In stages, not all at once
Losing 40 kg
- Baseline assessment covering related conditions and physical capacity
- Exercise that fits your joints — not the other way around
- Nutritional therapy and support beyond your goal weight
4.9
6,000+
5
15+
This page has been reviewed by
Dr. Nicolette Lammers.
Losing 40 Kilograms: What to Expect on This Page
Forty kilograms is a path of a year or more. It rarely runs in a straight line and places different demands along the way than smaller goals — on your joints, your circulation and your patience.
This page shows how such a path can be divided into stages, which forms of movement hold up at a higher weight and what support looks like when it runs from the first conversation through to life after your target weight. If you'd like your situation assessed, the free eligibility check takes just a few minutes.
We Don't Treat the Weight.
We Support the Person Behind It.
Forty kilograms isn't a goal you take on casually. Anyone starting here usually brings a long history with them — and often the experience of advice that missed their actual situation. That's why every treatment begins with where you stand: health, physical capacity, everyday life.
Check eligibility · Free initial consultation · Start your program
- Medical
Supervision - Nutritional Therapy
and Counseling - Behavior
Change - Individual
Support - Medication
Where Appropriate - Movement in
Daily Life - Regular
Follow-Up Checks - Weight
Stabilization
Forty Kilos Don't Begin With a Plan
They begin with taking stock. At this magnitude, high blood pressure, altered blood sugar levels, sleep apnea or joint problems are often already present — factors that determine which route is medically justifiable in the first place.
That isn't bad news. It means treatment can achieve more than a number on the scale — and that it belongs under medical supervision.
Same Goal, Different Starting Points
Forty kilograms is a third of total body mass at a starting weight of 120 kilograms — at 160 kilograms it's a quarter. This range changes not only the duration but also what takes medical priority.
When a Third Comes Off
A reduction of a third of body weight changes metabolism considerably. Basal metabolic rate falls markedly, and without deliberate countermeasures a substantial share of muscle mass goes with it — precisely the substance you need for stabilization afterward.
At this starting weight, the target weight arithmetically often falls in the upper normal range. Whether it's the medically right goal is assessed individually and not derived from the number.
When Comorbidities Set the Pace
In this range, several weight-related conditions are often present at once — for instance high blood pressure together with altered blood sugar levels and sleep apnea. They help determine how quickly reduction may proceed and which check-ups are necessary.
At the same time, weight reduction can have a clear effect here. Existing medications more frequently need adjusting along the way — one reason why this path belongs under medical supervision.
When 40 Kilos Are One Stage
At this starting weight, forty kilograms is a first stage for most people rather than an end point. That makes medical sense: even this reduction can change blood pressure, blood sugar, sleep quality and mobility, even if weight remains afterward.
Mobility is often limited here, which shapes how movement is planned. Movement isn't chosen by calorie expenditure but by what your joints can carry. You'll find what's possible in the section on joint-friendly movement.
For context: These percentages are purely arithmetic examples. They say nothing about whether weight reduction is medically necessary, sufficient or suitable in your case. That can only be assessed individually by a physician.
BMI-Calculator
Your body weight is below the recommended range. Medical weight loss is not advised and could carry health risks. We recommend speaking with your GP to receive appropriate guidance and support.
Your body weight is within the healthy range. Medical weight loss with medication is not necessary. If you have questions about maintaining a healthy lifestyle, feel free to reach out to us.
Sie haben leichtes Übergewicht. Eine Behandlung mit Medikamenten ist nicht vorgesehen, jedoch können Sie unser Coach-Only-Programm in Anspruch nehmen. Dieses Programm konzentriert sich auf Lebensstiländerungen unter professioneller Anleitung, ohne den Einsatz von Medikamenten.
Termin vereinbaren
Your BMI falls within a range that may be associated with a higher risk of weight-related health conditions. If you have conditions such as high blood pressure, prediabetes, type 2 diabetes, or sleep apnea, you may be eligible for medical weight loss with medication.
Make an Appointment
You may be eligible for treatment with medication. At The Body Clinic, we offer a carefully designed, medically supervised program tailored to your individual needs.
