I reside in Malaysia where obesity is a big problem.
And these days more often or not, everybody seems to be gaining weight easily!
Based on the World Health Organization (WHO) classification, the prevalence of overweight and obesity among adults (18 years and above) were 30.0% and 17.7% respectively in 2015
(National Health & Morbidity Survey [NHMS] 2015).
This means that almost HALF OF ALL MALAYSIANS are overweight or obese!!
This same phenomenon is also happening in many developing countries, the USA, the UK and the list goes on and on.
In fact, when it comes to my public clients these days, almost 95% of the time, it has some connection to an underlying overweight issue.
So let’s dive in shall we?
Why do people gain weight?
The fundamental theory of thermodynamics would simply imply that the basis of weight gain can be distilled in some form of excess energy present compared to what is expended.
In simpler terms, the net energy after subtracting energy spent in form of daily activities + exercises and addition of energy consumed through the diet,
If positive results in weight gain, negative with weight loss.
Now yes, with the human body, different foods digest differently and different body process food more or less efficiently than others.
However for the sake of understanding the current situation, let’s assume that those variables are constant for now.
With that said it falls upon our energy consumed or DIET; and our energy expended or LIFESTYLE.
How has diet and lifestyle changed?
Food these days have gotten more accessible than ever.
Because of food manufacturing, less people are now dying from hunger & starvation, and as refined foods solve that issue, it unfortunately also inadvertently promoted overconsumption of unhealthy calories without much nutrition (ie. vitamins/minerals/fiber).
Food stalls and establishments are everywhere around every corner, and even just a click a way from our phones, and while there is an uprising of healthy food establishments, most still focuses on maximise our culinary experience at often times, at the cost of a balanced nutrition intake.
Lifestyle wise, from long manual labour, we’ve since amalgamated to a sedentary position in front of a screen for most of our days, and resort to exercise, more often so as a luxury in the form of gym(s) and other exercise services, for more physical activity.
In Malaysia, this is majorly reflected when you look at the diet and lifestyle of Malaysians. Where most are consuming way too much salt, unhealthy fats, way too little fruits, veggies & whole foods, and of course not moving a lot. (NHMS 2015)
Put them all together, and you get a recipe for excessive weight gain after high school where physical activity dramatically reduces all the way to adulthood.
Healthcare wise, this has also led to a surge of non-communicable diseases like type 2 diabetes, heart disease and even cancer.
So what should we do about it?
How do we lose excessive weight?
So the immediate focus now is making sure you’re in the correct weight group and if not, then adjusting our lifestyle + diet and maintaining a sustainable one at that, to stay in a healthy weight range.
A healthy weight range.
A BMI or body mass index, is a simple way to start, you take your weight (kg) and divide it by your height (m) twice.
BMI categories for Asians (WHO/IASO/IOTF, 2000):
Below 18.5 – Underweight
18.5 – 22.9 – Normal/ healthy weight
23.0 – 24.9 – Overweight (pre-obesity)
25.0-29.9 – Obesity Class I
≥30.0 – Obesity Class II
However, that alone doesn’t reflect 100% accuracy as someone with a heavy muscle mass and little fat mass can also technically be overweight, however they do not possess the same overweight status in an unhealthy context where there’s excessive body fat for example.
For that, you can refer to your waist circumference.
The Ministry of Health Malaysia recommends that the cut-off points for waist circumference is 90cm Malaysian men and 80cm for Malaysian women (CPG, 2004); while the World Health Organisation (WHO) cut-off points for waist circumference is 94cm (37inches) for European men and 80cm (31.5inches) for European women (WHO, 2008).
I’m overweight/obese, what should I do?
Alright, so i’m overweight, what do i do then?
While these are generic recommendation and principles, they should be able to get you started.
1) Start with how much
As mentioned above, the fundamental variable here will always be energy input, or your diet. So ask yourself, are you mindful about how much you eat.
Being conscious about how much you eat, dramatically increases your odds for success weight modification.
Use your hand/palm as a guide, for general carbohydrates (rice/potatoes/noodles), general proteins (fish/tofu/meats), fruits, aim for 1 handful per meal,
and for non-starchy vegetables (ie. leaf vegetables), aim for at least 1-2 handful per meal.
2) What are you eating?
While portioning will always remain king, the qualitative or condition your portion food items are in can dramatically impact your food.
For example, a fried piece of chicken breast can have at least 180 calories more than a grilled piece of chicken breast. Extrapolate that to 3 meals, and you’re talking about 540 extra calories, which can be the difference of 2kg per week.
The general rule of thumb is to stay away from oily foods for all food groups.
Meaning to say:
– Carbs with minimal or non added fats; ie. white rice or noodles in a broth as compared to fried rice.
– Lean proteins without skin if possible that is not deep fried.
– Cooked vegetables with minimal added fat, salad with controlled amounts of salad dressings (ie. 1 tablespoon per meal)
3) Maintain some form of consistent exercise.
The rule of thumb is always 150 minutes of moderate intensity exercise a week.
But if you’re someone who has not been practicing exercise, that can be rather daunting.
Instead, I recommend to just start with whatever you can, 30 minutes, 1 hour, jogging, swimming, doesn’t matter.
But what matters is consistency and slowing aiming up to 150 minutes eventually.
Can’t exercise everyday? well just walk 15-30 minutes at the end of the day then, you’ll be surprise while it doesn’t significantly expands calories, the increase in physical activity can at the very least dramatically affect your mood and energy levels.
While it’s only 3 steps, these can already dramatically reduce your calorie intake significantly and increase your energy expenditure.
While we should go on to no. 4 which is WHEN you should eat.
We’ll save that for another time.
But hey, hopefully this helps you get started.
3) Ministry of Health, Clinical Practicing Guidelines on Management of Obesity, 2004
4) World Health Organisation (2008) Waist Circumference and Waist-Hip Ratio. Available at: http://apps.who.int/iris/bitstream/10665/44583/1/9789241501491_eng.pdf?ua=1
5) Malaysian Association for the Study of Obesity, Chapter 3: Defining Obesity, Available at : http://www.maso.org.my/spom/chap3.pdf