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Weight Control (Healthy Weight & Obesity)

Weight is one piece of health, not a verdict on a person. More than 4 in 10 U.S. adults live with obesity, and it raises the chance of conditions such as type 2 diabetes, high blood pressure and sleep apnea. Steady habits, support, and — for some people — prescription medicines or surgery can help. Sudden, unexplained weight change and signs of an eating disorder need a medical visit.

Get urgent help for these:

  • Chest pain or pressure. Chest pain, heaviness or discomfort is the most common sign of a heart attack; other signs include shortness of breath, heavy sweating for no reason, nausea, light-headedness, and pain in an arm, the back, the neck or the jaw. NHLBI says to call 9-1-1 even if you are not sure, and not to drive yourself (NHLBI).
  • Severe symptoms while taking a weight-loss medicine. The patient information for semaglutide (Wegovy) says to stop it and call your provider right away for severe belly pain that will not go away, with or without nausea or vomiting, sometimes felt through to the back (a sign of pancreatitis) (FDA label, Wegovy). Wegovy and tirzepatide (Zepbound) both list possible gallbladder-problem signs to report: pain in the upper belly, yellowing of the skin or eyes, fever, and clay-colored stools (FDA label, Wegovy, FDA label, Zepbound). The Wegovy label also says serious allergic reactions have been reported (stop the medicine and get medical advice promptly), and that kidney injury has been reported after vomiting or diarrhea led to dehydration (FDA label, Wegovy). MBHA suggests going to an emergency room rather than waiting for a call back if the pain is severe, you have trouble breathing, or your face, lips or throat swell.
  • Thoughts of suicide. The label for naltrexone-bupropion (Contrave) carries a boxed warning about suicidal thoughts and behaviors, mainly in children, teens and young adults (FDA label, Contrave). Anyone in crisis can call or text 988, the Suicide & Crisis Lifeline, 24 hours a day (988 Lifeline); MBHA suggests calling 911 if someone is in immediate danger.
  • Signs of an eating disorder. NIMH says eating disorders are serious and can be life-threatening, but can be treated successfully, and that early detection matters. Warning signs include extremely restricted eating, intense or excessive exercise, an intense fear of gaining weight, a distorted body image, eating unusually large amounts in a short time or in secret, feeling distressed or ashamed about eating, and throwing up, taking laxatives or fasting to get rid of food (NIMH). Please tell a doctor soon if you or someone you love shows these signs.
  • Weight that changes fast without a reason. The NHS says to see a doctor if you keep losing weight without changing your diet or exercise, and as soon as possible if you also have other symptoms; possible causes include thyroid problems, digestive disease, depression, heart failure and sometimes cancer (NHS). Weight gain together with swelling in the ankles, legs or belly, trouble breathing, or being unable to sleep lying flat can be a sign of heart failure (NHLBI). In both directions, a rapid change is a medical sign to check, not a success or a failure.

What “weight control” means here

This guide is for anyone who wants to understand weight and health — whether you are trying to reach a steadier weight, keep weight off, support a family member, or simply sort fact from marketing. NIDDK describes overweight and obesity as weight that is higher than what is considered healthy for a person’s height, a condition that can raise the risk of many health problems (NIDDK). CDC recommends person-first language, such as “adults with obesity” rather than “obese adults” (CDC), and we follow that here. An international consensus statement concluded that weight stigma — bias in workplaces, schools and health care — can cause physical and psychological harm and that people who face it are less likely to receive adequate care (Rubino et al., 2020). Nothing in this guide is meant to shame anyone.

CDC reports that 41.9% of U.S. adults had obesity in 2017 to March 2020, up from 30.5% in 1999–2000, and that 9.2% had severe obesity (CDC). NIDDK adds that nearly 3 in 4 adults have overweight or obesity (NIDDK). You are far from alone.

BMI and waist size: useful, but limited

Body mass index (BMI) is a calculation from your weight and height. NIDDK’s adult ranges are 18.5 to 24.9 (healthy weight), 25 to 29.9 (overweight), 30 or more (obesity) and 40 or more (severe obesity) (NIDDK). BMI is only a screening number. CDC says it does not directly measure body fat and does not distinguish between fat, muscle and bone mass, so it should be read together with other factors such as medical history and blood pressure (CDC). NIDDK gives three examples of where BMI can mislead: a very muscular person can have a high BMI without much body fat; some people with Asian ancestry store extra fat around the waist and can face higher risk at a lower BMI; and older adults tend to lose muscle and gain fat even when their BMI does not change (NIDDK). Medicare’s diabetes-prevention benefit reflects this by using a BMI of 25 or more, or 23 or more for people who are Asian (Medicare.gov).

