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Study after study has shown the benefits of healthy body weight in preventing chronic diseases and staying healthy. People with excess weight, on the other hand, are at increased risk of having high blood pressure, blood fat and cholesterol disorders, heart disease, and stroke.

People at high health risk

The UK House of Commons Committee on obesity has reported that obesity will soon surpass smoking as the greatest cause of premature loss of life. Obesity is a chronic disease, which you may have due to your family genes but mostly due to your unhealthy lifestyle such as frequent snacking, eating frequently in larger portions, excessive eating (binge eating), eating out frequently, and lack of physical activity. Whatever the cause, excess weight can be managed, but its management requires a life-long commitment to a healthy lifestyle.

WEIGHT AND DIABETES
Body weight has special significance in type 2 diabetes. Recently, type 2 diabetes, which is typically an adult-onset disease, has been occurring at an alarming rate even in children and adolescents who are overweight. This trend is a strong indicator that excess weight tends to promote type 2 diabetes. The Diabetes Prevention Program, the landmark study noted before, has firmly shown that even a moderate weight loss can prevent and delay the onset of type 2 diabetes in people who are at increased risk of developing this disease. Moderate weight loss is also helpful in lowering high blood pressure and controlling blood sugar in overweight or obese people with type 2 diabetes. A planned weight loss reduces the overall health risks in all people with and without diabetes.

Research is now showing that excess weight may also play a role in the development of type 1 diabetes. British and American studies are showing that excess weight may accelerate the development of type 1 diabetes in young children and young adults.

WHAT IS HEALTHY WEIGHT
The National Heart, Lung, and Blood Institute ( NHLBI) classifies a body mass index (BMI) range between 18.5 to less than 25 as healthy weight. This BMI range helps you prevent and manage many chronic diseases, including diabetes, and helps you stay healthy. But what is a BMI?

BODY MASS INDEX (BMI)
The body mass index is a new international measure that calculates your body fat in relation to your height and weight. This measure (BMI) is regarded as a more accurate standard of weight measurement for adults than the traditional weight tables that indicate body weight alone. The BMI, as a weight measurement tool, is now in common practice among the health care professionals. An increase in BMI over the normal level is associated with increased risk for various diseases, including diabetes, heart disease, and stroke. You can find out your BMI by consulting the BMI table. The table refers to weights without shoes and clothes (underwear allowed). When you have figured out your BMI, compare it with the weight classification noted below.

The BMI may not apply to pregnant women due to their excess weight, and body builders having extremely high muscular bodies.

WAIST MEASUREMENT
For good health, not only the amount of fat on your body is critical but where it is located is also important. Excess fat on the abdomen is a high risk factor for various disorders and diseases, including high blood pressure, cholesterol and other blood fat disorders, type 2 diabetes, and heart disease. Research shows that excess abdominal fat by itself, even if you have a normal BMI, is a health risk factor. Because deposits of fat on the abdomen increase waist measurement, you can estimate your abdominal fat by measuring your waist. Waist measurements exceeding 40 inches in men and greater than 35 inches in women are linked with increased risk of developing type 2 diabetes and its long-term complications. If your BMI is within the normal range, stay with your existing weight. Keep balance between what you eat and how much you exercise; doing so will help prevent unhealthy weight gain. But if you have excess weight, you are most likely a candidate for weight loss.

CANDIDATES FOR WEIGHT LOSS
These include:

• People who are overweight and who also have two or more health risk factors or diseases, including blood fat and cholesterol abnormalities, high blood pressure, type 2 diabetes, and sleep disorder.

• Elderly people (older than 65 years) with excess weight. These people should lose weight under close medical supervision.

• Men with a waist circumference greater than 40 inches and women with a waist circumference greater than 35 inches.

• People with a BMI of 25 or greater.

BENEFITS OF WEIGHT LOSS
A planned weight loss in overweight and obese people provides many health benefits such as:

• It helps prevent type 2 diabetes in people with excess weight who are at risk of developing this disease.

• It enhances insulin efficiency and reduces the body’s resistance to the action of insulin in people with type 2 diabetes. Both these effects are helpful in controlling blood sugar.

• When people with type 1 diabetes lose some of their excess weight, they need less amount of energy (calories) than before, which in turn reduces their need for injected insulin.

