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How to Lose Weight
Christine Michael


This one-stop practical guide will show you how to lose weight in the way that’s best suited to your body and lifestyle. To make your progress easier, it comes in a handy format with colour illustrations and expert advice throughout.The basics of all the different diets are explained – from Atkins to the Glycemic Index diet, together with their pros and cons. There are several 28-day plans to suit different personalities, offering readers a flexible approach to dieting.Portion guidelines, calorie guides and nutritional content tables of ready meals and fast foods arm readers against hidden fats and sugars.Easy-to-follow exercise plans promote a healthy approach to weight loss and help you achieve your ideal shape quicker.Contents include:1. The big picture: assessing your weight and shape2. Healthy weight, healthier you3. What causes a weight problem?4. The science of losing weight5. All about healthy eating6. Choosing a diet or weight loss method7. Exercise: the energy booster8. Stay slim for life: weight maintenance9. Personal record chart















Contents


Cover (#ucd490ac2-7cf9-5b7a-b440-182c851102d4)

Title Page (#udc087cf9-0c6f-57c7-8e7f-36133d9d870e)

Introduction (#ulink_86cc4bf9-22cc-5c02-ab39-698574cc8aca)

1 The big picture

Assessing your weight and shape (#ulink_86a02f6e-d0f9-5040-8806-085e41846f62)

2 Healthy weight, healthier you

Why overweight is a big dea (#ulink_8113c2b2-f2d5-5074-8343-95095940ea2a)

3 In search of a cause

Why we’re the shape we’re in (#ulink_020eff75-5dd9-5439-b750-18432d5cc0dd)

4 The science of weight loss

The energy balance (#ulink_060b17d5-6a07-578c-b179-9cb50d7a7530)

5 Healthy eating for slimmers

Healthy eating for slimmers (#litres_trial_promo)

6 Choosing a weight loss method

Where to get good advice (#litres_trial_promo)

Choose the right diet (#litres_trial_promo)

Calorie-counting diets (#litres_trial_promo)

Low-carbohydrate diets (#litres_trial_promo)

Low-fat diets (#litres_trial_promo)

High-fibre diets (#litres_trial_promo)

Glycaemic index (Gl) diets (#litres_trial_promo)

Mediterranean diet (#litres_trial_promo)

Detox diets (#litres_trial_promo)

Diuretic diets (#litres_trial_promo)

Food-combining diets (#litres_trial_promo)

Crash diets (#litres_trial_promo)

Food intolerance diets (#litres_trial_promo)

High-fat diets (#litres_trial_promo)

Anti-cellulite diets (#litres_trial_promo)

Body-type diets (#litres_trial_promo)

Meal replacement diets (#litres_trial_promo)

Other weight loss methods (#litres_trial_promo)

Slimming clubs (#litres_trial_promo)

Slimming websites (#litres_trial_promo)

7 Exercise: the energy booster

Move it to lose it (#litres_trial_promo)

8 Making it happen

Confidence and commitment (#litres_trial_promo)

9 Stay slim for life

Make it a habit (#litres_trial_promo)

Personal record planner (#litres_trial_promo)

Glossary (#litres_trial_promo)

Need to know more? (#litres_trial_promo)

Further reading (#litres_trial_promo)

Index (#litres_trial_promo)

Keep Reading (#litres_trial_promo)

Copyright (#litres_trial_promo)

About the publisher (#litres_trial_promo)




Introduction (#ulink_e064b619-fb48-5726-ac93-20577aaf141f)


There has never been so much information available to us about healthy eating, weight management and exercise, yet the sheer number of regimes and theories can make it even harder to choose a diet and stick to it. This book will guide you through the weight loss maze, equipping you with the information, confidence and motivation you need to achieve your personal slimming and fitness goals.

A guide for life

Around 13 million adults in the UK are watching their weight or are actively ‘on a diet’, yet public health statistics suggest this may be a losing battle. Over half of adults are overweight and one in five is at the ‘obese’ level that represents a significant health risk. So what’s going wrong and how can we reverse a trend that suggests that obesity-related diseases will soon overtake smoking as the biggest single cause of premature death?

Beginning with a self-assessment guide to working out your healthy weight range, you will discover the science behind how we lose weight –and put it on – and learn sound healthy-eating principles to ensure that your slimming campaign is safe as well as effective. With so many diets available, there’s an assessment of 30 different slimming methods, to help you evaluate all the conflicting information and claims that are made about weight loss products and services. And as getting more active is a vital part of a healthy, slim lifestyle, you’ll find a comprehensive guide to boosting fitness and weight loss with the exercise routine that suits you best.

Your chances of success depend on your motivation, confidence and readiness to make the permanent lifestyle changes that are essential to achieving your goal. Find ways to discover your deepest motivations, overcome your inner obstacles and tackle the setbacks that may have led to previous failed attempts at dieting. This book can help you throughout your slimming campaign, providing inspiration, reassurance and support.
















1 The big picture (#ulink_572a7c3e-91f1-5540-8928-fa8d43560a2e)


Before you set yourself a weight loss goal, it is a good idea to find out what kind of shape you are in. These days there is more to working out your ideal weight than just standing on the scales, which only tell part of the story. It takes just a few minutes to discover how healthy your weight and shape are and also to decide what you want to aim for.





Assessing your weight and shape (#ulink_73e19b00-31fd-566e-bf2b-559b0f1ec4f1)


Do you have a weight problem and, if so, how much do you need to lose to reach the weight range that is healthy for you? Here are some easy ways to find out the facts about your figure.



must know

Measure your BMI

To work out your BMI, you need to divide your weight by your height, squared - a calculator is handy to do the sums.

1 To find your BMI using metric measurements, take your weight in kilograms and your height in metres (get someone to check your height for you if it has been a while).

2 Now divide your weight in kilograms by your height in metres, squared. (To turn your weight in pounds into kilos, divide by 2.2; and to turn inches into metres, multiply by 0.025.)




So if your weight is: 59 kg (9 st 4 lb)




And your height is: 1.6 m (5 ft 4 in)




Your BMI is: 59 ft(1.6 X 1.6) = 23.



