Weight Management: Obesity

An ideal body weight is most conducive to good health. This ideal body weight varies for each individual. It is up to every individual to take the initiative to ensure that his or her body weight does not vary more than 2 kilograms of the ideal body weight.

The objective of any weight management program is to bring a person’s body weight within the ideal body weight range, and to maintain it there. The program revolves around ensuring a healthy diet and plenty of exercise.

Obesity management

Successful weight loss can be brought about through a combined nutritional and behavioral approach. The diet of the person should be well balanced and suited to his or her needs. This should be combined with an exercise program for effective results.

Dietary management

The objectives of diet modification in a weight reduction program are:

• To bring about a gradual weight loss.
  
• To maintain desirable weight and good nutritional status.
  
• To correct faulty food habits.

In order to achieve these objectives, suitable diet modifications must be made.

Energy: The energy intake must be reduced suitably to meet individual weight loss targets. A decrease of 1000 Cal daily is required to lose about one kilogram weight per week.

On an average, a 1000-1200 Cal diet is used for weight reduction in women and 1500-1800 Cal diet is prescribed for weight reduction in men.

Generally speaking, if you are overweight then reduce 500 Cal per day in your actual daily intake. If you are obese then you should reduce 1000 Cal per day in your actual daily intake. Another approach for determining energy requirement is based on body weight and activity.

Proteins: It is advisable to eat slightly more protein than the normal amounts, as protein makes you feel full, and helps to maintain a good nutritional status. Approximately twenty per cent of the total energy must be obtained from proteins. If you are taking a 1500 Cal diet, 300 Cal must come from proteins. To obtain 300 Cal from proteins, you need to consume 75 g proteins.

Fats: Unlike protein, fat intake needs to be reduced for weight reduction. A total of twenty per cent or less calories should come from fat. In a 1500 Cal diet, 300 Cal from fat will be obtained by consuming 33 g fat. The type of fat that is consumed should also be kept in mind.

Carbohydrates: Carbohydrates should provide the remaining sixty per cent of energy. In a 1500 Cal diet, 900 Cal from carbohydrates will be obtained by consuming 225 g carbohydrates. The carbohydrates should mainly be in complex form like starches and dietary fiber. Simple forms like sugars should be limited.
Minerals and vitamins: Weight reducing diets should provide adequate amounts of essential nutrients like minerals and vitamins, while being low in calories at the same time. Fruit and vegetables, therefore, should be amply included in meals as they are low in calories and a good source of vitamins, minerals and dietary fibers.

Alcohol: Alcohol must always be consumed in moderation. While a glass of red wine everyday is good for your heart, more than that could lead to serious complications.

Diet and feeding pattern: A proper diet should also leave you feeling full. If you feel hungry all the time it is an indication that your diet is not adequate. This will also cause you to eat additional food not prescribed in the diet. Adequate amounts of protein foods, fibrous fruits and vegetables, whole grain cereals and pulses provide satiety and thus help to cut down food intake. You should also drink plenty of unsweetened fluids.

Foods to be avoided:

• High fat foods like butter, processed cheese, chocolates, cream, ice-creams, fatty meats, pastries, cream soups, salad dressings, mayonnaise and white sauce.
• Fried foods like French fries, potato chips, etc.
• High carbohydrate foods such as breads, cakes, cookies, dried fruits, potatoes, sweet potatoes, honey, syrups, jams, rich puddings and preserves.
• Carbonated and malted beverages, alcoholic drinks and sweetened fruit juices.

Physical Activity:

Regular physical activity plays a major role in effective weight loss and weight management. It can also help prevent several diseases and improve your overall health. It does not matter what type of physical activity you perform - sports, planned exercise, household chores, or work-related tasks, all are beneficial. Studies show that even the most inactive people can gain significant health benefits if they accumulate thirty minutes or more of physical activity per day.

How can physical activity help control your weight?

Physical activity helps your body to burn excess calories, that would otherwise have been stored as fat.
Since body weight is regulated by the number of calories you eat and use each day, any physical activity in addition to what you normally do, will use up extra calories. The basic idea behind any such program is to balance your body’s calorie intake and output.
When you eat fewer calories than you burn, your body uses the stored calories and you lose weight. Any type of physical activity, whether light, moderate or strenuous, will increase the number of calories your body burns. The key to successful weight control and improved overall health is to make some sort of physical activity a part of your daily routine.

What are the health benefits of physical activity?

