It can be challenging to keep up with the demands of our work and personal lives In today’s fast-paced world driven by tech and social media. For young women in the age bracket of around 18-29 years, this is typically a time of socialising and focus on career.
It can be easy to let health habits slip while balancing such a lifestyle: a late night working at the computer while snacking, perhaps, or catchups with friends involving calorie rich foods, or feeling too tired to exercise because of poor sleep – these situations can lead to gradual weight gain if unhealthy habits aren’t kept in check.
The good news is that daily measures can be taken to aid in maintaining a healthy weight and achieving weight loss while contributing to optimal mental and physical health. Rather than engaging in short-term fixes, approaches to weight loss should focus on what can be sustained to achieve it and maintain a healthy weight.
Focusing on a healthy weight
Health would be considered the most important reason to lose weight. Excess weight and unhealthy diets are among the top three contributors to Australia’s total disease burden, according to the Australian Institute of Health and Welfare (AIHW).
Overweight is a marker for many chronic illnesses, including heart disease, stroke, type 2 diabetes and some cancers. Preventing weight gain from early adulthood can help reduce the risk of such health problems.
“I advise a patient to lose weight if they have a BMI of 25 or higher, or if they have health conditions being made worse by their weight,” said Dr Amy Carmichael, Gold Coat-based nutritional medical doctor, personal trainer, yoga instructor, life coach, speaker and blogger.
“For example, if a patient has high blood pressure or type 2 diabetes, losing weight can help to improve their condition and even in certain circumstances reverse it.”
She adds that an even better evaluation of health than BMI is waist circumference, which if more than 90cm in women would present a risk of chronic conditions.
Achieving a healthy mindset, body and weight
Some women may want to lose weight for other reasons than health – for example, to achieve a desired body size.
But Joyce Tam, Manager of Butterfly Foundation’s national helpline, says striving to reach a specific weight goal is strongly discouraged.
“It can lead to an unhealthy preoccupation with body weight and shape, potentially triggering, exacerbating or increasing the risk of developing disordered eating behaviours,” she said.
“Butterfly Foundation advocates for a focus on healthy behaviours and wellbeing, rather than reducing body size.
“Individuals can focus on setting realistic and healthy lifestyle goals that promote overall health and wellbeing. Non-weight-related goals, such as improving energy levels, nourishing the body and enhancing overall health, can be more meaningful and supportive of one’s mental and physical health, as well as fostering a positive body image and promoting body acceptance in the process.”
According to the scientist team behind Drop Bio Health, certain biomarkers may be responsible for hindering health and weight loss efforts. The team developed the ‘Wellbeing Test’, an at-home blood test that is said to provide analysis of stress, sleep, inflammation, energy, body fat composition and fitness levels. They say such biomarkers may be affecting weight and health.
Successful weight management using this test is determined, not by a number on the scales, but by measuring levels of improvement in energy, nutrition, exercise, sleep, stress and spirit.
Healthy weight loss approach
Physical activity and reduced caloric intake are both needed to control body weight. If weight has increased, this may indicate too much calorific intake from food, too little exercise, or both. Keeping a diary of food intake and exercise may help in recognising where there may be excess food intake, where better food choices may need to be made, or where exercise levels are falling short of what’s required.
Eating healthily to lose weight involves maintaining a balanced and varied diet of nutritious food and eating only enough to meet energy needs. The Australian Dietary Guidelines can be a good starting point.
Eating a variety of foods can ensure the body is nourished with a variety of nutrients. For example, fruit and vegetables are low in calories and contain fibre, helping to maintain fullness. This can ensure the body is nourished, preventing any drop in natural sugar levels or excessive hunger and the subsequent desire to reach for junk foods. Reducing added fats and sugars is important as these are high in calories.
For those who’ve tried to lose weight without success, it may be helpful to see a dietitian who can customise a weight-loss eating plan based on health and lifestyle. This is part of the service accredited sports dietitian, nutritionist and online nutrition coach Aleksa Gagic offers as owner of The Climbing Dietitian in Brisbane.
“There’s no single answer to a healthy way of weight loss,” he said, “as it largely depends on the individual’s needs and circumstances.”
He adds that achieving weight reduction healthily involves creating a lifestyle change and not approaching it with the mindset of “going on a diet”.
“This means focusing on sustainable, steady changes,” he said. “Many people want diets to rapidly lose weight, but with this comes an increased risk of excessive loss of muscle.”
When weight is lost too quickly, he points out, there’s loss in fat but also muscle. Muscle burns calories, but fat doesn’t, and so with this muscle loss, the metabolic rate is slower.
Ms Tam of the Butterfly Foundation says dieting is a major risk factor for developing an eating disorder.
“Research shows that at least one-third to two-thirds of people on diets regain more weight than they’ve lost within four or five years,” she said.
