Obesity

Obesity is a complex, chronic medical condition. It is not simply a matter of not having enough self-control. There are a multitude of causes of weight gain that are not limited to the following:

  1. Psychological: Mental illnesses such as depression, anxiety, addiction, and trauma can lead to emotional or disordered eating and weight gain, e.g. using food as a reward or numbing feelings with food or alcohol. Speak to your health care provider if these apply to you.
  2. Mechanical: Conditions such as arthritis and chronic pain can lead to weight gain and make it difficult to be physically active. Chronic insomnia and untreated sleep apnea can cause weight gain, as well.
  3. Biological: Hypothyroidism, PCOS, menopause, and certain medications used to treat other medical conditions can all be associated with weight gain. Women generally have a greater body fat percentage and thus have a slower metabolic rate compared to men who are the same height and weight.
  4. Social factors: Income, access to nutritious foods, and cultural factors can impact weight.

Weight management is a life-long process. This document was created with the goal of guiding you through this process. It might be helpful to skim through the entire document for a general idea, but don’t try to tackle everything all at once, or you’ll be overwhelmed. Rather, every month, choose one or two “S.M.A.R.T. goals” (you can look up this acronym) and practice turning those into lifelong habits. Refer back to this guide frequently. Below are some questions to ask yourself to guide your thinking.

Why do you want to lose weight? These goals need to be important to you, in order to help you follow-through on your goals:

  • Do you want to improve your energy levels?
  • Do you want to cut back on or avoid starting on medications?
  • Do you want to reduce your back and joint pain?
  • Focus on your “why” power, rather than on your will-power. The “why” is the most important aspect to ensure sustainability and happiness.

How much weight should you expect to lose?

  • Slow, gradual weight loss (e.g. 0.5-2 lbs per week) is the best kind as it is most likely to be successful in the long term. Dramatic weight loss is almost never sustainable for more than a few months to a year.
  • Aim for your “best weight”. This is not necessarily your “ideal weight” or what the BMI calculator tells you is ideal. Your best weight is the weight that you stabilize at after following healthy, sustainable lifestyle changes that allow you to enjoy a happy life. Keep in mind that 5% of weight loss from your baseline weight can have huge positive health benefits.
  • Although your “best weight” may not be your “dream weight”, remember that your weight will continue to yo-yo if you blindly follow unrealistic weight loss programs to try to achieve a specific number.
  • If you are at your “best weight” and are still struggling with significant obesity or other chronic diseases, then you may need to speak with your care provider to see if weight loss medications or bariatric surgery would be an appropriate option for you.

How often should you weigh yourself?

  • Daily, weekly, monthly or never. Whichever option you choose, ensure that you are using the number on the scale purely as a data point, and not as a source of self-judgment.
  • Keep in mind that it is common to have day to day fluctuations due to water retention (salt intake/bloating/menstrual cycle changes), constipation, etc.
  • Large day to day weight fluctuations are typically NOT due to actual fat gain or loss.

Should you follow “x” diet?

  • Any diet can work, but a diet is not something that you are on temporarily.
  • Be honest with yourself and ask yourself if you can stick with “x” diet for the rest of your life and be happy. If the honest answer is yes, and you are noticing positive results, then by all means, stick with it.
  • Be sure to inform your health care provider that you are following a particular diet as this information may affect certain health markers and if you are on medications, perhaps they need to be adjusted.

If you don’t follow a diet, how will you lose weight?

  • Focus on lifestyle changes rather than trying to follow a diet, as this is the most sustainable long term.
  • Focus on small changes that can have a huge long term impact on your weight and overall health. Here are some common culprits to address:
    1. Are you drinking enough water throughout the day? 8 cups of fluid is a rough bench mark, but your requirements depend on your activity level and the rest of your diet. Increased water consumption can help reduce symptoms of hunger.
    2. Are you having enough vegetables, particularly leafy greens and colour-rich vegetables? You should be having 1-2 fistfuls of these veggies with every meal (ideally with breakfast, as well), every single day. They are full of important micronutrients, prevent constipation, and (most importantly) keep you full.
    3. Have some protein with every meal (including breakfast), e.g. poultry, fish, seafood, eggs, legumes, yogurt (plain, unsweetened!)
    4. Choose whole fruits rather than juices. Juices are loaded with sugar even if the have no sugar added. One glass of orange juice has about 4 whole oranges worth of sugar! Be mindful of what’s going in your smoothies, especially store bought ones, as they can be PACKED with sugar.
    5. Be mindful of any sweet beverages, as they can be full of simple sugars and empty calories. Examples include flavoured tea and coffee drinks, juice, chocolate/flavoured milk, and energy drinks– essentially anything besides water, plain tea and plain coffee. Other healthful alternatives include unsweetened fizzy water, or water with a couple slices of lemon or fruit.
    6. Focus first on what you can ADD to your existing diet rather than restrict (see above). Simply restricting foods or food groups completely without first considering what your diet is missing will eventually lead to dissatisfaction, binging and disappointment.
    7. Be mindful of alcohol! All alcohol, in particular beer and mixed drinks, are high in empty calories

What about exercise?

  • Exercise is critically important for overall physical and mental health, for sleep, and for weight maintenance. However, the vast majority of weight loss comes predominantly from dietary changes rather than from exercise. For context, a 5km run is equivalent to only eating 3/4 of a cookie.
  • Aim for 150 min of moderate intensity exercise spread over 4-7 days per week; start small and build up
  • When you exercise, your body sometimes makes metabolic adjustments to “preserve” energy. Also, after intense exercise, you’re likely to be hungrier and consume more food afterwards.
  • Strength training to increase your muscle mass does increase your overall metabolic rate.
  • Exercise is extremely importance for overall health, so make it a daily habit, but don’t think of it as a weight loss tool.

I hope that you found this guide insightful. Remember aim for consistency, not perfection.