The History of Weight Loss: Every Method From 1860s Diets to 2026 Pills

Key takeaways

• William Banting's 1863 Letter on Corpulence described losing 46 pounds by cutting bread, sugar, beer and potatoes, an early low-carbohydrate diet.^[1]
• In 1997, fen-phen was linked to heart-valve disease in 24 women, after U.S. prescriptions for the two drugs had exceeded 18 million in 1996.^[13]
• Bariatric surgery began with a 1954 intestinal bypass; by 2023 the sleeve gastrectomy made up 58.2% of U.S. procedures.^[10]
• The GLP-1 era began with Wegovy's approval on June 4, 2021, followed by Zepbound in 2023 and the first GLP-1 weight-loss pills in 2025 and 2026.^[26]

In short: Modern weight loss started with a pamphlet: in 1863 a Londoner named William Banting described losing 46 pounds by cutting bread, sugar, beer and potatoes. Calorie counting went mainstream in 1918, group programs arrived in 1948 and 1963, surgery began in 1954, and weight-loss drugs went through cycles of hope and withdrawal, from a dangerous 1930s “fat burner” to fen-phen in 1997 and sibutramine in 2010, before GLP-1 medicines changed the field from 2021. Each era left a lesson that still applies, and this page links every one of them to where things stand today.

This is the overview of our history series. Dates and numbers come from original documents (such as Banting’s and Peters’ books, now in the public domain), FDA records and peer-reviewed papers. For today’s options side by side, see 40 ways to lose weight compared.

1863: Banting and the first diet bestseller

William Banting was in his sixties when he wrote his Letter on Corpulence, Addressed to the Public, dated May 1863. On his doctor’s advice he gave up bread, butter, milk, sugar, beer and potatoes, which he called the main foods of his old diet, and ate meat, fish, some vegetables, a little dry toast and fruit. He printed a careful weight log: from about 202 pounds in August 1862 to 156 pounds by September 1863, a total loss of 46 pounds, mostly at 2 to 3 pounds every three weeks. The first edition of 1,000 copies sold out, and “banting” became a word for dieting.

202 lbAug 1862

187 lbDec 1862

176 lbMar 1863

164 lbJun 1863

156 lbSep 1863

William Banting's own weight log, 1862 to 1863

Item	Value
Aug 1862	202 lb
Dec 1862	187 lb
Mar 1863	176 lb
Jun 1863	164 lb
Sep 1863	156 lb

Selected dates from his printed table (Aug 1862 = his reported 200 lb on Sept 7 plus the 2 lb he says he had lost). One person's report, not a study.

Source: Banting W., Letter on Corpulence, Addressed to the Public (1863), Project Gutenberg edition (checked on October 6, 2026)

The lesson that lasted: cutting refined starch and sugar can reduce how much people eat. What we know now: modern trials find that low-carbohydrate and low-fat diets give similar results when calories are similar. In DIETFITS, the 12-month difference was under 1 kg. Banting’s idea lives on in keto and other low-carb plans; our diets hub compares them.

1918: counting calories

Lulu Hunt Peters, a physician, published Diet and Health, With Key to the Calories in 1918. She urged readers to think of food in calories, writing that instead of “one slice of bread” they would say “100 Calories of bread”, and she included tables to make it practical. It became one of the best-known diet books of its time. What we know now: a calorie deficit is still the core of weight loss in the 2013 AHA/ACC/TOS guideline, which suggests 500 to 750 fewer calories a day, but the body adapts as weight falls, so the old “3,500 calories equals a pound” rule overpredicts losses. Our calorie deficit guide and calorie calculator use modern equations.

1930s to 1950s: dangerous drugs and the first rules

In the 1930s, 2,4-dinitrophenol (DNP), an industrial chemical that speeds up metabolism by making cells waste energy as heat, was briefly sold as a weight-loss drug before the FDA banned it after reports of severe toxicity. It has since reappeared as an illegal “fat burner” sold online, with deaths reported. The lesson is a recurring one: a drug that forces weight loss by overriding the body’s safety limits can kill.

Appetite-suppressing stimulants came next. Phentermine, related to amphetamine, received its initial U.S. approval in 1959 and is still labeled today only for short-term use (a few weeks) as part of a broader plan, and it is a controlled substance. Our appetite suppressants guide covers it.

1948 and 1963: weight loss becomes a group activity

TOPS (Take Off Pounds Sensibly), a nonprofit, says it opened in 1948 as the first weight-loss support organization of its kind. In 1961, Jean Nidetch, a homemaker in Queens, New York, joined a program run by the New York City health department and began inviting friends to her living room for weekly support; within about two months, 40 women were meeting. She founded Weight Watchers in 1963. What we know now: regular support works. The U.S. Preventive Services Task Force recommends intensive, multicomponent behavioral programs for adults with a BMI of 30 or more, and such programs often bring 5% to 10% loss. Today’s options are on our programs hub.

