Obesity (where someone is very overweight with a lot of body fat) is a health problem that mainly affects adults in affluent societies across the world, and the problem is growing.
In the UK, the NHS estimates that as many as 1 in 4 adults, and 1 in 5 children aged 10 to 11 are obese.
Clinically, someone is defined as obese if they have a body mass index (BMI) of 28 or more, this is a value calculated as a ratio of your weight to your height. Other factors are taken into consideration in deciding whether or not a patient might develop obesity-related illnesses. For instance, it is more dangerous to carry weight around your middle than your hips and thighs, and if you have a very inactive lifestyle or a family history of certain diseases you are more at risk of becoming unwell.
The good news is, most obese people will be able to lose weight if they follow these two basic principles:
- optimising the diet to eat a nutritious diet in the appropriate portion size decreasing calorie intake by eating less
- increasing physical activity to burn excess calories and use up existing fat stores
For those people who are struggling with weight loss, there are other options available, including surgery and weight loss tablets.
What are the benefits of weight loss?
For people who are very overweight, weight loss has numerous physical and psychological benefits.
Being overweight can lead to many different health conditions, including:
- type 2 diabetes (carrying a lot of fat around your tummy is particularly associated with this condition)
- heart disease
- cancers, including breast cancer and bowel cancer
- high blood pressure (in 2011, 53% of obese men and 44% of obese women were found to have high blood pressure)
- sleep apnoea (where breathing is interrupted during sleep)
- liver disease
- erectile dysfunction in men
- pregnancy complications in women
Weight loss can significantly reduce your chances of suffering from these conditions, as it reduces the amount of fat in your body, enables your blood to circulate more easily and reduces the strain on your heart and other organs. If weight loss is also accompanied by a change in diet, it can lead to a reduction in bad cholesterol, high blood pressure and other conditions brought on by eating unhealthy foods.
Many obese people find that being overweight causes them psychological issues. Obesity can lead to feelings of low self-esteem, anxiety, isolation and embarrassment, which are exacerbated by symptoms such as increased sweating, breathlessness, and difficulty doing physical activity. In some cases, obesity can lead to clinical depression.
What is the best way to lose weight?
As stated above, the best way for obese people to tackle weight loss is a combination of regular exercise and a healthier diet. It is important to stress, however, that weight loss works best when it is carried out over a long period. ‘Crash’ diets are not an effective, long-term solution to obesity because of the following reasons:
- they often miss out whole food groups, meaning they restrict your needed intake of vitamins and minerals
- the majority of initial weight loss you experience will be the loss of water and muscle
- crash diets tend to slow down the rate at which your body burns calories, effectively slowing down your ability to lose weight
As a result, people who undertake these kinds of diets tend to put weight on more easily after they have stopped, compared to people who undertake long-term considered changes to their diet and lifestyle. Similarly, doing too much exercise can have negative effects.
The NHS recommends that most people trying to lose a lot of weight should cut down their daily intake by 600 calories - this number depends largely on how heavy you are to begin with and how many calories you are already consuming in a day. In general, you should aim to reduce your calorie intake and exercise more in moderation, particularly when you have just begun a weight plan. As you become fitter and healthier you can adjust your diet and exercise plans accordingly.
What a healthy diet looks like
When assembling a meal you should aim to include the following:
- a variety of fresh vegetables and fruit to provide fibre and vitamins and minerals
- carbohydrates or starch, preferably (wholegrain bread and pasta, and brown rice)
- some protein in the form of lean meat, fish, eggs, nuts and beans
In addition, aim to:
- reduce your alcohol intake (alcohol contains a lot of caloriesand sugars)
- avoid eating foods that contain high amounts of saturated fat and trans fats (e.g. pastries, ready meals, processed meats)
- avoid or reduce sugary foods like chocolates, cakes, biscuits
- resist the urge to overeat by eating 3 meals per day slowly, enjoying each bite and keeping nuts and fruit on hand for a mid morning or a mid afternoon snack
Variety in food is important for health so that you get all the nutrients that your body needs.
What a healthy exercise plan looks like
The following exercise plan is recommended for adults aged 19 to 64:
- 150 minutes of moderate-intensity exercise every week (e.g. jogging, swimming, hiking)
- Muscle-strengthening twice a week (e.g. yoga, lifting weights, doing push-ups)
- Taking the active alternative where possible (e.g. walking up the stairs instead of taking the lift, standing up on public transport)
In some cases, more exercise may be required to help with weight loss. On the other hand, if you are very physically inactive you may have to start with a less active program and increase the amount of exercise you do as you grow fitter and healthier.
You should always consult a health professional before embarking upon an exercise program.
What happens when diet and exercise don’t work?
For some people, losing weight can be harder than for others. Having particular health conditions such as thyroid problems and type 2 diabetes can also make it easy to gain weight, but a lot harder to lose it.
Although a doctor will nearly always recommend diet and exercise to obese people, there are some medical solutions that can also help with weight loss.
Weight loss tablets
The only licensed prescription medicine available in the UK for weight loss is orlistat. Orlistat is available as a generic drug and under the brand name Xenical . In combination with a diet and exercise regime, orlistat can reduce the amount of fat that is absorbed into the body by about a third. It is only available on prescription from a registered doctor. You can buy a weaker version of orlistat (under the brand name Alli) in LloydsPharmacy without a prescription. If you decide to use one of these tablets, reducing the fat in your diet is important as well as making changes to your lifestyle, such as the diet and exercise suggestions explained above.
You should only purchase medical treatments for weight loss from a trusted source that is affiliated with a legitimate brand. There is also very little evidence to support the efficiency of herbal weight loss remedies.
In some circumstances, surgery may be a necessary measure to help with weight loss. Surgical procedures can either be done on the NHS or privately, but are usually only suitable for people with a BMI of more than 40, or those with a BMI over 35 who also have serious health issues like type 2 diabetes or high blood pressure.
There are two main types of weight loss surgery you can have:
- a gastric band, where the size of the stomach is reduced by a band, meaning you require less food to feel full
- gastric bypass, where the size of the stomach is reduced, with similar effects to the gastric band
Surgical options for weight loss should only be considered as a last resort, and you should bear in mind that they require drastic lifestyle changes after surgery, including a diet and exercise plans. As with all surgery, they come with their own set of risks. If you feel that surgery may be the only option for you, you should consult your GP.
Visit our weight loss clinic to learn more about Xenical.
For more information on losing weight, you can consult the NHS weight loss guide.