I want to lose 30 pounds and diets have not worked. What are my options?

I’m sorry diets haven’t worked — that’s very common. You have several safe, evidence‑based options beyond one-off “diets.” Which is best depends on your current weight, medical history, goals, and preferences. Below is a practical overview with concrete names so you can discuss choices with your clinician.

First step (recommended)

• See your primary care doctor (or an ABOM‑certified obesity medicine specialist). They’ll check BMI, screen for medical causes of weight gain, run basic labs, review medications, and discuss comorbidities (diabetes, high blood pressure, sleep apnea). Bring a list of what you’ve tried and how long.

Non-surgical options

1. Intensive lifestyle + behavioral programs

   • What: Structured, personalized plans with calorie goals, activity guidance, and behavioral counseling.
   • Examples: WW (WeightWatchers), Noom (mobile app with CBT-style coaching), medically supervised programs through clinical weight‑management centers.
   • Typical results: 5–10% weight loss in many people when followed closely; best long‑term when paired with ongoing support.
   • Good if you want a non‑medical approach, coaching, and accountability.

2. Prescription anti‑obesity medications

   • GLP‑1 / GIP drugs: semaglutide (Wegovy), tirzepatide (Zepbound for weight‑loss; Mounjaro is the diabetes brand often used off‑label)
     • Why consider: Trials show large average losses (often ~10–20% or more), higher than older drugs.
     • Downsides: GI side effects (nausea, vomiting, diarrhea), cost/insurance barriers, need ongoing use for maintenance, contraindicated in pregnancy and certain rare thyroid conditions.
   • Other prescription options:
     • Phentermine/topiramate (Qsymia) — effective, stimulant side effects possible.
     • Liraglutide (Saxenda) — injectable, moderate effect.
     • Naltrexone/bupropion (Contrave) — oral option affecting appetite and reward.
     • Orlistat (Xenical prescription; Alli OTC) — modest effect, can cause greasy stools.
   • Typical results: Vary by drug — from modest (~3–8% for older meds) to substantial (10–20%+ for GLP‑1 / GIP agents). Discuss side effects and monitoring with a clinician.

3. Endoscopic procedures (minimally invasive)

   • Options: Intragastric balloons (brands: Orbera, Obalon), endoscopic sleeve gastroplasty.
   • Who: People who want a non‑surgical but more intensive tool and meet certain criteria.
   • Typical results: Intermediate weight loss (more than meds alone in some cases), and usually temporary (balloon removed after months).

Surgical options (bariatric surgery)

• Types: Sleeve gastrectomy, Roux‑en‑Y gastric bypass (most common and effective), adjustable gastric banding (less used now).
• Why consider: Most effective for significant, sustained weight loss — typical excess weight loss often 25–35% (varies), with improvement or remission of diabetes and other conditions.
• Who qualifies: Usually BMI ≥40, or BMI ≥35 with obesity‑related health problems (some programs now use lower BMI thresholds based on health).
• Considerations: Requires lifelong follow‑up, nutrition/vitamin monitoring, possible complications, and pre‑op evaluations including mental health and diet counseling.

Other supports

• Registered dietitian (RD/RDN) for personalized meal planning and to address disordered eating.
• Behavioral therapy or CBT for emotional eating.
• Exercise programs and physical therapy for safe activity progression.
• Support groups and digital tools for accountability.

How to choose

• If BMI and health meet criteria for medications or surgery, discuss those options with an obesity specialist.
• If you prefer non‑medical routes, start with an evidence‑based program plus RD and behavioral therapy.
• Combine approaches: lifestyle change + medication or endoscopic/surgical procedures gives best outcomes for many people.

Practical next steps

1. Check BMI (I can calculate if you tell me your height and weight).
2. Book a visit with your PCP asking for: metabolic labs, medication review, and referral to an obesity medicine specialist or bariatric surgeon if appropriate.
3. Ask about ABOM‑certified physicians, local bariatric programs, or RDNs experienced in weight management.
4. If meds interest you, ask about Wegovy, Zepbound/Mounjaro, Saxenda, Qsymia, Contrave — and insurance coverage/authorization.

If you want, tell me your height, current weight, any medical conditions, and what you tried before (and what you liked/disliked). I can suggest a focused next step and help you find local specialists or resources.