-Dr. Manoj Bhattarai, Brown University, USA.

ManojMany of us have tried losing weight at some point in our lives. Whether it was to fit in a new tight outfit, look thinner for our forthcoming wedding, or any other reason, we have tried to shed off excess pounds. How many of us have succeeded in achieving these goals? How many of us have managed to shed excess weight, sustain the weight loss, and live an altogether healthier and happier life?


Sadly, the answer to these questions is: not many. Most of us start off the journey towards weight loss with zest, excitement and passion. However, most of us kill our passion shortly along the line. We end up returning to our unhealthy habits of sitting on the couch all day watching TV, sitting in front of screens playing video games or surfing the net.


The inevitable consequence of such a relapse is obesity. Being obese not only increases the risk of cardiovascular death, stroke and osteoarthritis; it also impacts sleep quality and mood. Ultimately, failing to sustain healthy habits condemns us to a lifetime of not just ill-health, but also general discontentment and unhappiness.


Truth be told: staying healthy is a lifetime commitment. A continuous supply of the gasoline of passion is needed to keep the healthy lifestyle running. Our ancestors did not require any exercise plan or dietary regimen to keep their weights off. This is because they spent their days on their feet – on average, walking or running 6 to 10 miles a day. In the modern world, people walk less than 2 miles a day on average.


To make matters worse, the very people who are supposed to be role models for health living are also struggling. Many nurses, doctors and other health professionals are actually obese. Seriously, how likely are you to follow the recommendations regarding lifestyle modifications from your obese doctor?


Based on scientific backing, this guide is aimed at educating patients and enhancing the knowledge of doctors as well. The ultimate goal is to enable everyone to live a healthy and happy life. The only aspects not covered in this article are medical approaches to losing weight, such as medications and bariatric surgery.


Myths about losing weight

It really bothers me when people tell me they are cutting back on the number of their daily meals to keep obesity at bay. This is because fasting often stimulates the release of stress hormones such as cortisol and insulin. The end result of such hormones getting released is disproportionate weight gain.


Many of us feel quite comfortable with our overall body shape, except for a little protruding belly. As such, we try sit ups and crunches intermittently to burn that belly fat and ultimately look better. If this sounds like your story, I am with you. The reality is you need whole body workout to lose weight and no such exercise regimen is available to lose only belly fat.


It is also not uncommon to see people cutting on their fat. This is because, for many years, we have lived with the misconception that FAT IS BAD. This actually isn’t true. Not all fat is bad. Saturated and trans fats found in hot dogs, whole milk, ice cream, chocolate, French fries, and processed foods like snacks (crackers and chips) are unhealthy fats. However, mono and polyunsaturated fats such as avocado, olive oil, nuts, walnuts, corn oil, sunflower oil, including omega-3s found in fishes, tofu and flaxseed are the healthy fats. The goal here is to limit saturated and trans fats.


When newbies hit the gym, it is common to see them start with heavy weight lifting. The consequence of this is often muscle injury which takes several days or even weeks to repair. In other words, it is not helpful, but detrimental to health. My own experience is of trying abdominal exercises such as crunches and sit-ups along with muscle building workouts 3 to 4 days a week for two years without being able to reduce belly size. My goal was achieved when I started running 2 to 3 miles before starting my usual workout.


There are a number of common but unrecognized causes of failure to lose weight despite appropriate diet and exercise. These include, but are not limited to, inadequate sleep, stress, depression or use of excessive antibiotics which destroys protective gut microbiomes. Similarly, our living conditions can have huge impact on our health. For instance, living in a family where every single family member is overeating or living unhealthy lifestyle, makes it hard for any member of that household to change in that environment.


Measures to lose weight


The ultimate question is: what measures can one undertake to not only lose weight, but be able to sustain the weight loss as well? Scientific studies suggest that the three most effective strategies are exercise, diet and behavioral modification.