• Weight loss lowers high blood pressure.

• Weight reduction lowers elevated blood levels of total cholesterol, LDL (bad) cholesterol, and triglycerides, and raises HDL (good) cholesterol. All these benefits reduce the risk for heart disease and stroke.

GOALS FOR WEIGHT LOSS
When you are overweight or obese, your goals for weight reduction should be both short-term and long-term:

• Short-term goal. Reduce your body weight at a rate of 1 to 2 pounds per week till you lose 10 percent of your existing weight within a period of 6 months or more.

• Long-term goal. Extend your weight loss program beyond 10 percent of your excess weight, and again lose weight gradually at a rate of 1 to 2 pounds per week till you achieve your target weight.

Once you achieve your target weight, you should aim to maintain it and prevent weight regain.

METHODS FOR LOSINGWEIGHT
To lose weight, several approaches are available: nutrition therapy or healthy eating, exercise, behavior therapy, use of drugs, and surgery. The standard recommendation is to use first the options of nutrition, exercise, and behavior modification for at least 6 months. If these approaches fail to reduce your weight to the desirable level, the doctor may prescribe weight loss drugs. In extreme obesity, the option of weight-loss surgery may be considered. The tried and tested formula to lose body weight, however, is to eat fewer calories and be more physically active.

Nutrition Therapy
Nutrition therapy in weight management aims to reduce and regulate your weight by managing your consumption of calories or food intake. One pound of body weight consists of 3,500 calories. To lose weight through diet, you should limit your calorie intake from all food groups, especially fat intake because calories derived from fat are twice that of carbohydrate and protein. Reduced fat intake will provide you greater loss of calories, resulting in greater loss of weight. However, the mere restriction of fat intake will not be sufficient to lose weight because a major part of your meals consists of carbohydrate and protein. For this reason, you will have to reduce your carbohydrate and protein intake also along with fat. Nutrition therapy for weight loss uses a reduced calorie diet, which can be either a low calorie diet (LCD) or a very low calorie diet (VLCD).

Low-Calorie Diet
Usually, a low-calorie diet (LCD) is recommended for gradual weight reduction:

• To lose weight, use a diet that provides 500 to 1,000 fewer calories than required for weight maintenance. In general, diets containing 1,200 to 1,600 calories per day for men, and 1,000 to 1,200 calories per day for women are right for weight reduction. These recommendations, however, are flexible and can be adjusted in your individual case. If these diets do not reduce your weight or they are too much starving, decrease or increase calories in your diet so that you can reasonably follow a weight loss plan.

• Because alcohol provides you mere calories without nutrition and adds to unhealthy weight gain, avoid or limit alcohol consumption in a low-calorie diet. Limited intake of alcohol will allow you to eat other nutritious foods with equivalent caloric value.

• A low-calorie diet may be deficient in some nutrients. Make sure that you take a good supplement of vitamins and minerals during your weigh loss program. Calcium intake of 1,000 to 1,300 milligrams per day is useful, especially for women who are likely to have weak bones that tend to fracture (osteoporosis).

Very-Low Calorie Diet
A diet very low in calories, containing about 800 calories or less, is called a very low calorie diet (VLCD) or crash diet. The VLCD aims to reduce weight rapidly, a weight loss of about 3 to 5 pounds per week. The crash diet, however, should not be used unless strictly supervised by a health care professional. Crash diets may be very risky, especially in diabetes, because such restricted diets may cause low blood sugar. Studies show that over the long term (1 year), very-low calorie diets are not superior to low-calorie diets in achieving weight loss. This is so because when these diets are stopped or relaxed, weight regain creeps back most frequently. A very-low calorie diet is therefore not recommended; instead, use a low calorie diet in your weight management plan.

Exercise
Include at least a moderate intensity exercise of 60 to 90 minutes every day in your weight loss plan. When exercise is added to nutrition, you achieve greater weight loss than can be achieved by nutrition or exercise alone. Although cutting down calorie consumption reduces much of the weight, a regular exercise program helps accelerate weight loss and prevent weight regain. In addition, exercise helps make your heart and lungs strong, reduce abdominal fat, and decrease the risk for type 2 diabetes. Exercise also helps prevent loss of muscle mass often occurring in people during weight loss.