Make an Appointment
With severe obesity, medical support is especially important. You may be eligible for treatment with medication. We provide professional guidance and will work with you to create a personalized treatment plan.
Make an Appointment
Calculate Your BMI: The Starting Point for Planning
With a goal of forty kilograms, the starting value usually falls within the range of pronounced obesity. The BMI shows you where you stand — and from which range closer medical supervision is indicated.
What it doesn't show: fat distribution, muscle mass, blood pressure, blood values or your physical capacity. With larger weight-loss goals, these are precisely the factors that help determine which route is medically justifiable and how quickly it may proceed.
What Shapes the Course at 40 Kilos
With a goal of this magnitude, nutrition alone isn't what decides the outcome. Six areas help determine which route is medically justifiable and how quickly it may proceed.
Comorbidities
Existing diagnoses and
their treatment
In this situation, several weight-related conditions are often present at once — for instance high blood pressure, altered blood sugar levels, fatty liver disease or sleep apnea. They aren't an exclusion criterion but the reason why supervised treatment often makes more sense here than going it alone. What matters is that they're known before the start.
Physical Capacity
Mobility, joints and
circulation in daily life
At a higher weight, knees, hips and spine carry more load continuously. That changes which forms of movement are even an option — and makes advice like "walk 10,000 steps a day" unusable for many people. What holds up instead is shown in the section on joint-friendly movement.
Current Medications
Need for adjustment and
possible interactions
With a reduction of this magnitude, the need for blood pressure medication or diabetes medication often falls considerably. Conversely, other medications influence body weight, including certain antidepressants, corticosteroids or insulin. Both belong in the planning — please don't change dosages or discontinue anything on your own.
Previous Attempts
Diet history and repeated
weight fluctuations
Anyone arriving at this weight-loss goal has usually tried before. That isn't a sign of failure but a piece of information: it shows where things haven't held up so far — often in the period after reaching an interim goal. That's exactly the phase we plan for from the outset.
Nutrient Supply
Protein, micronutrients
and fluids
Across twelve to eighteen months of reduced energy intake, nutrient supply becomes a topic in its own right. Adequate protein intake protects muscle mass, while micronutrients more easily fall into deficit with smaller portions. That's why nutritional therapy isn't an add-on here but part of the treatment.
Sleep and Recovery
Sleep quality and
possible sleep apnea
With pronounced overweight, undiagnosed sleep apnea is more frequently present. It causes daytime fatigue, affects hunger and satiety signals and makes movement additionally difficult. Recognizing it and getting it treated often changes more in daily life than any dietary adjustment. Read more under Sleep and Stress Management.
Losing Weight at 50 or 60
Over the years, body composition shifts: muscle mass decreases, basal metabolic rate falls, and hormonal changes may come on top of that. With forty kilograms, this has a stronger effect over the long duration than with smaller goals — above all because muscle preservation then counts twice over.
The goal remains achievable. The course is simply more uneven, and protein intake as well as muscle-preserving movement carry more weight in the planning. Read more in our article Losing Weight in Older Age.
Medically supervised weight loss—in person or online.
How Long Does It Take to Lose 40 Kilos?
People often ask about one year. That's achievable but ambitious — and not the right expectation for every starting situation. The overview below shows what different timeframes would mean arithmetically.
Forty kilograms across different timeframes: the arithmetic weekly loss and its medical assessment. All figures are points of reference, not a commitment regarding any individual course.
| Timeframe | Required pace | Assessment | What to keep in mind |
|---|---|---|---|
| 40 kilos in 6 months | around 1.5 kg per week | Not advisable | A deficit of this size can't be sustained safely over six months. Muscle loss, nutrient deficiency and circulatory problems become considerably more likely. |
| 40 kilos in 9 months | around 1 kg per week | Only under close supervision | Can occur with a very high starting weight during the first months. Requires regular monitoring of blood values and tolerability. |
| 40 kilos in 12 to 18 months | around 0.5 to 0.8 kg per week | Common orientation | This range leaves room for muscle preservation, adjustments and phases where little happens. A point of reference, not a commitment — and not a schedule you have to keep to. |
| In stages with breaks | variable, with stabilization phases | Often sensible at this magnitude | Reduction phases alternate with phases in which the weight is maintained. This takes longer but considerably reduces the risk of relapse. |
| Over two years or longer | less than 0.4 kg per week | Not a failure | Often the more sustainable path, particularly where comorbidities or limited physical capacity are present. The skin has more time to adapt. |
Three Things That Matter Especially at 40 Kilos
The First Success Comes Before the Goal
Even five to ten percent of starting weight can change blood pressure, blood sugar and mobility. At 140 kilograms that's seven to fourteen kilograms — achievable long before the overall goal.
