Family doctor



WEIGHT MANAGEMENT - a patient's guide


Weight gain is common in the Western world due to changing lifestyles and eating habits. This article provides an overview of how to maintain a healthy weight.

Why do people have such problems with weight control?

Our lives have become more sedentary over the last century as more machines have been used for tasks that were once done manually. In recent times we have had huge changes to our lifestyles with the introduction of new technology such as mobile phones, computers and e-mail, and increased television viewing time. All have reduced the opportunity for movement during both work and leisure.

At the same time we have changed our eating habits significantly away from simple, plain, home cooked foods to more frequent use of partly prepared or ready to eat takeaway foods which are often high in fat. New Zealanders are eating many more restaurant meals than in the past. These changes to our eating habits mean that we do not have the same knowledge about, and control over, what we are eating.

Another major contributing factor to problems with weight control is centred around the media, body image and the weight loss industry. We are bombarded with messages about attaining a perfect body shape and looks, new diets or potions that will work miracles and exercise equipment that will help do the work for you. These messages place more emphasis and focus on the whole problem of the difficulties people are having with weight control.

Key points to successful weight management

  • Have realistic expectations.
  • The amount of fat and fibre eaten is extremely important.
  • Total energy from food and drink is also important.
  • Physical activity and movement play a vital part.
Realistic expectations

How much fat we have stored in our bodies is the result of a lifetime of habits. Most overweight people would like to lose any excess weight as quickly as possible. However, our bodies have been programmed to hold onto our fat stores at all costs (in case of future starvation). Realistically people will lose body fat only slowly. When people do make changes resulting in less energy intake and more energy output, they may increase muscle whilst they decrease fat stores and hence their weight on the scales may not change. If people do lose weight it is quite normal for this loss to be in small bursts followed by plateaus where no weight loss is experienced. "Dieters" become very frustrated by these periods which is usually the point when they return to their pre-diet habits. The simple truth is that there are no quick and easy answers.

Instead of focussing on weight loss a much healthier attitude to weight management and fat loss is to keep a record of one's waist measurement over the years. What you measure around the waist is one of the best indications of how much fat you have stored in that area. Whilst fat stored in other parts of our bodies may be annoying to some of us in terms of our looks, it is the fat around the waist which has the most impact on our health. Most people tend to have difficulty with an expanding waist as they reach middle age. Physical activity which encourages use of the abdominal muscles, such as the usual gentle arm movement during walking, has been found to be helpful in keeping the waist measurement from expanding.

Fat and fibre intake

New Zealanders enjoy the taste of fatty food. Fat adds flavour to food, makes it look richer and moister. Recently published results of the 1997 National Nutrition Survey (NZ Food: NZ People 1999) showed that over 50% of females and 60% of males did not meet recommendations to have 33% or less energy from fat. The sort of fat eaten is also very important as saturated fat from animal products, coconut and palm oil, and the fats found in processed foods are not recommended for good health.

Flavour, richness and moisture can always be incorporated into foods instead of adding fat, for example by using herbs and spices, fruits, fruit juices and sauces. Reducing fat intake will usually mean choosing more foods with plant fibre on a daily basis. Vegetables, fruits, breads and cereals (mostly wholemeal) and pulses (baked beans, chickpeas, lentils, other varieties of dried beans) are all good sources of fibre. A dietitian can help you make these modifications to what you are currently choosing.

Total energy from food and drink is also important

Some people will make considerable changes to their eating habits by choosing low fat foods but at the same time eat more than usual to compensate. Researchers have shown that when people chose the low fat food option at one meal they overcompensated at the next. We don't necessarily eat when and how much our body tells us to eat. Emotions and feelings can play a big part in food choice. "Going on a diet" commonly causes feelings of deprivation and unhappiness triggering out of control eating. High sugar content food and drinks may also be used as a replacement for high fat foods.

Physical activity and movement play a vital part

Lifestyle changes involving a reduction of usual or accustomed movement can frequently be traced to a time when additional weight gain or fat gain began to occur. These include hormonal changes, stress, bereavement, retirement from sport, injuries, childbirth and employment changes. It is important to be aware of the physiological and psychological effects of these critical periods throughout the lifespan and to look for opportunities for building movement and activity into our daily lives. Enjoyable, low impact activities are preferable and the most sustainable.

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