Obesity is one of the largest epidemics in the world, showing steady growth in the last decades. The treatment of obesity requires a combination of three factors: diet, exercise and changes in lifestyle. Eventually it becomes necessary to use weight loss remedies. In more severe cases, bariatric surgery may be indicated.
We define obesity when the individual has a body mass index (BMI) greater than 30 kg/m². The BMI is easily calculated using the formula:
BMI = Weight (in kilograms) ÷ Height² (in meters)
The classification based on BMI is as follows:
Weight = BMI less than 18.5 kg/m²
Normal weight = BMI between 18.5 and 24.9 kg/m²
Overweight = BMI between 25 and 29.9 kg/m²
Obesity grade I = BMI between 30 and 35 kg/m²
Obesity grade II = BMI between 36 and 39.9 kg/m²
Morbid obesity = BMI greater than 40 kg/m²
Before you start a weight-loss treatment, you need to measure your BMI and your patient's waist circumference. We know that an abdominal circumference greater than 88 cm in women and 102 cm in men is associated with a higher prevalence of obesity-related diseases such as hypertension, diabetes and heart disease. Therefore, the higher the BMI and waist circumference, the more "aggressive" the plan should be for weight loss.
It is important not to create unrealistic expectations at first. Most obese patients, encouraged by the media and misleading advertising of slimming products, end up dreaming of very difficult to achieve weight loss in the short/medium term.
Many people dream of losing 30-40% of their weight, which is unrealistic for almost everyone. To do this, it takes willpower, discipline, a multidisciplinary team to guide diet, medication, psychological and exercise that most obese people do not have.
Initially, we should focus on losing weight but managing to maintain it. For example, in people at high risk of developing diabetes, losing only 5% of the weight and being able to maintain it is enough to reduce the risk of developing diabetes by up to 50%.
So if you have 100 kg and can reduce to 95 kg without re-fattening, it is a great start. Losing 15% of the weight without regaining weight in the long run can be considered an excellent result from the point of view of prevention of diseases related to obesity. If an individual weighing 120 kg can reach under 100 kg, this is a great success for health, even if it remains classified as overweight and far from the body that dreams.
The fact is that many people are aiming to lose weight not only because of health, but also because of the imposition of society that values more and more thin people, sometimes too much. Wanting to look like the television actress or magazine model is unrealistic even for many who are not obese, creating expectations that can not be met.
Another problem that can lead to frustration and abandonment of treatment is to think that weight loss will solve all other problems of everyday life, especially in professional, family and love life.
The main objective should be health. The well-being of the individual with his appearance is important for mental health, however, one should avoid making the aesthetic question more relevant than physical health.
Weight gain is the result of a simple math: daily calorie intake greater than the daily expenditure of calories. People who become obese come to this state due to an inappropriate diet and insufficient physical activity pattern.
Forget excuses like "gland problems," "thyroid disease," etc. No matter what justification you have created for your excess weight, in the end, the math above is what determines whether a person gains weight or not. The first step towards weight loss is to give up the excuses and take on the mistakes.
Eating improperly and being sedentary are bad habits acquired throughout life. Obese eat for various reasons other than simply satisfying hunger. You can eat excess calories throughout the day due to small snacks made only by habit or lack of what to do; frustration or looking for rewards (after an intense day of stressful work the individual decides to reward himself with a delicious but high calorie food); by laziness or by ignorance regarding the preparation of meals with less calories, etc.
Therefore, it is important to have a nutritional guidance and a notebook to note the eating pattern. This may sound silly, but it is not. Write down what you ate, what meals you ate, what time you ate, what you ate, what you felt after eating and what you felt before.
After a few days of taking notes, take the following tips:
Eat only in one place of the house, such as in the living room or kitchen. This can break the habit of eating in certain places outside the mealtime, such as in the office, in bed, in front of the TV, etc.
Create a rewards system at the end of the day or week after you have been able to follow a diet with fewer calories. Rewards can be anything that makes you feel good, whether it's going to the mall, cutting your hair, fingering, renting a movie, getting massages, having sex, etc. The collaboration of family members is very important in this system. The reward should not be for losing weight, but for better habits. Note: never use food as a reward.
Find out what feelings or activities trigger the trigger more often for the urge to eat. Try to have control over these situations. If possible, delete them.
See which high-calorie foods you consume the most. Stop buying them. If you have a habit of eating them and have them at home, it becomes almost impossible not to consume them. The best way to not eat something with lots of calories and not have easy access to it.
After each fork, take a sip of water. This will make the stomach fill up more quickly, reducing the amount of food needed to satisfy it.
Never fill the dish. Put less food than you think necessary. We often eat more than we need just to keep food out.
Eat very slowly, chew the food well and take short breaks during the meal. Allow time for the body's satiety mechanisms to activate.
Take a longer break between food and dessert. See if you really need dessert or whether candy is just a habit or a form of reward.
Along with dietary guidance, the above changes can cause you to cut up to 1000 calories per day.
Losing weight is easier than keeping weight off, so changes in lifestyle are essential to staying leaner. Among these changes, having regular physical activity is the most important. If there is no medical contraindication, every individual should exercise regularly.
A big mistake for people trying to lose weight is to think that they can do so just by reducing their calorie intake. Increasing daily calorie expenditure through exercise makes weight loss much easier. Just as proper eating is a matter of habit, so is exercise.
At least 150 minutes of light to moderate exercise per week (30 minutes 5 times a week), such as a faster walk, are a good start. It is good to remember that the activity works best if done in an uninterrupted manner.
The ideal is to maintain your heart rate higher than the basal continuously. Walking and stopping, walking and stopping, as some people do on a day-to-day basis from work does not work as well as an uninterrupted half-hour walk.
This does not mean, however, that some healthier lifestyle changes can not be implemented at work. Take the stairs instead of the elevator, park the car farther away from the entrance, go by bicycle if possible, try to go and talk to people instead of using the internal phone, walk while talking on the cell phone, etc.
The ideal physical activity, however, is to join aerobic exercises with bodybuilding. A pound of muscle burns 2.5 times more calories than 1 kg of fat when at rest. So when we gain muscle mass we are increasing our basal calorie intake. If we think that up to 75% of the calories burned during a day is done at rest, through the basal metabolism of our organism, the more muscle mass we have, the more calories we will burn, even if we sleep.
Physical activity, therefore, increases calorie expenditure during one's activity and during rest, making weight loss and maintenance easier.
The older the person becomes, the more important the bodybuilding becomes to avoid reducing caloric expenditure with the natural drop in metabolism and the reduction of muscle mass by age.
The effective treatment of obesity depends on several factors, and changes in lifestyle are as important as diet and medical treatment. There is no miracle formula. No effort or willpower no results. Avoid treatments that promise fast and effortless weight loss. That does not exist. If it's to spend money, get into a gym and start exercising.