Research has supported that losing as little as 5 percent of body weight can reduce the risk of heart disease and Type 2 diabetes. So, where can we start? The simple math to lose weight is to burn more calories than our total calorie intake. This can be achieved either by exercising to burn excessive calories or limiting calorie intake.


To answer the fundamental question of which method is more effective, a recent study performed in rats showed exercise to be more potent in the long run. There is no human data available though. Doing both is unquestionably best of all. One may be successful in losing weight with dietary restrictions and proper exercise regimen but if he/she is not eating nutritious food, this could invite other health problems in the long run.


Sitting more than three hours a day, despite exercising, may increase the risk of premature dying, according to a study with survey data obtained from 54 countries. A study conducted by scientists in Ontario couple of months ago showed that high intensity interval training maximizes the health benefits of exercise compared to moderate intensity exercise even with short time commitment. With this approach, one engages in short bursts of strenuous exercise, such as running, biking, and stair climbing, until the heart pounds and feeling of breathlessness arises. This is followed by light exercise or resting.


The 7-Minute Workout, widely available free on the Internet as well on apps version, is a scientifically proven exercise regimen for those with limited time availability. The latest technological innovations and new findings will make it difficult for anyone to get away with the common excuse of being unable to exercise because they have a little time available.



Obesity is a result of eating wrong types of food, such as sugars, refined grains and processed carbohydrates, which subsequently results in cravings, hunger and bingeing. The key is to eat low amount of processed sugars, high protein and modest unsaturated fat along with other essential micro nutrients.


It is important to understand what food we are eating. This knowledge can help make minor yet important adjustments. Additives used in processed and packed food, such as mono-sodium glutamate can give rise to chest pain, headache, nausea and difficulty breathing. Use of small and frequent meals, 4 to 5 daily, is suggested. Mediterranean diet which comprises of diet rich in fruits, vegetables, whole grains, beans, nuts, olive oil, fish, low fat dairy products and low to moderate red wine consumption, is recommended. In the past decades, Mediterranean diet has been shown to have significant health benefits including but not limited to reduction in overall mortality, cardiovascular mortality, cancer incidence, and incidences of Parkinson’s disease and Alzheimer’s dementia.


Behavioral Modification

Simple behavioral changes can make significant impacts on health. Simple modifications which can boost weight loss efforts include drinking 1 to 2 glasses of water before meals, constantly keeping ourselves hydrated, and using small meal plates for portion control. Others include keeping nuts, fruits and vegetables in easily accessible and visible areas.


Beyond eating habits, you can also undertake measures to increase the level of your physical activity. Examples include parking your vehicle farther in the parking lot from the building, keeping the water bottle away from your office desk and occasionally standing. These increase your energy expenditure.


Experts also recommend small bouts of physical activities such as crunches, and push-ups; as well as taking the stairs instead of elevators. This tiny bits of activity scattered throughout the day can be more effective than waiting for an hour-long workout at the end of the day. Exercise can elevate mood for up to 12 hours, therefore, it is highly recommend to work out in the morning.


A great strategy for sustaining behavioral modification is through finding social support. For instance, joining the gym together with your partner can reinforce the continuity of the gym workout behavior.


People often try using a food journal and apps like myfitnesspal to make a note of everything they eat. This can actually be effective, assuming you use them rightly. Once you get an idea of which high-calorie foods make up the bulk of your diet, take small subtle changes at a time to reduce them. Not eating at all is not a solution. Skipping the breakfast can lead to unhealthy food choices throughout the day. Thus allow yourself enough time to eating healthy breakfast such as berries, smoothies, cherry, strawberry, nuts, and low fat dairy.


Ultimately, it is important to look out for studies backed by science when it comes to pursuing any dietary and exercise practice. I strongly urge readers to be vigilant about new findings. This is because the above-mentioned recommendations may not remain relevant forever. A decade from now, a more effective intervention may be available. To stay in the loop, you need to keep your ear to the ground. Cheers!


Dr. Manoj Bhattarai is a nephrologist and geriatrics fellow at Brown University, USA.


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