Health and beauty spotlight: Weight loss and maintaining a healthy weight:

Body weight is determined by a simple formula; calories in vs calories out.

Calories in come from your food and drink.

Calories out are due to your basal (resting) metabolic rate, exercise, and muscle mass.

If you take more calories in than you “burn off” each day, you will gain weight

If you take fewer calories in than you burn off each day, you will lose weight.

In order to work out what these numbers are, you can count the number of calories you consume, and work out an estimate of the number of calories you would usually burn off each day.

You can either do these calculations and aim for your ideal number of calories per day in order to lose weight, OR practice mindful eating so that you naturally eat fewer calories per day without counting.

I will explain both approaches here, and advise both together initially, then maintaining a healthy weight for life with mindful eating alone.

It’s all about the maths:

If you are overweight and wish to lose weight, first decide what is a healthy, achievable and sustainable weight for you and eat the number of calories that would maintain that weight.

A good way to decide how many calories you should eat per day is to calculate what your base metabolic rate would be if you were your goal weight.

For example, if you are 80kg and you calculate your BMR to be 1600 calories, but your ideal weight is 60kg, calculate your BMR as if you were 60kg.

This will be a lower number.

This is because to maintain a higher weight your BMR is higher.

If say, your BMR at 60kg would be 1400 calories per day, you should aim for that number per day now.

Then you would lose weight as there is a calorie deficit between your current BMR and the amount you are eating.

In this way, weight will be lost gradually, and when you reach your goal weight of 60kg and stay eating 1400 calories per day, you should remain at that weight.

The amount of calories you now aim for should not be a “diet” – a better way of looking at it is that you are now eating the correct amount for your body at its ideal weight.

You will lose weight if you eat the appropriate amount, as when you are overweight, your BMR is higher in order to maintain it. When you reach your goal weight, stay on the same amount of calories per day.

If you “go on a diet” by temporarily reducing calorie intake and then stop the diet and start eating too many calories again, you will always gain the weight back.

Occasionally, a calculated BMR may not be accurate, due to incorrect calculations or an unexpectedly fast or slow metabolism.

An even simpler way to lose weight by counting calories is to keep a food diary over a few weeks, to determine the average number of calories that you eat per day.

If you are overweight, you now know that this number is more than your body needs.

Therefore, reduce the number of calories you consume to fewer than this. Start by just reducing by 100-200 calories per day under your usual amount. If you gradually lose weight, you know that you are on the right track.

Body mass index:

This is a weight-for-height index that categorises adults into underweight, healthy weight, overweight or obese. It is calculated by dividing your weight in kilograms by your height in metres squared. The ideal healthy BMI is between 19 and 25. Your risk of a number of health problems rises significantly from a BMI of 25 while anything over 30 is a serious health concern.

Healthy ranges for BMI may differ between population groups – the relationship between the measurements and the risk of weight-related health problems varies by sex, ethnicity and age.

BMI may underestimate risk in Asian people, or overestimate risk in highly muscular people who can be healthy at a higher BMI threshold.

You can check your BMI at: https://www.nhs.uk/live-well/healthy-weight/bmi-calculator/

Waist circumference:

This is another good check for healthy weight. If your weight is increased due to having a great deal of muscle rather than fat, your BMI could be raised when you are not in fact carrying too much fat.

In fit muscular people, even with their increased body weight due to muscle, the waist circumference should remain below 80cm for women and below 94cm for men, in order to be a healthy size.

Reference: https://www.nhs.uk/common-health-questions/lifestyle/why-is-my-waist-size-important/

Base metabolic rate:

This is the minimum number of calories your body needs at rest to fuel its metabolic activity, for example to maintain functions such as heart beat, breathing and temperature.

Basal energy expenditure usually accounts for about 50-80 per cent of total energy needs.

Your total daily energy expenditure is made up of three components:

Basal energy expenditure
Energy needed for physical activity
Energy required to metabolise your food

Because basal metabolism is affected by factors such as body fat and hormones, illness or infections, medications, or fasting, the values predicted by BMR equations may overestimate (some say by up to 20 per cent) or underestimate the true value. However, they are sufficiently accurate in the majority of people to fall within about 10 per cent of the true value.

