Many people are told weight loss is simply “eat less, move more.” In reality, weight is influenced by many factors—biology, sleep, stress, mental health, medications, environment, chronic conditions, and more. Obesity is a complex, chronic condition, and the goal of care is often better health and quality of life, not just a number on the scale. Please also see our article on the mediterranean diet as well which is plays an important part in any weight loss journey.

1) Eat in a way that supports your body (not a “perfect diet”)

Small changes that feel realistic and enjoyable tend to last longer:

• Try to eat when you’re hungry, sit down, and eat without distractions when possible.

• Slow down and notice taste and fullness—stop when you feel comfortably full.

• You don’t have to cut out foods you love—restriction can backfire. Aim for balance and mindful choices.

2) Make sleep part of the plan

Sleep affects hunger hormones, cravings, energy, and mood.

• Keep a regular schedule and a relaxing bedtime routine; limit caffeine/alcohol before bed.

• Most adults need about 6–9 hours, but it varies by person.

3) Move your body in ways you don’t hate

Physical activity helps health even if weight doesn’t change much.

• Choose activities you enjoy (walking with a friend, yoga, etc.).

• Build movement into daily life (stairs, short walks when you can).

4) Set small goals you can actually keep

Focus on progress, not perfection.

• Tiny changes add up—even if the scale doesn’t move right away.

• Pick 1–2 goals at a time, and make them SMART (Specific, Measurable, Achievable, Realistic, Time-bound).

• Example SMART goal: “15 minutes of gardening or yard work, 3 times per week.”

When to talk to your family doctor or nurse practitioner

Consider booking a visit if you:

• Feel stuck despite trying lifestyle changes

• Have weight-related health concerns (like high blood pressure, diabetes, sleep apnea, joint pain, fatty liver, cholesterol issues)

• Think medications, mental health, sleep, or pain are getting in the way

• Want to discuss medical options (medications or referral programs)

Your care plan should be individualized—BMI alone doesn’t tell the whole story.

Medical options (for some patients)

Prescription weight-loss medications (Canada)

In Canada, the most common and tolerated weight loss medications include wegovy, zepbound and contrave

These medications work in different ways—some help you feel full sooner and reduce hunger/cravings, and one reduces how much fat your body absorbs from food.

Before starting, we’ll review your health history and possible side effects, and confirm whether you meet criteria (often based on a screening number called BMI and whether you have weight-related health conditions like high blood pressure or type 2 diabetes).

What results can you expect?

Average weight loss at about 1 year (results vary from person to person):

• Wegovy (semaglutide): ~12.5%

• Zepbound (tirzepatide): ~15%

• Contrave (naltrexone/bupropion): ~4.8%

Medication details

Wegovy (semaglutide) and Zepbound — weekly injection

How it works (in plain terms): Helps you feel more satisfied, reduces hunger, and helps control cravings.
Typical weight loss: about 12.5% - 15% at 1 year
Common side effects: nausea, vomiting, diarrhea, constipation, indigestion
Reasons it may not be safe for you (not an exhaustive list):

• Personal or family history of a rare thyroid cancer (medullary thyroid cancer) or a related genetic condition (MEN2)

• Pregnancy, trying to conceive, or breastfeeding

Contrave (naltrexone/bupropion) — pills

How it works (in plain terms): Works on areas of the brain involved in hunger and cravings.
Typical weight loss: about 4.8% at 1 year
Common side effects: nausea, constipation, headache, dry mouth, dizziness, diarrhea
Reasons it may not be safe for you:

• High blood pressure that isn’t well controlled

• Opioid use (it contains naltrexone, which can interfere with opioids)

• Seizure history or certain seizure risk factors

• Suddenly stopping alcohol

• Certain medication combinations (including MAOIs)

• Severe liver disease or end-stage kidney failure

• Pregnancy, trying to conceive, or breastfeeding

Bariatric (weight-loss) surgery

Surgery can be an option for some people and can lead to larger, longer-term weight loss than medication alone. Canadian guidance suggests surgery may be considered for people with BMI ≥40, or BMI ≥35 with at least one weight-related health condition.

Common types of surgery in Canada and typical weight loss

The 3 most common procedures in Canada are adjustable gastric banding, sleeve gastrectomy, and gastric bypass.
Typical total body weight loss: 20% / 25% / 30% (varies by procedure and person).

Common side effects (depends on the procedure)

• Banding: trouble swallowing, vomiting

• Sleeve: vomiting, constipation

• Gastric bypass: “dumping syndrome” (feeling unwell after eating certain foods)

Longer-term risks to know about

• Banding: higher chance of long-term issues like weight regain, band erosion, or not tolerating the band

• Sleeve: reflux/heartburn (GERD), Barrett esophagus, weight regain

• Gastric bypass: internal hernia, bowel obstruction, ulcers at the connection point, kidney stones

Serious complications (uncommon, but important)

Complications can include leakage, bleeding, infection, and device-related issues (when devices are used).
Serious complications can include blood clots, breathing problems, and severe bleeding and more

Up to 25% of patients may experience significant weight regain or not lose as much as hoped over time.

A supportive note

There isn’t one “right” option. Some people do best with lifestyle changes alone, some benefit from medication, and some choose surgery. The best plan is the one that fits your health needs, your values, and what feels realistic in your day-to-day life.

This page is for general education and is not medical advice. If you’d like help building a plan that fits your health, schedule, budget, culture, and preferences, book an appointment with our team.

Credit to FMPE Obesity module