Weight Loss 101

SLOW BURN When you eat processed foods you only burn half the calories after your meal compared to eating whole foods. 

If you ever needed an incentive to keep your weight in check, your health is it. With so many diseases linked to being overweight and obese, those few extra kilograms you put on during the year could add up to a whole lot of trouble over time. Preventing weight gain in the first place is the best way to avoid a lifelong battle of the bulge. In this Body Confidence Special, we look at how our lifestyle, attitudes to food and dieting impact our future health.

WHAT’S EATING US?

It’s easy to think that when someone struggles with their weight that they lack willpower. But it’s not as simple as that and what many of us are dealing with is a problem on a global scale – one that requires the food culture in our society to change before the problem can be addressed and reversed.

THE SAD TRUTH

The idea that we’re solely to blame for obesity is exactly what food producers want us to believe. Yet supermarkets and convenience stores are filled with processed foods that are hard to resist because they’re made to be addictive. By making foods as tasty as possible, food manufacturers increase sales but they also promote overeating. Some people experience strong food cravings or addiction and this applies particularly to sugary, high-fat junk foods that stimulate the reward centres in the brain. To make matters worse, these foods are often cheaper than good-quality fresh foods.

NOT SO SWEET

Scientists believe that added sugar may be one of the main causes of obesity. That’s because sugar changes our hormones and biochemistry when consumed in excess, and on average Singaporeans consume 12 teaspoons (or 60 g) of sugar daily based on the Ministry of Health. 

THE WORLD AROUND US

The link between screen use and obesity has been well established but it’s not just because it makes us sedentary. Artificial light from light bulbs, computers, phones and televisions changes our circadian rhythm or body clock, which also influences weight gain. 

A Tale Of Two Hormones

If diet and exercise haven’t helped you lose weight, a hormonal imbalance could be to blame.

1. INSULIN Insulin is a hormone that transports the glucose in our blood to the cells to be used as energy. The more glucose we eat, the more insulin we make. Because insulin also promotes fat accumulation and storage, high insulin levels are linked to the development of obesity. In The Obesity Code, Dr Jason Fung talks about the hormonal obesity theory which is based on the evidence that when patients are given high doses of insulin, they gain weight. It almost doesn’t matter how much they eat or how much they exercise, the weight keeps piling on.

Insulin resistance: Highly refined foods act in the same way as glucose or sugar in the body. Eat too many of them and you produce more insulin to keep up with the constant supply of glucose. Over time insulin resistance develops, which means the body no longer responds normally to the hormone. When this happens, even a change in diet can’t reduce insulin levels and you will struggle to lose weight. 

2. LEPTIN

Insulin resistance often leads to leptin resistance. Leptin is a hormone produced by fat cells and the more fat cells you have, the more leptin you accumulate in your blood. This explains why leptin levels are high in people with obesity.

Leptin resistance: High leptin levels are linked to a reduced appetite and when working properly send messages to your brain about your fat stores, to help indicate when you’ve had enough. The problem arises when we develop leptin resistance and the hormone no longer does its job, which is the case in overweight people. Once we develop leptin resistance, we’ve effectively lost our ‘fullness’ signals. 

WHAT TO DO Ask your GP to check for insulin and leptin resistance. Dr Fung also recommends intermittent fasting or eating three meals a day with no snacks. 

A RISKY HEALTH PROBLEM

As a nation we’re struggling to keep our weight within healthy limits yet we’re obsessed with six-packs, muscle tone and too-skinny bodies. Learning how to ‘measure’ your health is an effective tool to help keep your weight in check in the long term.

ARE YOU REALLY OVERWEIGHT?

The idealised body is flashed before our eyes at every turn: On television and social media, and in magazines and advertising. For women, that means super-thin while men are expected to be muscular. Women have long been placing their health at risk with fad diets and fasting, laxative misuse, compulsive exercising, and vomiting, to shrink themselves into what they believe is an acceptable size. Men on the other hand are more likely to abuse steroids along with diets and compulsive exercising.

WHAT’S RIGHT FOR YOU?

Body mass index (BMI) and waist circumference can help you find out where you stand in the weight stakes.

BODY MASS INDEX

Use it to measure your weight in relation to your height to find what category you sit in.

Normal weight: BMI of 18.5 to 24.9

Overweight: BMI of 25 to 29.9

Obesity: HMI of 30 or higher

WAIST CIRCUMFERENCE

Too much fat around your waist can increase health risks more than fat on other parts of your body. Women with a waistline of more than 80 cm and men more than 94 cm have greater risk of developing certain diseases. 

