Medically reviewed by Dr. Meinolf Dorka, Medical Director, last reviewed September 2026
If you are reading this, there is a fair chance you have tried before. Perhaps a plan worked for a few months and then did not, or the weight came back after you stopped.
The WHO describes obesity as a chronic, relapsing disease. Put plainly, weight returning after an effort is a recognised feature of the condition, not a personal shortcoming. Previous attempts that did not last are information, not failure, and they show what a sustainable approach needs to account for.
The short version
Sustainable weight loss usually comes from a moderate reduction in the energy you take in, through an eating pattern you can keep, combined with regular physical activity, adequate sleep and support for the habits behind both.
Lasting changes to eating and activity are what tend to keep weight off, and a first goal of around 5% of your current weight is a realistic place to start. For some people, medical treatment is added to this foundation.
Why losing weight and keeping it off is difficult
At its simplest, weight changes when the energy you take in differs from the energy you use, as the WHO fact sheet on obesity puts it. In practice, many things shape both sides of that balance.
Some of them are outside your direct control. Certain medicines can contribute to weight gain, including some antidepressants, steroids, anti-seizure medicines, diabetes medicines and beta-blockers. Some people carry genes that affect appetite. Sleeping less than seven hours can affect the hormones that regulate hunger, and stress can increase the pull towards high-fat, high-sugar food. Conditions such as polycystic ovary syndrome can play a role.
The wider environment matters too, including how available and affordable healthy food is. And the body responds to weight loss itself: as weight falls, some muscle is lost along with fat and the body uses less energy than before, which is one reason progress slows.
None of this means effort does not matter. It means that difficulty losing weight is not evidence of a lack of willpower, and that understanding every cause is not a precondition for treating it. Obesity is a medical condition with many causes, not a verdict on character.
Eating: what the evidence supports
It helps to tailor changes in eating to what works for you. Established patterns such as the Mediterranean and DASH diets offer positive guidelines rather than restrictive rules, and a few principles recur across the evidence.
More vegetables, fruit, whole grains and legumes. These are high in fibre and relatively low in calories, and fibre helps you feel full.
Less added sugar and less energy from fats. Limiting energy from fats and sugars, especially foods and drinks with added sugar, is a sensible place to start.
Fresh rather than highly processed food where possible. Processed foods tend to contain more fat, sugar or salt.
Attention while eating. Eating without screens helps you notice when you are full.
Structured nutrition support can help translate these principles into meals that fit your health and routine, particularly if you have other conditions that affect what you eat.
To lose weight, the energy you take in needs to be lower than the energy you use. Cutting calories too far tends to backfire, because constant hunger makes overeating more likely. Losing weight very rapidly also carries risks of its own, including gallstones and a temporary form of hair shedding that can follow restrictive diets.
Physical activity
Activity matters both for losing weight and, especially, for keeping it off. Weight can be lost without exercise, but it is harder, and people who maintain weight loss over the long term tend to be regularly active.
As a general guide, Mayo Clinic suggests at least 150 minutes of moderate aerobic activity a week, such as brisk walking, or 75 minutes of vigorous activity. It describes at least 300 minutes a week as helpful for losing weight or keeping it off, and recommends strength exercises at least twice a week.
Everyday movement counts too: taking the stairs, walking short distances instead of driving, standing more during the day. If you have a heart condition, joint problems or another health issue, it is sensible to discuss a new activity plan with a doctor first.
Sleep, stress and habits
Sleep and stress are associated with appetite and eating patterns, as described above, so both deserve attention.
Habits carry much of the load in any plan. Action goals, such as walking for 30 minutes a day, work well alongside outcome goals, and a simple record of food, activity and weight makes patterns easier to see. It also helps to plan ahead for the situations that affected previous attempts, and to start again the next day after a setback.
Psychological support, such as cognitive behavioural therapy, can help with the emotional and practical side of change.
Setting a realistic goal
A modest first goal is more useful than a distant one. Mayo Clinic suggests starting with around 5% of your current weight (for someone weighing 90 kg, about 4.5 kg), approached at a gradual pace of about 0.5 to 1 kg a week over the long term.
