Depression, stress or boredom may contribute to weight increase, and in these cases, individuals are advised to seek medical help. A 2010 study found that dieters who got a full nights sleep lost more than twice as much fat as sleep-deprived dieters. Though hypothesized that supplementation of vitamin D may help, studies do not support this. The majority of dieters regain weight over the long term. According to the UK National Health Service and the Dietary Guidelines for Americans, those who achieve and manage a healthy weight do so most successfully by being careful to consume just enough calories to meet their needs, and being physically active.For weight loss to be permanent, changes in diet and lifestyle must be permanent as well. There is evidence that counseling or exercise alone do not result in weight loss, whereas dieting alone results in meaningful long-term weight loss, and a combination of dieting and exercise provides the best results. Meal replacements, orlistat, a very-low-calorie diet, and primary care intensive medical interventions can also support meaningful weight loss. Techniques
Diet and exercise
The least intrusive weight loss methods, and those most often recommended, are adjustments to eating patterns and increased physical activity, generally in the form of exercise. The World Health Organization recommends that people combine a reduction of processed foods high in saturated fats, sugar and salt, and reduced caloric intake with an increase in physical activity. Both long-term exercise programs and anti-obesity medications reduce abdominal fat volume.
Distal myopathy  is a group of rare genetic disorders that cause muscle damage and weakness, predominantly in the hands and/or feet. Mutation of many different genes can be causative. Many types involve dysferlin. Signs and symptoms
All of the different types affect different regions of the extremities and can show up as early as 5 years of age to as late as 50 years old. Distal myopathy has slow progress therefore the patient may not know that they have it until they are in their late 40s or 50s.Miyoshi myopathy affects the posterior muscles of the lower leg, more so than the anterior muscles of the lower leg. Cause
The cause of this myopathy is very hard to determine because it can be a mutation in any of at least eight genes and not all are known yet. These mutations can be inherited from one parent, autosomal dominant, or from both parents, autosomal recessive. There are eight known types of distal myopathy. Types
Diagnosis
In terms of diagnosis, Vocal cord and pharyngeal distal myopathy should be assessed via serum CK levels, as well as muscle biopsy of the individual suspected of being afflicted with this condition

Management
As of 2011, no disease modifying treatments are known. Foot drop can be managed with ankle-foot orthoses or surgical tendon transfer, in which the tibialis posterior muscle is repurposed to function as a tibialis anterior muscle. In select types of distal myopathy, evaluation of the heart may be indicated. Scoliosis and contractures can be surgically managed. References
Further reading
Udd, Bjarne (February 2007).