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Weight Loss

by Meredith Beil BPharm MNutr & Alice Downing APD, MDiet & BHumNutr

Weight Management

More than 60% of the adult Australian population is overweight or obese, with rates rising across all age and socioeconomic groups. Being overweight or obese significantly increases health risks, which shorten our lives and decrease our quality of life. Weight loss of 5-10% of body weight that is maintained long-term, is proven to provide significant health benefits.

Body Mass Index (BMI) Weight Categories

BMI (kg/m2) measurements are useful for population assessments, but are not always relevant for individuals due to differences in muscle mass.

BMI

Underweight

Healthy Weight Range

Overweight

Obese

Morbidly Obese

Value

<18.5

18.5-24.9

25-29.9

30-39.9

>40

Waist Circumference & Health Risk

A more useful indicator of health risk (due to excess body fat) is waist circumference, which indicates abdominal fat mass. Excess weight in this area is associated with increased risk of chronic illness as the adipose tissue in this area secretes harmful chemicals.

Waist Measurement Classifications

Slight Increase In Health Risk

Slight Increase In Health Risk

Substantial Increase In Health Risk

Caucasian

Asian

All Nationalities

Men

>94cm

>90cm

>102cm

Women

>80cm

>80cm

>88cm

ealth Risks of Obesity

Excess body weight is detrimental to health with obesity being a major risk factor for cardiovascular disease, Type 2 Diabetes and some cancers. Scientific research shows that a weight loss of 10% decreases diabetes-related deaths by >30% and obesity-related deaths by at least 40% whilst reducing blood pressure and improving cholesterol readings significantly.

Other health risks of excess body weight include osteoarthritis, GORD, sleep apnoea, kidney disease, respiratory disease, Gout, hormone and fertility problems, and depression.

Energy Balance & Physical Activity

Weight changes reflect a prolonged imbalance of ENERGY IN versus ENERGY OUT. Put simply, if you consume less energy (KJ) than you use, you will lose weight.

Basic Weight Loss Equation

Energy IN

<

Energy OUT

Food & Drinks

Weight Loss

Physical Activity 10-40%

Food Digestion 5-15%

Resting Metabolism 45-85%

Both sides of the equation need to be addressed. Reducing KJ intake without adequate physical activity will result in loss of muscle mass and reduced metabolic rate. Evidence shows that moderate to vigorous exercise for at least 1 hour per day is associated with long-term body fat reduction and weight loss. Remember, any physical activity is better than none. Australia’s Physical Activity & Sedentary Behaviour Guidelines for Adult’s recommend 2.5 -5.0 hours of moderate intensity activity OR 1.5-2.5 hours of vigorous activity OR a combination of both, per week.

Dietary Approaches to Weight Loss

Dietary changes need to be able to be maintained and research shows that overly restrictive diets or fad diets may be nutritionally deficient and unsustainable. It is vital that any eating plan is consistent with dietary guidelines such as the “Australian Guide to Healthy Eating” (www.eatforhealth.gov.au). Seek advice from an accredited practising dietitian (APD) for tailored advice to support sustainable weight loss.

edications & Surgical Procedures

Your health care practitioner may recommend medication or surgical procedures for weight loss. Discuss supplements and complementary medicines with you GP prior to starting. Bariatric surgery has proven to be the most successful intervention for severe obesity, but may not be appropriate for everyone.

Successful Long-Term Weight Loss Tips

· Low added sugar, low fat & moderate protein intake

· Eat a nutritious breakfast every day

· Exercise regularly & reduce screen time/sedentary activity

· Monitor weight regularly ( weekly or fortnightly)

· Seek support from a health care professional (GP & APD)

Remember, long-term behavioural modifications and gradual healthy weight loss will lead to a healthier you.

References

1. ABS 4338.0 Profiles of Health, AUSTRALIA 2011-13. http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4338.0~2011-13~Main%20Features~Overweight%20and%20obesity~10007. Retrieved 03/08/2014

2. Australian Government, Department of Health & Ageing, National Health & Medical Research Council. NHMRC Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia 2013 http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n57_obesity_guidelines_130531.pdf Retrieved 03/08/2014

3. Melanson KJ, Angelopoulos TJ, Nguyen V et al, 2008. “High fructose corn syrup, energy intake & appetite regulation.” American Journal of Clinical Nutrition. http://ajcn.nutrition.org/content/88/6/1738S.short. Retrieved 03/08/2014

4. Nutrition Volume 23, Issue 2, February 2007, Pages 103–112 Effects of high-fructose corn syrup and sucrose consumption on circulating glucose, insulin, leptin, and ghrelin and on appetite in normal-weight women Kathleen J. Melanson, Ph.D., R.D., L.D.a, Linda Zukley, M.A., R.N.b, Joshua Lowndes, M.A.c, et al.

5. Regulatory Peptides Volume 161, Issues 1–3, 9 April 2010, Pages 87–91 Fructose affects enzymes involved in the synthesis and degradation of hypothalamic endocannabinoids. Charlotte Erlanson-Albertssona, Andreas Lindqvistb, c, ,

6. Australian Institute of Health & Welfare www.aihw.gov.au

7. US National Weight Control Registry www.nwcr.ws

8. Jung R. Br Med Bull 1997;53:307-21.

9. Tate DF et al. Am J Clin Nutr 2007; 85:954-9.

10. Pittler & Ernst Am J Clin Nutr 2004;79:529-36.

11. Sjostrom L et al N Eng J Med 2007;357:741-52.