Waist size adds information because where the body stores fat matters. NIDDK lists a waist of 35 inches or more for women and 40 inches or more for men as raising the risk of obesity-related health problems (NIDDK). A 2025 international commission of 58 experts went further: it recommended using BMI only as a screening or population measure rather than an individual measure of health, and confirming excess body fat with a direct body-fat measurement or at least one other measure such as waist circumference, while noting that excess fat can be assumed at a BMI above 40 (Rubino et al., 2025). In short, ask your clinician what your numbers mean for you, along with your blood pressure, blood sugar, cholesterol and how you feel.

Why weight changes

Weight is shaped by much more than willpower. NIDDK lists lifestyle habits; where you live, work and play (for example, access to affordable healthy food and safe places to walk); how much you sleep; some medicines; health problems; and family history and genes (NIDDK). Medicines that may contribute to weight gain include some used for epilepsy, depression or psychotic disorders, steroids, some diabetes medicines such as insulin, some blood-pressure medicines and some antihistamines. Health problems that can lead to weight gain include polycystic ovary syndrome, Cushing’s syndrome, an underactive thyroid, depression and long-term stress (NIDDK). MBHA suggests asking your prescriber before changing any prescribed medicine. See our thyroid guide, depression guide and medication safety guide.

Health risks of excess weight

NIDDK says overweight and obesity may raise the risk of many health problems, especially with extra fat around the waist, and that reaching and staying at a healthy weight can help prevent them, stop them from getting worse, or even make them go away (NIDDK). The conditions it lists include:

  • Type 2 diabetes — nearly 9 in 10 people with type 2 diabetes have overweight or obesity; for people at risk, losing at least 5% to 7% of starting weight may prevent or delay it. See our diabetes guide.
  • High blood pressure, heart disease and stroke, and metabolic syndrome. See our blood pressure, cholesterol, heart and stroke guides.
  • Fatty liver disease (losing 3% to 5% of body weight may reduce liver fat), and kidney disease. See our liver and kidney guides.
  • Sleep apnea and asthma — extra fat around the neck can narrow the airway. See our Sleep Apnea guide and asthma guide.
  • Osteoarthritis and gout — obesity is a leading risk factor for osteoarthritis in the knees, hips and ankles. See arthritis, knees, hips and gout.
  • Gallbladder and pancreas disease — and losing weight quickly also raises the risk of gallstones, so talk with your clinician about losing weight safely. See our gallbladder and pancreas guides.
  • Some cancers, pregnancy and fertility problems, sexual-function problems, and mental-health effects including long-term stress, body-image problems, depression and eating disorders — along with weight-related bias at school and work.

Everything in this list is from NIDDK (NIDDK). Risk is not destiny: the 2025 commission distinguishes “preclinical” obesity (excess body fat with organs and tissues still working normally) from “clinical” obesity (excess fat that is affecting how organs and tissues function), which is why clinicians look at the whole picture (Rubino et al., 2025).

When to see a doctor: NIDDK suggests talking with a health care professional about your weight as a first step, and notes that you may need to bring it up yourself; it suggests practicing your questions beforehand, such as “Am I at a healthy weight?” and “How is my weight affecting my health?” (NIDDK). Your clinician may recommend losing weight if you have a BMI of 30 or higher, a large waist, heart disease or a family history of it, or a BMI of 25 to 29.9 plus factors such as diabetes, prediabetes, high blood pressure or abnormal cholesterol (NIDDK). If you feel stuck, ashamed or preoccupied with food or weight, a visit is still the right step. Other guides that may help: sleep problems, anxiety and digestion.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) A medical check of BMI, waist, blood pressure and medicines; a weight-management program with counseling, eating and activity plans; and, when lifestyle changes are not enough, prescription medicine or weight-loss surgery for those who qualify. Medicare Part B covers obesity screening and behavioral counseling at no cost if your provider accepts assignment (BMI of 30 or more, primary-care setting). The Medicare Diabetes Prevention Program is free if you qualify. Under the Medicare GLP-1 Bridge, eligible people pay $50 for a one-month supply of certain GLP-1 drugs. Other costs: being researched. Most care starts with lifestyle changes. Medicines help some people lose more weight but come with side effects and are usually long term. Surgery can bring larger, lasting change and needs lifelong follow-up.
Chiropractic No proven role in weight loss. Chiropractors may help with back, hip or knee discomfort that makes activity harder, and some clinics add nutrition counseling. About $55 to $100 per follow-up visit paying cash, per The Pricer. Medicare covers only spinal adjustments for a subluxation. We found only a small pilot study and a small retrospective review, neither of which can show that adjustments cause weight loss. A chiropractor should not replace medical care.
Acupuncture Needle, ear-point or pressure treatments added to a diet and activity plan. About $90 to $185 per follow-up visit paying cash, per The Pricer. Medicare covers acupuncture only for chronic low back pain. A 2026 review found modest extra weight loss of about 1.5 to 1.7 kg compared with lifestyle care or sham treatment, but the evidence quality was low to moderate. Placebo response is strong. Safe with a trained, licensed practitioner.
Herbal medicine Herbs and supplements marketed for weight loss. Most have not been shown to help, and some have caused serious harm. Cost estimate being researched. A 54-trial review found insufficient evidence to recommend any herbal medicine for weight loss. Garcinia products have been linked to liver injury; ephedra is banned in supplements; bitter orange has raised heart concerns. Tell your clinician about everything you take.
Massage therapy Hands-on bodywork for stress, muscle tension and comfort. Some reviews have studied massage alongside lifestyle programs. One national chain: about $70 to $90 a month on a 12-month membership, per The Pricer. Original Medicare does not cover massage therapy. Two recent reviews report small weight and waist changes, but the authors call for more high-quality trials. Treat massage as relaxation and self-care, not as a way to lose weight.
MBHA Wellness Coach One-to-one coaching on the daily habits behind weight: realistic goals, tracking, food and activity routines, sleep, stress, and getting back on track after setbacks. Cost estimate being researched. Supports — never replaces — medical care. Coaches do not diagnose, prescribe diets or medicines, or promise results; they work alongside your clinician.

