How can I lose weight?

 Weight loss can be achieved most effectively with a combination of dietary, exercise and drug measures.  Not everyone needs medication treatment and each person requires an individual approach to be most effective for success in shedding pounds.
 General emphasis is placed on a combination of increasing the basal metabolic rate(BMR) and a proper diet.  BMR can be increased by increasing muscle mass.  A common cause of insidious weight gain associated with a low BMR is hypothyroidism.  Treatment of this condition with an appropriate dose of thyroid hormone will adjust the BMR upward and into the appropriate range resulting in an increased calorie burn rate at rest.  Adjustment in the diet includes attention to the number of calories consumed.  Additional details such as consumption of low calorie foods such as vegetables as opposed to fats will allow for relatively larger sized portions without introducing as many calories in the diet.  The use of salads and protein rich foods and avoiding fat containing foods represent the cornerstone of an appropriate diet.  Particular diets now in popular use such as the Adkins Diet make use of this principle.
 Medication use has changed drastically over the last three years.  In 1997 the now notorious combination of Fenfluramine and Phentermine (fen-phen) as well as Redux or dexfenfluramine were removed from the market.  In their place has arisen a variety of herbal agents which are ephedrine based which raise BMR, Xenical which blocks intestinal enzymes from absorbing 30% of dietary fat, and seratonin reuptake inhibitors which slow depletion of the neurotransmitter seratonin in the brain.  Currently in development but not yet in use are the exciting Melanocortin-4 receptor agents which are believed to act at the hunger center of the brain to surpress appetite at the level of the brain.
 The most important factor not yet mentioned is the importance of a supportive program to encourage the change in lifestyle and departure from what has often become bad eating habits and lack of exercise.  A caring approach free of a judgemental attitude can result in successful weight control in the near term as well as into the future.
Beware of the many programs and advertised remedies that promise weight loss to you.  Hospitals and private businesses have jumped to make the most of your desire for a change in your weight.  Remember, only you can lose weight by your efforts alone.  Seek a sympathetic and caring health care professional whom you can trust to guide you to a cost effective and successful program.

Ideal Weight Calculator  http://www.drkoop.com/tools/calculator/ideal_weight.asp

Excellent Discussion from National Institutes of Health (NIH)  from 1992
http://text.nlm.nih.gov/nih/ta/www/10.html

Melanocortin-4 receptor   http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9019399&form=6&db=m&Dopt=b