The scientific approach

Most of us have several different ways of keeping an eye on our weight: for instance, we notice when a favourite pair of trousers feels too tight, or when we do not like what we see in the mirror or on the bathroom scales. To assess what your weight really says about your health and wellbeing though, it pays to take a more scientific approach.

If you’ve been in denial about your weight for years, the thought of finding out the cold facts might be daunting, but it might not be as bad as you think. Many people have a fixed idea about what their weight ‘should be’, and often it’s based on the slim figure they had as a teenager or on their wedding day, which might not be comfortable or realistic for them now. And if the truth about your weight does come as an unpleasant shock, turn that feeling into a motivational boost. Now that you are about to start a healthy weight loss campaign, you need never see that figure on the scales again.




Body Mass Index


A simple weight-and-height comparison used to be the favoured method of assessing whether someone was overweight or not. Today health professionals prefer to use the Body Mass Index (BMI), a figure that represents your weight per square metre.








must know

Obesity

Over 20 per cent of British women are obese yet in a Cancer Research survey only four per cent said they were. The health risk starts increasing before it reaches the point where you may look or feel extremely overweight.



Key to the BMI chart




Colour zone 1

BMI under 18.5: underweight.

You do not need to lose weight and may even have an increased risk of certain medical conditions that are linked to low body weight, such as osteoporosis (‘brittle bones’).




Colour zone 2




BMI 18.5 – 24.9: normal.

You do not need to lose weight for medical reasons. If you are at the top end of the range, it is worth taking care to eat healthily and exercise regularly to ensure you don’t creep into he ‘overweight’ range.




Colour zone 3




BMI 25 – 29.9: overweight.

A BMI of 25-plus indicates that you are over your ideal weight, and in this range you start to increase your risk of developing weight-related health problems. Aiming to lose a few pounds (or more, depending on where you are in the range) will benefit your health.




Colour zone 4




BMI 30 – 39.9: obese.

Within this range you are probably at least 14 kg (30 lb) or more over your ideal healthy weight and are running a ‘moderate’ risk of weight-related medical conditions. As a starting point, losing 10 per cent of your body weight will considerably reduce this risk. If your BMI is between 35 and 39.9, the risk it could pose to your health is classified as ‘severe’. A determined effort to lose weight and lower your BMI is worth making a top priority.




Colour zone 5




BMI 40 or over: extremely obese.

If you are within this range, then you are probably already experiencing weight-related symptoms and difficulties. Tackling your weight is important and urgent; see your doctor to discuss the various options and to access specialist advice.






BMI is based on the assumption that the difference between people who are the same height, but different weights, generally reflects how much fat they have on their bodies. So for assessing health status, BMI is a more accurate measurement than weight versus height alone, as it takes body composition into account.



must know

BMI facts




The standard BMI chart is for adults over 18; ask your GP about BMI for children. BMI is not a suitable measure for pregnant or breastfeeding women.




A high BMI might not mean an unhealthy weight for body builders and athletes, who may have a high proportion of muscle, which weighs more than fat.




The BMI might not be a reliable indicator for elderly or frail people who may have very low muscle mass.




There are many online BMI calculators on health websites, but take an average, as from experience they vary.



What your BMI means

The World Health Organization (WHO) has established that a BMI of between 18.5 and 24.9 is ‘normal’, by which it means that someone whose BMI is within this range has the least risk of developing weight-related health problems.

A BMI of 25–30 is considered ‘overweight’, with an increased risk of developing weight-related illnesses, such as certain cancers, heart disease and type 2 diabetes (#ulink_05384786-d31c-53dc-8302-47f640e6342b). The higher your BMI above this level, the more the risk to your health increases and the more you will benefit by losing weight: losing just five to 10 per cent of your body weight and keeping it off can make a difference, so it’s well worth aiming for.

Waist management

Your waist measurement is another important indicator of whether you are in healthy shape or not. This is because research has shown that where we carry any excess weight on the body is just as crucial to our overall health as how much extra we might have.

It appears that too much fat around the stomach, seen as an apple shape or ‘beer belly’, plays a damaging role in increasing the body’s resistance to insulin, which in turn can lead to an increased risk of type 2 diabetes and heart disease. Someone who is an ‘apple’ shape will have a greater risk of health problems than someone of the same weight who carries their weight around the hips, thighs and bottom (the classic ‘pear’ shape).






To work out your BMI, accurately you will have to weigh yourself.



must know

Body fat

An average healthy man has about 15–20 per cent body fat; an overweight man would have about 25 per cent body fat; and an obese man, 35 percent or more. For women, the figures are 25–27 per cent; 30 per cent; and 35 percent respectively. You can have your percentage of body fat measured: common methods include skin-fold callipers, bioelectrical impedance or dual energy X-ray absorptiometry.



Measure your waist

To measure your waist, keep the tape measure flat and hold it firmly but not too tightly against your skin. The place to measure is the midpoint between the bottom of the ribs and the top of the hip bone, about 2.5 cm (1 in) above the navel.

Check the table below to see how healthy your waist measurement is. If your BMI is in the normal range but your waist is in the ‘increased risk’ category, it would be a good idea to lose some weight to slim your waist and stomach.






Going pear-shaped is not bad news for ur health.

Note: Asian people with ‘apple’–shaped waists have been found to be at higher risk of developing health problems than other groups. Asian men with a waist measurement of 90 cm (36 in) or more, and Asian women whose waist is in excess of 80 cm (32 in) are in the ‘high risk’ group.











Does your waist shape up?

The Ashwell Shape Chart (opposite) was developed by leading nutritionist Dr Margaret Ashwell and is an at–a-glance way of checking whether your shape, as determined by your waist and your height, is in a healthy range or not. To use the chart, just read off your height in a horizontal line and your waist measurement in a vertical line. The point where the two lines meet is where your shape is on the chart.

Apple shapes

Fat seems to be more easily lost from ‘apple’ shapes than from ‘pears’, and this could help to explain why men often seem to slim more quickly than women. Being stressed stimulates production of the hormone cortisol, which is known to play a part in distributing stored fat in the central abdominal area, and this could contribute to an ‘apple’ shape. Fat stored in the central area is found deep down in the region of the stomach, while fat on the hips, thighs and bottom is stored nearer the surface of the skin. This can give it the ‘orange peel’ texture known as cellulite, so it is a small consolation that while it may not look attractive, it is less harmful to health than central abdominal fat.

