Nowadays obesity has become an important public health challenge. We need to be concerned about it because it is at least a risk factor for numerous diseases. Because of this and other reasons, many people wish to reduce their body weight and seem to exert all possible efforts. Practically, at least in my set-up, success rates to reduce body weight to a desired level are very low, despite the various efforts made. On the contrary, there are some people who want to have a higher body weight than they have so as to attain a normal body weight range. Still it is not usually easy to achieve it. Can you give tips, advice and experiences for both of these cases?
There is a lot of good advice here but obesity is a heterogeneous phenomenon. Once we get past the people who can manage their weight (and appropriate weight has some cultural biases), we get down to another group or several. One of the issues that has not been brought up directly, is that eating may be the best way of regulating emotions that result from severe emotional trauma available to the patient. This is a level of stress that might be helped but would not be helped enough by stress management instructions. Maybe food was the ONLY reliable source of comfort growing up. Without either finding something that works equally well to manage overwhelming distress, or more directly helping the person heal that trauma so that physiologically it is in the past, this effort is doomed and in the end feeds the sense of failure on the part of the patient that comes with the territory. More than that, as has been indicated in a way, the chronic autonomic dysregulation + eating disorder can result in more and more difficult-to-overcome adaptations in the physiology. The idea that our top down systems, if adequately educated, can control the deeper physiology has work for some, but can lead to suicidal despair in those for whom this is not enough.
From personal experience and what I've heard from others, small adjustments seem to be more effective than major changes in routine,
from what i had to comminicate to a pateint who was obese, asked him to reduce one gm per hour It becomes 24 gms in one day and 720 gms in one month and 8640gms per year. think about this. loosing 8 kilos a year. by just loosing one gm per hour.
I find that a common problem with over eating is "emotional eating" even though some do not recognize they have this problem. Background stress and anxiety even at low levels but continuous, definitely cause over eating. Awareness management and meditation do help. Their effect is not immediate but certainly long lasting if not permanent if one adopts them as a way of life. They also impact positively on all other aspects of life which also improves morale and keeps the weight off, or rather, brings the body back to the weight it should be physiologically which is always the right weight.
First of all we should eliminate obesojenic factors such as watching TV and working with computer for long hours. These factors can contribute unhealth eating. Doing exercise for 30 minutes/5 day, eating more vegetables and fruits, reducing fatty and sweety foods can help to us for maintaining body weight optimal levels.
Stress free life. how. daily chores, run to the work place, deadlines, EMI friends, gold house rent, husband or wife differences, childrens illhealth, study, purchases, rstlessness. you just name it there is stress. emotions are continous,
sedentary jobs, so on and so forth. avoid sweet, cut down oils, drink water instead of coca cola, cocnut water instead of pepsi, sprouts instead of chips, friuts instead of chocolates. walk instaed of a ride.
Your question is confusing. You ask about managing risk factors but you seem to want to know how to reduce body weight.
Once you are overweight it is very difficult to become normal weight again. All evidence so far points towards an adaption of the body towards reduced calorie intake. Resulting in short term moderate weight loss, which again results in even more weight gain . Even if, after abortion of a weight loss diet, you eat healthy. Dont send your patients towards a cycle of yoyo dieting. Encourage them to not gain more weight, encourage them to reduce salt intake, reduce red meat intake and stress that they take up exercise. Dont confuse a cosmetic issue with a health issue.
As towards your underweight patients ( and I assume you don’t talk about nutrient deficit due to poverty but just the (annoying) people who can eat a pint of ice cream, followed by a whole cake and still gain no weight and are slim), tell them that food is there to be enjoyed. But give them the same advice ( see above) you give to overweight people.
DIET
Follow a healthy and realistic eating pattern
Keep eating patterns consistent
In studies of people who have lost weight and kept it off for at least a year, most continued to eat a diet lower in calories as compared to their pre-weight loss diet.
Eat breakfast every day. Eating a healthful breakfast may help you avoid getting "over-hungry" and then overeating later in the day.
ACTIVITY
Be active, pursue activities you enjoy and will adhere to regularly, engage in physical activities 30-60 minutes most days of the week.
This doesn't necessarily mean 30-60 minutes at one time. It might mean 10-20 minutes of physical activity three times a day. For example, a brisk walk in the morning, at lunch time, and in the evening. Some people may need to talk to their healthcare provider before participating in this level of physical activity.
STAY ON Course
Monitor diet, activity, and weight Keeping a food and physical activity journal can help you track your progress and spot trends. For example, you might notice that your weight creeps up during periods when you have a lot of business travel or when you have to work overtime. Recognizing this tendency can be a signal to try different behaviors, such as packing your own healthful food for the plane and making time to use your hotel's exercise facility when you are traveling. Or if working overtime, maybe you can use your breaks for quick walks around the building.
