A guide to weight management

Weight plays a significant part in our health, and being under- or overweight can have devastating and chronic consequences, such as high blood pressure, heart disease, infertility, and diabetes. In this article, a GP shares their guide on managing weight in ways that are optimal for health.

There are many ways to lose and gain weight, however not all of them are recommended. Thousands of trendy diets, programmes, and unlicensed medications on the market promise quick and easy weight management, but can cause more harm than good. But the tried-and-true methods that are encouraged by doctors will leave patients feeling, and looking, good.

What is weight management and why is it important?

Weight management is a plan to stay or get healthy, and is often implemented for those who have chronic illnesses, eating disorders, and are at an unhealthy weight. To commit to weight management, patients must adhere to a routine and diet, and keep in mind that there will not be results overnight. It will likely require lifestyle changes, physical activity, diet, and sometimes medicinal intervention.

Being under- or overweight can cause health issues, but it can also come about as a result of health issues, such as polycystic ovary syndrome, AIDs, coeliac disease, eating disorders, and thyroid dysfunction.

What is a healthy weight?

People come in all shapes and sizes, and physical appearance may not always indicate if someone is of a healthy weight. That’s why body mass index (BMI), a calculation based on the measure of the weight and height of a person, is used as a tool to determine if the person is a healthy weight by estimating the body fat they have. A healthy BMI for an adult is between 18 and 25, but it's not a perfect science, more of a rule of thumb – for example, it cannot take into account high amounts of muscle mass, which is why professional athletes, arguably at the peak of their health, may have a BMI that is ‘too high’. A BMI that is under 18 is considered underweight, and more than 25 is overweight; 30 and above is categorised as obese.

How can weight be managed?

Before starting a weight management plan, patients need to manage their expectations and set a goal for their weight. It takes a lot of determination and will to stick to their goals, which should be worked towards gradually as sudden fluctuations can be destabilising and harmful.

Diet

As the age-old adage goes, ‘You are what you eat’. What we eat and how often we eat play a pivotal role in our bodily function. Unhealthy diets with a lot of saturated fats, salt, and sugar are some of the biggest leading factors of obesity, as there are too many minerals for the body to process, leading them to be stored in the body and leading to complications like atherosclerosis. Restricted diets where meals are few and far between will cause a deficit of the nutrients needed to power the body, causing systemic weaknesses that will manifest as anaemia, hair loss, bone issues, and a sensitive immune system.

Ideally, adult patients should be consuming roughly between 2000-2500 calories daily, with varied, balanced diets consisting of many fruits and vegetables at least three times a day, high-fibre and wholegrain foods like potatoes and brown rice, dairy or dairy alternatives for calcium and potassium, meat and fish or high-protein substitutes like tofu or textured vegetable protein, nuts and grains, healthy oils like olive and avocado oil used in moderation, and foods without added sugar and salts. Patients should prioritise fresh foods over pre-packaged or processed foods (i.e. those that come in plastics, cans, or boxes), and they should take the time to learn about responsible portion sizes.

Physical activity

Regular exercise is not only recommended for weight loss, but overall health – for example, it can reduce the risk of type 2 diabetes significantly. While it can help with burning off extra calories, it also promotes better sleep, strengthens bones and muscles, and improves blood and mental health.

However, overexercising can strain and stress the body, elevating cortisol levels to dangerous levels, which can cause further weight gain and when combined with malnutrition, can result in developing Cushing’s syndrome. This is why it is important to exercise responsibly and moderately.

Some of the best exercises to do are aerobic exercises, which include brisk walking, jogging, cycling, dancing, and swimming. Strength training like weights and resistance bands is also beneficial. It is recommended to do at least 150 minutes of exercise each week, and to avoid being sedentary or sitting for too long daily.

Medical treatments

There are anti-obesity and diet-stimulating medications and treatments to assist with weight management.

Bariatric surgeries are weight-loss procedures that are considered for patients who are morbidly obese, have type 2 diabetes, or have not had fruitful results from other interventions. It involves making the stomach smaller so less food can fit and the patient feels fuller sooner when eating.

Clinical trials are always ongoing for new medicines, but at the moment the ones that are available for prescription are:

• Orlistat, which are pills that work by blocking a portion of the fat from eaten food from being absorbed into the body, where it is instead passed with bowel movements.
• Liraglutide/semaglutide, which are appetite suppressants in the form of injections, may be prescribed to patients with a BMI over 32.5.
• Megestrol or dronabinol, which are diet stimulants recommended for patients who may be experiencing weight loss as a result of cancer or AIDs

One of the key points for patients to remember when undertaking a weight management mission is to keep a support network around them, and to not put too much pressure on themselves; it is a task that will take day after day before there are apparent results. The best treatments for each patient will vary on their needs and the urgency of the weight loss or gain.

If you are struggling with your weight, you can consult with a specialist on Top Doctors today.