Quick measures




If you can pinch more than an inch of fat at the back of your upper arm or at your midriff, you’re probably overweight.




Another method is to divide your hip measurement by your waist measurement: if the result is less than 1, you are a ‘pear’; if it’s more than 1, you are an ‘apple’.




If your waist measurement is less than half your height, your shape is likely to be in the ‘OK’ healthy range.



want to know more?

Take it to the next level. . .




Your weight and health 22




Cellulite 113




Assessing your fitness level 149




Increasing exercise 134

Other sources




Gyms and health spas may offer body composition tests which tell you the percentage of body fat, water and lean tissue in your body.




Book in for a lifestyle ‘MOT’ at your local surgery to test for weight-related conditions.




Invest in the latest bathroom scales that measure BMI and body fat percentage as well as your weight.




Join a fitness class to tone up troublesome areas such as your stomach, bottom and thighs.




For books on fitness training and exercise.




For more on the Ashwell Shape Chart, see www.ashwell.uk.com











2 Healthy weight, healthier you (#ulink_c3ba6a2a-1763-5762-8806-e413ce0f71bf)


Taking care of your weight is one of the most important things that you can do to maximize your chances of living a long and healthy life. The good news is that if you are overweight, you don’t need to slim down to a ‘perfect’ size in order to reap the health benefits – every pound that you lose can help, which is great motivation to get started.




Why overweight is a big deal (#ulink_49b411a1-e76c-5b82-82c6-267a6625a3e4)


Carrying excess weight means increasing the risk of health problems, either as a direct result of being heavier or from the likelihood of developing diseases in later life. Being aware of this is the first step to feeling more in control of your weight and your health.



must know

Stop smoking

Smoking is a bigger hazard to health than being overweight, yet some people - especially women - smoke to help keep their weight down. Giving up smoking does not mean you will automatically put on weight but weight gains of 1.8–3.2 kg (4–7 lb) are common; this seems to be because food tastes better and people snack more rather than any physiological reason. Trying to stop smoking and lose weight at the same time is a big job. Tackle smoking first, aiming to minimize any weight gain by eating healthily and being as active as possible – and then make your weight a priority.



Awareness, not worry

Good health would be top of most people’s list of ingredients for a happy life, and in an ideal world, we would choose to avoid illness and disability if we possibly could. In the real world, of course, we have to play with the cards that life deals us, and many of the factors that determine our long-term health are beyond our control.

However, that does not mean that we should not try to change the odds in our favour whenever we can do so. The overwhelming evidence, from scientific research that has been carried out around the world, is that managing our weight is one of the optimum ways to give ourselves the best possible chance of living a long, healthy and active life.

Consumer studies suggest, however, that improving their health is not always the main reason why people start a diet or fitness regime. About half of slimmers, especially younger ones, say that they want to lose weight in order to look better in clothes, or for a special occasion such as a forthcoming holiday or wedding. And that’s absolutely fine!

It is fantastic to know that you look your best, and to be able to wear whatever you want and to enjoy looking at your holiday photos instead of dreading them.

All too often, for health to become the main motivator to embark on a slimming regime it takes a crisis: perhaps your doctor warns that your blood pressure is too high, or recommends you lose weight before trying for a baby, or you find that you are increasingly breathless and uncomfortable.

But health can be a positive motivator as well as a cause of fear and worry. Skim through this section, and you will see that while some of the health implications of being overweight are serious, it does not take a massive weight loss to reduce your risk of developing problems, or to improve symptoms that might be bothering you already. If you only have a little weight to lose, knowing that you are benefitting your health by reaching and maintaining your target weight can be a deep source of satisfaction – in addition to the joys of shopping for smaller clothes.



must know

Weight gain is easy

It takes about 3,500 surplus calories to put on 0.45 kg (1 lb) of fat, which sounds like a lot until you consider that eating just 80 calories more than you need each day (that’s only one chocolate digestive) could lead to a weight gain of 3.6 kg (8 lb) in a year!



Facts of life

Can you be overweight and healthy? The answer is yes – and no. Of course your overall health depends on many risk factors, such as your family history, whether you smoke or drink heavily, your fitness level, where you carry your weight and so on. If being overweight is your only risk factor, then you have more chance of remaining in good health than someone who ticks a lot of ‘risk’ boxes. And there will always be overweight people who reach a hale and hearty old age without losing a pound.

Unfortunately, however, statistics show that if you are overweight you are unlikely to be one of those people – they are the exception that proves the rule. Here are five disturbing facts, which come from UK National Health Service-endorsed studies:




If your BMI is 24 or more, your risk of dying within a 26-year period increases by one per cent for every pound put on between the ages of 30 and 42, and by two per cent for every pound gained between the ages of 50 and 62.




Deaths linked to obesity, of which there are about 30,000 a year, shorten the life of the deceased by nine years on average.




Your risk of coronary heart disease doubles at a BMI of over 25, and nearly quadruples at a BMI of 29 or more.




The risk of developing type 2 diabetes is 40 times greater at a BMI of 35 or more.




III health linked to obesity is responsible for 18 million days off work a year and costs the NHS at least £500 million a year in treatment.



must know

Being underweight

Being underweight (BMI of 18.5 or less) is a health hazard, and can lead to loss of fertility in women, lower resistance to infection, osteoporosis and a lack of vital vitamins and minerals. Extreme loss of weight can also indicate eating disorders, such as bulimia or anorexia nervosa, which require careful and specialized treatment.



Why weight is to blame

It is easy to imagine why being overweight can cause certain health problems – breathlessness or pain in weight-bearing joints such as the knees and lower spine. Some medical conditions, however, have a more complex relationship with weight. As we saw earlier, a BMI of between 18.5 and 24.9 is thought to be within the desirable ‘healthy’ range, so, in theory, any weight gain that takes your BMI above 25 is potentially a risk to your health. It is generally accepted though that the risk of serious conditions, such as diabetes and heart disease, rises significantly at a BMI of around 27 or above.

So why worry if you are only a few pounds overweight? The trouble is that extra pounds can have a habit of creeping up on us unawares. So if your BMI hovers around the 25 level, it makes sense to keep your weight stable or to lose a few pounds. And, of course, if your BMI is unhealthily high, slimming will quickly bring big benefits (#ulink_1c8d2642-75dc-579b-8b38-e14c0498ba40).