Approach 1 of 6

Conventional medicine (AMA)

Mainstream care treats overweight and obesity as a chronic health condition and starts with a conversation rather than a number. NIDDK says a visit may include questions about your eating, drinking and activity habits, a BMI measurement, and a review of your medical problems and the medicines and supplements you take to see whether they affect your weight (NIDDK). You may be referred to a registered dietitian or to a weight-management team (NIDDK, NIDDK).

The treatment steps

  • Lifestyle changes — a healthy eating plan and more physical activity, usually with a tailored program (see Behavior programs and coverage below).
  • Prescription weight-loss medicines when lifestyle changes are not enough (NIDDK); see Prescription medicines, by class.
  • Weight-loss (metabolic and bariatric) surgery for people who qualify (NIDDK); see Weight-loss surgery.
  • Weight-loss devices are considered if other treatments have not worked; because they have only recently been FDA-approved, researchers do not know the long-term risks and benefits (NIDDK).

NIDDK says that, if you need to lose weight, a first goal of losing 5% of your body weight over about six months may be reasonable — for someone who weighs 200 pounds, that is 10 pounds (NIDDK). Weight loss of 5% to 10% may help improve blood sugar, blood pressure and triglycerides, and can ease joint pain and sleep apnea (NIDDK). Clinicians also check for other causes, such as medicines or hormone conditions (NIDDK).

What it costs

Medicare Part B covers obesity screening and behavioral counseling for people with a BMI of 30 or more, from a primary care provider in a primary care setting, at no cost if the provider accepts assignment; you must meet certain weight-loss requirements for coverage to continue (Medicare.gov). Coverage for medicines and surgery is described in the sections below. Costs without Medicare: cost estimate being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care is about the spine and joints. We found no government or guideline source that recommends it as a way to lose weight, and the research is thin.

What studies found

  • A 2026 pilot study enrolled 18 adults with obesity for six weeks of chiropractic care. Its main goal was to learn whether the study design was feasible. The authors say no causal conclusions can be drawn; they saw the largest within-group improvements in self-reported nervous-system functioning and perceived stress, and are planning a controlled trial (Perez et al., 2026).
  • A retrospective look at one clinic’s 13-week program combined chiropractic adjustments with diet, exercise and one-on-one counseling. Only 16 of 30 people completed it; those who did lost weight on average (about 190 to 175 pounds). The authors describe supportive evidence for a multi-modal approach (DeMaria et al., 2014). Because adjustments were bundled with diet and counseling and there was no comparison group, the study cannot show that adjustments were responsible.

Where a chiropractor may help

If back, hip or knee pain keeps you from moving, relieving it may make activity easier — see our back pain, hips and knees guides. NCCIH notes that serious side effects of spinal manipulation are more likely in people with underlying health problems, so share your health history and medicines (NCCIH). MBHA suggests being cautious of any clinic that promises weight loss from adjustments.

What it costs

The Pricer lists about $55 to $100 for a self-pay follow-up visit and about $90 to $200 for a first visit (The Pricer). Medicare Part B covers only spinal adjustments by a chiropractor to correct a subluxation, with 20% coinsurance after the deductible, and does not cover other services a chiropractor orders (Medicare.gov).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture has been tested for weight loss in many small trials. The results are mildly positive, but the quality of the evidence is limited.

What reviews found

  • A 2026 review of 20 randomized trials (2,261 adults) found acupuncture-type treatments — including needle, ear, laser and pressure methods — gave about 1.7 kg more weight loss than lifestyle care alone and about 1.6 kg more than placebo or sham treatment. Only one trial reported side effects systematically. The authors rated the certainty of the evidence low to moderate and concluded that acupuncture should be considered complementary, not a primary treatment (Ding et al., 2026).
  • A 2024 review of 25 trials (2,018 people) found acupuncture added to lifestyle changes outperformed lifestyle changes alone for body weight, BMI and waist size; the authors say high-quality trials are still needed (Zhao et al., 2024).
  • A 2025 review of 15 trials with sham acupuncture found a strong placebo response: people in the sham groups lost weight too (Liu et al., 2025). That is a reminder that attention, routine and expectation can matter.

