The Science of Weight Loss

A sign of the time has surely got to be the advertising of weight loss surgery and over the counter (OTC) tablets of a potentially risky weight loss pill. It was only a couple of years ago that I wrote a feature article on this whole issue of surgery in the context of a national obesity crisis but little did I realise at the time that even the slightly overweight have such an aversion to diet and exercise that there is a clear demand for drastic measures and quick fixes which has resulted in radical surgery being the only solution. Do we live in such a superficial, fickle, image-driven and highly materialistic world that surgery has become the first resort (as opposed to the last) and even the most reluctant have been duped into thinking that somehow they should scrutinise their figures simply because having the perfect, slim body is aligned to happiness and success. And let's face it, the entire world of work and business profile conspires to support this notion - in simple terms, image and visual presentation has become a commercial commodity and talent, skill, ability and being unique is somehow loathesome, breeds resentment, has become secondary and is to be discounted, even, discarded. Together with its equally obsessive promotion of youth, this is a damning indictment on a society!

There is something very wrong and very paradoxical about the psyche of people living in the Western world. We have extremes on every level. On the one hand we have those that are obsessed with the way they look, even resorting to surgery to rid themselves of a few pounds when a stint at a gym would have done the trick! It wasn't that long ago when the whole debate on size zero purported by the fashion industry raged on into the public arena. The backlash from many quarters doesn't seem to have had any impact and once again we see the increasing demand for acquiring the physique of a stick insect. At the other end of the spectrum of course, the UK has one of the highest rates of obesity in Western Europe. The US has similarly alarming rates of incidence but where cosmetic surgery is king, why would anyone who can afford it worry? And why would a minor matter of health and well-being influence or dictate changes in eating habits or lifestyle? Perish the thought!

OTC slimming pills such as Alli has been made available for some time now in the UK. This is essentially a drug that prevents the breakdown of excess fat from the food. And whilst, the chronically obese may gain some benefit, the fact that it presents a number of side-effects barely gets a mention. The main side effect relates to the gut and digestive function. Because the drug prevents the absorption of fat after a certain level, any excess fat from the food just passes straight out which means faecal incontinence; stools are oily and diarrhoea-like. Other problems can include wind, frequent or urgent bowel movements and abdominal bloating. Of couse, there are also certain groups of people who should not even consider taking this drug such as:

• those who have problems absorbing nutrients and have poor digestive function
• pregnant women or women who are breast-feeding
• those on any other medication especially immunosuppressant drugs such as cyclosporin or anticlotting drugs such as warfarin
• those who have problems with bile flow from the liver

However, monitoring the sale and usage of this drug is now impossible given that it is OTC. Anyone wishing to lose weight really needs to do the maths before embarking on such quick fixes. The science of weight loss is really simple. In short, output must equal input if weight gain is to be avoided. That is, the amount of food eaten (energy content) must equal the amount of calories burned through daily energy consumption and/or activity. By no means does this factor in the quality of the diet and any health practitioner worth their salt, will advise and focus on nutrients in as much as quantity. Of course, there are always going to be variations such as age, gender differences, metabolism (the rate at which we burn food), activity levels, food requirements and other factors. With age, the metabolic rate declines, so we need to take more care about the quantity of food eaten. The quality of our diet is paramount and the emphasis should be on the unique requirements of each system and responding to the changes in those requirements as we age. Many people don't realise that the body shape also changes over time and exercise patterns needs to change to reflect these changes. Varying the types of exercise to work all the muscle groups is important - exercise has a host of benefits not least of which is to increase the metabolic rate.

One of my recent clients gave me chapter and verse about all the various diets that she has been on over the years and was seeking my advice on gastric banding or whether she ought to consider any of the OTC slimming pills. What was glaringly obvious was her detailed knowledge of food (even down to the calorie content of the average peanut and the mineral content of a typical cabbage leaf!) but very little about the body nor indeed the consequences of such drastic measures to lose the desired weight. She wasn't even that particularly overweight either! After a radical overhaul in changing her attitude to weight loss regimes and giving her a better understanding of risky measures and the consequences to health, we did work out a more sensible plan of diet and exercise. Importantly, her obsession with her weight and reminding herself why she wanted to lose it had shifted towards something more positive and dare I say... healthy.

Britain has certainly got a ticking timebomb regarding its obesity levels, particualrly in children. We have to gain a healthier, more holistic perspective and a better education of food before promoting potentially risky quick fixes. This would make a significant cost saving for the NHS and allied health services in treating and managing obesity-related illnesses and the desire for immediate solutions or indeed surgery could be non-existent if the crisis can be prevented in the first place.

For more information, advice or a consultation with a nutritionist, go to http://www.bant.org.uk/ or http://www.nimh.org.uk/ for help with herbal approaches or dietary and lifestyle changes.