The problem

The number of obese individuals has risen dramatically worldwide and the World Health Organization (WHO) has called the increase a global epidemic. Australia is no exception to this increase.

Overweight, and in particularly obese, individuals are at a higher risk of death and illness. Excess body fat increases the risk of developing a range of health problems including diabetes, heart and artery problems, high blood pressure, certain cancers, sleep apnoea, osteoarthritis, psychological disorders and social problems (WHO 2000).

Weight gain arises through an energy imbalance over a sustained period of time. While many factors may influence a person’s weight, weight gain is essentially due to the energy intake from the diet being greater than the energy expended through physical activity. The energy imbalance need only be minor for weight gain to occur, and some people—due to genetic and biological factors—may be more likely to gain weight than others (WHO 2000).

How do I know if I am overweight?

A quick way of measuring this is by using the Body Mass Index (BMI). BMI is calculated by dividing your weight in kilograms by the square of your height in metres. If you don't have a calculator or are not good with maths here is a link to an online calculator! Here..

Weight categories for adults aged 18 years and over based on BMI are:

o Underweight (BMI < 18.5)
o Healthy weight (BMI ≥18.5 and BMI < 25)
o Overweight but not obese (BMI ≥25 and BMI < 30)
o Obese (BMI ≥30).

How can I lose weight?

The two most common and effective ways to lose weight are diet and exercise. Important scientific facts are:

o Reducing the amount of energy (calories or kilojoules) obtained from food is the most important thing for long-term weight maintenance regardless of which specific diet is followed (Tangney et al., 2005).
o Low fat diets were no better than other types of weight reducing diets in achieving and maintaining weight loss over 12 to 18 months (Pirozzo S et al 2006).
o Individuals that increase physical activity are most successful in losing and maintaining weight (Diabetes Prevention Program Research Group, 2002).
o Exercise is important as a weight loss intervention and has beneficial effects on the heart and vessels of the body. Diet increases the effects of exercise on weight loss. Exercise improves health even if no weight is lost (Shaw K et al., 2006).

Do medications for weight loss work?

Drugs such as Xenical (Orlistat) and Subitramine (Reductil) can produce modest reductions in weight. One important review published by the Cochrane Collaboration (Padwal, R et al 2003) showed that when used in the longer term i.e. over a year there was a weight loss of about 3kg on average for Xenical and 4.3kg for Subitramine. Unfortunately many patients (33%) stopped taking Orlistat perhaps partly due to unpleasant side effects such as gastrointestinal upset or incontinence. Also 43% stopped Subitramine which has side effects of increased blood pressure and pulse rate. Always talk to your pharmacist or doctor about medication. More...

References

WHO consultation on Obesity. Obesity: Preventing and Managing the Global Epidemic. WHO technical report series 894. Geneva 2000. More...

Tangney CC Gustashaw KA Stefan TM Sullivan C Ventrelle J Filipowski CA Heffernan AD Hankins J. Clinical Nutrition Department at Rush University Medical Center. A review: which dietary plan is best for your patients seeking weight loss and sustained weight management?. Disease-A-Month. 51(5):284-316, 2005 May.

Knowler WC Barrett-Connor E Fowler SE Hamman RF Lachin JM Walker EA Nathan DM. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine. 346(6):393-403, 2002 Feb 7. More...

Shaw K Gennat H O'Rourke P Del Mar C. Exercise for overweight or obesity. Cochrane Database of Systematic Reviews 2006 Issue 4. More...

Pirozzo S, Summerbell C, Cameron C, Glasziou P. Advice on low-fat diets for obesity. Cochrane Database of Systematic Reviews 2006, Issue 4. More...

Padwal R, Li SK, Lau DCW. Long-term pharmacotherapy for obesity and overweight. Cochrane Database of Systematic Reviews 2003, Issue 4. More...

QOH runs a variety of programs on health promotion for workplaces including weight loss, healthy eating, quit smoking, stress management, healthy heart and others. For more information, assistance, or suggestions please contact david allen@qoh.com.au or call 98977699