Safety

NCCIH says relatively few complications have been reported, mostly from non-sterile needles or improper treatment, which can cause infections, punctured organs or nervous-system injury (NCCIH). Choose a licensed practitioner who uses single-use needles. Pregnant women and people who take blood thinners should tell the practitioner and their doctor first (MBHA suggestion).

What it costs

The Pricer lists about $90 to $185 per follow-up visit and roughly $125 to $230 for a first private visit, with community acupuncture around $50 to $90 (The Pricer). Medicare covers acupuncture only for chronic low back pain (Medicare.gov).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

The supplement aisle is full of products promising weight loss. The honest summary: the evidence is weak, and several ingredients have caused harm. NCCIH says “natural” does not always mean “safe” (NCCIH), and that dietary supplements are not approved by the FDA before they are sold (NCCIH).

What the research shows

A systematic review of 54 placebo-controlled trials in adults found that, as a single ingredient, only Phaseolus vulgaris produced statistically significant weight loss, and that was not considered clinically significant. No effect was seen for Camellia sinensis (green tea) or Garcinia cambogia. The authors concluded there is currently insufficient evidence to recommend any of the herbal medicines reviewed for weight loss, and noted that trial quality and reporting were often poor (Maunder et al., 2020). A 2024 review of Chinese medicine treatments (46 trials in Chinese adults) found promising results, but its authors say long-term effects and safety still need study (Chen et al., 2024).

Safety concerns, product by product

  • Garcinia cambogia: NCCIH says it is unclear whether it helps weight loss, and that numerous reports of liver toxicity exist, a few severe. It may be unsafe, including in multi-ingredient products (NCCIH).
  • Green tea extract: may have a modest effect on weight, but liver injury has been reported, mainly with extracts in tablets or capsules (NCCIH).
  • Bitter orange (synephrine): its effect on weight is unclear. Serious events including abnormal heart rhythms, heart attacks and strokes have been reported, mostly with multi-ingredient products, and FDA testing found some products contained unlisted synthetic ingredients (NCCIH).
  • Ephedra: the FDA banned supplements containing ephedrine alkaloids in 2004. NCCIH says it produced modest short-term weight loss that did not outweigh serious risks such as high blood pressure, heart attack, seizure and stroke (NCCIH).
  • Hidden drugs: some products promoted for weight loss may contain prescription drugs or unlisted ingredients, and one study estimated that dietary supplements cause about 23,000 emergency room visits a year, many involving young adults with heart problems from weight-loss or energy products (NCCIH).

Be wary of claims. NIDDK advises staying away from programs that promise weight loss without diet or exercise, losing 30 pounds in 30 days, or losing it from one body part (NIDDK). NIDDK also says not to combine prescribed weight-loss medicines with other weight-loss products unless your health care professional directs it (NIDDK). Show every product to your clinician or pharmacist. We do not list doses.

What it costs

Cost estimate being researched.

Approach 5 of 6

Massage therapy

Massage will not melt fat, but it can be a kind way to look after a body that is working hard to change habits. It can ease stress and muscle tension, which may make activity more comfortable.

What reviews found

  • A 2024 review of 12 studies found massage therapy was more effective than conventional therapy for weight, BMI, waist size, total cholesterol and triglycerides in people with obesity; the authors note the small number of studies and potential heterogeneity, and call for more high-quality randomized trials (Cong et al., 2024).
  • A 2025 review of 13 randomized trials found massage combined with lifestyle changes reduced body weight, BMI and waist size more than lifestyle changes alone, with high variation between studies in several subgroup comparisons (Wang et al., 2025).

These reviews suggest a possible add-on effect, but they are not definitive. We would not choose massage mainly for weight loss.

Safety

NCCIH says the risk of harm from massage appears low, but rare serious problems — a blood clot, nerve injury or bone fracture — have been reported, some after vigorous deep-tissue massage or in people at higher risk of injury (NCCIH). If you have osteoporosis, take blood thinners or have a swollen, warm, painful leg, check with your doctor first (MBHA suggestion). See our blood clots guide. You can also ask for a therapist who treats every body with respect and for a table or setup that fits you comfortably.

What it costs

One national chain, Massage Envy, charges about $70 to $90 a month on a 12-month membership, per The Pricer (The Pricer). Original Medicare does not cover massage therapy (Medicare.gov).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach works with you on the daily habits behind weight — alongside, never instead of, your clinician. Coaches do not diagnose, set calorie targets, prescribe medicines, or promise a number on the scale. They help you turn your care team’s plan into routines you can keep. NIDDK describes the features of successful programs as realistic goals, counseling on how to stick with healthy habits, help addressing barriers and setbacks, regular feedback, and the option of group support (NIDDK). That is the coach’s role.