Weight-related health problems

Below is some background information to the most common weight-related health problems that may develop.

Coronary heart disease

One of the key aspects of heart health is the ability of the heart and its surrounding arteries to circulate blood strongly and freely round the body. Being overweight can damage heart health in a number of ways, mainly by raising the level of unhealthy fats, such as low-density lipoprotein (LDL) cholesterol and triglycerides, in the blood. A build-up of these fats over time can narrow or clog the arteries, a condition known as atherosclerosis, and this in turn can lead to chronic diseases such as angina, or acute conditions such as a heart attack.






Make the most of seasonal food like berries to give your health a boost.






Change the odds on good health in your favour by eating well.

High blood pressure, which is three times more common among overweight people than slim people, is also a big risk factor. And even where there are no problems with blood fats or blood pressure, just carrying excess weight, especially around the middle, seems to increase the likelihood of developing heart disease.



must know

Body fat

This is not always the bad guy! We need a certain amount of body fat to protect and insulate our organs; it also has a role in producing certain beneficial hormones, and protects against loss of bone mass (osteoporosis).



Type 2 diabetes

This condition affects 1.4 million people in the UK and possibly a further million who have not had their condition diagnosed, according to the charity Diabetes UK. Type 2 diabetes is sometimes called ‘late onset’ because, unlike type 1, it tends to develop in adult life, and being overweight is a big risk factor: over 80 per cent of adults with type 2 diabetes have a BMI of more than 25 when they are diagnosed. Children and teenagers are also being diagnosed more frequently as obesity rises.

Type 2 diabetes is caused when the insulin that the pancreas produces in the body fails to control blood sugar properly (insulin resistance) or when the pancreas fails to produce enough insulin for the body’s needs. Research shows that excess weight, especially around the waistline, increases insulin resistance so the pancreas has to work harder to get the same effect. Having too much sugar in the blood causes symptoms such as excessive thirst, blurred vision, fatigue and passing urine frequently. Having too much insulin in the blood causes other problems, such as increasing blood pressure and raising the level of various fats in the blood. This puts people with type 2 diabetes at high risk of heart disease and stroke; untreated diabetes can also cause serious damage to the eyes, kidneys, nerves and circulation.



must know

‘Syndrome X’

Also known as metabolic syndrome, this term refers to a collection of symptoms that include evidence of insulin resistance, fat carried around the middle (‘apple’ shape), high blood pressure and raised levels of unhealthy fats (LDL cholesterol and triglycerides) in the blood. Together, they represent an increased risk of heart disease, diabetes or stroke. Some diets claim to have specific benefits for people with Syndrome X, but any healthy eating and exercise programme, leading to a five or 10 per cent initial weight loss, should reduce all these symptoms without any special diets being needed.



Cancers

Cancer Research UK states that after smoking, obesity is the second biggest preventable cause of cancers. The links between being overweight and cancer are complex and not all of them are fully understood.However, it seems that obesity can unbalance the function of certain hormones, which could increase the risk of hormonally-sensitive cancers in women, such as cancer of the uterus, ovaries, cervix and endometrium (uterus lining). Excess abdominal fat (the ‘apple’ shape) has also been linked to a higher risk of breast cancer in women after the menopause. Cancers of the digestive system, such as colon or rectal cancer, may have more of a link to a high-fat, low-fibre diet, which is likely to lead to weight gain.



must know

Weight reduction benefits

Here is an overview of the average benefits of a 10 per cent (10 kg or 22 lb) reduction in weight of a man with a starting weight of 100 kg (220 lb) or just under 16 stone.




The risk of premature death is reduced by 25 per cent.




Systolic blood pressure is down by 10 points, and dystolic blood pressure down by 20 points.




The level of LDL cholesterol is down by 15 per cent.




The risk of dying from diabetes complications is down by 30–40 per cent.




The risk of dying from obesity-related cancer is reduced by 40–50 percent.



High blood pressure

Blood pressure is measured by taking two readings: the systolic pressure (the first, higher figure, taken when the heart contracts) and the dystolic pressure (the second, lower pressure, taken when the heart is relaxed). A normal level is 120/80, and a reading that is consistently over 140/90 is unhealthily high. Many people with high blood pressure have no symptoms, but that does not necessarily mean that there is no problem: untreated high blood pressure can cause a stroke, heart disease or damage to other organs in the body.

Being overweight is not the only cause of high blood pressure: eating too much salt, drinking too much alcohol and being inactive can also contribute. The good news is that as well as losing weight, changing your diet and lifestyle is a quick and effective way to reduce your blood pressure.

Gall bladder disease

One large study found that overweight women were 33 per cent more likely to develop gallstones than a similar group of healthy-weight women. Gallstones are a painful side-effect of the build-up of fats in the blood, as they are caused by clumps of cholesterol in the gall bladder, which plays a part in digestion. Cancer of the gall bladder is a rarer complication.

You lose, you win!

As we said at the beginning of this chapter, knowing the facts about the serious health consequences of being overweight is not all bad news. The flipside of the problems of gaining weight is that losing weight can bring quick and significant health benefits. A reassuring body of research has concluded that if you are seriously overweight (BMI of 30 or more), then losing just 10 per cent of your body weight can improve your health and even add years to your life.

Other health benefits

As well as the established evidence of improvements to these life-threatening aspects of obesity, successful slimmers often report that losing weight benefits their health and well being in many other ways, too. These can include improving the symptoms of asthma; less heavy or painful periods; reducing backache, arthritis pain and gout; improving digestive conditions such as irritable bowel syndrome; getting a better night’s sleep (being seriously overweight can lead to a distressing and dangerous condition called obstructive sleep apnoea); and a general lifting of mood.

Add to all these benefits the overall feel-good factor that comes from having more energy, feeling fitter and healthier, and experiencing the confidence that comes from knowing that you are looking good. It is hardly surprising that people who have lost weight successfully nearly always say: ‘I just wish I’d done it sooner.’



want to know more?

Take it to the next level. . .




Cutting down on salt




Diabetes and the Glycaemic Index




Slimming clubs




Energy and fitness




Maintaining a healthy weight

Other sources




Consult your doctor if you have any symptoms of diabetes.




