Obesity screen and weight loss

Weight Reduction – How to Lose Weight

Lifestyle change for life

To lose weight and to keep it off, it is vital that you are motivated, really want to lose weight, and want to improve aspects of your lifestyle. Some people lose weight by strict dieting for a short period. However, as soon as the diet is over, they often go back to their old eating habits, and the weight goes straight back on. Losing weight, and then keeping it off, needs a whole change of attitude and lifestyle for life. This includes such things as:

• the type of foods and drink that you normally buy.
• the type of meals that you eat.
• your pattern of eating.
• the amount of physical activity that you do.

Top tip – ask family or friends to help and encourage you to keep to a healthy lifestyle.

Be realistic

What is your goal weight? Many people aim to get down to a ‘perfect’ weight. This is often unrealistic and may never be achieved. If the weight that you aim for is too low, you are likely to become fed up about slow progress, and give up. To lose 5 kg is good. To lose 10 kg is excellent. (10 kg is about one and a half stone.)

Top tip – in most cases, most health benefits come from losing the first 5-10% of your weight. This is often about 5-10 kg.

Timescale

What is your planned timetable? A weight reducing diet for about three months is realistic. After about three months, many people find it difficult to keep motivated. It may be useful to have a start and finish date for your weight-reducing diet.

It is best not to lose weight too fast. If you lose more than a kilogram per week, you may lose muscle tissue rather than fat. It is best to lose an average of ½-1 kg per week (about 1-2 lb per week). To do this you need to eat 500-1000 calories per day less than you did before your diet. You will lose 6-12 kg if you keep this up for three months. Don’t be disheartened by minor increases or levelling off in weight for a few days. Look for the overall trend over several months.

Top tip – aim to lose weight steadily for about three months.

Healthy eating and understanding food

Do you know which foods are the best to eat? In general, a healthy diet consists of foods high in starchy carbohydrates, fruits and vegetables, but low in fat, sugar, alcohol, and salt. Can you list several common foods that are in each category?

Top tip – low-fat foods are generally best. But remember, some low-fat foods and drinks are high in calories, such as alcohol, sugary drinks, and sweets.

Food diaries

It is helpful to know how much you normally eat. Estimating from memory is not very accurate. It is best to keep a diary, and write down every amount of food and drink that you have over a week or so. Include even the smallest of snacks. Add up the number of calories that you eat and drink each day. You may need advice from a practice nurse or dietician to calculate calories. However, there are plenty of books that give calorie counts for different foods.

It may be helpful to keep up the diary for several weeks to see the difference in calories that you eat before and after a change to a healthier diet. To lose weight, you must eat less calories each day than previously.

Top tip – do not forget the drinks. Some drinks contain lots of calories, such as alcoholic drinks and sugary drinks.

Planning what you eat

It is important to plan ahead. Perhaps you could plan each day’s meals and recipes the day before. In this way you will know exactly how much food you will be eating. This is better than looking in the cupboard and fridge before mealtimes or snacks to see what is there.

It is best to separate eating from other activities, as this helps to you keep to your planned eating for the day. So, try not to eat whilst on the move, whilst watching TV, during meetings, etc.

Top tip – plan tomorrows eating today.

Change of eating habits

Do you have any eating habits that can improve?

• Are you eating larger and larger portions when you have a meal? Try to deliberately take smaller portions when you have a meal. Do not feel that you have to ’empty your plate’. Perhaps change the plates that you have in your cupboard (which may be large) to more medium sized plates. In this way you will naturally serve up smaller portions.
• What do you have for snacks? Try changing chocolates or cakes for fruit.
• Do you have second helpings at meal times when you are really already full?
• Skipping meals is usually a bad idea. It sounds a good idea, but many people just become hungry, and have snacks later in the day, and eat too much at the next meal. Eating at regular mealtimes may be a first important change. Three healthy meals a day is best.
• Do you always have a pudding? Will a light yoghurt do instead of a sweet pastry?
• Do you eat quickly? Are you ready for a second helping before most people have half finished their first plateful? Obese people, on average, eat faster than non-obese people. It is best to train yourself to chew each mouthful for longer, and to eat slowly.

Top tip – three healthy meals each day, including breakfast, is better than skipping meals. Eat slowly, chew longer.

Shopping

One step towards improving eating habits is to change the contents of your shopping basket. For example, if you never buy biscuits, they will not be in the cupboard to tempt you. Most food labels say what is in the food, so it is easy to buy ‘healthy’ food. Some people argue that you should plan a shopping list, and stick to it. However, whilst you are learning which are the healthier foods, it may be better to spend some time comparing food labels before deciding on what to buy.

Top tip – do not shop for food when you are hungry. After a meal is best.

