The majority of people around the world aren’t happy with their current weight and are constantly searching for new weight loss ideas. I’ve gathered a few weight loss tips that might help you to achieve your goals.
However, first I’d like to discuss several important topics about weight and weight loss.
What is obesity?
Obesity is a complex, multi-faceted disease. Almost 98 million adults in the United States are overweight or obese.
We’ve limited knowledge about the causes and physiology of obesity. As a result, it’s difficult for us to treat this condition.
The definition of obesity
In the medical literature, the obesity classification is based on body mass index or BMI.
Here are the BMI formulas:
An individual’s weight (in pounds) times 703, then divided by their height (in inches)
The individual’s weight (kg) divided by their height squared (m2 )
Most experts agree on the following BMI classifications:
Normal 18.5–24.9 kg/m2
Overweight 25 to 29.9 kg/m2
Obesity ≥ 30 kg/m2
Research suggests that measuring waist circumference might be more accurate than using BMI as a tool to assess the risks associated with obesity and overweight.
How to measure waist circumference correctly
It’s important that you use the proper measurement techniques. Otherwise, the results will be incorrect.
Steps you should take to measure your waist circumference
- To measure the waist circumference you should be in a standing position with the feet close to each other.
- Place a flexible tape measure above the hip bones around your abdomen and parallel to the floor.
- The tape should be snug around the body but not too tight.
- You should exhale the air before measuring the abdomen circumference.
To obtain an accurate measurement, it’s important that you relax the abdominal muscles. Otherwise, pulling the muscles in, could result in artificially low values.
The stomach should be empty therefore you should fast for at least 8 hours before measuring the circumference. Waist circumference can artificially increase if the stomach and intestine contain gas and food.
Waist circumference ranges
Most organizations agree that men with a waist circumference of more than 40 inches (102 cm) and women larger than 35 inches (88 cm) are at higher risk for complications.
These numbers are different for the South Asian population. Research shows that in this population, waist circumference is more accurate than BMI in estimating the risk of complications.
Obesity is associated with increased risk for cardiovascular disease, such as heart attack and stroke, diabetes, hypertension, high blood cholesterol and triglycerides levels, sleep apnea, arthritis and gallstones.
Weight loss treatment
It’s difficult to achieve and maintain a weight loss goal. For decades, people have searched for answers by adopting different fad diets and intense exercise routines. Unfortunately, most of these interventions aren’t effective and fail in maintaining the weight loss success that individuals have achieved at the beginning.
The mother of all weight loss tips
I’d like to analyze the steps that are vital to weight loss and, most importantly, being able to maintain what you have achieved.
Consistency is important. The weight of many individuals fluctuates on a regular basis. This so-called yo-yo effect can harm these individuals’ health. That’s why I always emphasize weight gain prevention as the primary approach.
An individual who is able to prevent continuous weight gain will have a much greater chance of losing and maintaining weight over the long-run.
Stop gaining weight
Studies have shown that people will gain weight when they get older. Therefore, aging causes weight gain on its own. If you’re able to prevent three to five pounds of weight gain each year, it would mean that you’ve lost three to five pounds of weight that specific year.
To be able to prevent weight gain, we’ve to understand its causes. Here is a list of known weight gain causes that you should be aware of.
- Hormonal imbalance
- Physical inactivity
- Unbalanced nutrition
- Eating disorders
There are other reasons for weight gain that are related to diseases causing fluid retention, such as heart failure, that I won’t address here.
Individuals who could be harmed by weight loss
To have a healthier life, the majority of people would benefit from weight gain prevention and a large number of people would need to lose weight. However, there are groups of people in whom risk of weight loss might be greater than the benefits.
Here is a list of this population
- Pregnant women
- Individuals with uncontrolled psychiatric illnesses
- Individuals with history of anorexia nervosa or bulimia
- People with active substance abuse issues
Four pillars of a healthy weight
Most weight loss tips are based on four major pillars. if you’re not able to devote sufficient attention to any of these pillars, then your weight loss won’t be effective and you’ll have difficulty maintaining this weight loss.
These are the four pillars:
- Optimized and tailored diet
- Well-planned physical exercise
- Behavior modifications
- Effective support system
Every person, including you, will need to work on all these four pillars. Optimally, these pillars should match to each individual’s specific needs.
For instance, even though you might have a good exercise routine, you still might need some help with behavior modifications and diet optimization.
People aren’t the same. Thus, each person needs an individual evaluation and an understanding of his specific needs.
In my opinion, a lack of individualized planning is the main reason for an unsuccessful weight gain prevention and weight loss attempt.
Let me explain a little more about each one of these pillars.
Optimized and tailored diet
In this section, I like to discuss the ways to optimize your diet and to answer the following question from one of my patients: “What should I eat to lose weight?”