In addition to helping control your weight, research shows that regular physical activity can reduce your risk for several diseases and conditions and improve your overall quality of life. Regular physical activity can help protect you from health problems such as heart disease, stroke, high blood pressure, diabetes, back pain, and osteoporosis. In addition, when you exercise, the brain releases chemicals that lighten your mood and give you positive outlook on life.

How much should you exercise?

Experts recommend that you should do twenty to thirty minutes of aerobic activity three or more times a week, and some type of muscle strengthening activity and stretching at least twice a week. If you are unable to sustain this level of activity, you should try to engage in thirty minutes of moderate intensity at least five days in a week.
However, if you are unable to sustain this level of activity, you can gain substantial health benefits by accumulating 30 minutes or more of moderate-intensity physical activity a day, at least five times a week. While choosing physical activities to include in your weight loss program, ensure that you pick a variety of activities that you will enjoy doing on a regular basis. Remember, if you are not having fun, you will be less likely to stick to your exercise routine.

If you have been inactive for a while, you should start with less strenuous activities such as walking or swimming at a comfortable pace. Begin at a slow pace so that you do not overstrain yourself. Once you are in better shape, you can gradually do more strenuous activity.

Moderate-intensity activity:

Moderate-intensity activities include gardening and housework. These activities can be done in short spurts; accumulating 30 minutes of activity over the course of the day can result in substantial health benefits.

Aerobic activity:

Aerobic activity is an important component of any exercise program. Aerobic exercise is any extended activity that makes you breathe harder while using the large muscles at a regular and even pace. Aerobic activities are very good for your heart and help make to make it stronger and more efficient. They also burn more calories than other activities. Some examples of aerobic activities include brisk walking, jogging, cycling, swimming, aerobic dancing, ice or roller skating, skiing, and using aerobic equipment such as a treadmill, or stationary bike. Any exercise program should include time for warming up and cooling down, each lasting 5 minutes.

Behavior modification:

Behavior modification is an important component of a weight management program. Behavior modification consists of three components: self-monitoring, stimulus control and self-¬reward.

Self-monitoring involves a daily record of place and time of food intake, as well as accompanying thoughts and feelings. It helps to identify the physical and emotional conditions under which the person craves food. Once these conditions have been identified, they must be modified and controlled. This is called Stimulus control. Successful stimulus control should be rewarded. Self-reward includes techniques of rewarding self for eating control.

Extreme approaches to weight loss

A desperate desire to lose weight may cause some obese people to resort to extreme approaches of weight loss, which may be undesirable. Some of these extreme approaches include:

• Fasting: Fasting is a drastic measure and is seldom prescribed as a treatment for obesity. However, individuals often invoke fasting for religious reasons or in a personal effort to lose weight. Prolonged fasting can lead to acidosis, hypertension, lowered BMR, neurological and hormonal side-effects.

• Fad diets: Weight loss foods available in the market are often based on scientific inaccuracies and may be nutritionally inadequate too. They may in fact, make weight loss more difficult each time as they may not be practical and may not bring about behavioral changes.

• Drugs: Drugs such as amphetamines are commonly used to suppress appetite and may cause many side effects such as confusion, stroke, hallucinations and psychotic behavior.

• Special clothing and body wraps: These help weight loss in specific spots of the body so as to reduce body size. The small weight loss that occurs is the result of temporary water loss due to application of heat and vibrations.

• Surgery: Surgical techniques such as jaw wiring, liposuction and intestinal bypass are used for severely obese persons and may result in some side effects. These should only be resorted to if all else fails and your obesity severely limits your good health.

Obesity management: Strategies for success

Successful weight management requires perseverance and discipline. Do not expect fat that has accumulated over the years to disappear overnight. Some strategies that you should keep in mind to aid your weight management program are:

• Do not set very high goals. Target a reasonable weight loss of one kilogram per week.
  
• Adapt family meals to specific needs by adjusting the method of preparation and reducing consumption of fats.
  
• Avoid binging. If you overeat due to social pressure, adjust other meals of the day or of the next day.
  
• While eating outside home, select simply prepared items rather than combination dishes. Avoid fried foods, use fruit as desserts as opposed to ice-creams, puddings, etc.
  
• Spread food throughout the day to meet your body’s energy requirements.
  
• Follow a gradual approach to exercise in order to get the most benefits.
  
• Exercise regularly at a comfortable pace.
  
• Select varied exercises that you enjoy and those that fit your personality, your work schedule, and your fitness level.
  
• Encourage your family and friends to support you and join you in your activities. This will ensure that you stick to your program and will also prove beneficial for your family’s health.
  
• Any exercise program invariably hits a plateau. Do not be discouraged. Circumvent them by increasing your exercise or varying the activity.