What a coach can help with

  • Goals you can meet. NIDDK suggests specific goals, such as walking 15 to 30 minutes on set days, rather than “be more active” (NIDDK). CDC warns that unrealistic goals, such as losing 20 pounds in 2 weeks, can leave you feeling defeated, and that a gradual pace of about 1 to 2 pounds a week is more likely to be kept off (CDC).
  • Tracking and feedback. Keeping a record of food, activity and weight can help you spot progress and catch setbacks (NIDDK).
  • Setbacks. NIDDK says setbacks are normal and do not mean you have failed; the key is to get back on track as soon as you can (NIDDK).
  • Sleep and stress. CDC lists enough sleep and stress management as part of healthy weight loss (CDC).
  • Support. Asking family, friends and health professionals for encouragement, or joining a support group (NIDDK). A coach can also help you prepare questions for medical visits.

The limits. In the Look AHEAD trial of 5,145 adults with overweight or obesity and type 2 diabetes, an intensive lifestyle program produced more weight loss than education alone (8.6% versus 0.7% at one year), but by the end of the study the gap had narrowed (6.0% versus 3.5%), and the program did not reduce heart-related events (Wing et al., 2013). Habits help health in many ways, but weight is not the only measure of success. A coach should celebrate improved sleep, energy, strength and mood too.

MBHA suggests that anyone with a history of disordered eating tell their coach and clinician before setting any weight or food goals.

What it costs

Cost estimate being researched.

Another approach

Eating, physical activity, sleep and stress

These pages deliberately avoid calorie numbers and named diets. We share what NIDDK and CDC say, and suggest that your clinician or a registered dietitian tailor the details to you.

Nutrition patterns

NIDDK says the key is a healthy eating plan you can maintain over time. It points to the 2020–2025 Dietary Guidelines for Americans, which recommend vegetables of all types; fruits, especially whole fruits; whole grains; dairy or fortified alternatives; protein from lean meats, poultry, eggs, seafood, beans, nuts and soy; and certain oils such as olive oil. Adults who want to lose weight are advised to take in fewer calories from food and drinks, and to limit added sugars, saturated fat and sodium (NIDDK). NIDDK also says different eating plans can promote weight loss and that the best plan is one tailored to your health, culture, preferences and values, so you can stick with it (NIDDK). If you have diabetes or kidney disease, ask your care team before changing how you eat; see our diabetes guide.

Physical activity

CDC says adults need at least 150 minutes of moderate-intensity activity a week, plus muscle-strengthening activity on at least 2 days a week, and that some activity is better than none (CDC). NIDDK adds that activity helps you stay at a healthy weight, and that to prevent weight regain you may need at least 300 minutes a week of moderate-intensity activity (NIDDK). It also says activity may not have a big effect on weight loss by itself but has important health benefits independent of weight loss (NIDDK). If you have heart disease, high blood pressure or diabetes, talk with your clinician before you start, and choose activities you can do safely (NIDDK). If joints hurt, see our knees and hips guides.

Sleep

NIDDK says not getting enough sleep is linked to weight gain, may make you feel hungrier and more likely to choose higher-calorie foods, and that experts advise 7 to 9 hours a night for adults 18 to 64 and 7 to 8 hours for adults 65 and older (NIDDK). CDC suggests regular bed and wake times, avoiding caffeine in the afternoon and evening, and turning off electronics at least 30 minutes before bed (CDC). MBHA suggests asking a clinician about loud snoring or pauses in breathing; see our Sleep Apnea guide and sleep problems guide.

Stress and mood

NIDDK lists long-term stress and depression among health problems that can lead to weight gain (NIDDK), and notes that obesity can in turn affect mood and body image (NIDDK). CDC includes stress management in its steps for healthy weight loss (CDC). MBHA suggests gentle routines such as walking or a regular wind-down time, and counseling when stress or low mood feels heavy — see our depression and anxiety guides.

Keeping weight off

NIDDK is candid that keeping weight off can be hard: metabolism slows during weight loss, the body needs fewer calories at the new weight, and hormone changes can make it harder (NIDDK). Strategies that may help include an eating plan suited to your new weight, 150 to 300 minutes or more of activity a week, and weighing yourself at least once a week (NIDDK). Weighing yourself is a choice: if checking the scale feeds anxiety or unhealthy habits, tell your clinician (MBHA suggestion).

What it costs

Cost estimate being researched.

