While counselling my patients in Obesity and Metabolic Surgery Clinic, the first thing I usually hear from them is – Doctor, I have gained so much weight in past few years / after pregnancy but I hardly eat anything! I go to Gym also but despite all these efforts I am not able to reduce! I went to various clinics claiming instant weight loss also but I regained everything! Please do my surgery!
Do I offer them Bariatric surgery right away? No, I dont!
So why exactly one should lose weight? How can you do it? Are there any shortcuts? Who needs surgery and who doesn’t? And why losing weight is such a hard task after all? There is so much material available on internet, in the form of books, lectures, videos and articles which one can read. What is the difference then, You may ask? And you may say “Oh crap! I have heard this before……Dieting..Exercising…..Fruits and Vegetables and Salads….Say no to Sugar, Fat and Junk food….Eat less, burn more…blah blah…been there, done that! Sorry!”
But Hey wait!!!!There are some facts you should know. Lets read them and make an effective plan to achieve your target! Who knows, after reading it, you might have everything to lose ? 🙂
Who should reduce weight? Know Your Body Mass Index
Now that you know your BMI, I have a bad news for you! As per the WHO expert consultation report published in The lancet in 2004, Asians, specially Indian people have high percentage of body fat as compared to their European or American counterparts. If you are from India and have a BMI of more than 23 kg/m2 (in comparision to white people where it is 25 kg/m2 ), there is a significantly increased health risk for you in the form of diabetes, high blood pressure and cardiac problems, fertility related problems, snoring and tiredness, joint pains, poor self esteem, depression and overall decreased life expectancy (How many 60+ years old obese people have you really seen, by the way?). Bariatric surgery for weight loss is recommended if your BMI is more than 32.5 with a comorbidity (>35 for whites) and 37.5 without comorbidity(>40 for whites) and failure of dietery and lifestyle modifications. I will not talk about surgical options here.
Why should I lose weight?
You should lose weight because It will make you healthy and feel good. It will make you look young. It will bring down the stress levels. It will make you a lot happier and confident. It will make your partner happier which in turn can lead to improved interpersonal relationship. It will bring down future health related expenses. It will increase your life expectancy. It will save you from those cruel remarks and on the contrary will let you get appreciations and enable you to become a role model for others to follow! This really sounds cool!! Isn’t it? One of my friends channelized his failure elsewhere into weight loss. (Sublimation is a mature type of ego defense mechanism, where socially unacceptable impulses or idealizations are consciously transformed into socially acceptable or constructive actions or behaviour). Choose what motivates you the most!!
OK!! I am convinced that I should lose weight! So what? I’ve tried various methods and nothing works actually. Infact I have gained more weight after dieting and exercising. Something is wrong with my body. I am just unlucky!
Listen to me! Please understand the 3 basic laws which govern this universe- that life is hard, that whatever you are or ever will be is up to you and lastly, you can learn whatever you need to learn, to become anyone you want to become and achieve anything you want to achieve. The limitations are within you not in the external world!!(From the book Maximum Achievement by Brian Tracy)
My own story- During my surgical training, beacause of my irregular life style, extended study hours and poor food choices I gained weight. When I realized it, I formulated a plan and applied on myself! I was happy with the results (7 kgs in one and a half month and counting) and I was happy to share it with my patients. I am happy to share it with you here!
Are you motivated now? Awesome! Degree of motivation is the rate limiting step! Higher the motivation, more effective will be the plan
Get a full length mirror and watch yourself nude! AND get a weighing scale, preferably digital because it will tell you the difference of even 100 gms, so you can monitor your daily progress! This should be done daily. It will serve two purpose- First, you will have an initial picture of yourself in your mind with which you can compare the results and second, both the acts will prove to be strong motivator for you to keep going!! Viewing yourself in mirror and weighing daily will give you daily feedback on how well you are doing! I will reiterate that both the things are mandatory for you to achieve your goal!
Note- Always weigh yourself at the same time of the day in minimum cloths. There is a daily fluctuation of weight of around 1 kg to 1.5 kg which depends on your food, water and salt intake. More salt will lead to water retention but it will be temporary. Your weight is lowest in the morning.
Know the math right!
