The Best Weight Loss Option for Every BMI Level

In 2024, we have more weight loss options than ever. From traditional diet and exercise to medically supervised weight loss, weight loss programs such as WW, weight loss medications, and bariatric surgery, patients have a full roster of options to consider. However, with so many options also comes a great deal of confusion.

For example, the hype surrounding GLP-1 agonists, also known as Wegovy and Zepbound (and off-label prescribing of Ozempic and Mounjaro), has given many the false impression that they are the be-all and end-all, or magic bullet, that will solve all their weight issues.

To that end, weight loss specialists must offer clear guidance on which therapy may be best. This article will discuss the ideal weight loss options for a relatively healthy person at different BMI ranges. The BMI has plenty of limitations, but for ease, we will use it as the most straightforward measure we currently have.

People Within a Normal BMI Range of 18.5-24.9

These people are considered within the normal range of BMI and likely do not need much in the way of structured weight loss therapy. These individuals should closely examine their BMI and how it measures up to their body type. Remember that the BMI does not consider gender, body frame, musculature, and other features that can make a difference (Yes, you can be big-boned). If you look in the mirror and are in a normal BMI range but don’t see what you’re expecting, this is likely due to a lack of exercise, particularly strength training. It’s important to remember that while many of us do lots of cardio, strength training builds an ideal body shape. You’ll almost certainly get the shape you want by increasing the strength training portion of your exercise routine.

Also, consider rededicating yourself to eliminating processed, empty carbs and sugars and instead replace them with lean meats, vegetables, and fruits. Remember that your BMI might tick up once you build more muscle, but again, looking back at the BMI limitations, this would be perfectly normal.

A BMI of 25 to 29.9 – Overweight

The overweight BMI range does not typically qualify a patient for bariatric surgery or GLP-1 agonist medication like Wegovy and Zepbound (or Ozempic and Mounjaro, prescribed off-label). However, there is nothing to say that just because a patient isn’t tech technically obese, they can’t be experiencing obesity and excess weight-related conditions. Any patients who are in the overweight range may experience joint pain, high blood pressure, high cholesterol, prediabetes or even full-blown diabetes, sleep apnea, and other significant conditions that can help their lifestyles and even cardiovascular problems. These patients may not qualify for more substantial interventions but should be acutely aware of their weight and start to change their diet and exercise programs to improve.

A BMI of 30 to 39.9 – Obesity

A BMI from 30 to 40 is generally associated with obesity, where the risks of significant conditions and diseases related to excess weight are higher. Of course, as we’ve mentioned before, body type and musculature can influence the BMI. Think that a bodybuilder will often be considered obese according to the BMI because of their muscle weight. That said, average patients in this BMI range begin to qualify for specific bariatric and medical weight loss options, including GLP-1 agonists like Wegovy and Zepbound. During recent shortages, you may have also seen that Ozempic and Mounjaro were prescribed off-label for the same use. With the upper level of weight loss reaching about 15% of body weight for Wegovy and 20% for Zepbound, patients can often drop back into the overweight or normal BMI range at this point.

At the very least, if these drugs are even somewhat effective, they can often improve excess weight-related comorbidities. However, it’s important to remember that a significant number of patients who try these medications will not see success, or at least not as much as they need to drop into a lower-weight category or hit their goals. If you notice prolonged weight plateaus, still have weight-related conditions, and cannot drop more, we encourage you to speak to a weight loss specialist and bariatric surgeon like Dr. Higa to learn more about surgical weight loss options.

A BMI of 40 and up – Morbid Obesity

Once patients reach a BMI of 40 or over, they are considered to have morbid obesity. At this point, traditional weight loss options like diet and exercise, medically supervised weight loss programs, and even weight loss medications are only somewhat effective. Indeed, the only long-term weight loss option for patients in this BMI category is bariatric surgery, with few exceptions. This is not to say that weight loss medications can’t work symbiotically with bariatric surgery to boost pre- or post-op weight loss. However, the likelihood is that bariatric surgery will be the definitive option. With a BMI of 40 or over, patients are also taking on significant cardiovascular risks, which only increase as they gain additional weight. As such, they must speak to a weight loss specialist as soon as possible to understand their options and evaluate their health to minimize the risk of further issues.

The Bottom Line

While every person is different, stratification according to the BMI helps us tailor an appropriate weight loss option for each patient who sees us needing help. As the BMI increases, the possibilities become narrower, eventually reaching a point where weight loss surgery is the definitive answer for most patients. However, if the intervention has begun early in the weight gain process, patients can often attack the underlying concerns causing them to gain weight and start to reverse this process, as well as the diseases and comorbidities that come with it. To schedule a consultation with Dr. Higa, please give us a call or fill out the form on our website.