Weight Management

Weight management:

Being overweight or obese increases your risk of developing chronic diseases such as cardiovascular disease, high blood pressure and diabetes. Some simple tools used to determine if someone is overweight or obese include body mass index, (BMI), waist circumference and waist to hip ratio.

 

BMI is a measure of your weight relative to your height. It gives an approximation of total body fat. Calculate your BMI now:

 

Your BMI is

 

Waist circumference measurement gives an approximation of body fat in the stomach area. A waist measurement of more than 35 (90cm) inches in women and more than 40 inches (102cm) in men is considered high. In Asian populations, however, disease risk increases substantially with a waist measurement of over 90 cm in men and over 80 cm in women.

Measure your waist circumference now and determine your health risk (Include how to measure waist circumference properly)

BIA or bioimpedance analysis is another method of assessing your body fatness. It requires special scales that measures your fat mass from resistance to the low voltage current. Even individuals with normal BMI may have a higher percentage of body fat. On the other hand, muscular individuals may have a higher BMI but low-fat mass. Which one do you think is healthier?

It is the excess body fat, in particular fat deposits around your internal organs (visceral fat) which increases the risk of chronic diseases. Therefore using a combination of different methods is a more accurate way of determining if you are at risk.

Do you feel hungry all the time?

Do you experience frequent hunger pangs?

Do you eat “supersize” meals?

Do you graze throughout the day?

Do you have food cravings?

Do you eat when you are stressed or sad?

We can help!

 

How we can help

  • Comprehensive weight management programme which includes diet, physical activity and behaviour therapy is most successful
  • Setting realistic, achievable and sustainable goals
  • Aim to reduce 0.5-1.0kg per week to achieve up to 10% weight loss from baseline. It is estimated that to lose 0.5kg of fat per week we need a deficit of 500cal per day or 3,500cal per week. This can be achieved by eating less and burning more through physical activity and exercise.
  • To determine the energy target numerous predictive equations can be used in clinical practice however more accurate method is to use indirect calorimetry. Indirect calorimetry also known as metabolic cart is a piece of non-invasive equipment which measures the metabolic rate of an individual from the gas exchange (oxygen consumption and carbon dioxide production)
  • Portion control and mindful eating strategies
  • Behaviour therapy in addition to diet and exercise may optimise weight loss and prevent weight regain in certain individuals

Selected dietary approaches:

  • Individualised and based on comprehensive nutrition and metabolic assessment.
  • Dependent on existing chronic conditions e.g. cardiovascular diseases, diabetes or fatty liver.
  • Some examples of tools or strategies which can be employed include:
    • Calorie counting
    • Glycaemic index
    • Low-fat eating plans
    • Low carbohydrate diet
    • Intermittent fasting
    • DASH diet
    • Meal replacements
  • It is important to remember however that restrictive diets only work short-term and usually lead to weight regain when the diet ends. Small but sustainable changes over time are more effective long term.

Healthy Tips:

  1. Make your New Year’s resolution about adopting a healthy lifestyle not about just losing weight and going on a “diet”.

  2. Restrictive or FAD diets are only short-term solutions and often result in weight regain.

  3. Eat foods that are low in calories but rich in nutrients to give your body proper nourishment.

  4. Yo-yo dieting described as diet followed by weight regain followed by another diet may lead to poor self-esteem, depression and worse health outcomes.

Other approaches:

  • The addition of approved weight loss medications may improve weight loss in some overweight and obese individuals. In Singapore, two medications are available: Phenteramine and Orlistat. Phenteramine marketed as Duromine or Panbesy is an appetite suppressant while Orlistat (Xenical) reduces fat absorption. However, all medications have side-effects therefore should be discussed with the doctor.
  • For morbidly obese individuals or those who have tried and failed to lose weight bariatric surgery can be considered.

An accredited practicing dietitian can provide an expert nutrition advice to help manage your weight which is tailored to your needs.