Healthy weight

Lifestyle changes including changes in eating, exercise and behaviour are the first steps to lose weight successfully. In some cases, weight loss medications can help in addition to lifestyle changes. A medical doctor can prescribe suitable medication when indicated and safe for that person. In people who have severe obesity and when lifestyle changes have been unsuccessful, weight loss surgery can be considered. Weight loss surgery does have risks and may not be financially feasible but should be discussed with a medical doctor.

Modern lifestyles include motorized transport, less physical activity at work, more time spent sitting in front of a TV or computer, and less active leisure time. Most people are leading much less active lives compared to even 10 or 20 years ago. Exercise is often seen as a sure way to lose weight. Yet, to increase exercise requires more fuel, which stimulates weight loss but also increases appetite. In a modern environment where food is plentiful, it is easy to compensate for the fuel expended in exercise by increasing food intake. Therefore, exercise alone is seldom a recipe for successful weight control.

Gradual and sustained weight loss is best achieved by combining a healthy eating pattern with regular physical activity. Individuals should aim for at least 150 minutes a week of moderate intensity physical activity – any activities that increases heart rate and breathing rate. Individuals who exercise even more or at higher intensity achieve better results and are more successful at maintaining weight loss. Exercise should include some activity that strengthens muscles and maintains muscle mass such as weight training, body-weight exercises, heavy gardening or yoga. Weight loss that occurs too rapidly may result in a loss of muscle tissue, which can lead to a plateau in weight loss thereafter or weight regain.

If you are not currently exercising or very unfit then it is important to start slow and build up gradually as your fitness levels increase. An exercise professional like a biokineticist or personal trainer can develop a personalised plan and provide ongoing supervision. Read more about exercise here.

To achieve weight loss, a reduction in energy intake from foods of approximately 2 000KJ (500 calories) less per day than usual is needed. In doing so, the body starts to use some of the stored fat reserves for energy.  There is not one specific diet that is best to achieve weight loss, rather it is more important to find a new eating pattern that suites the individual and that can be sustained long-term.

A variety of dietary approaches can be used to effectively lose weight, as long as the amount of energy from food and drinks is reduced in doing so: 

• Mediterranean-style diet
• Higher protein diets
• Low-carbohydrate diets
• Low-fat diets
• Low kilojoule diets
• Low-fat vegan style diets
• Lower fat and high dairy diets
• Diets than include meal replacements or structured meal plans
• Commercial weight loss programmes that use one of these approaches

The key therefore lies in finding a dietary approach that suites the person’s lifestyle and taste preferences. It is also important to consider any existing medical conditions when deciding on a dietary plan. For detailed and personalised nutritional support and meal plans, contact a registered dietitian near you.

General nutrition weight loss tips

Eating to lose weight is not only about eating less energy to start burning fat. Different foods can increase or decrease the risk for disease such as high blood pressure, diabetes and heart disease. Read more about the foods that form part of a healthy diet here.

In addition to making healthy food choices, these tips can be useful to lose weight, irrespective of the dietary strategy followed:

• Create a regular eating routine on a daily basis.
• Reduce portion sizes
• Eat slowly and mindfully
• Limit the intake of drinks that contain unnecessary energy, such as sugary drinks and alcoholic beverages
• Plan ahead for meals, particularly what to eat at work or school
• Drink plenty of clean fresh water
• Increase the amount of non-starchy veggies as part of meals or snacks
• Choose higher fibre or wholegrain foods instead of refined starches, to stay fuller for longer
• Limit foods that contain added sugar or fats
• Get support and encouragement from friends and family

Weight loss is not only about the foods eaten and amount of exercise, but also about why people behave in a certain way. Most regular habits, good or bad, are established over time by repeating them many times. Breaking bad habits and creating new, better habits in their place can be particularly difficult. It is important to consider the obstacles to change, readiness to change, motivation, and the external factors that influence eating and exercise habits. Behaviour therapy includes strategies to self-monitor progress, to be more mindful about what and how to eat, and changing thought patterns. It also uses strategies like goal setting, problem-solving, stimulus control, and planning ahead to avoid possible obstacles. In addition to nutrition and exercise professionals, a psychologist or counsellor can help to implement behaviour strategies to effectively lose weight.

Weight loss is not only about the foods eaten and amount of exercise, but also about why people behave in a certain way. Most regular habits, good or bad, are established over time by repeating them many times. Breaking bad habits and creating new, better habits in their place can be particularly difficult. It is important to consider the obstacles to change, readiness to change, motivation, and the external factors that influence eating and exercise habits. Behaviour therapy includes strategies to self-monitor progress, to be more mindful about what and how to eat, and changing thought patterns. It also uses strategies like goal setting, problem-solving, stimulus control, and planning ahead to avoid possible obstacles. In addition to nutrition and exercise professionals, a psychologist or counsellor can help to implement behaviour strategies to effectively lose weight.

If someone is overweight and they have other risk factors for cardiovascular disease and cardiocerebro disease such as high blood pressure, cholesterol or glucose, then even 2 – 5 kg of weight loss can produce significant health benefits, with greater weight loss providing even greater benefits. Weight loss is likely to improve:

• Triglycerides (levels of fat in the blood)
• Blood pressure
• LDL- and HDL–cholesterol
• Fasting blood glucose and HbA1c in people with diabetes
• Risk of developing type 2 diabetes
• Risk of heart disease and strokes

Body Mass Index

Body Mass Index (BMI) is commonly used to classify weight in relation to height and a high BMI means someone is too heavy for their height. BMI may not be accurate in people who are very muscular like athletes or rugby players. Even people with a normal BMI can still have excess weight around their stomach, therefore BMI is best used in combination with waist circumference. BMI is only suitable for adults because children need to have a BMI score calculated specific to their age. Ask a health care professional to do this.

Calculate BMI by dividing weight in kilograms by height in metres twice, e.g., (90kg/ (1.8m x 1.8m)) = 27.8kg/m2.

Waist circumference

The distribution of excess weight around the body matters. That’s because the type of fat that accumulates around the stomach area, called abdominal fat, is more dangerous than subcutaneous fat – the fat underneath the skin, spread across the rest of the body. Abdominal fat, also commonly called visceral fat, is more likely to cause diabetes, abnormal blood cholesterol, high blood pressure, and heart disease. Waist circumference measures abdominal fatness by a measurement in centimeters around the waist, at the level of the belly button.