Obesity: Ideal body weight can be defined in several ways. The Metropolitan Life Insurance Tables are a traditional method; however, these are not usually readily available. The American Diabetes Association has used a simple method: For women, 100 pounds is allowed for the first 5 feet of height and then 5 pounds for each inch over 5 feet. For example, a woman 5'4" tall would be allowed 100 + (4 x 5) = 120 plus or minus 10% based on frame size. Men are allowed 106 pounds for the first 5 feet and 6 pounds for each inch over five feet. For example, a 5'10" tall male would be allowed 106 + (10 x 6) = 166 pounds. More recently, the Body Mass Index has become popular for defining ideal weight. (see http://nhlbisupport.com/bmi) Morbid obesity has been defined in the past as either 100 pounds over ideal weight, or more than twice ideal body weight. After testing for secondary causes of obesity, patients who remain morbidly obese after more conservative treatment may be considered for gastric surgery. The ratio of height (in centimeters) to weight (in kilograms) has become a popular way to define obesity. A BMI from 20-25 is considered health; a BMI over 25 to 30 is considered to be obese. Activity is very helpful in reducing weight. Walking is the safest exercise for most patients. The daily caloric needs of overweight patients who are not very active can be estimated as about 10 pounds their ideal body weight in pounds. In other words, for the woman listed above who has an ideal body weight of 120 pounds for her height of 5'4", she would need no more than 1200 Calores/day (120 x 10). In fact, many patients require even lower calories than calculated to establish weight loss if they have a "sluggish" metabolism. Commerical weight loss programs, such as Optfast, Medifast require close supervision for their very low calorie diets of 500 Calories per day. Over the counter Slim Fast diets usually provide two servings of Slim Fast (each about 250 Calories) and then a small meal of 300-400 Calories) so that these individuals take in 800-1000 Calories/day without medical supervision. Very strict low calorie diets are usually associated with diuresis and loss of potassium and other electrolytes which should be monitored and replaced. Sluggish gall bladder activity can lead to cholecystitis and kidney stones may occur if there is dehydration. Constipation should be anticipated if the patient is on a low calorie diet. The easiest way to generate a low calorie diet with regular food is to recommend lots of vegetables, seafood and walking.