The Body Adapts Along the Way
After forty kilograms, the same person burns considerably less energy than at the start. What worked in month four no longer suffices in month fourteen. That's plannable if you expect it.
Take Warning Signs Seriously
Persistent fatigue, hair loss, feeling cold, dizziness or circulatory problems can indicate the pace is too high. Our article Warning Signs of Too Rapid Weight Loss describes which signs to watch for.
Important: The timeframes mentioned are points of reference based on general recommendations. How your weight actually develops depends on factors including starting weight, comorbidities, medications, physical capacity, sleep and previous weight-loss attempts. No specific duration can be guaranteed.
Why Interim Goals Work Better
Having forty kilograms in front of you as a single number overwhelms most people — not physically but mentally. A path in stages therefore has a practical advantage: every stage is reachable, and every one already brings health changes with it.
The First 5 to 10 Percent
At 140 kilograms that's seven to fourteen kilograms. Within this range, blood pressure, blood sugar and sleep quality can already change — long before the overall goal is in sight. This first stage is therefore medically meaningful, not merely a stepping stone.
First Stabilization
A deliberate phase in which the weight is maintained rather than reduced further. It feels like a step backward and is therefore often skipped — yet it contributes to long-term success and has usually been missing in previous attempts.
Second Stage
Reduction resumes, with adjusted figures. Energy requirements are lower by now, physical capacity usually higher. What's possible in terms of movement at this point often wasn't imaginable at the start.
And at the End: Lasting Stabilization
After the final stage comes no conclusion, but a stage of its own with its own requirements. Calorie intake is raised gradually, the routines stay, and support and check-ups continue. This phase is part of the treatment plan, not something that follows it.
For context: This division is a model, not a fixed sequence. How many stages make sense, how long they last and whether a stabilization phase belongs in between is discussed individually and adjusted along the way.
Movement That Suits Your Joints
"Walk 10,000 steps a day" isn't helpful advice with pronounced overweight — it's often simply not feasible. Movement here isn't chosen by calorie expenditure but by what your joints can carry, and by what can be built up over time.
What's Usually Possible Here
- Movement in water — buoyancy takes much of the load off the joints
- Strengthening while seated, for instance with resistance bands or light weights
- Short walking distances in daily life, spread across the day
- Breathing and mobility exercises while lying down or seated
What Matters Most
The aim at this stage isn't energy expenditure but preserving muscle mass and mobility. Both pay off later, once more becomes possible.
Start below what you think you can manage, and only increase once the current level feels comfortable. Pain during or after movement is a signal to adjust — not to push through.
You can read more about starting in water under Lose Weight With Swimming.
What's Usually Possible Here
- Cycling or a stationary bike — seated, with low joint load
- Longer walking distances on level ground
- Strength training on machines with guided movement
- Water aerobics or aqua fitness in a group
What Matters Most
In this range, volume can be increased step by step. It usually makes sense to raise frequency first and only then duration or intensity.
Strength training deserves particular attention here: it protects muscle mass during the reduction and improves stability in the knees and hips — which in turn makes walking easier.
If nausea or low energy make starting difficult, our article Exercise When Feeling Nauseous or Low on Energy can help.
What's Usually Possible Here
- Brisk walking, including on gently undulating terrain
- Strength training with free weights and more exercise variety
- Swimming laps rather than just moving in the water
- Deliberately expanding everyday movement — stairs, errands, routes
What Matters Most
When movement comes more easily, the goal shifts: it's less about getting started and more about anchoring what you've built into daily life — so that it holds after the program ends.
What remains important is not increasing the pace abruptly. The musculoskeletal system needs time to adapt to new loads, even when your cardiovascular fitness is already further along.