You can calculate your base metabolic rate (BMR) on https://www.diabetes.co.uk/bmr-calculator.html

Calories:

The number of calories required to gain or lose 1kg (2.2 pounds) = approximately 7500 calories

Therefore, if you were to eat 500 calories below your base metabolic rate every day (for example, your BMR is 1500, and you eat 1000 calories per day), in 15 days this equals 7500 calories. Therefore in 15 days in this scenario, you would lose around 1kg.

A healthy rate of weight loss is around ¼ to ½ a kilogram per week. (About a pound a week)

Risks of being overweight:

Being overweight increases your risk of dying early, and of suffering from many health problems, including:

High blood pressure
High cholesterol
Type 2 diabetes
Heart disease
Stroke
Joint problems
Gallbladder disease
Sleep and lung problems and
Some cancers (including prostate, bowel, and breast cancers).
Infertility in women
Erectile dysfunction in men

Abdominal body fat, the ‘apple shape’, is a higher health risk than the ‘pear shape’. Also, the relationship between weight and cardiovascular risk is continuous — the more you gain weight, the higher your risk. Also, if you are overweight you may not feel your best and this can have an effect on your energy levels, confidence and many parts of your life.

Benefits of losing weight:

Even losing 5-10 per cent of your bodyweight if you are overweight or obese can have a beneficial effect on your risk of heart disease and other conditions.

How to lose weight if you need to:

In order to lose weight and keep it off, you need to eat fewer calories than you currently do, and continue to eat this amount rather than going back to the original amount when a “diet” is over.

You can either count calories in order to achieve this, or you can reduce the number of calories you eat but without counting them – see the section on Mindful eating for more information on this.

There are hundreds of diet programmes that have been advertised and come in and out of fashion over the years.

All of them work because the number of calories consumed is lower than usual.

Whether you try the cabbage soup diet, Atkins, paleo, meal replacement, dukan, Zone, ultra low fat, low GI, slim fast, weight watchers, or intermittent fasting such as 5:2, if you follow the diet correctly you are likely to lose weight, as they all involve eating fewer calories than you did before.

When you stop the diet, and go back to eating as you did before, you will gain the weight back again.

If you continue the diet for the rest of your life this will not happen. However very few people are able to continue one of these restrictive diets every day until they are in their 90s!

Therefore, it is best not to go on a “diet” or aim for rapid weight loss with any programme that you cannot sustain for life. Instead, calculate the correct number of calories that your body needs to be a healthy weight, and eat this every day.

You should then lose weight very slowly, reach your goal weight and most importantly, stay at it.

You will not have to cut out any particular food, have days when you feel starving, or agonise over what to order in a restaurant. You can live your normal life, eating your favourite foods when you feel hungry, just not exceeding the healthy number of calories for you.

Food diary:

To begin with, it is a good idea to get insight into how many calories you are consuming and how you can achieve the ideal amount.

Record your daily food intake and exercise. Studies have shown that this is the best way to ensure your weight-loss programme will succeed.

Write down your food and drink each day. Calculate how many calories are in each thing you eat or drink.

Beware of labels that state calories per portion. There may be many “portions” in each packet.

The food label may alternatively say how many calories are in 100g of the food, so you need to calculate the number of calories for the weight of the food you are consuming.

Write down the number of calories in any non-water drinks you have as well

After completing a food diary in this way, you may be able to find what parts of your diet can be changed

Weigh yourself regularly, say every 1 or 2 weeks, at the same time of day, and record your progress. This has been shown to help in managing weight loss.

While keeping your food diary, if you “cheat”, write down what you have eaten and the calories, rather than deciding to give up and start eating sensibly again another day. The purpose of this exercise is to gain honest insight into your eating habits.

A typical pattern of eating for an overweight person might be calorie deprivation followed by binge eating. Another common pattern is consistent slight overeating with slightly too large portion sizes. Finding out what your pattern is can help immensely to improve habits for the future.

Portion sizes:

Typical portion sizes have doubled in 20 years; a major contributor to the ever-rising obesity rates in western countries.