Get support from family, friends, and others
There is a lot of good advice here but obesity is a heterogeneous phenomenon. Once we get past the people who can manage their weight (and appropriate weight has some cultural biases), we get down to another group or several. One of the issues that has not been brought up directly, is that eating may be the best way of regulating emotions that result from severe emotional trauma available to the patient. This is a level of stress that might be helped but would not be helped enough by stress management instructions. Maybe food was the ONLY reliable source of comfort growing up. Without either finding something that works equally well to manage overwhelming distress, or more directly helping the person heal that trauma so that physiologically it is in the past, this effort is doomed and in the end feeds the sense of failure on the part of the patient that comes with the territory. More than that, as has been indicated in a way, the chronic autonomic dysregulation + eating disorder can result in more and more difficult-to-overcome adaptations in the physiology. The idea that our top down systems, if adequately educated, can control the deeper physiology has work for some, but can lead to suicidal despair in those for whom this is not enough.
1) Changing food habit: Avoiding fat rich diet and soft drinks, consuming vegetables and drinking water more, if possible two times eating everyday or two days fasting every week
2) Changing Life style: Regular moderate physical activity, if possible going to workplace by walking or cycling, at least performing personal works by yourself e.g. cooking, washing cloth e.t.c.
3) If above is not feasible then every morning and evening perform half an our physical exercise regularly.
A team work from a dietitian, a psychologist and a trainer would benefit people with weight problems. These healthcare professionals would help to educate individuals on how to adapt a healthy lifestyle ie 1. balanced diet without strict prohibitions, 2. an active life in an acceptable way meaning if someone does not like going to a sports center, just go walking or cycling every day for at least 30min and 3. be emotionally balanced and disconnect feelings with eating habits (overeating or abstention)
The issue of obesity and reduction of weight should also be viewed from contextual, cultural and societal approaches.
I do perfectly agree with most advices and tips provided by everyone, but it is often difficult to coordinate these recommendations in some contexts. For instance in some countries people develop eating pattern dues to available foods and physical activities facilities. For example in the town i stay there is virtually no sports facilities in most schools and community.
Finally it is almost impossible to get clinical psychologist support because there are too view and busy for more serious cases.
In my view obesity should be tackle from social determinant approach instead of stressing on individual change that is inhibit by those factors.
Obesity is a disease not a risk factor possessing genetic, nutritional and environment causes. It is a serious issue the world over having consequences leading to poorer health. Most of it can be prevented by raising awareness, imparting health education at all levels of the society including schools, colleges and at the community level through books, literature, pamphlets, talks and discussions and through media. Obesity due to binge eating due to psychiatric disorders must be identified and be dealt accordingly. How every individual takes it to eat a rationale diet and do exercise and avoid excessive calories needs the models for research and exploration.
1. Don't be poor so you can afford nutritious food
2. Live in an area where nutritious food is conveniently available
3. Don't work in a low paid manual job (see 1.) or multiple jobs so you have the discretionary time to exercise and prepare nutritious food.
4. More importantly, have parents who have done 1-3.
While this is to some extent tongue-in-cheek, it's easy to forget that determinants that can also influence healthy weights are more systemic.
As Phyllis mentioned, there are also cultural biases. Not only what constitutes "normal weight" but also what constitutes healthy eating and exercise practices. Obesity has not spared wealthy countries and while the list above applies in wealthy countries too, I think the heavy marketing, easy availability, and low cost of low nutritional quality foods and the cultural acceptance of same is a problem. This cultural backdrop may be related to the relationship of between obesity of immigrants and extent of acculturation http://www.ncbi.nlm.nih.gov/pubmed/23663279
As a student it happen that i seat till late nigth getting my next assignement ready for the next submission date since my brain does not bear with tea or cofee i develop a habit of drinking just hot water , few month later i realise that i've lost few kg . Then i happen to chaire the experience with my chinise freind who told me that there is a link between me loosing weigth and the hot water. Then i state drinking it even more often and lost even more weigth so we need some research to confirm this experience. More specialy after a meal hot water is a good experiece just notice that most chinise are not fat because theiy often drink hot water.
This is great and needs to be explored. Yes, infact, the Chinese are thin and slim and they consume just a hot water frequently as in other parts of world, we consume tea and coffee. The association or the causal link needs to be investigated to save the world with a quantum of obesity.
being active and choosing healthy foods has health benefits for everyone—no matter your age or weight. It’s important to choose nutrient-dense foods and be active at least 150 minutes per week
Anything that goes into your body (except water) increases your weight. It may be green tea, chia seeds, lemon water, herbs....medicinal plant parts etc., etc. Remember, anything that goes inside your body increases weight..ha ha Its true.
Balanced food, sport and a lot of health and diet culture are the main keys for body weight control.
Best regards
SM Najim
Eat less but enough to maintain health and work and make more physical exercise /effective walking is usefull. Walk for 30 minutes per day for 5-6 days a week. The walk should be hard enough to accelerate your heart rate.
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