Recipes

Most people have a standard set of recipes and meals that they repeat. These may be old favourites, but may need to be abandoned in favour of new, healthier recipes. It takes time and effort to find recipes that you like.

Top tip – when you are on a weight reducing diet, try to learn a new ‘healthy’ recipe each week. When the weight reducing diet is over, you should then have plenty of new healthy meal ideas to help keep your weight down.

Drink mainly water

Many people use drinks full of calories to quench their thirst. Sugary drinks such as cola, tea and coffee with milk and sugar, milk, and alcoholic drinks, all contain calories. One of the easiest ways to cut back on calories is simply to drink water as your main drink.

Top tip – keep some water in a plastic bottle in the fridge. Chilled water is surprisingly refreshing.

Physical activity

If you are able, aim to do at least 60-90 minutes of moderate physical activity on at least five days a week. (All adults should aim for at least 30 minutes on five days a week. However, 60-90 minutes is recommended if you are overweight or obese and are aiming to lose weight.) Moderate physical activity includes: brisk walking, jogging, dancing, swimming, badminton, tennis, etc. In addition, try to do more in your daily routines.

Top tip – If you are not used to physical activity, try starting with a 30 minute brisk walk every day and then building up from there.

Morale

The first kilogram is the easiest to lose. This is because you lose water from your body at first as well as fat. Be aware that the first kilogram or so may seem to fall off, but then the weight loss slows down. This is normal, so don’t get disheartened!

Top tip – regular weighing and encouragement by a practice nurse or dietician is often helpful.

Special diets

Special ‘wonder’ diets are often advertised, but they are often not helpful. This is because your old eating habits will usually return after a short ‘special diet’, and weight often goes back on.

Top tip – it is not usually a special diet that you need, but a life-long change to a healthy diet.

Tempting situations and special occasions

It is important to recognise that holidays, festivals, eating out, etc, may interfere with your everyday food choices and eating schedule. Also, do you find that watching food programmes on TV makes you hungry? How about smells from the kitchen from someone cooking who is not aware that you are trying to lose weight? Do you get pressure from family or friends to eat or drink more?

You will be tempted by different situations to abandon your planned food intake. Can you identify any tempting situations? Can you avoid them? If not, how do you cope with them?

Top tip – go and clean your teeth when you are tempted to eat between meals.

Stress and depression

Many people eat as a comfort, or as a way of coping with stress. How do you cope with stress? Is stress, unhappiness, depression, etc, a reason for you to overeat or to binge eat? If so, can you plan alternative strategies. For example, relaxation tapes, going for a walk, talking to a friend, etc.

Top tip – see a doctor if you feel that depression is a problem. Depression can often be treated.

The power of the appetite

The appetite is a very powerful feeling. This is why many people find it so difficult to lose weight. There is no easy answer to this. Some people feel hungry more often than others. Feeling hungry does not always mean the body needs food. You have to be aware of the power of your appetite, and try to resist eating as soon as you feel hungry. One way of helping with a strong appetite is to fill up at meal times with vegetables and fruit which have a lot of fibre and bulk, but are low in calories.

Top tip – drink lots or water, and eat lots of fruit and vegetables to help counter appetite.

Medical treatments

• Medicines to help with weight loss are an option in some cases. They may help, but they are not wonder-drugs, and you still need to eat less. Doctors are given guidelines on when to prescribe these medicines.
• Counselling or referral to a dietician for advice is sometimes useful, but may not be available in all areas. Counselling may be done ‘one-to-one’, or in a group setting.
• Surgery is an option if you are very obese. Results are usually good, but surgery is not without some risk. And, you still have to reduce the amount that you eat afterwards.

Keeping to a reduced weight

Many people who lose weight soon put it back on again when they stop their weight reducing diet. The main reason this happens is because the weight reducing diet was only a temporary cut back of an unhealthy diet. Once you have lost some weight, to keep the weight off you need to stick to a healthy diet. An active lifestyle with more physical activity would also help. Even better is for the whole family or household to have changed to healthy eating habits and a healthy lifestyle.

To keep your weight down you will still need to eat less and/or do more physical actvity than previously. For example, if you have lost 10kg, to keep this off and maintain your weight you will still need to:

• Eat about 300 calories per day less than you did prior to the weight loss diet, or
• Do more physical activity to ‘burn up’ an extra 300 calories per day, or
• A combination of the two.

Top tip – after losing some weight, weigh yourself once a week to keep a check on your weight.

Body mass index
Your body mass index (BMI) is a good estimate of how much of your body is made up of fat. It relates your weight to your height. You can work out your BMI by dividing your weight (in kilograms) by the square of your height (in metres).

So, for example, if you weigh 70 kg and are 1.75 metres tall, your BMI is 70 / 1.75 x 1.75, which is 22.9. Alternatively, your practice nurse can measure and weigh you, and tell you your BMI.