The Truth About Weight Loss
People often believe that they have a problem with their metabolism that is causing them to retain or gain weight. Unfortunately the sad truth is that that weight loss is hard and that metabolic problems are rare.
The most common reason medical reason for weight gain is indeed an underactive thyroid. This can be diagnosed with a simple blood test. Diabetes is another medical problem which can cause weight gain. Rarer still are Cushing’s Syndrome and polycystic ovarian syndrome. These are all easily diagnosed when they occur.
There are also a number of drugs that can cause you to put on weight. One of the most common I see is the anti-depressant mirtazapine. I’ve seen it cause up to a 2-stone weight gain. Long-term steroids can also cause weight gain, as can a lot of the anti-epileptic and diabetes medications. It is useful to check with your doctor to see if you are on any of these meds.
The truth, however, is that the vast majority of weight gain is not caused by a condition or any medication. It is simply caused by overeating and under exercising. You’re probably eating more than you think. A quick diet history with my patients often reveals that the weight gain is down to that big 100g daily bag of nuts that the person has been grazing on at his or her desk, or the half pack of biscuits eaten in front of the telly every evening. Keep an honest food diary for a week and you’ll see exactly how many calories you’re taking in
The advice I give about losing weight is simple: Keep to three small meals and walk at least 5km per day. I’d suggest focusing on the food side first, but to keep the pounds off you need to take more exercise. Exercising doesn’t burn as many calories as we think and if you rely only on exercise to lose weight then you need to be prepared for plenty of it. One kilogram of fat represents about 7,000 calories of energy. That’s a whopping 20 hours of walking at a brisk pace, depending on your weight.
Consider buying yourself a pedometer or activity tracker. We all tend to overestimate how active we are during the day and you might be shocked by how few steps you do. Walking costs nothing and is by far the easiest exercise to slot into your day.
Despite all the fad diets and internet memes, it really is as simple as that. Keeping to the regime can be hard. Try weighing yourself once a week and the falling numbers on the scales should be motivating.
A large industry has grown up around weight loss but self-discipline is all that is required. I do recommend one medication to those struggling. Orlistat (trade name Alli) can be bought over the counter in pharmacies. It works by preventing fat being absorbed through the gut. It can result in a 5% weight loss. It has some unfortunate side effects though. The fat is passed directly causing the stools to be very runny and it also causes flatulence. If you can handle this, it is the only real medication that works. It is also available at a higher dose from your GP, as Xenical.
So that’s it. I’m afraid that for the majority of folks there are no easy fixes and no way round the pain of dieting.