And if exercise isn't an option right now: weight reduction is possible without training too. Our article Lose Weight Without Exercise explains why.
Please note: This classification is general guidance and doesn't replace an individual assessment. Which forms of movement are suitable for you depends on your joints, your circulation, existing conditions and your current physical capacity. If you have discomfort or pre-existing conditions, please discuss getting started with a physician beforehand.
How We Support You Throughout the Entire Journey
With a goal of this magnitude, the outcome isn't determined by the start but by what happens in month seven, twelve and eighteen. That's why our support isn't a program with an end date but continuous care — medically, nutritionally and in everyday life.
01 Free Initial Consultation Understanding your situation before anything is planned
The first step isn't about programs or products but about your starting position: weight history, existing conditions, current medications, physical capacity in daily life and what you've already tried.
- Reviewing your medical history
- Assessing BMI, waist circumference and comorbidities
- Clarifying whether and which treatment route is medically viable
- Room for your questions — with no obligation to start a program
An inquiry does not automatically lead to treatment or a prescription.
02 Nutritional Counseling and Therapy Not an off-the-shelf plan, but work on your daily life
Across twelve to eighteen months of reduced energy intake, nutrition becomes a medical question — not just a matter of calories. Protein intake, micronutrients and a meal structure that fits your daily life all contribute to muscle preservation and tolerability.
- Analysis of your current eating habits
- Keeping protein intake and nutrient supply in view
- Working on eating patterns, triggers and cravings
- Adjusting when tolerability or appetite changes
- Strategies for vacations, holidays and difficult weeks
Nutritional therapy is included in all treatment routes — including when medication is part of the treatment.
03 Medical Supervision Throughout Regular check-ups rather than a one-time assessment
With forty kilograms, more than the weight changes along the way. Blood values shift, the need for existing medications can fall significantly, and physical capacity increases. All of this requires regular monitoring — not as a formality, but because it's what makes the treatment safe.
- Monitoring of blood pressure, blood sugar and blood lipids
- Adjusting existing medication when requirements fall
- Observing tolerability and possible side effects
- Checking nutrient supply over the longer course
- Adjusting the pace if warning signs appear
Dosages are changed exclusively by a physician. Please don't adjust anything on your own.
04 Stabilization After the Goal The stage that has usually been missing so far
After forty kilograms, energy requirements are considerably lower than at the start. Returning to the previous way of eating mathematically leads back — not through carelessness, but because the same person now burns less. Those who approach this phase without support often lose part of what they've achieved.
- A gradual increase in calorie intake rather than an abrupt end
- Keeping the routines from the reduction phase
- Continued check-ups at longer intervals
- Handling upward fluctuations in weight
This phase is part of the treatment plan — not something that follows it.
Where Your Journey Begins
In the free initial consultation we clarify your starting situation and discuss which next step might make sense medically. An inquiry does not automatically lead to treatment or a prescription.
Which Route Is Appropriate for Your Starting Point?
With a 40-kilogram goal, the question of medication support is often raised — and it is a valid one. Even so, the answer is not determined by the number of kilograms, but by your health situation. For some people, this type of treatment is not medically suitable.
Included in Every Program:
- Medical assessment
- Physician supervision
- Nutritional therapy
- Digital support
- Follow-up checks
- Long-term stabilization
-
Weight Loss With Injections
A physician-supervised program that requires established medical eligibility.
- Physician-supervised GLP-1 program
- From €139 per month incl. medication
- Support throughout the entire process
-
Weight Loss With Tablets
A physician-supervised treatment option where medical eligibility has been established.
- Initial consultation and medical review
- Availability depends on the medication
- Follow-up monitoring and adjustment
-
Weight Loss Without Medication
Nutritional analysis, counseling and therapy take center stage here.
- Nutritional analysis, counseling & therapy
- From €120 for the program
- Joint-friendly build-up of physical activity
How the Decision Is Made
BMI, waist circumference, blood values, pre-existing conditions, current medication and possible contraindications are reviewed. Only then can it be determined which route is medically appropriate — and how quickly it should progress. Where related health conditions are present, supervised treatment may be more strongly indicated, but it is not an automatic consequence of the weight-loss goal.