Check your blood pressure; many people don’t know that theirs is too high.




If you are very overweight, see your GP or practice nurse about slimming strategies. Some offer free or low-cost referral to local slimming clubs or leisure centres, for extra support.




For help on quitting smoking, call the NHS Smoking Helpline on 0800 169 0 169. www.quit.org.uk




For advice on eating disorders, contact the Eating Disorders Association helpline: 0845 634 1414. www.edauk.com











3 In search of a cause (#ulink_743c3815-4e48-54fa-a766-77b525d9ddf3)


As a nation, we are gaining weight faster than ever before in our history and obesity is now officially classed as an epidemic. How can this be happening? Is it ‘all in our genes’, or are our modern diet and environment to blame? The truth is complex but one thing is clear: being aware of the theories can help you to find your own practical solution.




Why we’re the shape we’re in (#ulink_1aeeb211-f385-5668-816d-7427d0754cde)


Why do some people put on weight easily while others seem to eat what they like and stay slim? We don’t fully understand but the evidence has a positive message: in health and fitness, nearly all of us have the power to take our destiny into our own hands.






It’s worth getting babies into healthy eating habits as early as possible: overweight children are more likely to stay that way into adult life.

The energy equation

There is no getting away from it: we gain weight when we eat more calories than we expend, and vice versa. This ‘energy equation’ is a basic law of physics and it is important not to lose sight of it, especially if you are weighing up some of the commercial weight-loss plans on offer. Any diet that promises that you can slim without changing your diet or activity level in anyway is one to strike off your list!

However, the simple truth of the energy equation hides a multitude of complex factors that can affect, on the one side, how and why we eat, and on the other, how efficiently our bodies burn fuel. These factors include our genetic make-up; our age; our metabolism; our environment; our state of general health; and our emotional response to food.

Very often you will read about a new scientific breakthrough that appears to lay the blame for our weight problems solely at the door of one of these factors: ‘it’s all in our genes’ or ‘how hormones make you fat’. In reality, however, it is unlikely that any single discovery will ever give us all the answers or provide a complete solution. And in a way this is good news because it means that we have more control than we might think over the many factors that affect our weight, and there is a lot that we can do to improve our chances of staying in good shape throughout our lives.



must know

Getting heavier?

There is now evidence that our environment can seriously damage our size. In 1955, fewer cars and more housework meant that the average woman could expend up to 800 calories a day more in activity than she does today. According to a recent survey, the average woman now weighs 65 kg (10 st 3.5 lb) and measures 38-34-40.5, but in 1951 she weighed 62 kg (9 st 10 lb) and she measured 37–27.5–39.



Family matters

A child with two obese parents has a 70 per cent chance of becoming obese, compared to 20 per cent for a child of two slim parents. That alone suggests strongly that our weight is predetermined by what we inherit from our parents. But how far is that inheritance down to genes, and how much is due to the family’s lifestyle? And if the link is genetic, which side of the energy equation are the inherited genes affecting?

Much of the current research into the link between genes and weight concerns the behaviour of individual genes and how they affect our appetite or the way we turn food into energy. There have been some exciting developments: for instance, it has been shown that in very rare cases, severe obesity is caused by a genetic mutation that causes the failure of a hormone called leptin, which regulates appetite in the brain. Children born without leptin will eat uncontrollably, but their appetite and weight will return to normal once they receive leptin injections.

Our caveman inheritance

Eventually, research into leptin deficiency and some other specific gene mutations may lead to effective treatments for what scientists now call ‘common obesity’. However, whereas only a very few people are unlucky enough to have faulty genes, none of us can escape the genetic pattern that has been handed down to us over millions of years.

Our earliest human ancestors evolved in an environment where food supplies were scarce and sporadic. Our strongest food preferences and cravings – for sweet, fatty and salty foods – are a reminder of the times when sources of glucose, essential fats and minerals were hard to come by. Energy conservation in time of famine was vital, so those human beings who had ‘thrifty genes’ –who were most able to convert food to fat and store it effectively – were the most likely to survive, breed and pass on those genes.



must know

Body shapes

Basic body shape is inherited and can only be modified, not completely changed, by diet and exercise. Typical body shapes are as follows:




Endomorph (soft and rounded, with a higher than average percentage of body fat).




Mesomorph (well proportioned with a higher proportion of muscle to fat).




Ectomorph (taller and narrower than average with lower than average body fat).



Old genes, new environment

Unfortunately, the genetic make-up that suited us so well for survival in prehistoric times is very unhelpful today in our modern environment. Instead of eating fatty, sweet or salty foods only rarely, we now have access to them 24 hours a day, seven days a week, if we want. When we do eat excess fat and sugar, our ‘thrifty genes’ ensure that we store it very efficiently as fat. And instead of foraging and hunting to find our food, we only have to drive to the supermarket, pick up the phone or log on to the internet.

So how can a history lesson help us to lose weight? One vital thing it teaches us is that weight is not a moral issue. People do not put on weight because they are essentially greedy, lazy or sinful: on the contrary, gaining weight is the natural human response to life in a food-rich and activity-poor environment. If our ancestors had had the choice between hunting for their food or going to the supermarket, which one do you think they would have chosen?






From generation to generation, it’s hard for us to escape the genetic patterns that are handed down through the ages.

As we are discovering, the fact that our genes have not yet caught up with our environment is bad news for our health. So the other lesson that history teaches us is that, as we cannot change our genes, in order to stay slim and healthy we need to adapt our environment-with small changes to diet and lifestyle that can swing the energy balance back in our favour.

Metabolism

This is the process by which the body converts the food that we eat into everything it needs to function, and as such it plays a key role in regulating our weight. Between 20 and 30 per cent of the energy that our metabolism produces is spent on exercise, and between five and 10 per cent is used to digest our food. The remaining energy – which is between 60 and 75 per cent – is consumed as ‘resting metabolic expenditure’ (RME), and this can vary widely between individuals. Medical problems that can affect the metabolism include an under-active thyroid and, in very rare cases, conditions such as Prader-Willi Syndrome.






If you’re stressed, try to relax or have a massage rather than comfort eating.