Behavior Therapy
The success of nutrition therapy and exercise in weight management depends upon how closely you follow these measures. If you lack will or willingness to adopt a healthy eating habits and healthy lifestyle, you need behavior modification.You may need counseling from a psychologist who will help you identify your personality problems that are responsible for your unhealthy behavior. Once you identify the problem areas of your personality such as eating between meals, overeating when you are happy or tense, snacking while you are watching TV, or unwilling to be physically active, the psychologist will help you learn how to develop healthy attitudes. Such positive attitudes will help you change unhealthy eating patterns to healthy eating habits and physical inactivity to regular exercise. This modified behavior will be beneficial for your health.

Managing Your Stress
When you are on “diet”, the restriction of calories and change in eating patterns cause stress. You should be able to cope with this stress effectively, or the unbearable stress may force you to give up your weight management efforts. A regular walk is very beneficial in relieving stress. Walking causes release of mood-enhancing hormones called endorphins in your body; secretion of these hormones helps you to be relaxed. Relaxation is helpful in coping with stress.

Social Support
In implementing your weight management plan, you may need to make changes in your meal patterns that will affect your family members. Also, the time you will spend on exercise will be the time away from your family. Ask your family, friends, and colleagues at work to support you in your efforts. Generally, they will be supportive.

HELPFULTIPS
Here are some helpful tips that will influence your weight management plan and aid to make it successful:

• Keep daily records of the amount and types of food you have eaten and the frequency, intensity, and type of physical activity you have undertaken. This record will let you track any excess in diet and deficiency in exercise, allowing you to make necessary adjustments in the future.

• Occasionally, you may slip in your weight management goal. That is not unusual. Resume your healthy lifestyle and continue with your efforts to achieve your goal.

• Plan meals in advance; keep the right food items handy.

• Do not drink soda; it is high in calories without much nutrition. If you cannot help it, drink diet soda.

• Digestion is sluggish at night. Big meals taken at night are not properly digested and may upset your stomach. Avoid eating late at night unless your blood sugar is running low.

• Drink about 11 to 16 cups of water a day, unless you have a medical problem requiring restriction of fluid intake. Water gives a feeling of fullness and flushes your body system.

• Drink water if you feel hungry between separate meals. (But test your blood sugar to make sure that your hunger is not due to low blood sugar).

• Avoid frying foods in oils. Use cooking methods that use little or no oils; this way you will consume reduced amount of calories and fat.

• To lose weight, join a support group, which will provide you motivation and support.

• Before going out for dining, decide in advance what you will eat. Such a planning will prevent from making unhealthy food choices.

• At the start of meals, eat lots of raw vegetables, which are low in calories. Filling the stomach with vegetables will make you feel full and you will eat less of the high-calorie food.

• Stretch in your abdomen and hold it till you can; release it; repeat several times. Perform this abdominal stretching 3 to 4 times a day; it will tone up your abdominal muscles, and help reduce your abdominal fat.

• Eat slowly, chewing every bite. When you eat slowly, you eat less but the brain gets the message of fullness and satisfaction in about 15 minutes.

• Avoid eating while watching television or talking on the phone; eating this way you tend to overeat.

• When you go to social gatherings, remind yourself that the purpose of attending these gatherings and functions is to enjoy the company of people and not eating.

• When you are in a new environment or away from your regular routine, you may feel a sense of freedom and indulge in overeating. Be alert in such situations, and do not eat aimlessly.

• Read food labels carefully. To know how much fat is there in a food, do not simply count the grams of fat a food contains; but see how many calories are derived from fat.

• Choose to keep low-calorie foods in your home.

• Visualize yourself as a person who has lost weight. Feel yourself as a slimmer, smart person, and act like that.

• Do not skip meals or you will eat too much during your next meal.

• Walk during your lunch break; such walks will provide you added time to be physically active.

• Listen to your doctor’s advice to lose weight. Studies show that the doctor’s advice works and motivates obese patients to lose weight. 

Drug Therapy and Surgery
When healthy eating and modified lifestyle measures together fail to reduce your weight, the doctor may suggest you to add weight-loss drugs. In extreme cases of obesity, weight loss surgery may be considered.