Where medication support is suitable, the treatment is selected individually — for example Mounjaro with tirzepatide or Wegovy with semaglutide. You can find an overview of all active ingredients on the relevant page.
Medication does not replace the other components. Nutritional therapy, movement and physician supervision remain part of the program in every case — they are what determine what happens after the target weight has been reached.
What Can Change After Losing 40 Kilos?
At this magnitude, a great deal changes at once for most people — physical capacity, laboratory values, sleep and daily life. How strongly and how quickly depends on the starting situation and can't be predicted.
Physical Capacity and Joints
Every kilogram less relieves the knees, hips and spine with every step. Many people report that stairs, standing for longer periods or getting around feel noticeably different along the way — and that forms of movement become possible that weren't an option at the start.
Whether existing joint problems recede also depends on which changes are already present in the joint. Relief isn't the same as healing.
Blood Pressure, Blood Sugar and Blood Lipids
A reduction of this magnitude can have a clear effect on laboratory values, particularly where elevated values existed beforehand. Existing sleep apnea or fatty liver disease may change as well. Whether and to what extent depends on your starting situation.
If you take blood pressure medication or diabetes medication: your requirement may fall considerably along the way. Have your values monitored regularly by a physician and don't adjust dosages on your own.
Putting Excess Skin in Perspective
At forty kilograms, visible excess skin is likely — how pronounced it will be can't be said in advance. Age, skin elasticity, genetic factors, starting weight, the duration of overweight and the pace all interact.
A calmer course, sufficient protein and muscle-preserving movement can support body shape. Skin adaptation can't be fully controlled. Read more under Skin Changes After Weight Loss.
Sleep and Everyday Energy
Where sleep apnea was present, sleep quality can change along the way — which often has an effect on daytime fatigue, concentration and drive. Some people notice this change earlier than any difference in the mirror.
Existing sleep apnea therapy should be reviewed medically along the way. Please don't change settings or usage on your own.
Body Composition Rather Than Weight
Forty kilograms less doesn't yet say what that loss consisted of. What matters is the ratio of fat mass to muscle mass — it determines your physical capacity at the end and how well the weight can be maintained.
That's why weighing isn't the only measure taken along the way. More on the background in our article Maintaining Muscle Mass Despite a Calorie Deficit.
And Afterward? Maintaining the Weight
After forty kilograms, energy requirements are considerably lower than at the start. The previous way of eating mathematically leads back — not through carelessness, but because the same person now burns less.
The stabilization phase is therefore part of the treatment plan, not something that follows it. You'll find the programs that cover this in our Medical Weight Loss overview.
A note on before-and-after expectations: Changes don't appear the same way in everyone, nor at the same pace. This page deliberately contains no before-and-after depictions, because they would suggest a course that cannot be transferred to others.
Further Reading
Three topic areas that come up particularly often with a goal of this magnitude. You'll find all articles in our blog.
Understanding Your Health
-
Therapy Process and Side Effects Before Starting
What is clarified before treatment begins and what to expect along the way.
-
What Are GLP-1 Agonists Approved For?
Indications, the limits of approval and what off-label use means.
-
Obesity in Germany: Figures 2025 to 2030
How widespread obesity is and why it's classified as a chronic disease.
Movement and Physical Capacity
-
Lose Weight With Swimming
Why movement in water is often the best entry point with high joint load.
-
Exercise When Feeling Nauseous or Low on Energy
What remains possible when your body has little to give — and when rest is right.
-
Lose Weight Without Exercise: Is It Possible?
What's achievable when training isn't an option, and what matters then.
Treating Safely
-
Managing Side Effects: Warning Signs
Which symptoms are normal along the way and which belong in medical hands.
-
Avoiding Nutrient Deficiencies
What to watch for in nutrient supply across long reduction phases.
-
Stabilizing Blood Sugar Through Diet
How to structure meals when blood sugar is part of the picture.
Frequently Asked Questions About Losing 40 Kilograms
How long does it take to lose 40 kilos?