People with weight problems often believe they have a slow metabolism, but in fact overweight people have a faster metabolism than average as they need to burn energy more efficiently to move a heavier body around. This explains why slimmers often find it hard to lose the last few pounds towards their target; with less weight to carry, the body requires slightly fewer calories to support the metabolic process and therefore their diet and exercise plan might need a slight adjustment. This does not mean though that dieting ‘damages’ the metabolism; it is a natural process that re-sets the body’s energy balance over time.

One major factor that influences your metabolic rate though is the amount of lean muscle tissue in your body, as lean tissue is a more efficient fuel-burner than fat. Becoming more active is a great way to boost your metabolism – exercise burns fat, and builds muscle, which burns fat more efficiently. . . a win–win situation for your body.



must know

Fast food

It’s official: fast food causes weight gain. A 15-year study in the US showed that people who ate at fast food restaurants more than twice a week gained an extra 4.5 kg (10 lb) compared to those who ate fast food less than once a week.



A NEAT trick

Scientists are also excited about the way that we move and use energy when we’re not consciously exercising: a process they call Non–Exercise Activity Thermogenesis (NEAT). Studies at the Mayo Clinic in Minnesota, USA, have shown that obese people expend fewer calories in all areas of daily life than slim people; they sit still for longer periods and even fidget less. Researchers estimate that slim people could ‘naturally’ burn up to 350 calories more per day in this way than overweight people – the equivalent of a 30–minute run. When slim volunteers were overfed so that they put on weight, their energy output remained the same, however, suggesting that the overweight people were not being lazy’: there is a bio–chemical process at work that predisposes them to be less active.

While it may take years to identify exactly how and why this happens, it is further evidence that making activity an everyday habit is key to losing weight and staying slim –wherever you start on the road from completely sedentary to fighting fit.

Eating for two

A 2005 survey of 2,000 new mothers found that nearly two years after giving birth, their average weight was a stone heavier than they had been before their pregnancy. Of course, putting on some weight is expected and desirable in pregnancy. However, many women who have never had a weight problem find that the pounds pile on and then prove very hard to lose long after their baby is born – so much so that they despair that pregnancy has somehow changed their natural weight forever. The reassuring news is that there seems to be no fundamental, physical reason why this should be the case. It appears more likely that any weight gain is a side-effect of the upheaval in lifestyle that can come with the arrival of a new baby: lack of sleep, snatched meals, no time for exercise and more time spent at home can all alter the energy balance sufficiently so that weight goes on and stays put.

Monitoring your weight in pregnancy and not ‘eating for two’ so that you do not gain too much is sensible; around 13 kg (28 lb) is an average amount. Breastfeeding is good for the baby and for you, as it uses up around 500 calories a day. Crash diets and intensive exercise are not the way to regain your pre-pregnancy shape, whatever you might read in celebrity magazines. Instead, go for a slow and steady weight loss, with a healthy diet and gradual increase in activity, and aim to lose any surplus pounds over a period of months rather than weeks.

It’s my age

Is it inevitable to gain weight as we get older? Surveys suggest that we are at our heaviest in our 40s and 50s, and that the main reason for this is that we become gradually less active, rather than eating more. One large research project found that most adults will gain 9 kg (20 lb) between the ages of 20 and 55 years unless they take specific steps to avoid it.

So eating as if you are still playing football twice a week, when these days you are watching it on television twice a week, is a relatively effective way to score an own-goal as far as your weight goes.



must know

Drugs and medication

Weight gain can be a side-effect of some drugs and medical treatments. These include cancer drugs, such as tamoxifen; some steroids and antidepressants; and some drugs for diabetes and epilepsy. Ask your GP about the side-effects of any medication you are prescribed and whether you need to be careful about your diet while you are taking it.



The menopause

Women going through the menopause often feel they have more trouble managing their weight and may accept gaining the ‘menopause 10’ as an inevitable side-effect. However, as with pregnancy, that other major hormonal event, research suggests that the menopause does not necessarily lead directly to weight gain, although increased levels of testosterone and decreased levels of oestrogen may mean that the distribution of weight will change slightly, so that ‘pear’ shapes become ‘apples’ – the classic middle-age spread.

As we saw earlier, carrying excess weight around the waist represents a higher risk of developing health problems than on the hips and thighs, so it is well worth aiming to get your weight into the healthy range and your waist below 80 cm (32 in).



want to know more?

Take it to the next level. . .




Work out your own energy balance (#litres_trial_promo)




Boost your metabolism with exercise (#litres_trial_promo)




Build activity into daily life (#litres_trial_promo)

Other sources




Buy a pedometer to monitor how active you are each day.




Swap to low-fat, low-sugar versions of the foods you crave to enjoy the taste without the calories.




For more on healthy family eating: www.nutrition.org.uk




Spot the obesogens in your daily life: are there ways to combat them?




Join a reputable slimming club for support in healthy eating and managing your weight.











4 The science of weight loss (#ulink_2eb559d7-a6d3-5669-8944-4e263679eefb)


Understanding the energy equation and how to alter it in order to promote weight loss instead of weight gain is the key to reaching a healthy weight. Knowing the facts can be the basis of taking control of your weight and staying motivated throughout a safe and steady weight loss campaign.




The energy balance (#ulink_9fb02747-cf2f-5273-9940-d6b2e42d5e04)


The last section looked at the energy equation and the different factors that can affect it. Now the time has come to apply those principles to individual circumstances.



must know

Calories

One calorie (4.2 joules) is the amount of energy required to raise the temperature of 1 gram of water by 1 degree Centigrade. Nutritionists measure the calorie values of foods by burning them in a calorimeter to see how much heat they give off. The major food groups differ in ‘energy density’ –the number of calories they contain per gram:




Fats have 9 calories per gram.




Alcohol has 7 calories per gram.




Carbohydrates have 4 calories per gram.




Proteins have 4 calories per gram.



Altering the energy balance

The next few pages set out how far to reduce your calorie intake and increase your calorie output in order to create your own personalized slimming plan which will guarantee safe and steady weight loss.

As the previous chapter showed, the science behind weight loss and weight gain is all about the energy equation: consuming more energy, in the form of food, than is expended in activity results in weight gain. To lose weight, it is essential to create an ‘energy deficit’ so that more energy is expended in activity than is taken into the body as food.