Research shown that a lower calorie intake will result in weight loss. It means that if the energy intake is lower than energy expenditure, you’ll lose weight because your body uses more energy than it takes in.
Research suggests that to lose around one to two pounds per week, you need to eat 500-1000 less calories each day.
Losing a large amount of weight in very short time increases your risk of regaining weight.
Almost all the commonly known fad diets rely on reducing total energy intake to cause weight loss. There are many variations of the common fad diets such as low carb diet, low fat diet, high carb diet, high protein diet etc.
Therefore, if you decide to eat fewer carbohydrates, you need to increase protein and/or fat intake. If you decide to increase fat consumption, then you’ll end up eating more carbohydrates and/or proteins.
The fact is that if you reduce one food group, you might end up eating larger amounts of other food groups.
What to eat to lose weight
I’m going to dedicate other articles to discuss this issue in more detail. However, in general and, most importantly, you should limit the consumption of processed foods.
Most processed foods are full of sugar, fat and salt. If you consume these three products in excessive levels, they can harm you. Therefore, all candies, sodas, snacks and sugary drinks should be eliminated or strictly limited.
I’d also suggest eating about five servings of vegetables and two servings of fruits each day.
Otherwise, you should eat all other natural foods based on the needs of your body (here you should work closely with your doctor). This includes foods such as rice, meat, dairy products and potatoes.
It’s often easy to know what to eat but difficult to maintain discipline. It would, therefore, be beneficial to have a support system that can help you to stick to the plan.
Go to our nutrition page for further reading.
Well-planned physical exercise
Exercise is essential in strengthening your muscles and burning calories. To burn calories, you’re going to need aerobic or cardiovascular exercise.
In my opinion, the best exercise is walking.
Walking for weight loss
Walking is free and very effective. You don’t have to pay for a club membership and you can do it anytime you want. More importantly, the risk of injury from walking is very low.
The American Heart Association recommends 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise each week.
Brisk walking is a moderate intensity exercise and it’s suitable for weight loss.
Examples of moderate intensity exercise
- Brisk walking
- Water aerobics
- Ballroom dancing
- Biking (slower than 10 miles per hour)
Examples for vigorous intensity exercise
- Jogging and running
- Biking (faster than 10 miles per hour)
- Jumping rope
- Heavy gardening
- Tennis (single)
In addition to a tailored nutrition program and exercise plan, you need to identify the flaws in your health behavior.
For instance, it’s important for you to know “how to eat” in addition to know “what to eat”. To have a better insight into the optimal eating behavior, I suggest that you read my e-book “A Simple Guide to the Secrets of Healthy Eating”.
There are other behaviors that are related to sleep quality and stress management. You can achieve a much healthier body and mind with an appropriate behavior modification strategy.
Effective support system
Studies have shown that to maintain a successful weight loss program, you would benefit from a an effective support system.
This system could be a group of friends, family members and/or other people who are also trying to lose or maintain their weight.
You’ll often need somebody who can encourage you and guide you through difficult times until the habits that you’re trying to adopt engrave in your body and mind.
Types of weight loss surgeries
In the past few years, we’ve a larger number of invasive and less invasive weight-loss surgeries that we can choose from.
- Roux-en-Y Gastric Bypass
- Vertical Banded Gastroplasty
- Sleeve gastrectomy
- Duodenal switch with biliopancreatic diversion
- Gastric balloon
It’s important to know the difference between open and laparoscopic surgery. In open surgery, the surgeon opens the abdomen with a large single cut.
Laparoscopic surgery is less invasive. The surgeon enters the abdomen through three to four small holes using surgical tools and a camera.
The benefits of laparoscopic surgery include its faster healing process and lower rate of complications.
Indications for bariatric surgery procedure
Here is a list of candidates who would benefit from bariatric surgery procedures.
Adults with BMI of more than 40 kg/m2 who do not have any other major medical conditions.
Adults with BMI of 35 to 39.9 kg/m2 with at least one serious medical condition. Here is a partial list of these conditions:
- Type 2 diabetes
- Sleep apnea
- Severe acid reflux disease
- Uncontrolled arthritic pain
- Non-alcoholic fatty liver disease
- Venous stasis disease
Patients who shouldn’t get weight loss surgery
For many patients with uncontrolled obesity and serious medical conditions, bariatric surgery could make a difference. However, there are groups of individuals who shouldn’t have the bariatric surgery due to concern over future harm.
- Uncontrolled depression and other mental conditions
- Individuals with a predisposition for having blood clots or bleeding
- Active dependency on drugs and illicit substances
- Severe heart disease
- Individuals who are not able to follow their nutritional requirements
Pre-procedural assessment of bariatric surgery candidates
Each individual who plans to undergo bariatric surgery should have an extensive pre-operative evaluation including: psychological, physical and nutrition assessments.