WEIGHING UP THE RISKS

Excess weight can damage your health and increase your risk of certain diseases and conditions - and many of the symptoms are associated with more than one disease.

TYPE 2 DIABETES

Prime Minister Lee Hsien Loong cited recently that one in nine Singaporeans has diabetes, and three in 10 over the age of 60 have the disease. The most common type of diabetes that affects most Singaporeans is Type 2 diabetes – a disease in which blood sugar levels are above normal.

Are you at risk? “Asians tend to accumulate more intra-abdominal (visceral) adipose tissue – the ‘harmful fat’ that places them at a higher risk of metabolic diseases,” said Dr Sonali Ganguly, a consultant at the Singapore General Hospital’s department of endocrinology.

HIGH BLOOD PRESSURE

Having a large body size has the effect of increasing blood pressure because your heart needs to work harder. Excess fat can damage your kidneys, which help regulate blood pressure. How will weight loss help? Weight loss that gets you close to the normal BMI range can significantly lower high blood pressure. Other helpful changes are to quit smoking, reduce salt intake, and get regular physical activity.

HEART DISEASE

Heart disease is the single biggest killer of Singaporean women, according to the Singapore Heart Foundation. Being overweight or obese bumps up your risk of heart disease, thanks to high blood pressure, high cholesterol and high blood sugar. Excess weight also makes your heart pump harder to send blood to all the cells in your body.

How can weight loss help? Losing five to 10 per cent of your weight can lower your risk of heart disease as weight loss leads to improvements in blood pressure, cholesterol levels, and blood flow.

STROKE

High blood pressure is the leading cause of strokes. Excess weight also increases your chances of developing other problems linked to strokes, including high cholesterol, high blood sugar, and heart disease. A stroke happens when the flow of blood to a part of your brain stops, causing brain cells to die.

How can weight loss help? One of the most important things you can do to reduce your stroke risk is to keep your blood pressure under control. Losing weight can help lower blood pressure, as well as improve cholesterol and blood sugar, which in turn lowers your risk for stroke. 

CANCER

Gaining weight as an adult can up your chances of developing certain cancers, even if weight gain doesn’t result in obesity. Experts believe cell growth is affected by fat cells and the hormones they release, leading to cancer.

How can weight loss help? Avoiding weight gain can help prevent a rise in cancer risk while losing those extra kilos through healthy eating and exercise will also contribute to the risk-lowering effect. How can weight loss help? Avoiding weight gain while losing those extra kilos through healthy eating and exercise will help prevent a rise in cancer risk.

SLEEP APNOEA

Sleep apnoea is a condition that causes one or more pauses in breathing during sleep. A sign you may be suffering from sleep apnoea is daytime sleepiness and poor concentration. Obesity is the most important risk factor for sleep apnoea. A person who is overweight may have more fat stored around the neck, narrowing the airway and making breathing difficult, or breathing may stop for short periods of time. And fat stored in the neck and throughout the body may produce substances that cause inflammation in the neck is a risk factor for sleep apnoea.

How can weight loss help? Weight loss usually improves sleep apnoea by helping to decrease the size of the neck as well as reducing inflammation.

WHEN YOU EAT MATTERS

Research has shown that eating your evening meal before 9 pm or at least two hours before bed could lower the risk of breast cancer by 20 per cent compared to eating after 10 pm or going to bed soon after eating. 

WHEN YOU’RE PREGNANT

Gaining too much weight during pregnancy can have long-term effects for you and your baby. You could be at risk of:

● Developing gestational diabetes.

● Having preeclampsia (high blood pressure during pregnancy that can cause severe problems for both mother and baby if left untreated).

● Needing a C-section.

● Babies of overweight or obese mothers are at an increased risk of being born too soon, being stillborn, and having a neural tube defect.

● Another risk is that the baby may gain too much weight later in life.

How can weight loss help? If you are overweight or obese and would like to become pregnant, talk to your doctor about losing weight first, to reduce your chances of developing weight-related problems. Pregnant women who are overweight or obese should speak to their doctor about limiting weight gain and how to be physically active during pregnancy. 

Your Health Safety Zone

Keep these numbers in the normal range to help prevent disease.

BMI 18.5-24.9 = general healthy weight range

WAIST Below 80 cm = healthy waist measurement for women Below 94 cm = healthy waist measurement for men

CHOLESTEROL Total cholesterol = less than 5.5mmol/L LDL cholesterol for ‘bad’ cholesterol) = less than 3.5mmol/L

BLOOD GLUCOSE 4.0-6.Ommol/L = healthy fasting blood glucose level

BLOOD PRESSURE 120/80 or less = normal blood pressure 

Tip: Don’t let old habits, stress or boredom undermine your weight-loss efforts. Pack healthy snacks, such as apple slices or almonds. 