Another approach

Behavior programs and coverage

A weight-loss program, NIDDK says, is more than a book or an app: it gives ongoing guidance and support. It should include a healthy reduced-calorie eating plan, a plan for more activity if appropriate, guidance and support for new habits, and a plan for keeping weight off (NIDDK). Programs shown to be safe and successful typically include 14 or more counseling sessions over six months, regular feedback from specialists, and daily tracking of food and activity with weekly weight checks (NIDDK). Online programs are still being researched; NIDDK suggests looking for weekly sessions tailored to your goals, support from a trained professional and regular feedback (NIDDK).

Questions to ask

  • Do studies show that your program works, and have the results been published in a scientific journal? (NIDDK)
  • What does it cost in total, and what happens when I stop? (MBHA suggestion)
  • Does it treat my whole health, not just a number? (MBHA suggestion)

NIDDK advises reporting false claims or scams to the Federal Trade Commission (NIDDK).

Programs with Medicare coverage

  • Obesity behavioral therapy. Medicare Part B covers a BMI screening and behavioral therapy sessions with a dietary assessment and counseling on diet and exercise, from a primary care provider in a primary care setting, for people with a BMI of 30 or more; you pay nothing if the provider accepts assignment, and you must meet certain weight-loss requirements for coverage to continue (Medicare.gov).
  • Medicare Diabetes Prevention Program. A 16-session program (one per week within six months) with a trained coach, followed by six monthly follow-ups. You qualify if you are at risk for type 2 diabetes (a recent A1c of 5.7% to 6.4%, or other listed blood-sugar results), have a BMI of 25 or more (23 or more if Asian), and have never been diagnosed with diabetes or end-stage kidney disease; you pay nothing if you qualify (Medicare.gov).
  • CDC National Diabetes Prevention Program. A yearlong lifestyle change program led by a trained Lifestyle Coach, for people with prediabetes or at risk of type 2 diabetes who do not already have it, offered in person and online (CDC). CDC says the program is proven to cut type 2 diabetes risk in half (CDC). NIDDK notes that losing at least 5% to 7% of starting weight may prevent or delay type 2 diabetes (NIDDK). See our diabetes guide.

What it costs

Medicare programs above are free if you qualify. Private programs vary and many are not covered by insurance; cost estimate being researched.

Another approach

Prescription medicines, by class

NIDDK says prescription medicines may be offered when lifestyle changes are not enough: adults with a BMI of 30 or more, or 27 or more with weight-related problems such as high blood pressure or type 2 diabetes. They are not for everyone with a high BMI, never for appearance alone, and do not replace healthy eating and activity. On average after a year, adults taking medicine within a lifestyle program lose 3% to 12% more of their starting weight than those in a lifestyle program alone; some lose 10% or more, and results vary by medicine and person (NIDDK). The details below come from FDA labels and NIDDK. We do not list doses — your prescriber will.

GLP-1 and related injectables and tablets

These medicines mimic gut hormones that act on appetite and food intake. NIDDK lists semaglutide (Wegovy), liraglutide (Saxenda) and tirzepatide (Zepbound), which also mimics a second hormone, GIP; some are injected daily or weekly (NIDDK). Wegovy is also available as a tablet, and the Wegovy label adds that it is indicated to reduce heart-attack and stroke risk in adults with established heart disease and obesity or overweight (FDA label, Wegovy). Zepbound’s label also lists moderate to severe obstructive sleep apnea in adults with obesity (FDA label, Zepbound). Orforglipron (Foundayo) is a newer GLP-1 tablet whose label lists weight reduction in adults (FDA label, Foundayo). Their labels state they are for use with a reduced-calorie diet and increased physical activity (FDA label, Wegovy, FDA label, Zepbound, FDA label, Saxenda, FDA label, Foundayo).

  • Boxed warning: the semaglutide, tirzepatide and liraglutide labels warn that in rodents these medicines caused thyroid C-cell tumors, and that it is unknown whether they do in people; the orforglipron label carries a boxed warning about the same risk, noting its own rodent findings differ. All are contraindicated for anyone with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2 (MEN 2). Report a neck lump, trouble swallowing, shortness of breath or persistent hoarseness (FDA label, Wegovy, FDA label, Zepbound, FDA label, Saxenda, FDA label, Foundayo).
  • Other warnings in the Wegovy label: acute pancreatitis; gallbladder disease (gallstones and cholecystitis, even after accounting for weight loss); severe gastrointestinal reactions, and not recommended in severe gastroparesis; acute kidney injury from dehydration; low blood sugar if combined with insulin or sulfonylureas; worsening diabetic retinopathy; and a risk of aspiration during anesthesia or deep sedation, so tell your surgical team about any GLP-1 medicine (FDA label, Wegovy). See our anesthesia guide.
  • Common effects: nausea, diarrhea, vomiting, constipation, abdominal pain, headache and fatigue (FDA label, Wegovy). NIDDK says most side effects are mild and often improve with time (NIDDK).
  • Pregnancy: Wegovy’s label advises stopping it when pregnancy is recognized and at least 2 months before a planned pregnancy; Zepbound’s label advises people who use oral contraceptives to switch to a non-oral method or add a barrier method for 4 weeks after starting and after each increase (FDA label, Wegovy, FDA label, Zepbound).

