Dietary approaches for weight loss
Dietary control has probably been the main treatment used for weight loss in the past. Diets are based on the principles of metabolism and work by reducing the intake of calories (energy) to create a negative energy balance (i.e. more energy is used than is consumed). There are countless commercial diets available and you should try to choose one that is suitable for you. The crash or fad diets published in magazines should generally be avoided, as they can be dangerous to your health and tend not to produce good long term results. You should try to choose diets that are medically proven or diets developed by dedicated weight loss services such as Weight Watchers or Jenny Craig. Your doctor can help you choose a diet which is safe, effective and suited to your needs. Below are some of the different mechanisms used in diets for weight loss:
- Reducing fat, carbohydrate (especially those with a high glycaemic index), protein or alcohol intake. Reducing alcohol intake is a very good way to lose weight, as each gram of alcohol contains a large amount of energy on top of your normal daily intake.
- Smaller portion sizes. You can try using a smaller plate size at each meal.
- Food restrictions at various times of the day. It can be helpful to have a big breakfast and reduce the intake of energy rich foods later in the day. This can help your metabolism and ensure that most of the energy that you consume is burnt throughout the day.
- Combining different foods to reduce total energy intake. Some diets have set food regimes for weight loss.
- Diets centered on a single low-energy food.
Obesity lifestyle changes Most diets produce some weight loss and are successful in the short-term. However, less than 10% of patients will maintain the weight loss in the long term. Once again it must be emphasized that permanent changes to eating habits are required. You must be careful whilst dieting to ensure that you still receive all the essential proteins, vitamins and trace elements. The best way to achieve this is by eating a well balanced diet with a wide variety of nutritious foods. A successful weight loss program may include cutting fats and sugars from your diet while ensuring you eat lots of healthy foods such as wholegrain, fruits and vegetables. Some diet programs may also require you to take vitamin or mineral supplements.
Be careful when shopping for low fat foods or brands labeled as ‘diet’ in the supermarket. Many low fat foods can be high in sugar and still contribute a lot to your daily energy or caloric intake. You should learn how to read food labels carefully and aim to consume foods that are low in saturated fat, sugars and, if appropriate, glycaemic index.
Diets that teach you how to select and prepare healthy foods may be more successful in the long term than restrictive diets with strict daily eating regimes or pre-prepared meals.
Reduced energy diets encourage you to choose healthy meal options, aiming to reduce your energy intake by a small amount every day. They teach you healthy eating behaviors which you can maintain in the long term.
Low energy diets are more restrictive and limit your energy intake to a greater degree. Set meal programs need to be followed. This type of diet can lead to a weight loss between 7-13 kilograms and may be used if you have significant health problems related to obesity.
Very low energy diets cut daily energy intake significantly and tend to be reserved for people who have failed other treatments or who have significant co-morbidities. These types of diets are generally followed for 8-16 weeks and often consist of liquid meal replacements (discussed below) from pharmacies. Unfortunately much of the weight lost is regained after the diet is stopped, but behavioral or drug therapies following treatment can help maintain some of the weight loss.
Meal Replacement Programs
Recently weight loss programs have been developed that replace normal meals with prepared meal plans or meal supplements (such as vitamin-rich shakes, soups and bars). These supplements act as complete meals, as they contain all the required vitamins and minerals. Meal Replacement Programs operate on the principles of a low calorie diet and induce a mild state of ketosis. The diets limit your intake of carbohydrates so that the body starts to break down fat stores for energy. The meal replacement programs are specially formulated so that they contain adequate energy and do not cause malnutrition.
Physical activity for weight loss
Obesity lifestyle changes In addition to reducing your energy intake, increased physical activity is essential for the maintenance of weight loss and should form part of any weight loss program. However, to achieve significant weight loss from exercise alone, a very high level of activity is required, which can be challenging.
You should gradually build up your exercise as your personal fitness allows. You can start with simple measures such as walking to nearby places rather than driving, or climbing the stairs rather than using an elevator or escalator. Thirty minutes of walking 3-5 times per week is a good starting point.
If you are very overweight, some exercises (especially those that require weight bearing) can be physically difficult. In this case you could try activities such as swimming, walking in water or cycling. Once your fitness levels improve you could change to other exercises in the long term.
You should try to choose activities that you enjoy, as you will be more likely to continue them in the long term. Participating in team sports or exercising with a friend or family member can help you to remain motivated. It may be useful to see a physiotherapist or exercise physiologist to help you develop an appropriate exercise program. Try to focus on overall lifestyle measures as they tend to produce greater long term adherence.
Exercise has benefits beyond modest reductions in weight. Increasing your physical activity can improve your cardio-respiratory fitness, metabolic health, quality of life and general well being. However, strenuous exercise can be risky in some patients such as those with cardiovascular problems. You should consult your doctor to discuss what level of physical activity will be safe for you.
Behavioral therapy for weight loss
Behavioral techniques may be useful in conjunction with diet and exercise programs to improve long-term weight loss. Behavioral treatment is usually performed by a psychologist who analyses your eating, physical activity and thinking habits. Cognitive behavioral therapy (CBT) is a classic example which encourages you to change these behaviors and take responsibility for your lifestyle changes. Other strategies may include stress management, relapse prevention, counseling, and techniques such as hypnosis and psychotherapy. However, some of these behavioral techniques can be very time consuming and expensive.
Some basic steps may include:
- Self monitoring: Identifying and recording any adverse patterns of behavior.
- Stimulus control: This involves removing factors that encourage you to eat badly. For example, you should shop carefully and remove trouble foods (such as chocolates and chips) from the house so you cannot be tempted.
- Problem solving: Identifying and addressing problems associated with eating and physical activity. You should consider which factors have led to your excess weight and address them appropriately.
- Reward systems: You could reward yourself for positive behaviors such as exercise by treating yourself to new clothes.
- Social support: Strong social support from your friends and family can improve weight loss. It may be beneficial for you to enroll in a commercial program which offers a social support network.