For example, many people eat five times the recommended serving of pasta in a typical meal

Almost any meal – even most starters – served at a restaurant /café / fast food outlet are a far larger portion size than recommended for a meal; we have lost awareness of what a normal, healthy portion of food should be.

We tend to eat more when there is a larger portion in front of us, whether or not we are still hungry.

Researchers at the University of New South Wales in Australia found that even when study participants had been given a lesson in mindful eating, when served a large portion of macaroni, they ate 69 calories MORE than those who were served smaller portions.

You should start by preparing meals for yourself with the recommended portion sizes of food. This may seem very small at first!

Eat slowly and chew each bite. If you feel hungry immediately after eating this meal, plan to wait an hour before getting more food – it can take time for your body to register that it is actually full.

There are many online resources for checking what a healthy portion size is for various foods.

Tips to avoid overeating:

Eat plenty of fruit and vegetables
Serve yourself the recommended portion sizes
Avoid fast food/junk food
Avoid soft drinks
Think about your relationship with food; figure out if there are times when controlling food intake is hard. You may be eating for comfort, out of habit or absent-mindedness, or just because there’s food around. Find other ways of controlling stress, and break old habits.
Don’t try to starve yourself to lose weight, this will cause you to overeat due to feeling excessively hungry later. When you are genuinely hungry, EAT.
Avoid too many snacks; don’t keep high fat or sugar treats in the house — have them when you are out, occasionally. Have the fridge stocked at all times with healthy options.
Look at your food portions — if you are in the habit of piling up your plate, try gradually easing back. Use smaller plates and bulkier food so the ‘eye’ is full, and eat slowly so the message that the stomach is full has time to reach the brain. Bulking up with fruit and vegetables gives essential fibre and helps stave off hunger.
Check drink portion sizes too. A typical glass of wine is equivalent to 2 standard drinks and alcohol adds almost as many calories as fat.
Don’t confuse thirst with hunger. Make sure you plenty drink of water; carrying a large water bottle with you in your daily routine will ensure you keep hydrated and stop you from eating unnecessarily when you are actually thirsty.
Avoid restrictive diets or trying to lose weight too rapidly; people who do this tend to gain more weight long term.
You could begin by aiming to stay at your current weight for the first few weeks, while gaining insight by keeping your food diary, rather than aiming to lose weight immediately and quickly. As most people who try crash diets end up gaining more weight afterwards, simply staying at the same weight and not gaining any more is an achievement in itself!
Aim to adopt these healthier eating habits, a more active lifestyle, and sensible portion sizes, as your lifestyle, rather than as a temporary diet.

Barriers to weight loss:

Some people find that they gain weight when on certain medications or due to certain health conditions. If you think this could be the case, speak to your doctor about how this could be managed.

However, it is important to note that fat is still coming from the food and drink you consume – certain medications “Make you gain weight”, however, this is because they increase your appetite and it is the excess food you consume that causes the weight gain.

Some people feel that it is impossible to be a healthy weight when they are unable to exercise due to health conditions. However, there are plenty of people who do not exercise who are a healthy weight – they simply eat an appropriate number of calories per day for their body’s needs.

Healthy foods:

While you can lose weight and keep it off by eating an appropriate number of calories per day, no matter what foods this is comprised of, it is also important for your health to have nutritious foods.

If you are overweight, stopping overeating is a major step towards improving your health, and you might find that you naturally desire more nutritious foods when you are sticking to a healthy number of calories per day.

A balanced diet consists of plenty of vegetables, fruit, legumes (e.g. lentils, beans, chickpeas) and wholegrains (including wholegrain breads, cereals, pasta, rice, couscous and other grain foods).
Unless you are vegetarian or vegan, also include low-fat milk and dairy products, lean meat, poultry, fish, eggs and nuts. The so-called “Mediterranean diet” is a good example of a balanced diet that has been shown to help in weight loss and also has a beneficial effect on heart health.
It is best to consumefew foods containing saturated fats. Also avoid reduced fat foods where the fat has been replaced with sugar or refined starches such as maltodextrins. Instead, choose moderate portions of foods containing unsaturated fats, such as olive oil, avocado and nuts. Cut off any visible fat from meat, eat less fried food, takeaways, snacks, cakes, pastries and biscuits, all of which are high in saturated fat.
Limit intake of sugars. Avoid sugar-sweetened drinks. These are high in calories, but don’t fill you up, and are associated with an increased risk of weight gain. Sweetened fruit juice, sports drinks, and sugar added to tea or coffee should also be avoided.
Drink plenty of water each day.
Limit alcohol intake – it has multiple harmful effects on health, and is low in nutrients and high in calories.
Read labels, looking for calorie content, saturated fat and ingredient listing (they are in order of prominence in the product). Beware of so-called ‘low-fat’ or ‘reduced-fat’ foods, as many are made palatable by adding lots of sugar or starches.