Other medicine classes

  • Naltrexone-bupropion (Contrave). A combination of an opioid blocker and an antidepressant ingredient. Boxed warning: increased risk of suicidal thoughts and behaviors. Not for people with uncontrolled high blood pressure, a seizure disorder, or anorexia or bulimia (FDA label, Contrave).
  • Phentermine-topiramate (Qsymia). The label warns it can cause fetal harm (including cleft lip and palate), is contraindicated in pregnancy, requires pregnancy testing before and monthly during treatment for people who can become pregnant, and is dispensed through a restricted program (FDA label, Qsymia).
  • Orlistat (Xenical; a lower-strength version, Alli, is sold without a prescription). Works in the gut to reduce the fat the body absorbs (NIDDK). The label advises a multivitamin with fat-soluble vitamins, and warns of rare severe liver injury and of kidney stones and kidney injury from oxalate (FDA label, Xenical).
  • Phentermine alone. NIDDK says phentermine and similar appetite suppressants are approved only for use for a few weeks (NIDDK); the label for phentermine (Lomaira) says the same and lists primary pulmonary hypertension and heart-valve disease cautions (FDA label, Lomaira).
  • Setmelanotide (Imcivree). For obesity caused by a few rare, genetically confirmed conditions, in people ages 6 and older (NIDDK).

Staying safe with GLP-1 products

The FDA says unapproved versions of GLP-1 drugs do not go through FDA review for safety, effectiveness and quality; it has received reports of adverse events, some needing hospitalization, linked to dosing errors with compounded semaglutide, and it warns of counterfeit products. It recommends getting a prescription from your doctor and filling it at a state-licensed pharmacy, and watching for red flags such as prices that seem too good to be true or products sold “for research purposes” (FDA). NIDDK adds: buy only from a pharmacy or distributor your clinician approves (NIDDK).

How long, and what happens when you stop

NIDDK says that if you do not lose at least 5% of starting weight after 12 weeks on the full dose, your clinician will probably advise stopping, and that if the medicine works and you have no serious side effects you may stay on it indefinitely. You probably will regain some weight after you stop (NIDDK).

What it costs

Some, but not all, insurance plans cover these medicines (NIDDK). Medicare has a temporary “GLP-1 Bridge” program (prior approvals are valid through December 31, 2027) that covers Wegovy (injection or tablet), Foundayo and the Zepbound KwikPen for $50 a month for eligible people with Medicare drug coverage. Eligibility depends on BMI (35 or higher; 30 or higher with certain conditions; or 27 or higher with prediabetes, a prior heart attack or stroke, or symptomatic peripheral artery disease). It does not cover people with type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease, whose Part D plan might cover these drugs instead, and it requires a prescription, prior authorization and a certification that you are using the medicine as part of a lifestyle program (Medicare.gov). Other costs: cost estimate being researched.

Another approach

Weight-loss surgery

Weight-loss surgery, also called metabolic and bariatric surgery, changes the digestive system to help people with obesity lose weight when other methods have not worked (NIDDK).

Main types

  • Gastric sleeve: most of the stomach is removed, leaving a banana-shaped section. It cannot be reversed. Risks include vitamin and iron deficiency and acid reflux.
  • Gastric bypass: a small stomach pouch is created and connected to the small intestine so food bypasses most of the stomach. It is difficult to reverse, and has a higher chance of vitamin and iron shortage and may increase the risk of alcohol use disorder.
  • Adjustable gastric band: an inflatable band is placed around the top of the stomach. It can be adjusted and reversed, but it leads to less weight loss and needs frequent follow-up, and is less commonly performed today because of complications, mainly band removal.
  • Biliopancreatic diversion with duodenal switch: a more complex combination that leads to the most weight loss but is the most likely to cause surgical problems and shortages of vitamins, minerals and protein, so it is done less often.

All four descriptions are from NIDDK (NIDDK).

Who may qualify

NIDDK says surgery may be an option for adults with a BMI of 40 or more, a BMI of 35 or more with a serious health problem linked to obesity (such as type 2 diabetes, heart disease or sleep apnea), or a BMI of 30 or more with type 2 diabetes that is hard to control. It poses questions to consider, including whether you can commit to lifelong healthy habits, medical follow-up and extra vitamins and minerals (NIDDK). A separate NIDDK page notes that some doctors and professional groups recommend surgery at a lower BMI for people with a serious obesity-related health problem (NIDDK). Teens may be considered if they have severe obesity and are evaluated by a multidisciplinary pediatric team (NIDDK). Because these criteria are changing, ask a bariatric program what applies to you.

