How to Lose Weight ?

How to Lose Weight ?

Obesity is associated with an increased risk of premature death and chronic illness such as diabetes mellitus, high blood pressure, high cholesterol, stroke and heart disease. Weight reduction not only leads to decline in these health risks but also improves appearance, mental health, quality of life and offers better social and workplace acceptance. It is imperative that overweight and obese individuals seek professional medical advice on how to lose weight. They should not take Over-The-Counter  (OTC) slimming products.

Weight Management

A multidisciplinary, structured team approach is required for successful management of obesity. The weight management team usually comprises of a physician, endocrinologist, bariatric surgeon, dietician, behavioral therapist or psychiatrist and exercise therapist. 95% of obese patients have no known cause but it is essential to exclude any underlying cause (ex, thyroid disorders, Cushings syndrome, etc) before treatment. Obesity-related disorders require careful evaluation. Diet, exercise and behavioral changes remain the cornerstones of treatment of overweight and obese adults.


Dietary strategy involves calorie restriction through dietary modification. A dietician will educate patients and family on the most appropriate diet to lose weight. Problematic areas in patients current diet are highlighted and suggestions are offered to make the diet healthier. Patients are taught the reading of labels an glycaemic index of foods. Meals of adequate size are advised so that snacks are not needed between meals. Any one of the 3 main meals should not be 'skipped' as a weight control method.

Behavioral Therapy

The key to long-term weight loss is behavioral modification. Behavioral therapy aims to :

  • change key attitudes
  • motivate self-change while maintaining self-esteem
  • maintain changes with peer support
  • control responses to external stimuli
  • learn problem solving
  • and prevent relapses through rewards


Slimming medications can be a useful adjunct to exercise and behavioral therapy. They must never used alone for weight reduction. The judicious of slimming medications under medical supervision achieve excellent results in weight reduction and weight maintenance. These are commonly used for patients with BMI 30kg/m2 or above, and those with BMI 27kg/m2 or above with concomitant medical problems which include diabetes mellitus, hypertension, stroke and heart disease. They should not be prescribed for patients below 18 years of age and women who are pregnant or breastfeeding.


Surgical treatment is indicated for the morbidly obese (ie; BMI 40kg/m2 or above) or those with BMI 35-39.9kg/m2 with severe mediScal problems. Surgery is the last resort when all the above mentioned options have been used for a period of 6 months and failed to achieve any significant weight loss. Gastric bypass, gastric plication or gastric banding are the usual surgical procedures. Other procedures include jaw wiring  and replacement of gastric balloons. Laparoscopic banding is another procedure in which an adjustable silicon band is placed around the upper portion of the stomach, thus creating a small pouch. When food is consumed, the pouch distends rapidly, thus creating a feeling of fullness.

Weight loss of more than 20kg over 6 months have been achieved in some patients treated with Lap-Band. Like all surgical procedures, there is a small but definite risk of complications. Subsequent plastic surgery to correct folds of loose skin is usually required after weight loss has been achieved. Liposuction is useful for removing unsightly local collections of fat.


Last but not least, "prevention is better than cure". A healthy lifestyle needs to be developed throughout life. Incorporation of healthy eating and daily physical activity into person's lifestyle make him more likely to achieve and maintain a healthy weight.

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