Exercise:

Any increase in physical activity is beneficial to health, and will burn calories.

The increased exercise will also reduce your risk of type 2 diabetes and bowel cancer.

You can start slowly, andwork up to 150 to 300 minutes of moderate (where you can still hold a conversation, e.g. a brisk walk) of exercise per week – this equates to about 25-50 minutes most days of the week. Or, 75-150 minutes per week of vigorous, higher intensity activity.

It is best to do exercise that you enjoy, that doesn’t burn a huge number of calories, than something very intense that you feel you “should” do, but don’t enjoy, as you will not sustain this forever.

Anything that gets you moving is better than nothing; if you can’t schedule a block of time for exercise, try shorter bursts of activity, such as walking around the block at lunch time, or after dinner every day.

Try different sports or forms of exercise to find what you enjoy the most, and if you can do an activity with friends or family, you are even more likely to stick to it.

In one study, the average number of steps taken per day by women between the age of 18 and 50 was just over 5000. For men the average was 6000.

People who were overweight took 1500-2000 fewer steps per day than the people who were a healthy weight.

Therefore, the difference between being slim and overweight was only the difference of walking a few blocks!

If you feel that exercise is a case of “all or nothing”, remember this – one walk per day – if part of your usual routine – can make a big difference over time.

Strength training:

Strength training and muscle-strengthening activities increase your metabolism. Muscle burns more calories at rest than fat does.

Each day, a kilogram of muscle burns over 10 times as much energy as a kilogram of fat just to maintain itself. Therefore, having extra kilos of muscle in your body will automatically mean you burn off more energy from food.

Also, the stronger you are, the more likely you are to exercise, and you’ll look trimmer because you are toned.

Other benefits of building muscle mass include reducing the risk of health problems including type 2 diabetes.

Weight loss programmes:

There are many weight-loss programmes, personal trainers, gym programmes, online weight-loss programmes, apps, and self-help books available.

If you decide to try one of these, choose a programme that teaches you how to make permanent changes in eating habits and levels of physical activity so you take weight off AND keep it off.

If it offers a quick fix or recommends removing whole food groups, this is very unlikely to cause long term weight loss, and it is common to gain more weight than you had originally after stopping it.

If choosing a weight-loss programme, ask yourself these questions:

Is the person/staff qualified to offer advice?
Does the programme include lifestyle changes in food intake AND physical activity?
Does the programme promote a slow, gradual weight loss?
Is there a maintenance plan included and does it teach you how to get through difficult times?
Are the food choices flexible, suitable and affordable?
Are there hidden costs (special foods/supplements)?
What is the success rate of the programme in long-termweight loss?

The most important question to ask, is do you see yourself following this programme forever – imagine yourself in 10 or 20 years time – are you still doing this programme? Are you enjoying the food you are eating? If there anything you had to cut out that you crave? Are you enjoying the exercise?

If you do not see yourself doing this in 10 years time, don’t bother starting it – dieting temporarily only ever causes temporary weight loss before it is gained back again (usually ending up at a higher weight than before).

Mostpills, potions and herbs, passive machines (such as vibrating or electric shock machines) and rub-on creams do not help you lose weight. There is also little evidence for complementary medicines or nutritional supplements as an aid to weight loss.

If these products state that they caused weight loss in their clients, it will be because their clients ate fewer calories per day or exercised more as well as taking that supplement.