“Restricting the food you eat can be extremely dangerous as it doesn’t take individual requirements into consideration and can result in malnutrition, low energy levels, low moods, reduced coping and increased risk of health complications.
“Dieting can also create a vicious cycle, where the body is deprived of the food it needs, driving someone to binge eat, leading to more guilt and worry about losing weight, and then resorting back to strict diet rules and overeating again.
“Weight management products aren’t advised, as they can lead to similar disordered eating issues.”
Improving the Australian population’s exposure to lifestyle risk factors in physical inactivity and overweight (including obesity) reduces the risk of disease and the disease burden attributable to these risk factors, says the AIHW. If exposure to overweight (including obesity) and physical inactivity is reduced, the loss of thousands of healthy years of life could be avoided by 2030, it adds.
In April, the AIHW reported that an extra hour of weekly activity could lead to a reduction by 2030 in the disease burden attributed to physical activity by 16 per cent.
A healthy exercise plan means being physically active on most if not all, days of the week. This can involve, for example, at least two and a half hours a week of moderate physical activity, such as a brisk walk, or at least 75 minutes of vigorous physical activity a week, such as jogging or aerobics. Ideally, muscle-strengthening activities are also incorporated, such as push-ups, lunges and weight training.
A 2021 UNSW study showed strength training can help gain muscle mass and lose body fat. While this can be helpful, as muscle burns calories, it should be recognised that the number on the scales may increase as muscle weighs more than fat. Other and better indicators of measuring success can be the way that clothes fit or the waist circumference measurement.
Ditch the fad
We often come across fad diets through media or product advertisements, but these are temporary solutions and often require restricting certain food groups without the supervision of a health professional, they often include pills or preparations and are not backed by science.
Dietitian Mr Gagic notes a trend towards trying ‘quick-fix’ diets or those claimed to be ‘best for fat loss’, yet he dismisses these as implausible.
“Some of the more common diet trends for weight loss I see among young women are those that restrict carbs, such as the keto diet, intermittent fasting, plant-based eating, and ‘fat burning’ supplements,” he said.
“The only ones that have some balance and merit are intermittent fasting and plant-based eating. The rest are either misinformation, unnecessary, or too restrictive for a sustainable fat loss practice.”
Mr Gagic says no magic is involved in any of these diets. Calorie deficit, he points out, is the key to weight loss, which requires no fancy diet, but one that’s not too restrictive and that can be maintained longer term.
Once this weight is lost, he adds, weight management also requires a healthy eating plan that’s sustainable in the long term.
Weight management ideally should be seen as a life-long commitment rather than just following a diet for a short time to lose some kilograms.
Role of pharmacies
It’s increasingly being recognised that obesity can be caused by genetic factors, not just those related to lifestyle and societal issues.
“Obesity and the drive to eat has a very strong genetic component,” said Professor Jerry Greenfield from UNSW Medicine & Health and the Garvan Institute of Medical Research. “Some individuals could benefit from medications targeting these biological factors in addition to diet and exercise.”
Pharmacies can provide basic lifestyle advice, and information about different diets, help patients track their progress, and offer support and encouragement. This is where liaising with dietitians may help.
Mr Gagic says pharmacists can refer patients to dietitians, while dietitians could run education sessions. For example, they could educate pharmacists about supplements, to help guide decisions on what to stock and the avoidance of useless or harmful supplements.
Dr Carmichael says pharmacies could also offer additional services, such as community walking groups, health expert talks, or even dietitian services.
“It’s imperative that healthcare professionals are aware of any explicit or implicit weight bias they hold, and instead treat the individual as more than just a number on a scale,” she said.
“Individuals in larger bodies are at increased risk of experiencing body dissatisfaction, a risk factor for developing an eating disorder, because of weight stigma and the way they’re mistreated about their body size.
“While certain metabolic health issues may be statistically associated with higher body weight in some studies, individuals living in larger bodies can be healthy and thrive when they engage in balanced and healthy behaviours that support their overall well-being.
“Conversely, assuming that a person of lower body weight is automatically healthy can be misleading, as they too may face health challenges or mental health implications, particularly if they’re experiencing an eating disorder.
“Butterfly advises health professionals to adopt a balanced, non-diet, client-centred approach, prioritising overall physical and mental wellbeing. This approach should focus on developing a healthy relationship with food and a positive body image while addressing metabolic health in a safe and appropriate manner.”
If you’re impacted by an eating disorder or body image concern, or know someone who is, contact Butterfly Foundation’s national helpline on 1800 ED HOPE (1800 33 4673), via webchat, or email email@example.com. The foundation’s counsellors are available seven days a week, 8am-midnight (AEST)
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This feature was written by Tracey Cheung and was originally published in the September issue of Retail Pharmacy Assistants e-magazine.