Weight Loss

Information about losing weight safely with exercise and prescription medication

It's estimated that 26% of all adults are classified as obese. