Weight Management

While sensible lifestyle changes are the key for long-term success, there are many options a person could consider when making the initial choice about losing weight. The following information is designed to cover the main types of weight loss approaches.

Eating Plans

Contrary to the claims of fad diets, no single food plan is a guaranteed way to weight loss success for every person, and no specific food must be included or avoided in a weight-management program. In designing a plan either alone or with a weight management consultant, people should consider foods that they like or can learn to like, that are available, and that are within their means.

There certainly is no one-size-fits-all approach, but many of the following principles should appear in your eating plan and be promoted by anyone offering a credible tailored weight loss plan.

General Advice

  • Focus on healthy eating and activity habits, not on weight losses or gains.
  • Eat regularly, and don’t skip meals, especially breakfast.
  • Adopt reasonable expectations about health and fitness goals and about how long it will take to achieve them.
  • Make nutritional quality of the food you eat a high priority.
  • Learn, practice, and follow a healthy eating plan for the rest of your life.
  • Participate in some form of physical activity regularly.
  • Adopt permanent lifestyle changes to achieve and maintain a healthy weight.

Advice for Weight Loss

  • Energy out should exceed energy in by about 2100 kilojoules (500 Calories) per day. Increase your physical activity enough to spend more energy than you consume from foods.
  • Emphasise foods with a low energy density (typically foods lower in fat) and a high nutrient density (usually unprocessed foods).
  • Eat small portions. Share a restaurant meal with a friend or take home half for lunch tomorrow.
  • Eat slowly
  • Make legumes, whole grains, vegetables, and fruits central to your diet plan
  • Limit treats to the serving size on the label.
  • Limit concentrated sweets and alcoholic beverages.
  • Water is always a better choice than soft drinks and even fruit juice. Drink a glass of water before you begin to eat and another while you eat. Drink plenty of water throughout the day.
  • Keep a record of diet and exercise habits; it reveals problem areas, the first step toward improving behaviours
  • Learn alternative ways to deal with emotions and stresses rather than turning to food.
  • Attend support groups regularly or develop supportive relationships with others.

Very-Low-Energy Diets

Very-low-energy diets (VLEDs) are sometimes used in the treatment of morbid obesity. Such a diet provides only 1700 to 3300 kJ per day (less than 800 Calories). To achieve such a low kilojoule diet and still meet the body's protein, vitamin and mineral needs, the use of a specialised liquid meal is required as the source of nutrition. Such diets need medical supervision and should only be used for a period of up to four months. As expected, weight loss on such a diet is dramatic (1.5 to 2.5 kg per week in obese people) yet long-term weight loss success is not superior to other conventional weight loss approaches. VLEDs can be helpful with initial weight loss in morbidly obese people, but behavioural therapy and lifestyle changes are needed to increase the likelihood of maintaining some of the weight loss.

Meal replacements

Meal replacement shakes, bars and soups are sometimes popular options to help control weight. The products are designed to replace one or more of your daily meals, but are not a substitute for your entire normal daily food intake. Meal replacement products are usually very low in fat and often have added fibre. If used as part of dietary changes, meal replacement products have been shown in clinical trials to produce a weight loss of 3 to 9.5 kg over one to five years. When combined with counselling by a dietitian, meal replacement products may be even more effective. Partial meal replacements seem to be safe and more effective over the long-term than most other diet-based weight loss techniques. The main downside to these products is that they can be expensive.

Dietitian

If you want professional advice with weight loss, seeing an accredited practising dietitian (APD) can be a good option. Dietitians are university qualified professionals with expertise in applying the science of nutrition to help people understand food and health relationships and make food choices to achieve good health and enjoy a healthy lifestyle. A dietitian can develop personalised eating plans based on your current health, job, lifestyle, past medical history, food preferences, food access and cooking skills, and provide ongoing support, advice and guidance. All Council members have in-house consulting dietitians.

Weight loss supplements

Because weight loss is difficult to achieve, there is an abundance of supplements and alternative treatments that offer the promise of quick and effective weight loss. Many of the claims made by these products have little scientific proof to back them up. Many popular products have been tested in controlled trials and there is little evidence to support any of them having a significant benefit in weight loss. Most products promote an energy controlled diet combined with exercise, which if followed, would explain any weight loss seen while taking the product.

Popular over-the-counter weight-loss supplements Proposed method of action
Caffeine/Guarana Increases metabolic rate
Carnitine Fat 'metaboliser'
Chitosan Inhibits fat absorption
Chromium picolinate Improves insulin sensitivity
Gingko biloba Stress reduction leading to reduced appetite
Grapeseed extract Antioxidant; benefits circulation
Lecithin Increases transportation of fat
Sweet clover Estrogen-like properties; increases circulation
St John's wort Natural antidepressant may lead to reduced appetite

If a miracle supplement existed, obesity rates would be in rapid decline, but unfortunately that is not happening. While some supplements may provide a small benefit that is difficult to measure in a scientific study, most of them of are of little value. Rather than spending your money on supplements of questionable benefit, perhaps invest in a good pair of walking shoes and a pedometer instead. The next time you are tempted to try a newly released 'breakthrough' supplement be especially wary if some of the following claims for the product are made:

  • Fat burner, burn fat, fat trapper or fat blocker.
  • Quick and easy weight loss.
  • Secret formula or ancient formula.
  • Weight loss breakthrough or scientific breakthrough.
  • Weight loss without dieting or exercise.
  • ‘Secret’, ’magical’, or ‘synergistic’ ingredients.

Other gimmicks do not help with weight loss either. Hot baths do not speed up metabolism so that kilograms can be lost in hours. Steam and sauna baths do not melt the fat off the body, although they may dehydrate people so that they lose water weight. Brushes, sponges, wraps, creams, and massages intended to move, burn, or break up “cellulite” do nothing of the kind.

