Copyright Anna Read 2013 'Trying to lose weight? Everything you need and dont need to know Anna Read...

Copyright Anna Read 2013

'Trying to lose weight? Everything you need and

don’t need to know’

Anna Read

Obesity Specialist Dietitian

QMC - NUH

anna.read


1940s – Manual work and full time motherhood.

Walking, high streets, sweeping, cleaning and chopping, washing by hand, carrying water, visiting people, making beds, manual jobs.


Modern Life – The obesogenic environment

Driving, supermarkets/home delivery, vacuuming, pre-prepared foods, washing machines, dishwashers, texting/messaging people, duvets, desk jobs.


Then and Now

1940’s Average man was

10 stones 2. Average woman

was 8 stones 7. 1% of men and 2%

women were obese.

2010’s Average man is 13

stones 2. Average woman is

11 stones 1. 26% of adults are

obese.

Since 1950, the amount of nutritional information available to the public has doubled every 7 years.

Obesity has risen by 214%.

Obesity research has blossomed.


The mars bar challenge!!!

How many calories are in a mars bar?

How quickly can you eat a mars bar?


Energy balance

One mars bar (260 calories) can be eaten in less than a minute.

260 calories takes a long time to burn off:147 Minutes sitting.73 Minutes walking27 Minutes jogging.?? Minutes of rowing.


National Weight Control Registry

American cohort of people who have successfully managed to lose a substantial amount of weight……………..AND kept it off.

This group of people are real life examples of what works.


Do diets work?


The Basics

Weight loss requires a negative energy balance. Daily calorie intake needs to be less than total

daily calorie expenditure. Recommendation to reduce calories to 600 less

than daily requirement. An increase in calories burned off (exercise)

increases weight loss, prevents plateau and is especially important in preventing regain.

Increasing exercise alone is often insufficient to achieve weight loss as amount of exercise needed is beyond practical/physical capabilities.


Why is losing weight so hard?

To lose weight you have to eat less than your body needs, every day, every week, every month………….

This might involve: being hungry, resisting favourite foods and snacks, putting more effort into food, changing habits and changing behaviour.

To keep the same weight you can eat as much as your body needs and if you can be quite active you can ‘burn off’ treats or extras.

A person trying to lose weight has to work harder at it than a slim person who eats healthily and is quite active.


The (boring) Basics

Three meals per day.Watch portion size.Reducing sugar.Reducing fat.Controlled low calorie snacks.Five a day.Low calorie drinks.


Regular meals

Breakfast IS the most important meal of the day!

Regular planned meals helps people to stick to their planned food and reduces the likelihood of snacking.

Snack foods are the most likely to be high in fat and or sugar.

Long gaps between meals can lead to snacking, overeating at the next meal and changes in metabolism hormone levels.


Portion sizes

Aim for ‘your palm size’ protein.Aim for ‘your hand size and thickness’

starchy food.Plenty of vegetables and salad.Watch portion size of breakfast cereal.Aim two slices bread (medium sliced).


Reducing sugar

‘Empty calories’ 1 teaspoon sugar is ‘just’ 20 calories. 4 drinks per day is 29,120 calories per year. (8 drinks = 58,240 calories, 8 drinks with 2

teaspoons sugar is 116,480 calories……)

Sweeteners No human data that unsafe. Much sweeter than sugar so only need tip of a teaspoon. Try different sweeteners.


Reducing fat

Healthy fats have just as many calories as unhealthy fats.

Try to use minimal amounts of fat during cooking.

Remove visible fat/skin from meat/poultry. Use low fat milk and dairy products.

Give 1% milk a go! Low fat cheeses have improved so much in the last

couple of years. Avoid pastry, processed meat products and

fried foods.


Careful snacking

Stop Are you hungry? Can you wait? Will a drink do?

Think Low calorie Filling. Nutritious.

Go Fruit. Vegetable. Low fat savoury snack e.g. 2 crisp breads. Small sweet treat (e.g. 100 calorie small chocolate bar).


Five a day

One portion is generally one small handful: One apple/pear/banana. Two satsumas Twelve grapes/berries. Two tablespoons vegetables. Small bowl of salad vegetables.

Fruit juice 150ml maximum one a day. Dried fruit one tablespoon maximum one a day. Can have more than five portions per day but try to

limit fruit to four portions if having trouble losing weight or if you have diabetes.


Calories from drinks

Avoid adding sugar to any drinks. Choose low fat milks. Do you regularly have lattes? Grande regular 230 calories, semi

skimmed milk 190 calories, skimmed milk 130 calories. Choose diet / light / zero versions of soft drinks. Limit fruit juice. Choose no added sugar squashes. Think about calories from alcohol:

One pint of beer 170 – 200 calories. One large glass of wine 220 calories. One single spirit and diet coke 75 calories. One measure of baileys 130 calories.


Simple techniques

Reduce all meals by a third.Cut out all snacks except for fruit and

vegetables.Don’t eat after main meal.Only choose foods with less than 5% fat.