1954 to 1994: the surgical era begins

The first metabolic operation is credited to Kremen in 1954: a jejuno-ileal bypass that skipped much of the small intestine. It caused serious nutritional complications and was abandoned. In 1966, Edward Mason, a surgeon at the University of Iowa, noticed that patients who had part of the stomach removed for cancer lost weight, and proposed the first gastric bypass. Vertical banded gastroplasty followed in 1982, the first laparoscopic (keyhole) gastric band was placed in 1992, and the first laparoscopic gastric bypass was performed in 1994, which made surgery safer and far more common. The sleeve gastrectomy began as the first stage of a bigger operation and became a stand-alone procedure after surgeons saw how much weight patients lost from it alone.

• Sleeve gastrectomy58.2%60%
• Gastric bypass23.4%24%
• Revisions11.9%12%
• Other (duodenal switch, ESG, balloons, band)3.9%4%

U.S. metabolic and bariatric procedures in 2023, by type

Item	Value
Sleeve gastrectomy	58.2%
Gastric bypass	23.4%
Revisions	11.9%
Other (duodenal switch, ESG, balloons, band)	3.9%

Other = duodenal switch 1.4%, endoscopic sleeve gastroplasty 1.7%, balloons 0.5%, band 0.3%.

Source: ASMBS, Estimate of Bariatric Surgery Numbers (2023: 270,089 procedures) (checked on October 6, 2026)

What we know now: surgery produces the largest and longest-lasting average losses. In the Swedish Obese Subjects study, people who had gastric bypass were 25% lighter ten years later. The once-popular band is now rarely used: it made up 0.3% of U.S. procedures in 2023. Our bariatric surgery guide covers today’s operations.

1972: naming the body mass index

The ratio of weight to height squared got its modern name in 1972, when Ancel Keys and colleagues compared several “indices of relative weight” in 7,424 men in five countries and wrote that “the ratio of weight to height squared, here termed the body mass index” worked slightly better than the others. BMI became the standard screening number for obesity. What we know now: BMI is a quick screen, not a diagnosis. Labels and guidelines use it to describe who medicines and surgery are generally considered for, and clinicians add waist size and health history. Try our BMI calculator.

1990s to 2010: fen-phen, withdrawals and supplement scares

In the 1990s, doctors combined fenfluramine with phentermine, a pairing never approved by the FDA as a combination. In 1996, U.S. prescriptions for the two drugs exceeded 18 million. In August 1997, Mayo Clinic doctors reported unusual heart-valve disease in 24 women who had taken fen-phen, and fenfluramine and dexfenfluramine were withdrawn from the U.S. market that year. Sibutramine (Meridia), approved in November 1997, was withdrawn in December 2010 because of heart attack and stroke risk, yet the FDA still finds it hidden in products sold as supplements. The FDA banned ephedra in supplements in 2004.

One approval from this era is still used: orlistat (Xenical), approved in April 1999, blocks some fat absorption. Pooled one-year trials showed 13.4 pounds lost vs 5.8 with placebo, and a half-strength version, Alli, became the first over-the-counter weight-loss medicine in 2007. See orlistat and our supplements guide for why supplements are not FDA approved.

2012 to 2020: new pills, and another withdrawal

In 2012, the FDA approved Qsymia (phentermine and topiramate) in July, and lorcaserin (Belviq) the same year. In 2014 came Contrave (September) and Saxenda (December), the first GLP-1 medicine approved for weight. Belviq was withdrawn in 2020 after a safety trial found more cancers. In their label trials, Qsymia, Contrave and Saxenda added roughly 4 to 9 percentage points of weight loss over placebo. Research on keeping weight off also grew: studies of the National Weight Control Registry described habits such as about an hour of daily activity, consistent eating and regular self-weighing among people who maintained large losses.

2021 to 2026: the GLP-1 era

On June 4, 2021, the FDA approved Wegovy (semaglutide 2.4 mg), a weekly injection that averaged -14.9% vs -2.4% with placebo in its main trial. Zepbound (tirzepatide) followed on November 8, 2023, at up to -20.9% vs -3.1%. Then came pills: Wegovy tablets on December 22, 2025, and Foundayo, a small-molecule daily pill, on April 1, 2026, plus a higher Wegovy dose in March 2026. Weight medicines also began to show benefits beyond the scale: in the SELECT trial of 17,604 adults with heart disease and overweight or obesity, semaglutide lowered the rate of heart attack, stroke or cardiovascular death (6.5% vs 8.0%), and in March 2024 Wegovy became the first weight-loss medicine approved to reduce that risk. Our GLP-1 guide explains how these medicines work.