Units of energy

The units of energy used to measure this process are kilojoules or calories – the word that can be very off-putting for people who have followed the kind of diet that requires the counting and measuring of every single mouthful they consume. Unfortunately, it is impossible to ignore calories when trying to lose weight. It is true that there are plenty of diets that promise you ‘need never count another calorie’. This is generally because they either give calories another name, such as ‘units’, or because they ensure that calorie intake is controlled automatically by limiting the kinds of foods that can be eaten.



Calculating your energy deficit

The aim of this section is to show you how to calculate a personalized energy deficit by working out:




Your current energy expenditure.




Your current energy consumption.




Your daily energy requirements needed to lose weight steadily.

Inevitably, this means talking about calories. However, it is possible to lose weight easily by being calorie-conscious and without having to become a calorie slave



must know

Calorie guides

Buy a calorie counter book for an at-a-glance guide to thousands of everyday foods. These are available at most newsagents and bookshops. Don’t guesstimate!








Bulky, watery foods like salad vegetables make good low-calorie fillers in a slimming diet.



must know

Diet or exercise?

When thinking about losing weight, men and women tend to have different approaches: women say it’s ‘time to start the diet’ and men say it’s ‘time to hit the gym’. It is perfectly possible to create an energy deficit by changing your diet alone, or just by doing a lot more exercise (although the exercise-only route is slower). The perfect combination for health and weight loss is to do both: to make some small changes to your diet, and to become a bit more active as often as possible.



Where does it all go?

The body uses the food we eat in three main ways: for growth; to replace damaged or worn-out tissues; and to fulfil all the body’s daily functions, which can range from breathing to ballroom dancing. The amount of energy needed from food to keep the body going, without gaining or losing weight, is called the basal metabolic rate (BMR). Any energy (calories) which is taken in over and above the requirements of the BMR is stored – and, as the last chapter showed, this is one thing at which the body is very efficient.

Once food has been digested, any surplus energy is stored either as glycogen – a short-term energy source, which is stored in the liver and the muscles – or as fat, which is stored in ‘fat depots’ under the skin, around the kidneys and in the abdomen. There is a limit as to how much glycogen can be stored before it is released back into the bloodstream to be used, but there is no limit to the amount of fat that can be stored. Fat cells get bigger, multiply and form adipose tissue which can eventually present a threat to our health.

It takes about 3,500 calories surplus to the requirements of the BMR to create 1lb (454 g) of stored energy (otherwise known as fat). So an individual whose BMR is 2,500 calories per day, and who eats 3,000 calories’ worth of food per day without changing his or her activity level in any way, could expect to put on a pound a week (7x500 = 3,500 calories). In practice, our body weight fluctuates from day to day and even at different times of the day, which is why it is best to weigh yourself only once a week at the same time –jumping on the scales more often can be misleading. However, overtime, a steady over-supply of calories without an increase in activity to compensate will surely result in a weight gain.






Healthy home-grown vegetables: fantastic for taste, freshness and providing valuable nutrients.



And in the same way, creating an energy deficit, so that more energy is expended than the BMR requires, will equally surely result, overtime, in weight loss. So, again, someone whose BMR is 2,500 calories and who eats 2,000 calories’ worth of food each day could expect to lose a pound a week.

Find your balance

There are four steps to working out your basal metabolic rate (BMR):



1 Assessing the resting metabolic expenditure (RME).

2 Making an allowance for activity.

3 Adding in 10 per cent for the energy used in digesting food.

4 Totalling it all up.


As you will see from the instructions and the example given below, this is much easier than it sounds.

Step 1

Use the table to read off your RME. The differences in the table are accounted for by gender and age: generally, men need more calories than women to maintain their weight because they have a higher percentage of muscle tissue, which burns fuel more efficiently than fat. Age is a factor, too, because the amount of energy the body needs for maintenance peaks at the age of about 25 and declines gradually after that, at a rate of about two per cent per decade.



Your RME











Step 2

Factor in your activity level, based on what you normally spend most of the day doing. The guidelines and calculation are as in the table opposite (top).

Multiply your RME from Step 1 by the activity factor to find the number of calories needed for activity each day.



Your activity level






Step 3

Add together your RME figure and your ‘activity calories’ figure and divide by 10 to find the calories needed for digestion.

Step 4

Add together your RME figure, ‘activity calories’ figure and ‘digestion calories’ figure in order to find your BMR (basal metabolic rate) – the total number of calories that are needed each day to maintain your weight.

To lose weight steadily, the best combination is to reduce your calorie intake and to increase your calorie expenditure by making changes to your daily diet and activity levels.



must know

Working out BMR

Jane is a 30-year-old mother of two with a part-time office job. She weighs 76 kg (12 stone).




In step 1, Jane works out her RME to be: 8.7 x 76 + 829 = 1,490 calories.




In step 2, she estimates her activity level as ‘light’ and her activity factor as 0.3. So the calories she needs for activity are: 1,490 x 0.3 = 447




In step 3, Jane adds her RME and activity calories together and divides by 10 to find the calories she needs for digestion: 1,490 + 447 = 1,937 10 = 193




In step 4, she adds the three totals together to find her BMR (total daily calorie needs): 1,490 + 447 + 193 = 2,130 calories.



Keeping a food diary

Having worked out how many calories you need to maintain your current weight, the next step is to work out how many calories you are taking in as food. Nutritionists recommend that the best way to do this is to keep a food diary. To get a full picture of calorie intake it is important to keep the diary for at least a week, or longer if you feel it would be helpful. Keeping a food diary sounds easy but, in practice, researchers have found that people who are asked to record their food intake almost always under-report what they actually eat. However, to identify patterns of where calories are coming from and where easy savings can be made, it is important to be as detailed and honest as possible – after all, no one else will see the diary. It is also important to eat and drink exactly as usual and not to change your normal routine in any way, as you need to keep track of all the occasions during the week when you might have an opportunity to save calories.



must know

Calorie savings

Look over your food diary to identify the areas where it would be easy for you to make calorie savings.



