How to overcome the obesity monster

Twenty-year-old Owais entered the clinic room breathless and looking anxious. The first sentence that came out of his mouth was “Doctor, please help me shed this weight and give me a magic pill.” On questioning, he said that he had always been bullied as a child because of his weight and this always made him upset and eat more — resulting in weight gain.

He shared that he preferred junk food for lunch and dinner and loved to play video games alone. Asked about his previous attempts to lose weight, he said these were never serious but now he was willing to go to any extent to lose weight. His calculated body mass index — the ratio of weight to height less than the 23.5 ideal was 32. Over the course of a few visits, a mutual plan was developed to help Owais reduce his weight gradually motivating him towards healthy eating and the regular exercise regimen of walking. His friends and family were also approached to help Owais succeed in his efforts.

Over time with the combined efforts of his family, friends and the physician, Owais managed to bring his BMI down to 27. Two years later, Owais is a healthy young man who loves to socialise and play cricket with friends, he still occasionally eats junk food but it no longer rules his life.

The World Health Organisation defines obesity as BMI above 27.5. Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity, and genetics. A few medical conditions can also result in obesity-like thyroid problems. It not only leads to loss of self-confidence but also can have detrimental effects on different parts of the body. Knee joints get worn out early, blood pressure goes up, diabetes can set in and it becomes difficult to breathe as the lungs have no place to expand.

It is important to encourage people not to lose hope as it is a treatable and preventable problem. Changing one’s diet dramatically is not sustainable. A gentle and steady plan with simple modifications of diet, for example, taking a bowl of salad or fruit before lunch or dinner, serving in a smaller plate and getting up from the table before satiety is achieved are small and reasonable steps towards achieving target weight.

Foods like potato chips, carbonated drinks and juices having added sugars should be excluded from the diet. One can of soft drinks adds 150 empty calories with no benefit to the body. One way to make healthy food choices is to select wisely when eating out like grilled or barbecued items in place of fried foods, clear sauces in food, salads without mayonnaise, etc. Also sharing food with others will control portion size. While preparing a family meal it is important to prepare a simple meal for the whole family so that everyone eats healthy and the person trying to reduce weight is not tempted and singled out.

Exercise also plays a crucial role in weight reduction and physical fitness through toning the body. The key point of exercise is that people need to choose an activity they enjoy and can sustain. Simple options for regular exercise which can be incorporated into the daily routine should be planned like brisk walking, cycling, and swimming. Gym can be a good option for those who can manage it along with the daily activity.

Walking should be brisk and at least for half an hour daily. If that is not possible it can be split into 15-minute slots twice daily preferably before meals. Other simple measures include choosing to climb stairs rather than using the escalator or lift, walking for short distances, and parking at a distance from the destination.

No measure can succeed without family support. It is important to involve family members and friends to keep motivating and encouraging the person at every opportunity. It is always better to remain connected with your family doctor who can help you achieve your targets.

Published in The Express Tribune, June 12^th, 2017.

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