Most of the time people dont have an idea that how well they are doing or I will say, in the absence of feedback they lose hope and stop all the efforts midway! An average persons needs about 2000 Calories on a daily basis which can vary depending on age, sex and level of daily activity! Know your calorie requirement here! Now the important part- In order to lose 1 kg, you have to burn 7700 Calories (1 gm of fat yields 9 Calories). In comparison, when you briskly walk 15 steps, you burn just 1 calorie! Or 10 minutes of moderate exercise/ walking burns 50 Calories. So how are you going to achieve that?Well, By reducing your intake and burning more Calories! Lets say, your daily requirement is 2000 Cal and you go for 1200 Calorie diet ( ie -800 cal) and you start brisk walking for 5 km/ 1 hour daily and burn around 300 Calories, you are in a deficit of 1100 Calories (800+300) i e YOU HAVE MANAGED TO LOSE 142 GMS IN A SINGLE DAY!! You can confirm that on your weighing scale! you should lose at a rate of 3-4 kg/month. Each one of us can design his/her own program by this calculation and predict results. Rate of weight loss will decrease over time because Caloric requirement of your body will also decrease. And that is why there is a role of weight training to increase muscle mass as it will increase your calorie expenditure at rest!
Next you should know how much calories a particular food item has! you can google it or can see the nutritional value printed on the packet itself. Keep a log of calorie consumed starting from your morning tea till your last meal of the day! It should be around 1200 per day and not less than this.
Now you are all set. I am not suggesting what you should eat and what you should not, because now you know that 1 Samosa can ruin your 25-30 minutes of exercise. By consciously making an effort of choosing your food wisely and burning more by choosing to remain active you are changing your life style! Congratulations!!!
You dont have to starve!! just choose your food wisely and remain active! Eat more of proteins (especially breakfast) and less carbohydrates and minimum fats. Proteins increase your metabolic rate also! Sugar substitutes can be used for short term! I am not going into the nitty gritty of percentage, RDA and other values etc . Developing the right attitutde is more important. Ofcourse, once you see the results you can do a research of your own! Know that 1 plain roti just has 60-80 calories. If you can take eggs, nothing like it!! 1 egg white has just 17 Calories. 4 egg whites will keep you full for at least 4-5 hours( less than 100 Calories) (If you have any allergies, are vegetarian or have renal disorder, consult your doctor). Prefer complex carbohydrates, food with low glycemic index and fresh fruits over canned juices.
You have to do this calculation of calorie intake and output for rest of your life. There will be days when you will cheat. Its ok! Go have that pizza, or ice cream or puri sabzi once or twice a week! But keep a tab on how much you have consumed! Constant calorie restriction slows down your metabolism so you can go out and let your hair down occasionally! Weigh yourself, see the mirror and start afresh!! There are no deadlines, remember! Because you are going for a life style change! When you repeat a particular act many times, it eventually becomes a habit!! (Remember, How home sick we were during the first year of our stay at hostel and 2-3 years later, whenever we went home we used to get hostel sick?! :) ) And If you can manage this for 3 weeks strictly, you will be out of your present comfort zone and will be amazed to see that your body is actually enjoying this new life style. (Your body always pulls you back towards your existing comfort zone, whenever you try to do something new!)
Eat slow, Use small plates and small portions
Do you know fast eating can make you gain weight? How? well, On an average it takes around 17- 20 minutes for your brain to register that your stomach is full. If you are a fast eater you will consume extra calories by that time.
A study was conducted at Cornell university, NY which concluded that most of the time we overeat due to hedonic pleasure! So taking a pause after eating little portion of pizza or ice cream or cakes, will make you feel as good as you would feel after consuming whole lot of it!! All that remains will be a memory of having eaten your favourite food! Believe me!
Similerly, eating in small plates will trick your brain into believing that you have enough already!!
Remain active. Short bursts of intensive activity is preferable followed by normal activity. Eg. You may run for 60 seconds then walk for 2 minutes and repeat the cycle. You can choose your favourite activity. Briskwalking/ jogging needs no special equipment, imvestment or place to begin.
If you are a busy person, have a passion or hobby to pursue you are in luck! Because boredom= hunger! Remain busy! Please Remain Busy!
Be in the company of those who follow healthy lifestyles, take advices, take feedbacks. Ask your partner/ family members/ friends to join you/ help you in achieving your goal! Indulge in a sport/ group activity. Have a Support system!
Dont fall in the trap of crash dieting. That is not physiological. They will make you lose body water, which you are sure to regain!
And after you finish reading this- Dont say ” I will follow a healthy life style” (future tense). Rather, stand in front of the mirror and say loudly to yourself and later to your friends, partner and others in your social circle- I am the one who follows a healthy life style”( Present tense). It is a very effective old psychological trick!!! (ref. BT)
I wish you success!!! Losing weight is not all that difficult! Believe! You are responsible for what you are today and you will be responsible for what you become tommorrow!
(With necessary inputs from my friend Dr Karthikeyan Raju, who has lost around 20 kgs in last 6 month.Kudos!)