WHAT’S YOUR MIND GOT TO DO WITH IT?

Our emotional health plays a significant part in how we eat and how food affects our bodies.

THE STRESS FACTOR

In a UK study, researchers found a definite link between stress and obesity – the higher the levels of the stress hormone cortisol, the greater the body weight, BMI, and waist circumference. Higher cortisol levels were also associated with long-term obesity.

Looking for comfort: Some people lose their appetite when they’re stressed while others turn to high-fat, high-sugar snacks to reduce their stress response. Not surprising then that when we make a habit of eating in response to emotional triggers like stress, rather than hunger, we have difficulty keeping weight off.

FEELING BLUE

A research had shown that close to six per cent of the adult population in Singapore had suffered from Major Depressive Disorder at some time in their lifetime. If you are suffering from a bout of depression you will probably notice that your appetite, energy levels, self-esteem and weight are affected. Depression can make you feel lethargic so you might find yourself moving a lot less than usual and possibly eating unhealthy convenience foods because you haven’t got the energy to shop and cook healthier options. A low or flat mood can also make you turn to food as a source of comfort, leading to overeating.

Avoid sneaky weight gain: Don’t beat yourself up but do your best to continue with healthy habits whenever you can – home-cooked meals are a better option than most takeaways because they’re likely to contain less sugar, salt and unhealthy fats. 

CHANGE YOUR MEDICATION

Medications like certain antidepressants can lead to weight gain quite quickly because they reduce the number of calories burned and may increase appetite. Talk to your doctor about trying a different medication, if available.

PSYCHOLOGY CAN HELP

Weight loss often relies on addressing the underlying factors that caused the weight gain in the first place, such as stress, anxiety, boredom, work problems, relationship issues, a traumatic event. A weight-loss psychologist can help you identify the issues that may be holding you back and give you a real chance of permanent weight control. Is it for you? If you can relate to comfort eating, yo-yo dieting or erratic bursts of fitness enthusiasm, this is definitely worth a try. Find a therapist at Singapore Counselling Centre or visit www.scc.sg/e/eating-disorder

CONSIDER HYPNOTHERAPY

Hypnotherapy can help you access and tackle problems using a state of deep mental relaxation. If you’re someone who uses food as comfort or to satisfy an emotional need, you may overeat or eat badly and put on weight. You might do this out of fear or frustration, an inability to cope with responsibility and risk, need for love or nurturing, to cover unhappiness, to suppress anger, and in some cases even to create a physical barrier of fat as protection from hurt.

How does hypnotherapy help? Hypnosis can help people disconnect from patterns of compulsive or emotional eating and support new, positive thoughts and actions. 

TOP TIP

Try on your snug jeans for size every week. According to Brian Wansink, a weight-loss expert from Comell University, your jeans are the best alarm for weight gain. Research at a prison found that inmates gained about 10 kg in six months – in spite of the tasteless food and plenty of time to exercise – without realising it because their baggy jumpsuits gave no feedback! 

A Case Of Mistaken Identity

Studies have shown that women often perceive their bodies as heavier than their ideal and as heavier than men prefer. The reverse is also true – most men estimate women prefer a male body about 14 kg more muscular than their own body. 

DO YOU HAVE METABOLIC SYNDROME?

Metabolic syndrome is a cluster of conditions that occur together and put you at greater risk of heart disease, stroke, and diabetes. Metabolic syndrome and abdominal obesity go hand in hand. You have metabolic syndrome if you tick yes to three or more of these issues: 

◘ Fat around the middle

◘ High triglycerldes

◘ Low HDL (good) cholesterol

◘ High blood pressure

◘ High blood sugar 

IT’S ALL ABOUT YOU!

There always seems to be someone who benefits from a particular eating style and it’s easy to think that it will be the solution for us, too. Weight-loss experts say that the key is to focus on why you want to lose weight: Is it because you want to improve your health, have more energy or help you to feel more confident about your body? Having a goal in mind, and finding an eating plan that will help you work towards that goal is the best plan of action.

THE SCIENCE OF EATING

Some carbs are good, some are bad, fat is good, fat is bad and on it goes… With many new “proven” ways to eat, it can be hard to know what to believe. Here we take a look at what the food science shows.

CARBS UNDER THE MICROSCOPE

A study into low-carb diets found that low-carbers burnt off the most energy when compared to participants on moderate and high-carb eating plans.