3%Xenical (1999)

10.9%Qsymia (2012)

7.4%Saxenda (2014)

5.4%Contrave (2014)

14.9%Wegovy (2021)

20.9%Zepbound (2023)

11.1%Foundayo (2026)

Average weight change in the main trial of medicines approved over time

Item	Value
Xenical (1999)	3%
Qsymia (2012)	10.9%
Saxenda (2014)	7.4%
Contrave (2014)	5.4%
Wegovy (2021)	14.9%
Zepbound (2023)	20.9%
Foundayo (2026)	11.1%

Chronological, not a ranking. Medicine arm only (placebo groups also lost weight). Xenical = about 3 percentage points more than placebo in pooled 1-year trials. Different trials and lengths.

Source: FDA labels on DailyMed; STEP 1 (NEJM 2021); SURMOUNT-1 (NEJM 2022) (checked on October 6, 2026)

What we know now: these medicines work best as long-term treatment. When people stop, much of the weight tends to return, and losing muscle along with fat is a concern that strength training and enough protein help address. The bigger losses also brought new problems: shortages, then compounded and counterfeit versions that the FDA warns about.

Shaping the body: corsets to contouring

Alongside weight loss, people have always tried to change shape. Today’s versions are shapewear, waist trainers and cosmetic procedures such as liposuction and fat freezing. None of them is weight loss: the American Society of Plastic Surgeons says liposuction is not a treatment for obesity or a substitute for diet and exercise. Our guides to shapewear, waist trainers and body contouring explain what each can and cannot do.

Era timeline

Year	Milestone	Type
1863	Banting’s Letter on Corpulence	Diet
1918	Peters’ Diet and Health, With Key to the Calories	Diet
1930s	DNP sold for weight loss, then banned by the FDA	Drug
1948	TOPS opens	Program
1954	First metabolic operation (jejuno-ileal bypass)	Surgery
1959	Phentermine’s initial U.S. approval	Drug
1963	Weight Watchers founded	Program
1966	Mason proposes the gastric bypass	Surgery
1972	Keys names the body mass index	Measurement
1992-1994	First laparoscopic band and gastric bypass	Surgery
1997	Fen-phen heart-valve report; fenfluramines withdrawn; sibutramine approved	Drug
1999	Orlistat (Xenical) approved	Drug
2004	FDA bans ephedra in supplements	Supplement
2007	Alli, first over-the-counter weight-loss medicine	Drug
2010	Sibutramine (Meridia) withdrawn	Drug
2012-2014	Qsymia, Belviq, Contrave and Saxenda approved	Drug
2018	USPSTF recommends intensive behavioral programs for BMI 30+	Program
2020	Belviq withdrawn	Drug
2021	Wegovy approved	Drug
2023	Zepbound approved	Drug
2025-2026	GLP-1 pills (Wegovy tablets, Foundayo) and Wegovy HD approved	Drug

Five lessons from 160 years

The thread through all of it is that lasting change comes from something you can keep doing, with the right medical help when you need it. Our keeping weight off guide and the exercise hub are good places to put these lessons to work, and what’s new in 2026 picks up the story from here.

Questions to ask a professional

• Which of today's approaches has the best evidence for someone like me?
• Is a medicine I have heard about approved, and what do its trials show?
• Would a structured program or a dietitian help me more than doing it alone?
• What would long-term maintenance look like for me?

Frequently asked questions

What was the first diet book?

One of the earliest and most famous is William Banting's Letter on Corpulence (1863), which described his low-sugar, low-starch diet and a 46-pound weight loss. Its first edition of 1,000 copies sold out.

When did people start counting calories?

Calorie counting was popularized by Lulu Hunt Peters' 1918 book Diet and Health, With Key to the Calories, which taught readers to think of food in calories.

What was fen-phen and why was it pulled?

Fen-phen was a 1990s combination of fenfluramine and phentermine, never approved as a combination. After a 1997 report linked it to heart-valve disease, fenfluramine and dexfenfluramine were withdrawn from the U.S. market that year. Phentermine alone is still approved for short-term use.

When was the first weight-loss surgery?

The first metabolic operation, a jejuno-ileal bypass, is credited to Kremen in 1954. Mason proposed the gastric bypass in 1966, and laparoscopic surgery spread in the 1990s.

When were GLP-1 medicines approved for weight loss?

Saxenda (liraglutide) was the first, in December 2014. Wegovy (semaglutide) followed in June 2021, Zepbound (tirzepatide) in November 2023, Wegovy tablets in December 2025 and Foundayo in April 2026.

References

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Facts checked on October 6, 2026

Educational information, not medical advice. Talk with a qualified healthcare professional about your own situation. In an emergency call 911.