August 13, 2015

Today’s news featured an article discussing the idea that the weight loss message needs to be more positive. Of course it does. Guilt and fear have no place in helping people lose weight.

For too long, it has been accepted that obesity is the result of eating too much and exercising too little. By extension, this would mean that an obese person is a glutton on the one hand and a sloth on the other. Neither of these are true for the majority of people battling their weight.

Federal Health Minister, Sussan Ley, was reported as instructing people to “put down the remote” and “go for a walk”. Of course this is good advice and we should all be doing some exercise, but what the Minister must not realise is that there is no evidence that walking leads to weight loss.

In response, the Australian Medical Association Queensland president, Chris Zappala, said that while Ms Ley’s initiative is excellent, people would benefit more from messages of the benefits of weight loss and from GPs talking about it with their patients. This is sensible but simplistic: messages of this kind do nothing to help people know how to take action.

All GPs know about the dangers and problems of excess weight, but most have no education or training in how to actually help their patients lose weight. Only those GPs with a special interest in obesity and who have elected to undertake further study in the treatment and prevention of obesity are able to assist in developing meaningful and effective weight loss strategies for their patients. In fact, many GPs are reluctant (scared?) to bring up the weight issue with their overweight patients: they’re simply at a loss as to what advice is effective.

‘Eat less and exercise more’ just doesn’t work for those struggling with their weight. Their hormonal status may be compromised, their microbiome may be working against losing weight, the size of their goal may be a genuine psychological obstacle, and the attention they receive when out exercising may not always be positive.

Rather than eating less, what about eating better? If calories dictate their choice of food, a meat pie (400 calories) might be seen the same as steak, baked potato with butter, and vegies (386 calories). ‘Eat less’ is obviously not the right message, as the meat and veg meal is bigger and would be much more filling than the pie, and with slightly fewer calories.

Food can used by the body to effect change in a range of areas that, in turn, affect weight. A low-fat diet high in carbohydrate stimulates an insulin response and resultant hunger, which in turn causes weight gain. A diet high in unprocessed foods stimulates beneficial gut bacteria and satiety, which in turn can assist weight loss. Neither of these has anything to do with calories, amount of food, or exercise.

Instead of listening to yet more gratuitous, simplistic, ineffective advice from people who should (or could if they bothered) know better, the overweight person needs understanding and an effective strategy to enable their body to access their own stored body fat for energy. Not only will this help them lose weight, it will, ironically, make them more inclined to be active.

Despite mixed messages from government and the medical fraternity, many people are taking matters into their own hands – much to the relief of their doctors. We’re even finding that many GPs are learning more about weight loss success from their Healthy Inspirations patients than from any other source. The positive result of this is that the GP can then refer other patients to a program that works.

Guilt and fear be gone!