At any given moment, up to half of all Americans are on a weight-loss diet. While an estimated 45 million of us spend $30 billion in the pursuit of weight loss annually, most remain overweight—if not obese.

Considering some of the adverse effects of alli, the only nonprescription diet drug approved by the U.S. Food and Drug Administration (FDA), you may be throwing your money down the drain. Besides preventing nutrient absorption, this weight-loss medication creates considerable lower bowel distress. Anyone taking blood thinners or being treated for diabetes or a thyroid condition should take this drug only with a doctor’s permission. And this over-the-counter version of orlistat is not recommended for anyone who’s had an organ transplant.

If the rate at which we’re packing on pounds continues, 75 percent of us will be overweight by 2015. Sixteen percent of American children and adolescents are currently overweight, with another 34 percent likely to become too heavy—and the long-term health risks of overweight and obesity appear even greater for young people.

Why We’re Heavy
A variety of factors contribute to overweight and obesity: Clever marketing techniques (particularly with children), genetic heritage, cultural and socioeconomic status, environmental factors, metabolism, lifestyle (few of us are as active as our parents or grandparents), a number of diseases and medications, stress, lack of sleep, and hormonal factors are just some of the causes. Increased portion size is one obvious reason for overweight, while low thyroid function and exhausted adrenals (not uncommon in our 24/7 lifestyle) can make it difficult for some individuals to get up and work out.

“Any disruption of the liver detoxification pathway contributes to excesses or imbalances in hormones, toxins, and our ability to lose weight,” says medical journalist Lorna R. Vanderhaeghe. “If you have been dieting for years and were never told a healthy liver is essential for fat loss, it isn’t any wonder you may not have reached your fat-loss goals,” she explains. “Clogged bile ducts, inadequate secretion of bile, not enough bile, or an overwhelmed or congested liver from too many prescription drugs, toxins, or alcohol can all contribute to a fatty liver,” which may inadequately break down or emulsify fats, so “our fat cells store too much fat, promoting weight gain or resistance to fat loss.”

A Holistic Approach
Eating a plant-based diet that includes fish and other sources of healthy fats is an important first step. Whole foods are high in nutrients, as well as fiber that helps keep you feeling full. Pay attention to portion size: Protein (one serving is the size of a computer mouse) at all three meals is wise, as is avoiding refined grains and sugary foods. “Quantity of food is given most of the credit for our weight woes,” says Vanderhaeghe, while “the quality of the food we eat plays an equally important role. Saturated fats, trans fats, fake fats, aspartame and other artificial sweeteners, refined carbohydrates, processed meats and cheese, diet foods and sodas conspire to make us fat and disrupt our hormones,” so eliminate these from your diet.

Work with a healthcare provider or fitness trainer to set appropriate exercise goals. “When you exercise during weight loss, you lose more fat from the visceral stores around the waist, because this fat is very metabolically active and turns over more rapidly,” says William J. Evans, PhD, director of the Nutrition, Exercise, and Metabolism Laboratory at the University of Arkansas for Medical Sciences.

Toxins in our food and water supply, the air we breathe, plastics, conventional household cleaners and beauty products, and even clothing and home furnishings can contribute to xenoestrogens, or false estrogens, that overwork the liver and lead to estrogen dominance. It’s often useful to help the body’s natural detoxification system out periodically with internal cleansing to support the liver and slow weight gain. Nutritionist Ann Louise Gittleman, PhD, CNS, recommends eating as much organic food as you can for the week before going on a juice fast and then slowly adding back organic foods to help cleanse your body of fattening toxins.

As someone “who works with literally thousands of dieters each year, I have to tell you what I know: The extra cost of organic is absolutely justified by the benefits to your health, beauty, and ability to stay slim.” Certified organic foods tend to taste better, and research suggests they’re higher in antioxidants and many minerals. “If you want to lose weight and keep it off, the only really effective way to do so is to eat organic,” Dr. Gittleman adds.

Drink at least eight glasses of clean water throughout the day (no more than four ounces with meals). In addition to keeping you hydrated, water contains no calories but helps fill you up so you won’t feel as hungry and want to eat as often. If you’re planning to support your liver and health with detoxification, be sure to drink more water before, during, and after detox. Drinking green tea can help boost metabolism and burn fat, while adding important antioxidants to your diet.

Anyone who’s dieting needs plenty of rest and sleep. Reward your progress with nonfood treats: a journal for jotting down your thoughts and goals, relaxation or visualization CDs, or some natural cosmetics. Ask your family and friends to cheer you on and remind you that you’re getting healthier by eating better and exercising more.

Additional Support
As “nutrient” insurance, to assist thyroid function and support the adrenal glands, and during any weight-loss plan, a daily multivitamin/mineral formula is essential. Whether taken with meals or found in your daily multi, enzymes can improve nutrient absorption, so your body gets the full benefits of healthy foods.

Dr. Gittleman recommends eating organic yogurt with live cultures or taking probiotics to restore friendly flora to the digestive tract. “New studies suggest that friendly bacteria may offer a host of other benefits, including helping you digest fats, proteins, and carbohydrates,” she adds.

“Chromium is a mineral essential for regulating the production of the hormone insulin, which is responsible for stabilizing blood sugar levels and preventing the conversion of blood sugar into fat,” says Ellen Kamhi, PhD, RN, HNC. Found in the outer bran portion of grains (removed in the refining process), this mineral is often lacking in the American diet today, making supplementation (200 mcg/day) useful for overall health and weight management.

For additional support (as long as you’re not pregnant or breastfeeding), see “Supplements for Weight Loss.”