Weight loss programmes will try to justify themselves by making weight loss seem more complicated than it has to be. Remember, if a diet works, it is invariably because the people on it eat fewer calories than they did before, not because of a special trick which is specific to that diet or programme.

Mindful eating:

The following is a summary of Paul McKennas brilliant book, “I can make you thin”.

He advises 4 golden rules, for people to eat their favourite foods, without starving themselves, lose weight and keep it off.

He does not advise counting calories, as I have, but instead to eat mindfully so that you naturally eat fewer calories than before.

I usually advise initially keeping a food diary and counting calories as well as mindful eating, as this gives good insight and helps to start a more positive lifestyle, and then maintaining results by continuing mindful eating for life.

Paul McKenna’s 4 Golden rules:

When you are hungry – EAT. Do not go on a “diet”, do not starve yourself, do not obsess about foodand feel guilty for eating. Food is there to be enjoyed and give us nutrition!
Eat only what you want, not what you think you should. Do not eat diet ready meals just because the packet says they are low in calories (unless you happen to find them delicious!)
Eat consciously and enjoy every mouthful. Free yourself from the guilt of eating – enjoy it! Slow your eating speed down to about a quarter of usual. Savour every bite like a gourmet. When you have got the nutrition you need, you will likely stop enjoying each bite as much.
Stop when you even think you are full. When you eat slowly and mindfully, you will notice when you start to feel full. The first sign is that each bite is less delicious – as you have had the nutrition you need.STOP eating when you suspect you might be full. Throw away the rest of the food or save it for later if possible. DO NOT eat everything on your plate.

This advice is based on the fact that so many of us overeat without realising it – due to a large portion being put in front of us, out of habit, being bored, feeling excessively hungry due to yet another restrictive diet, or simply because we are not paying attention to our body telling us it is full.

If we eat slowly, and mindfully, savouring every mouthful, and pay attention to when we start to feel full, we are likely to eat only what we need and not too much.

If overweight, this approach will cause weight loss and then weight should be maintained at the healthy weight which is achieved.

In order for this to work, you must get into the habit of leaving food on your plate; the principle is that you eat what you want, when you want, but very slowly and STOP as soon as you feel full.

By eating everything on your plate, you are letting someone else (or you from earlier that day!) determine your calorie intake and therefore weight. Get comfortable with leaving food. It may feel strange initially to throw away 1/3^rdof the sandwich you brought to work for lunch, but it is better to “waste” food by discarding it, than waste it by turning it into fat on your body.

As you get accustomed to eating the correct amount for your body, you will start to serve yourself smaller portions to begin with and therefore waste less.

You will not have to count calories with this approach, but will eat significantly less than before, without counting them.

Summary:

If you are overweight, this means that you must be taking in more calories than your body needs.
You can calculate your base metabolic rate as if you were your ideal weight – the number of calories per day that your body needs to be healthy – and aim for that number.
Keeping a food diary including calories can help you gain insight into what you are eating. If you choose to do this, keep the diary for several weeks in order to gain an understanding and encourage you to be more mindful of what you are eating. Don’t just keep the diary on “good” days!
Eat whatever foods you like (just stop when you are full, or approaching your daily calorie limit), but try to include lots of fruit and vegetables and only rarely have obviously unhealthy food such as fried or oily foods, or sweets.
Drink plenty of water – it helps to invest in a personalised water bottle and keep it with you.
Mindful eating means eating slowly and savouring every bite. STOP eating when you stop enjoying your food as much, and suspect that you are full, even if there is a lot of food left on the plate or half of a sandwich left.
Do not follow “diets” – going on a diet implies that you will come off it one day. Instead, decide to eat the right amount for your body – for life.
A “diet” also implies restriction, and hardship. With mindful eating and being more kind to yourself, you can enjoy food and still achieve a healthy weight. Get rid of the calorie restricted ready meals that taste like cardboard, and instead eat foods that you find nutritious and delicious, savouring every bite, and stopping when you are full.
Exercise more – something that you enjoy, can fit in to your life, and that you are likely to KEEP DOING because you actually want to.
The main thing is to enjoy food, and enjoy exercise. Try not to see either as a sin or a punishment, they are both things that we need to keep healthy and happy.