Twelve to eighteen months is often cited as a rough guide, corresponding to around 0.5 to 0.8 kilograms per week. With a very high starting weight the beginning is often faster, and the pace slows down later. This figure is not a commitment: starting weight, comorbidities, medications and physical capacity influence the process considerably.
Is it realistic to lose 40 kilos in one year?
Arithmetically this corresponds to around 0.8 kilograms per week — ambitious, but not impossible, particularly with a high starting weight and under medical supervision. The decisive question is whether this pace can still be maintained in the second half of the year without muscle loss, exhaustion or nutrient deficiency increasing. A longer period is the more sustainable path for many people.
Is losing 40 kilos possible without surgery?
Yes, that's generally possible. Whether a non-surgical treatment is sufficient in an individual case depends on the starting situation, existing comorbidities and how things have gone so far. With more pronounced obesity, surgical procedures may also be considered following specialized interdisciplinary assessment — this is judged individually and not based on the weight-loss goal.
What kind of movement makes sense with severe obesity?
Whatever your joints can carry. Movement in water, cycling or a stationary bike and strengthening while seated place considerably less strain on knees and hips than walking or running. The aim isn't calorie expenditure at first but preserving muscle mass and mobility. If you have discomfort or pre-existing conditions, discuss getting started with a physician.
What happens to my medications if I lose 40 kilos?
The need for blood pressure medication or diabetes medication can fall significantly with a reduction of this magnitude. That's why regular check-ups are part of the treatment. Adjustments are made exclusively by a physician — please don't change dosages or discontinue anything on your own.
Will losing 40 kilos cause excess skin?
Visible excess skin is likely at this magnitude; how pronounced it will be can't be predicted. Age, skin elasticity, genetic factors, starting weight, the duration of overweight and the pace all interact. A calmer course, sufficient protein and muscle-preserving movement can support body shape.
Are interim goals better than one overall goal?
For many people, yes. Even five to ten percent of starting weight can change blood pressure, blood sugar and mobility — achievable long before the overall goal. Interim stabilization phases extend the path overall but reduce the risk of relapse. How many stages make sense is discussed individually.
How do I avoid muscle loss when losing 40 kilos?
It can't be avoided entirely, but it can be limited. A moderate rather than extreme deficit, sufficient protein intake throughout the entire period and muscle-preserving movement, including joint-friendly forms, all help. Across twelve to eighteen months, this is one of the most important factors for stabilization afterward.
What if I've already failed several times?
Repeated attempts are the rule rather than the exception with this weight-loss goal. Medically, obesity is considered a chronic disease, not a question of discipline. Your previous history usually shows where things haven't held up before — often in the period after reaching an interim goal. That's exactly the phase we plan for from the outset.
How do you maintain the weight after losing 40 kilos?
After forty kilograms, energy requirements are considerably lower than at the start — the previous way of eating mathematically leads back to the old weight. A gradual increase in calorie intake rather than an abrupt end is helpful, combined with the routines from the reduction phase and continued support. You can read what other patients report under Reviews.
Sources
- Association of the Scientific Medical Societies in Germany (AWMF) and German Obesity Society (DAG). S3 Guideline on the Prevention and Treatment of Obesity. Registry number 050-001, version 5.0, October 2024. Basis for classifying obesity as a chronic disease, for treatment options including surgical procedures, and for the importance of long-term support. View guideline (in German).
- World Health Organization. Obesity and overweight. Definitions, classification of the body mass index as an indirect measure, and possible health consequences of obesity. View fact sheet.
- Federal Statistical Office of Germany (Destatis). First results of the 2025 Microcensus on height, weight and body mass index. Figure of the Week no. 23, June 2, 2026. Data basis on the prevalence of a BMI of 25 and above and 30 and above among adults in Germany. View release (in German).
- Robert Koch Institute. Federal Health Reporting. Data on the prevalence of overweight and obesity in Germany and on differences by age and sex. View reporting (in German).
- German Federal Centre for Nutrition (BZfE). Information on nutrition and weight management. Practical recommendations on nutrition, protein intake, meal structure and nutrient supply. View information (in German).
- National Institute for Health and Care Excellence. Overweight and obesity management. NICE guideline NG246. Guidance on a moderate rate of weight reduction, long-term weight stabilization and support throughout the process. View guideline.