Losing 5% to 10% of your weight is associated with a lower risk of serious health problems, and keeping it off can lower blood pressure, blood sugar and blood fats.
When medical support is worth considering
Medical support is not a last resort. Common reasons to consider an assessment include:
a BMI of 30 or more, or of 27 or more with a weight-related condition such as type 2 diabetes or high blood pressure;
weight-related health problems, such as raised blood pressure, blood sugar or blood fats, sleep apnoea or joint pain;
previous approaches that did not produce lasting change;
questions about whether a medicine or another health condition is affecting your weight.
You do not need all of these, and you do not need to have exhausted every other option first. The BMI thresholds above are those in Swissmedic’s authorisation of semaglutide for weight regulation; the WHO’s 2025 recommendation on GLP-1 therapies covers adults with a BMI of 30 or more. Basic insurance applies higher thresholds before it covers these medicines. BMI is a screening measure, and measurements such as waist circumference add information.
A medical assessment looks at your weight history, other conditions, medicines, sleep, stress and eating habits. Depending on the findings, options may include structured nutrition support, medication or, for some people, surgery. Weight-regulation medicines are prescription-only, and whether one is appropriate depends on your health history.
A note on eating and wellbeing
For some people, food and weight are closely tied to distress. If thinking about food, eating or your body causes you significant distress, or if you have had an eating disorder, please speak with a doctor before starting any plan to lose weight. That conversation comes first, and it is a reason to seek support in its own right.
Support in Switzerland
Depending on what you need, either a family doctor or a clinical nutritionist can be a useful first point of contact. A doctor is the appropriate place to start if you have weight-related symptoms or health conditions, take medication that may affect your weight, have a history of disordered eating, or want to discuss prescription treatment. If your main aim is to improve your eating pattern and build a realistic plan, starting with a clinical nutritionist may be more helpful. They can assess your current habits, support structured changes and recommend medical input if needed. In family-doctor, HMO and Telmed insurance models, check whether your first contact needs to go through the doctor or service your model specifies.
Specialists in endocrinology and diabetology, nutrition counsellors recognised under Swiss law and specialised obesity centres provide more targeted care. Basic insurance covers examinations and treatment in case of illness, subject to your deductible and a co-payment. Some weight-regulation medicines are covered only under strict conditions set by the Federal Office of Public Health (BAG).
Questions you might have
What is the healthiest way to lose weight?
Is it better to focus on diet or exercise?
Why have I stopped losing weight?
Does basic insurance cover support for weight loss?
Do I need to count calories?
ahtida Health and weight management
ahtida Health is a structured digital medical clinic. Weight management is one of the areas in which it provides care, with Consultations in German and English. You can find out more about its weight management care.
One step at a time
Much of this can begin at home, at your own pace. If at some point you would like medical input as well, you can explore the weight management support available at ahtida Health.
References
- World Health Organization. Obesity and overweight (fact sheet). 8 December 2025.
- World Health Organization. WHO issues global guidelines on the use of GLP-1 medicines in treating obesity. 1 December 2025.
- Mayo Clinic. Weight loss: 6 strategies for success. 22 June 2024.
- Mayo Clinic. Getting past a weight-loss plateau. 9 April 2024.
- Mayo Clinic. Prescription weight-loss drugs. 21 January 2026.
- Cleveland Clinic. Obesity. Last updated 10 September 2024.
- Cleveland Clinic. Semaglutide Injection (weight management). Date not stated on page.
- Mayo Clinic Health System. Gallstones. Date not stated on page.
- Cleveland Clinic. Telogen Effluvium. Last updated 1 December 2022.
- Federal Office of Public Health (BAG). Decision admitting semaglutide 2.4 mg for weight regulation to the list of pharmaceutical specialities (Spezialitätenliste), effective 1 March 2024.
- ch.ch (Swiss federal portal). Taking out, changing and cancelling health insurance. Date not stated on page.
- ch.ch (Swiss federal portal). Health insurance benefits. Date not stated on page.
- ch.ch (Swiss federal portal). Health insurance costs and premium reductions. Date not stated on page.