropriate goal setting, problem solving and planning. Where necessary, cognitive components can be included to address any underlying psychological problems.
The research identifies 2 distinct parts to successful weight loss over the long term. There is weight loss and weight maintenance and it's usually the maintenance that falls down. Both diet and exercise are important to both, but diet is more important in the loss phase, exercise more important for maintenance. And for most people monitoring and control of both (though at a lower level) are considered necessary for life. That is.... FAD DIETS THAT HAVE AN END DON'T WORK (a least if you go back to your previous patterns - in fact the metabolic effect means you go in to a cycle of lose it, put it back on plus some). The reviews I have read are very critical of fad diets on a number of fronts. Most of them claim some kind of scientific secret which medical science disagrees with. Secondly, most of them when followed simply reduce calories (which will lead to weight loss regardless of the precise foods you eat). Third, they can be dangerous especially the very restrictive ones which technically are often safe for the short term (which most of them direct you do only do in the short term) but because they're available and easy to implement, people try to do them for too long, or repeatedly which is not healthy. Fourth, as noted, many people will lose the weight, but because the diet is not sustainable they go back to their previous eating habits and lo and behold here comes the weight again.
So what does all this mean? Well according to the guidelines, all levels of supported treatments include components of monitoring and controlling to appropriate levels your calorie intake, as well as monitoring and increasing your exercise. Even for surgery and medication - you can't expect these to be miracle treatments with no work required by you. This is what is recommended based on all the research on what actually works in the long term.
35kg lost. (November 2005 - October 2006)
15kg gained again (as at October 2010).
Back to the drawing board - Let's do this thing!
"You can't change the winds, but you can change the sails"
"Reach out and take control of what lands in your lap"