Sample food diary for a single day

Breakfast

Med egg, 2 rashers back bacon, 1 tbsp vegetable oil, 2 slices white toast, 2 tsp butter, 200 ml glass orange juice, 2 cups tea, whole milk, 2 sugars

Lunch

100 g chicken, 15 cm baguette with 1 tbsp mayo, 25 g packet plain crisps, apple, 2 cups tea, whole milk, 2 sugars

Dinner

225 g grilled rump steak, 225 g jacket potato, 1 tbsp butter, 2 tbsp poached mushrooms, 1 grilled tomato, medium bowl strawberries, 2 tbsp double cream

Snacks/drinks

2 cups coffee, whole milk and 2 sugars; 2 chocolate digestives; 2 x 175 ml glasses red wine; 1 glass water

Total calories per day: 3,048



At this pre-weight loss stage your aim is just to observe everything you eat and drink over the diary period. You are not trying to lose weight – not yet anyway. The example shows the level of detail that is required.

Food diary rules




Write down everything you eat and drink, as you are eating it.




Always be specific – include cooking methods, brand names, quantities (estimate as closely as you can) and varieties, e.g. ‘diet drink’ or ‘full-fat yogurt’.




Include ‘hidden’ ingredients such as butter in sandwiches or sugar on cereal.



Identifying calorie savings

After a few days of diary keeping it may well be that eating patterns can be seen more clearly, so that it is possible to see ways of reducing your calorie intake by swapping to lower-calorie, lower-fat foods or by reducing portion sizes. For example, from the diary it can be seen that the day’s intake is high in sugar and in full-fat products, such as butter, milk and oil. The table below shows just how many calories could be saved by swapping to different varieties:




Making the swaps shown above would save 623 calories in a single day –without having to make any noticeable changes to the diet. Some people will find that there are easy, daily calorie-savings they can make in their diet, whereas others may identify regular but not daily occasions –such as a weekly takeaway or a night out –where big calorie-savings can be made at a stroke. This is why it is important to keep the food diary for as long as it takes to establish a pattern.



must know

Average intake

At the end of the diary period, the average daily calorie intake can be worked out by adding up the daily totals and dividing by the number of days. To do this, it is worth investing in a comprehensive calorie-counting guide which has thousands of food products, including branded ones.



How quickly should you lose?

Now that you know how many calories you need to maintain your weight, and how many you are currently eating each day, you can decide how much of an energy deficit you will need to set up to lose weight steadily and safely. Cutting back on food drastically– such as by sticking to a rigid 1,000 calories a day diet when your BMR is 3,000 calories – would undoubtedly lead to rapid weight loss. But it is very unlikely that you would be able to sustain it in the long term, leading to a dispiriting ‘failure’ and, probably, an equally rapid weight gain once you started eating normally again.

Gradual weight loss is best

Health professionals recommend that a safe and steady weight loss is about 1–2 lb (0.45–0.9 kg) a week. Slimming at this rate ensures that you will be losing fat rather than lean tissue, such as muscle, and it should be fairly easy to achieve without drastic calorie-cutting measures, so that you can stick with your plan without it feeling like a ‘diet’. And, as a bonus, research shows that people who lose weight slowly are more likely to keep it off in the long run.

As it takes an energy deficit of around 3,500 calories to lose 1lb of fat, a daily saving of about 500 calories should be enough to lose 1 lb a week (7 x 500). Saving 1,000 calories a day (say, from 3,000 to 2,000) could result in a 2lb weekly loss, but this depends on current intake: women should not try to lose weight on less than around 1,500 calories a day, while for men the minimum is around 1,900 calories a day.

In the first few weeks of a weight loss plan it is possible to lose more than 1lb or 2lb a week. This is because glycogen (the short-term store of surplus energy) is stored in three times its weight of water, which accounts for a lot of the initial weight loss. This can be a very motivating start to a weight-loss campaign and it may continue for longer than a week or two, especially if you have a lot of weight to lose.



must know

Working out calorie needs

For a rough guide to your daily calorie needs, multiply your weight in pounds by 15 if you are moderately active: or 13 if you have a sedentary lifestyle. Using Jane as an example (#ulink_a1fc2ce1-95fc-58f4-8ef2-35160633cc42), this method would estimate her total calorie needs at 2,173 compared to 2,130 for the four-step calculation.








There is no need for any drastic calorie cutting – or boring meals – when losing weight; healthy food can be filling and delicious.



must know

Calories from alcohol

These are not stored in the body but are used immediately as energy. That sounds like good news but it’s not; this is because instead the body stores calories from other sources such as fat, which tend to accumulate in fat deposits in the abdomen, and may account for the observation that many heavy drinkers are ‘apple-shaped’.



Weight loss, balance and health

This chapter has looked at ‘calories in and calories out’, a concept which is essential to understand in order to create an energy deficit. However, it is not enough on its own to help the slimmer because it does not address the other key question: what you should eat in order to ensure that a weight loss plan is also healthy, balanced and enjoyable for you to follow.

After all, if your only aim was to lose weight by creating an energy deficit, then the diet could consist of anything at all, as long as it saved calories. However, when you are devising an effective and personalized slimming plan, it is vital to ensure that your daily diet is healthy and balanced; that hunger is kept at bay; and that enough favourite foods are included so that the plan feels comfortable and enjoyable and you don’t feel that you are missing out on meals. All of these aspects are covered in the next section.






Adding lemon to a gin and tonic doesn’t make it healthy! Alcoholic drinks provide ‘empty calories’ with little nutritional value.

Energy deficit

By calculating your BMR (#ulink_1ef76f1b-1a00-5bb6-b1d4-e016779a37d8) and your calorie intake you will build up a picture of whether your current energy balance is likely to help you maintain your weight or whether you are consistently taking in too many calories for your needs.

Adjusting both your food intake and your activity level will help to shift the balance so that you begin to lose weight; it will be important to keep a food diary (#ulink_6c0b46dc-5e4e-5fa8-8e09-98b768bbaa9d) for the first few weeks of your weight loss plan so that you can keep track of all the meals, snacks and drinks that you consume.

Once you have started this process, have done all the calculations and are sure that you are in energy deficit but you are not losing weight, then the most likely explanation is that somewhere something has been missed; it may be that daily activity has been over-estimated, or calorie intake has been under-estimated. Another week’s food diary and another calculation of the ‘activity factor’ could reveal what has been happening.




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