Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Obesity - Management
What advice should I give about diet?

  • Advice on dietary changes should take into account the person's food preferences and allow for flexible approaches to reducing calorie intake.
  • Promote a diet which is in line with healthy eating recommendations, is acceptable to the person, and is sustainable in the long term.
  • Ensure that the person is aware of the changes they will need to make to their usual eating habits.
  • All healthy people over 5 years old should eat a balanced diet rich in fruit, vegetables, and starchy foods including:
    • Five portions of a variety of types of fruit and vegetables each day.
    • Meals based on starchy foods (e.g. bread, pasta, rice, and potatoes) — include high fibre varieties if possible.
    • Moderate amounts of milk and dairy products — should be low fat if possible.
    • Moderate amounts of protein-rich foods (e.g. meat, fish, eggs, beans, and lentils).
    • A reduction in the amounts of foods high in fat (especially saturated fat), sugar, and salt.
    • A reduction in alcohol intake (alcohol is high in calories).
    • Cooking using methods which reduce fat (e.g. grilling, steaming).
  • People should be encouraged to improve their diet even if they do not lose weight.
  • Diets that are recommended for sustainable weight loss in combination with expert support and intensive follow up are:
    • Those with a 600 kcal/day deficit (i.e. they contain 600 kcal less than the person needs to stay the same weight), or
    • Those which reduce calories by lowering the fat content (low-fat diets).
  • Low-calorie diets (1000–1600 kcal/day) are less likely to be nutritionally complete, but can be considered in combination with expert support and intensive follow up.
  • Do not use unduly restrictive and nutritionally unbalanced diets.
Clarification / Additional information
  • The 'Your Weight, Your Health' booklet available from the Department of Health website, www.dh.gov.uk is aimed at people who are ready to address their weight, and discusses diet as part of a healthy life [DH, 2006b].
  • Very-low-calorie diets (less than 1000 kcal/day) may be used, under specialist clinical supervision, for a maximum of 12 weeks continuously, or intermittently with a low-calorie diet (for example for 2–4 days a week), if a person is obese and has reached a plateau in weight loss.
  • Any diet of less than 600 kcal/day should be used only under specialist clinical supervision.
  • In the longer term, people should move towards eating a balanced diet, consistent with other healthy eating advice.
Basis for recommendation
  • This recommendation is based on guidance from the National Institute for Health and Clinical Excellence on the prevention, identification, assessment, and management of overweight and obesity in adults and children [NICE, 2006b] and the associated NICE quick reference guide [NICE, 2006c]. Recommendations for healthy eating are based on the Balance of Good Health from the Food Standards Agency [DH, 2006a; National Heart Forum, 2007].
  • There is evidence to suggest that dietary interventions in people with overweight or obesity are effective in terms of weight loss, and that this effectiveness is increased when dietary interventions are combined with physical activity [National Collaborating Centre for Primary Care, 2006].
    • Unduly restrictive and nutritionally unbalanced diets should not be used, because they are ineffective in the long term and can be harmful [NICE, 2006b].
    • People should be encouraged to improve their diet even if they do not lose weight, because there can be other health benefits [NICE, 2006b].

© NHS Institute for Innovation and Improvement