Planning for success

Get support and arrange weighing. Identify your realistic goals.

Plan your week’s meals. Write a shopping list and stick to it. Consider home delivery. Use fresh meals first: stir fries, salads, fish/meat/chicken and

vegetables and towards the end of the week choose jacket potatoes, omelettes, pasta dishes.

Bulk cook healthy meals such as lasagne, cottage pie, stews and casseroles.

Take own lunch to work – sandwiches, salads, leftovers or tins of soup and bread or crackers are a quick and easy choice.

Include fruit and vegetables in meals and snacks. If eating out, try to look at menu’s in advance.


Healthy Surprises

Fruit juice has more calories than beer ‘beer bellies’……..

Smoothies – very healthy but not very helpful for losing weight.

Olive oil has the same calories as lard. Flapjacks and cereal bars can be very high

calorie snacks. Dried fruit and dried nuts are also very healthy

but very high in calories. Low calorie and ‘diet’ foods still ‘add up’. ‘Energy Drinks’ not healthy, never will be…..


Exercise

‘For health’ recommendations of thirty minutes moderate intensity activity five times a week.

Equivalent health benefits achieved by 15 minutes vigorous activity five times a week.

All adults should minimise time spent sitting for long periods.

‘For weight loss’ recommendations are higher than this.

Active Commuting a government priority – what could you do?


Exercise

For weight loss:Focus on decreasing sedentary behaviour.Aim for 45 – 60 minutes exercise daily

For preventing weight regain:60 – 90 minutes total exercise daily

achieved by those who manage to prevent weight gain after losing weight.


Active Commuting

Walk to work / part way to work. Walk to next bus/tram stops. Get off a few stops early.

Cycle to work / one way to work. Leave cycle overnight in secure compound. Be dropped off or collected with foldable bike.

Lunchtime walks From QMC – part of the University Lake, as far as University Central

Building, corner shop at Leengate, round the QMC perimeter road, loop of A floor East Block to West block and up to a higher floor and back again.

From City – To Hucknall Road roundabout co-op, walk around the campus.


Weight Loss Medication

One safe and effective medication that can be prescribed by the NHS: Orlistat (Xenical) for BMI above 30 (or 28 with

health problems). Stops body absorbing some fat so requires low fat

diet to prevent unpleasant bowel side effects. Only GP can prescribe, must be taken three times a

day with regular meals and must lose 5% of your weight in 12 weeks to be eligible for continued prescription.

A weaker strength can be bought in chemists – Alli.


Weight Loss Surgery

Dramatically increasing business in NHS and private settings.

VERY strict NHS availability - for BMI over 50 (or 45 with serious health problems).

Available privately for BMI above 35 (or slightly lower with weight related problems). ~£7000 for a gastric band, ~£11,000 for a gastric bypass.

The only weight loss treatment that is not associated with weight regain.


What’s available in Nottingham?

Commercial Slimming Organisations – Slimming World, Weightwatchers, Rosemary Conley – joining fee and weekly fee.

Motivate – Notts County Football Club 12 week programme. (BMI 30+ (28+Asian ethnicity)-Nottingham City Boundary -home or GP address).

Healthy Change – self or health professional referral for Slimming World, YMCA exercise, cook and eat sessions. (BMI 30+-Nottingham City Boundary – home or GP address).

Ridewise training.

Local council exercise referral schemes.

Practice Nurse – first line advice.

Dietitian referral community or hospital for BMI above 35 (or 30 with health problems).


What’s available at NUH?

NUH Active.Staff Weight Management group

(BMI>30) to run from September – contact Steph Knowles if keen to find out more.

Weightwatchers QMC Tuesday lunchtimes – self pay.


What doesn’t work

Drastic, limited diets. Expensive programmes. Fat melting potions, tablets or lotions. Internet/illegal drugs. Unsustainable exercise. Anything described as ‘miracle’, ‘magical’ or

that ‘requires no dieting’. Tummy tuck/liposuction. Believing everything you read in the papers….


What probably doesn’t work

Hypnotism.Gastric Balloon.Jaw wiring.Fear factor.


Everything, nothing and anything case study.

60

65

70

75

80

85

90

95

100

105

1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020

Year

Wei

gh

t (k

g)


National Weight Control Registry

Average weight losses of 70 pounds (30 kg) and kept it off for 5.5 years.

Over three quarters had a ‘triggering event’ to start their weight loss.

Lost their weight by wide variety of methods. 45% did it on their own, 55% were part of a programme. Almost all eat breakfast everyday. Watch less TV than average. Weigh themselves at least once a week. Exercise for average 60 minutes a day. Huge reported increased in levels of energy, physical mobility,

general mood, self-confidence, and health.


Summary

You need: a plan, help and support, a realistic goal and determination.


Any Questions?

Copyright Anna Read 2013 'Trying to lose weight? Everything you need and dont need to know Anna Read...

Documents

Transcript of Copyright Anna Read 2013 'Trying to lose weight? Everything you need and dont need to know Anna Read...