The Low Down On Weight Loss: A Doctor Weighs In

Everywhere you go, you meet people who say they need to lose weight. Even those thin, petite ones who look like they do not have an ounce of fat on their body talk about weight loss hacks and how much weight they have to lose. Maybe their jeans are starting to feel a little snug. Perhaps they feel their arms are starting to look flabbier. Everyone has their personal reason for wanting to lose weight.

With weight loss being such a popular topic, we did an interview with Dr. Terence Tan of Halley Body Slimming Clinic to ask him everything about losing weight. What is a good weight loss strategy, why can’t we maintain the weight loss, what is a healthy rate of weight loss, and when should we take medications for weight loss?

1. People like to say they need to lose weight. But practically speaking, when is a person considered overweight?

We need fat in our body to give us energy, protect our organs, and keep us warm. Fat also ensures that our nerves and brain function properly. But having too much fat in our body and being overweight increases our risk of heart disease and stroke. There are also many health problems related to obesity like diabetes, high blood pressure, kidney disease, and sleep apnea.

A person is considered overweight when his body mass index (BMI) is 23 or higher and he is obese when his BMI is 30 or higher. You will need to get your weight back to the healthy range if your BMI hits those numbers. BMI can be easily calculated by dividing your weight in kilograms with your height in metres. Then take the answer and divide it again with your height.

2. Why are people not losing weight effectively?

weight loss

For a person to maintain a constant weight, their energy intake (i.e. the food you eat) needs to be equivalent to the energy you use. This is what we call “caloric balance”.
So, if you want to lose weight, you need to use more energy than you consume. You need to put your body in a caloric deficit state.

However, if you eat more calories than you use, you’re putting your body into caloric excess. This means that you will gain weight.

When people are trying to lose weight, they often go through an emotional roller-coaster especially at meal times. They give in to their hunger pangs and eat more than they should. Although satiated, they feel a huge amount of guilt and under eat at the next meal, or skip it totally. When the hunger is too much to bear, they end up overeating or eating something that is totally unhealthy. Then they feel guilty, and the vicious cycle continues.

In the end, not only do they fail to lose weight, they end up hurting their body. They are also unable to maintain a caloric deficit state, which is necessary for effective weight loss. Many people also subscribe to “fad diets”, which promises fast and extreme weight loss. They may be able to lose a huge amount of weight initially, but because the diet is unsustainable in the long-term, people return to their habit of overeating again. The result is rapid weight gain after a period of extreme weight loss. In some cases, people may end up weighing more than what they weighed at the start of the diet.

This yo-yo dieting or weight cycling is harmful to the body and puts people in a negative, emotional state. This depressed state is certainly not a good place to be in if you want to achieve sustainable weight loss.

3. There are so many weight loss programmes in the market. How do I know which weight loss programme suits me better?

An effective weight loss plan will require combination of weight loss tactics. This includes lifestyle changes on how much and what to eat, exercises to expend the calories consumed, meal supplements, and even weight loss medications. Whether you need just one or a combination of tactics will depend on a multitude of factors like your weight, height, BMI, and other health factors which a doctor can advise during a consultation.

Doctors in Singapore see less patients with a BMI of above 30 as compared to western countries. Although this is a good situation, studies are beginning to show that Asians need to have a lower weight baseline as compared to Caucasians. Studies also do not reflect improvements in intangible benefits like mental well being and reduction of societal stress that comes with weight loss. As such, I feel that having short-term weight loss medications can help most people, even if the experts tell us that based on their studies, medications are only for people with a BMI of above 30.

The first phase of weight loss is usually the most painful and most difficult one. This initial phase of active weight loss is where I feel short-term consumption of medications is important. It takes the pain out of the initial weight loss phase by reducing the feeling of hunger when one needs to eat far less than one needs or exercise far more than one used to do in order to achieve weight loss.

Weight loss medications also allow people to see rapid weight loss. Rapid weight loss motivates people during the second phase of weight loss maintenance.

At phase two, people would have achieved their ideal weight, and the goal now is to maintain caloric balance. Those who have achieved their desired weight should stop or tail down their medications because there is no need to maintain an ultra-low calorie diet any more.

The seemingly impossible task of losing weight has been done. They should feel motivated by that achievement. Armed with the knowledge they gained, they can now keep the weight off.

4. What is considered a healthy rate of weight loss?

How long and how fast the weight loss process would take, would depend on your initial body weight, your ideal body weight, and the prescribed weight loss regime. In general, I would not suggest losing more than 1kg per week. Losing 1.5kg per month is a reasonable weight loss target for most people. Our weight loss programmes can last from three months to over a year.

The weight loss process need to be controlled and well managed by a doctor because uncontrolled, rapid weight loss can result in reduction of muscle mass and is generally not good for one’s health.

5. What should I do to maintain the weight loss?

The weight maintenance phase is the phase where, after having achieved their ideal weight, there is no need to maintain an ultra-low calorie diet anymore. During this phase, people who have achieved the desired weight should stop or tail down their medications because it is not needed any more. To maintain the weight loss, people need to maintain their caloric balance.

When maintaining weight loss, motivation is key. Exercise is as important as eating less as it increases our energy expenditure. Exercise also increases hormone levels of adrenaline and endorphins in our blood. These hormones naturally reduce our appetite and make us feel spiritedly and alert.
Of course, eating less is also important; just be mindful of what your eat without overdoing it. And also, please keep away from watching too much television food programmes as they make you crave for food!

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