| Dr Andrew Binns, Let's face it - most overweight people would love to look like they did when they were 21. However this may not only be quite unrealistic but there are no health reasons why they should lose weight to that level and they are probably wise to not even try. What's more it is counter-productive to set unrealistic goals that may lead to disillusionment with the whole notion of trying to lose weight when there may be significant health benefits in losing just a bit of weight.
Consequently there are two questions we should ask.
1) Who should try to lose weight?
Those people who are significantly overweight or obese particularly if they have complications such as high blood pressure, high cholesterol or high blood sugars or even diabetes.
Men with a waist circumference greater than 102 cm and women with a waist circumference greater than 88 cm are most at risk of the complications of being obese. These high waist measurements are associated with excessive abdominal fat, which is associated with greater risk of heart diease and diabetes. Fat around the hips and buttocks in women is not associated with these risk factors and is really nature's way of storing fat for child rearing. Losing this fat is both difficult and unnecessary.
2) How much weight should we try to lose?
There are many studies that show that a modest loss of 5-10% of one's weight is all that is necessary for health benefit. This should be good news and this amount can often be achieved in a few months. Some may lose more weight than this over a greater period of time. Slow loss is more sustainable than rapid weight loss - 0.5-1 kgm loss per month is quite sufficient.
The health benefits of weight loss
First of all there is heart disease risk factor reduction. Cholesterol comes down particularly the bad type (LDL) whilst the heart protective good cholesterol (HDL) goes up significantly. In addition blood pressure comes down and sugar levels come down, which is particularly helpful for diabetics. Plus there are all the side benefits such as less tiredness, back pain, joint pain sweating, breathlessness, snoring, infertility, menstrual irregularities, urinary leakage, etc. There is also improved quality of life including raised self esteem and less depression.
How do we lose weight?
The simple answer is lifestyle modification with consumption of low fat, high carbohydrate and fibre food, smaller food portion sizes plus increasing physical activity. This can be discussed with your GP. Sometimes referral to a dietitian or exercise consultant will be advised. Commercial programs may also have a role to play and for resilient cases there is medication that may help.
So don't aim for slimness - just lose those few kilograms and enjoy the resulting improved quality of life and health benefits.
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