Common weight loss procedures
The weight loss or bariatric procedures are divided into two major groups. They work by causing restriction and, therefore, limit the food intake or by causing malabsorption and reducing the food absorption into the body.
The most common form of bariatric surgery that combines restriction and malabsorption is the Roux-en-Y Gastric Bypass.
Roux-en-Y Gastric Bypass
In this surgery, the surgeon first staples the stomach and creates a small pouch. He then cuts the small intestine and attaches it to the stomach pouch.
The gastric bypass can achieve two goals simultaneously. First, a smaller stomach makes you want to eat less and causes you to feel full faster.
In addition, by connecting the small stomach to lower part of the small intestine, less food is absorbed and consequently the energy intake decreases.
Weight loss range
A study that followed gastric patients for three years reported an average 90 pounds weight loss after gastric bypass surgery.
Gastric bypass harms
We hear a lot about the benefits of weight loss, especially gastric bypass surgery. However, this surgery has also its own known drawbacks. I’ve listed few of the established problems with this surgery.
- Vitamin deficiency
- Dumping syndrome (causing diarrhea, abdominal pain, sweating, nausea with ingestion of high sugar meals)
- Small bowel obstruction
- Kidney stones
- Kidney failure
This procedure was the most common bariatric surgery performed around the world, including United States, in 2016.
In this procedure, the surgeon removes a large part of the stomach. It results in a much smaller stomach and, therefore, causes much earlier satiety. This procedure is easier to perform than Roux-en Y gastric bypass.
Sleeve gastrectomy complications
- Stomach leaks
- Acid reflux
Vertical Banded Gastroplasty
The gastric banding procedure is an example of purely restrictive bariatric surgery. In this operation, the surgeon places an adjustable band around the upper portion of the stomach.
The amount of weight loss achieved with this procedure is lower than other bariatric surgeries. This is probably the reason why the number of these operations has been declining.
This procedure is primarily a laparoscopic operation. Therefore, the rate of complications is very low.
Possible adverse outcomes of gastric banding
- Port infection
- Band erosion
- Stomach obstruction
Duodenal switch with biliopancreatic diversion
This switch and diversion surgery is a combination of a restrictive and malabsorptive procedure. It’s a complex operation. Therefore, few centers in the United States are capable to perform this procedure.
In this procedure a saline filled balloon placed into the stomach, causing early satiety and fullness.
Studies report a 6.5 kg weight loss in patients treated with gastric balloon.
FDA-approved weight loss pills
The pharmaceutical companies have recognized the great need for an effective weight loss pill. In recent years, the FDA has approved several weight loss pills.
Experts suggest using weight loss pills to treat individuals with a BMI of more than 30 kg/m2 or all individuals with a BMI more than 27 kg/m2 and one of the major risk factors or diseases (including hypertension, hyperlipidemia, diabetes, heart disease, stroke and …).
The following is a list of these medications:
The FDA approved this medication in 1990s. It has been available over the counter in the United States since 2007.
Orlistat can cause a modest weight loss of approximately 5.8 kilograms. The side effects of this medication include flatulence and a loose stool.
There have been some reports of serious adverse effects, such as kidney stones and kidney failure from the use of this medication.
This weight-loss medication regulates the appetite by activating serotonin receptors. This medication can also result in around 5.8 kg of weight loss. However, the effect of this medication diminishes with time.
This is a combination of a stimulant and an anti- seizure medication. Using a higher dosage of this drug will result in more effective weight loss. In studies, most patients on a higher dosage of phentermine/topiramate were able to lose about 5% of their body weight.
A phentermine/topiramate combination has shown to increase the rate of depression that was four to seven times higher in patients treated with this medication compared to the placebo group.
This combination can also reduce the estradiol (estrogen) blood level and, therefore, diminish the effect of contraceptives.
This drug is a combination of an antidepressant and opioid receptor blocker. A 28 week study reported a 5% weight loss in patients treated with this drug combination, compared to patients on a placebo. Nausea is the most common adverse effect of this medication.
Weight loss tips-summary
I’ve discussed several topics relate to weight and weight loss, including diagnosis, treatment and prevention. The four pillars of any successful weight loss plan relies on optimized and individualized nutrition, tailored physical activity, appropriate behavior changes and an effective support system.
The most important strategy to achieve a healthier weight is to prevent weight gain. This is an easier way of managing weight compared to losing weight.
Although, a conservative management based on these four pillars is the preferable way of managing weight, there are other more invasive treatments including medications and surgery.
Back to you.
Please send me your questions and experiences about this topic. Have you tried any weight loss methods in the past? What are your thoughts about weight loss and the commonly known weight loss methods?
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