Benefits and risks

Surgery can help improve type 2 diabetes, high blood pressure, heart disease, cholesterol, sleep apnea, urinary incontinence and joint pain, and for people with severe obesity can extend years of life; people may also take fewer prescription medicines (NIDDK). Side effects can include bleeding, infection, leaks, diarrhea and blood clots in the legs that can travel to the lungs or heart; follow-up interventions, surgery and hospital stays within five years affect about one-third of patients; rarely, surgery-related problems lead to death. Later problems include nutrient shortages (anemia, osteoporosis), gallstones after rapid weight loss, strictures and hernias, and possibly more alcohol-related problems (NIDDK). See our osteoporosis guide and blood clots guide.

What it costs

Medicare Part B covers some bariatric surgical procedures, such as gastric bypass and laparoscopic banding, if you meet certain conditions related to morbid obesity; costs are hard to predict in advance, and Medicare does not pay for your transportation to a bariatric surgery center (Medicare.gov). Other insurers vary; ask the surgical program for a written estimate. Costs without insurance: cost estimate being researched.

Another approach

Children and teens

Children are growing, so weight is judged differently from adults. CDC says BMI for children and teens is interpreted using sex-specific BMI-for-age percentiles: healthy weight is from the 5th to under the 85th percentile, overweight is from the 85th to under the 95th, and obesity is the 95th percentile or greater. CDC emphasizes that BMI is a screening measure and not intended to diagnose disease (CDC). The U.S. Preventive Services Task Force reported that about 19.7% of U.S. children and teens ages 2 to 19 are at or above the 95th percentile (USPSTF, 2024).

What helps

  • Family-centered behavior programs. The USPSTF concluded, with moderate certainty, that referring children and teens 6 or older with a high BMI to comprehensive, intensive behavioral interventions has a moderate net benefit (USPSTF, 2024).
  • The pediatric guideline. The American Academy of Pediatrics published a clinical practice guideline for the evaluation and treatment of children and adolescents with obesity in 2023 (Hampl et al., 2023). Its full text was not available to us, so we do not summarize its recommendations; ask your pediatrician about it.
  • Medicines, only in older children. NIDDK says the FDA has approved four weight management medicines for ages 12 and older — orlistat, liraglutide, phentermine-topiramate and semaglutide — and setmelanotide for ages 6 and older with certain rare genetic disorders (NIDDK).
  • Surgery for some teens. NIDDK notes guidelines recommend evaluation by a team with pediatric expertise for teens with a BMI of 40, or 35 or more with serious obesity-related problems (NIDDK).

Kindness matters

A broader Children guide is planned. Weight stigma harms health and makes people less likely to get care (Rubino et al., 2020). Talk with children about health, energy and strength rather than size, and never put a child on a restrictive diet without a pediatrician’s advice (MBHA suggestion). Dieting, binge eating and an intense fear of weight gain can be warning signs of an eating disorder (NIMH).

What it costs

Cost estimate being researched.

Another approach

Eating disorders and mental health

Focusing on weight can be risky for anyone prone to disordered eating. NIMH describes warning signs by type: for anorexia nervosa, extremely restricted eating, intense exercise, extreme thinness, intense fear of gaining weight, a distorted body image and denial of low body weight; for binge-eating disorder, eating unusually large amounts quickly, eating when full, eating alone or in secret, feeling distressed or ashamed about eating, and frequent dieting, possibly without weight loss; and for bulimia nervosa, those binge signs plus throwing up, taking laxatives, excessive exercise or fasting. NIMH says anorexia can be fatal, that eating disorders can be treated successfully, and that treatment may include psychotherapy, medical monitoring and nutritional counseling (NIMH). The NHS lists physical signs such as feeling cold, tired or dizzy, a racing heartbeat or fainting, and missed periods, and advises seeing a doctor as soon as you can (NHS).

NIDDK notes that some eating disorders, such as binge-eating disorder and bulimia, can also lead to weight gain (NIDDK), and that obesity can raise the risk of body-image problems, low self-esteem and depression (NIDDK). The Contrave label lists bulimia and anorexia as reasons not to use that medicine (FDA label, Contrave). If you are struggling, you deserve care without judgment; tell a clinician, and if you are in crisis, call or text 988 (988 Lifeline).

What it costs

Cost estimate being researched.

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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The Monterey Bay Holistic Alliance is a charitable, independent registered nonprofit 501(c)(3) organization and does not endorse any particular products or practices. Claims and statements herein are for informational purposes only and have not been evaluated by the Food and Drug Administration. We strongly recommend that you seek out your trusted medical doctor or practitioner for diagnosis and treatment of any existing health condition. MBHA provides administrative support, education and navigation — not medical, legal or tax advice — and cannot guarantee claim, billing or fundraising outcomes. MBHA is not an emergency service: in an emergency, call 911 or go to the nearest emergency room.