Balancing the scales in obesity: 5 signposts along your weight loss journey

This series on common health concerns among youth was created in collaboration with Tan Tock Seng Hospital.

What comes to mind when you hear the word “Obesity”?

Obesity is a medical condition – defined by the World Health Organisation as a body mass index (BMI) of more than 27.5 kg/m², with a BMI of 23-27.5 kg/m² being in the overweight range. Obesity is the root cause of many other diseases such as high blood pressure, Type-2 diabetes, high cholesterol as well as joint and back problems. Left unchecked, these can lead to complications and disabilities in the long run.

Contrary to popular belief, obesity is not entirely caused by an “unhealthy lifestyle.” In fact, research shows there is a strong genetic basis for obesity. For example, certain genes cause people to feel full less easily, or to use food as fuel less efficiently. That’s why different people can put on different amounts of weight after eating the same things!

Unfortunately, obesity carries a certain stigma in modern times. Shaming and bullying people who are struggling with their weight has become commonplace, especially online. Such negativity is certainly unhelpful and can be psychologically damaging – especially when focused on unrealistic body image and aesthetic ideals.

If you’re struggling with your weight, and feeling discouraged or resigned – remember that you are not alone. We acknowledge that weight loss can be challenging, almost like a mountain to climb. However, there are little steps you can start taking day by day to improve your health – and if you’re motivated to embark on this journey, you’ll find it worth your while!

Here are five signposts for you as you travel along in your weight loss journey.

Changing what you eat can often be the most difficult first step. You might want to start by reducing the amount of “energy” you’re taking in from your food – in nutritional terms, this means reducing your calorie intake. A calorie count is simply a way to measure the energy contained within a specific food.

If your energy intake (from food) equals your energy output (from exercise) – you’ll maintain your weight. Reducing calorie intake helps to tip these scales in your favour.

Different nutrients contain different amounts of calories:

This makes it clear that fat and alcohol should be the first things to go – so no more deep-fried chicken and beer! Reduce your fat intake by choosing lower-fat alternatives to replace high-fat options. For example:

At the same time, increase your fibre intake from fruits, vegetables and whole grains – the fibre will keep you feeling full, so you can keep your meal portions under control.

Instead of cutting out snacks altogether (hard for anyone!) – why not try and change your snacking habits?

We often default to snacks either high in sugar (like cookies, chocolate and bubble tea) or deep-fried and heavily-salted (like potato chips, french fries, and chicken nuggets). These types of snacks trigger reward circuits in our brains and leave us wanting more.

A good step to take here is to first meet your daily 2 servings of fruit a day, treating these as snacks. Fruits are generally packed with vitamins and fibre. They make for good after-meal snacks (instead of that ice cream or cake) and work just as well for a tea break.

If you find chopping fruits to be too time-consuming, you can select fruits that are easily eaten whole (apples, pears, bananas) or purchase frozen fruits (berries, peaches, mangoes) that can be stored for long periods of time.

Other healthy and nutritious snack alternatives include eggs (rich in protein), low-fat cheese and yoghurt, crunchy vegetables (like cucumbers, carrots, and cherry tomatoes), beans (like edamame), nuts and seeds.

And maybe make that bubble tea a once-in-a-while treat? You might not miss it as much as you think!

Everyone needs to exercise – not just people who are overweight. Incorporating exercise into your daily routine will strengthen your heart and lungs, improve your muscle strength, and do your body good in the long run.

Start with any activity you enjoy. Whether team sports or racquet sports, jogging or swimming, cycling or rollerblading or hiking – anything that gets you moving!

Set some goals for yourself – commit to a certain frequency (e.g. once a week to start with, perhaps with a group of friends), and work from there. You’ll eventually want to be working up a sweat and a little breathlessness for about 2.5 hours per week in total – but just get started first!

Exercise can also work its way into your daily schedule, if you’re clever about it. Should you find yourself sitting in a chair most of the day – get up from time to time, stretch and walk around.

Take the long route to the toilet. Take the stairs, not the lift. Get off the bus one stop early to walk the rest of the way – and walk briskly. Cycle to school or work. Do the chores at home. Do some push-ups, sit-ups, planks, or jumping jacks every morning. The possibilities are nearly endless!

HIIT (high-intensity interval training) has gained popularity recently. Its short duration and hassle-free setup are appealing to those with busy schedules – all you need are good shoes, an exercise mat, and 15 minutes (and probably good shower after that)!

One of the keys to safe HIIT training is to gradually modify the intensity of the work interval – start low, and go slow. Don’t compare yourself to others or try to build Rome in a day – focus on finding your own optimal training intensity.

As you try to get more physically active, remember to prioritise your own safety. If you have any pre-existing medical problems or sports-related injuries, seek tailored advice from your doctor or physiotherapist before embarking on HIIT or any exercise training.

A well-rounded fitness program that includes strength training may in fact decrease the incidence of sports injuries by increasing the strength of your muscles, tendons, ligaments, and bones.

Be kind to yourself. Recognise that weight loss does not happen overnight, and is more sustainable if it happens gradually and steadily. Continue pushing ahead with new goals – perhaps set one to two realistic targets for yourself every one to two weeks (e.g. stopping a particular sugary drink, limiting yourself to a particular snack just once a month, cutting down portion sizes by a certain percentage, going for a walk – then a jog – twice a week).

A medical professional can help you set some goals if you’re not sure where to start, or how much weight you need to lose.

What about intensive diet plans? Weight loss through diets such as intermittent fasting or short-term low-calorie ketogenic diets are effective in adults – but their effects on youths aren’t so well-known. Overly restrictive diets, especially in growing teenagers, may result in harmful nutritional deficiencies and eating disorders.

Fad “keto diets” also have significant downsides – they are high in saturated fat, exclude healthy carbohydrates such as whole grains, and are difficult to sustain.

Instead of “miracle” diets, perhaps think in the long-term. Adopting a diet low in refined sugar, high in whole grains, and low in saturated fat is a healthier and more balanced approach.

It’s best to begin laying foundations for good lifelong habits, rather than fixating just on quick results. In a weight loss journey, it is axiomatically true that slow and steady wins the race.

We’d like to close by saying this – don’t underestimate the power of your community. Weight loss is a long road – but it doesn’t have to be travelled alone! Let your friends and family know how you’re feeling, what you’re trying to do, and how they can support you in both emotional and practical ways.

Be intentional about seeking the company of people who encourage and motivate you with their words and actions, rather than tear you down.

If you don’t lose much weight at first, don’t be discouraged. Your body has a defence mechanism in place that actually tries to prevent you from losing weight as you lose it, by increasing your tendency to feel hungry, and by slowing your metabolism.

Acknowledge these barriers, and don’t give up – remember how far you’ve come, stay positive, and stay committed to your goals.

The medical community is here to help. We’ve already highlighted how obesity is a medical condition, and it can accordingly be diagnosed and treated. Seek help for your weight loss struggles, and you’ll find it is readily available.

From exercise programmes, to nutritional counselling, to support groups, to medications, and even to surgery – there are many treatment options out there, and perhaps one or more are suited to you!

Remember that you’re not in this alone.

This article was written by Dr Abel Chen – Associate Consultant, Endocrinology, Ms Melissa Ho – Senior Dietitian, Dr Rasminder Kaur – Family Physician, Endocrinology, Dr Ray Lai – Associate Consultant, Endocrinology, and Ms Swapna Tony – Principal Physiotherapist.