Energy: Those on a low-carb diet (20 per cent carbs) burnt 219 kcal more than the high-carbers, and those having moderate carbs (40 per cent) burnt 95.6 kcal more than high-carbers (60 per cent).

Insulin: When tested on participants with insulin resistance, the low-carb diet offered an unexpected health bonus. They burned 310.7 kcal more than high-carbers with insulin resistance.

Leptin: The low-carbers had a healthy leptin response so their fullness signals were working well compared with high-carbers.

Ghrelin: This hormone sends hunger signals and was much lower in the low-carbers than high-carbers.

RECIPE FOR SUCCESS

A report from the International Association for the Study of Obesity states that if we cut the carbs we will start to eat fewer calories automatically and without going hungry - and most importantly, we cut sugars and starches, like refined grain products, white rice, and added sugar. Now instead of burning carbs for energy, your body starts feeding off stored fat. Another benefit of cutting carbs, the report says, is that it lowers insulin levels.

Fill the gap: Now that you’ve ditched the bad carbs, fill your plate with protein like meat and fish, and healthy fats like olive oil, avocados and nuts. 

Expert advice: The secret is not to be afraid of eating fat – healthy fats, that is – as trying to do both low-carb and low-fat at the same time is a recipe for failure. Plus, you’ll feel miserable eating this way. 

Break Your Fast… Later

Daily fasting is an effective tool to reduce weight and lower blood pressure, according to a recent US study. Time-restricted eating is a form of fasting that limits food consumption to a particular time frame. Also called the 16/8 diet, all that is required is that you eat within an eight-hour window, then fast for the other 16 hours. “The 16/8 diet is another tool for weight loss that we now have preliminary scientific evidence to support,” say the researchers. 

The Keto Worked For Me… To A Point

I’d yo-yo dieted most of my life and had great success with WeightWatchers, but I put all the weight back on – and more – after my second pregnancy. After this, I felt like nothing worked. No matter how little I ate or how healthy my food choices were, the weight just stayed but also slowly increased. By the time I was 45, I was 12 kg heavier than after my first pregnancy. My doctor suggested the keto diet. It worked for me, to a point. I didn’t really enjoy the food because it involved eating a lot of eggs and meat, but I never went hungry and that was a nice change. I was amazed how quickly the weight fell off but, after a year, the occasional slice of toast or two slipped back into my diet, and before I knew it, I’d put it all back on and more. I couldn’t believe it because I wasn’t overeating at all. It was a valuable lesson for me though, because I now know that, in the long-term, I just can’t stick to a diet that doesn’t allow me to eat a little of what I like. 

– anonymous keto dieter 

Tailored For You

Fitgenes is a test that analyses as many as 81 genes involved in fat metabolism and weight management, such as identifying how your body processes carbs and which type suits you best. Along with your results, you’ll be given a programme that combines exercise, dietary and lifestyle recommendations, based on your test results and what you’re trying to achieve. Find out more at fitgenes.com 

Are You An Emotional Eater?

It’s not unusual for 40 to 80 per cent of a person’s eating in a day to be non-hungry eating, so that’s bingeing, over-eating and emotionally eating. You might find yourself reaching for food when you’re bored, sad, angry, or stressed, without a hunger pang in sight. Get help: The solution seems simple – wait for hunger signals before you eat. But it can be surprisingly difficult, especially if you have been blissfully unaware that you might be eating for reasons other than hunger. Allowing yourself to go hungry from time to time will help you better recognise the feeling, but the best way to tackle emotional eating is to consult a psychologist who can help you get to the root of the problem. 

USEFUL CONTACTS

Ministry of Health www.moh.gov.sg

Singapore Heart Foundation www.myheart.org.sg

Ministry of Communications and Information www.mci.gov.sg

Singapore Nutrition and Dietetics Association www.snda.org.sg 

ACKNOWLEDGEMENTS

This health guide has been compiled using information from Ministry of Health Singapore and The Straits Times.

GENERAL NOTE

This is intended as a general introduction to the topic and in no way should be seen as a substitute for your own doctor’s or health professional’s advice. All care is taken to ensure that the information contained here is free from error and/or omissions, however, no responsibility can be accepted by the publisher, author, editor or any person involves In the preparation of the material for loss occasioned to any person acting or refraining from action as a result of the published information. Before commencing any health treatment, you should always consult your doctor. 

TEXT: BAUERSYNDICATION.COM.AU / ADDITIONAL REPORTING: SEAH PEI JUN / PHOTOS: 123RF.COM