Be wary of 'miracle' weight-loss cures seen on ‘current affairs’ programs or infomercials, where the evidence is likely distorted and mostly based on anecdotes and testimonials. Obesity is a chronic disease that cannot be cured overnight with creams, wraps, gels and pills.

Drug therapy

There are only two approved drugs available in Australia specifically targeted for weight loss and that’s the intestinal lipase inhibitor orlistat (Xenical™) which is available ‘over the counter’ from pharmacies, and the prescription-only medication Phentermine.

Orlistat works by inhibiting the enzyme that breaks down fat in the intestine. This results in about 30% of ingested fat remaining unabsorbed. People taking orlistat have to follow a low-fat diet to minimise unpleasant gastrointestinal side-effects from fat malabsorption. Most of the weight loss when taking the drug is due to dietary changes because of the risk of gastrointestinal consequences of a high fat diet, not because of the reduced fat absorption. In Australia, orlistat is available over-the-counter through pharmacies though has restrictions for its sale. On average, people who use orlistat lose about five percent to ten percent of their original weight.

Phentermine works as an appetite-suppressant by changing the brain's serotonin level, thereby, affecting neurotransmitters' metabolism. Phentermine can have side effects such as rapid heartbeat, constipation, dizziness, alertness and insomnia and is recommended for more short-term use under the care of a doctor.

While drug therapy may seem like an attractive option to help with weight loss, there is no known 'cure' for obesity and only modest weight loss reductions are seen using drugs. Drugs do have side-effects and their long-term safety is still unclear. The cost of obesity drugs is not covered under the PBS (Pharmaceutical Benefits Scheme) hence the ongoing need to take these medications can represent a significant financial cost for the user.

Surgery

Surgery is an effective option for anyone with a serious weight problem that does not respond to diet, exercise and lifestyle changes, and may be particularly appropriate when there are significant medical complications of obesity present. Although the most common surgical method for treating obesity in Australia is laprascopic banding (lap banding), this is not necessarily the most effective procedure, and may not have the same metabolic benefits as alternative procedures such as a Roux-En-Y gastric bypass (RYBG). Before undergoing any procedure it is important to ensure that you obtain independent advice and that you understand all of the benefits and risks and most importantly whether it is the best type of operation for you.
 
How is BMI calculated and interpreted?

Calculation of BMI
BMI is calculated the same way for both adults and children. The calculation is based on the following formulas:

Measurement Units
Formula and Calculation
Kilograms and meters (or centimeters) Formula: weight (kg) / [height (m)]2

With the metric system, the formula for BMI is weight in kilograms divided by height in meters squared. Since height is commonly measured in centimeters, divide height in centimeters by 100 to obtain height in meters.

Example: Weight = 68 kg, Height = 165 cm (1.65 m)
Calculation: 68 ÷ (1.65)2 = 24.98

 
The standard weight status categories associated with BMI ranges for adults are shown in the following table.
 
Body Mass Index is used to estimate your total amount of fat. It is only an approximate measure of the best weight for your health.


This calculator is designed for men and women over the age of 18.

A healthy BMI for an adult is between 20 and 25. For older Australians over the age of 74 years, your general health may be more important than being mildly overweight. Some researchers have suggested that a BMI range of 22-26 is acceptable for older Australians.

What your BMI means


Once you have measured your BMI, you can determine your healthy weight range. If your BMI is:
  • Under 18.5 - you are very underweight and possibly malnourished.
  • 18.5 to 24.9 - you have a healthy weight range for young and middle-aged adults.
  • 25.0 to 29.9 - you are overweight
  • Over 30 - you are obese.

Some exceptions to the rule

BMI does not differentiate between body fat and muscle mass. This means there are some exceptions to the BMI guidelines.

 
 

BMR Calculator (Basal Metabolic Rate)

The BMR formula uses the variables of height, weight, age and gender to calculate the Basal Metabolic Rate (BMR). This is more accurate than calculating calorie needs based on body weight alone.

The only factor it omits is lean body mass and thus the ratio of muscle-to-fat a body has. Remember, leaner bodies need more calories than less leaner ones. Therefore, this equation will be very accurate in all but the very muscular (will underestimate calorie needs) and the very fat (will over-estimate calorie needs).

BMR Formula

Women: BMR = 655 ( 9.6 x weight in kilos ) ( 1.8 x height in cm ) - ( 4.7 x age in years )
Men: BMR = 66 ( 13.7 x weight in kilos ) ( 5 x height in cm ) - ( 6.8 x age in years )

De-stress Meal ideas

Breakfast

  • One or two poached, boiled or scrambled eggs with smoked salmon, avocado and sourdough rye bread.
  • Baked beans (low sugar and low salt) with wilted spinach and grilled tomato.
  • Bircher Muesli Medley*: rolled oats, nuts and seeds soaked in water or yoghurt, mixed with apple and berries.

Lunch

  • Spiced Chicken and Vegetable Soup*.
  • Roast beef slices with a salad of green leaves and herbs, avocado, roast zucchini, asparagus and a sprinkle of goatís cheese.
  • Roast chicken with garlic, onion, tomato, carrot and thyme. Quinoa optional.

Dinner

  • Green Leafy Ginger and Cashew Stir-fry*.
  • Lentil dahl with broccoli.
  • Mixed green salad with grilled lamb, capsicum and sweet potato.

Snacks

  • A piece of fruit.
  • Handful of nuts and seeds.
  • Hearty Smoothie*.

This is an edited extract from The De-Stress Diet (Hay House, $19.95) by Charlotte Watts and Anna Magee.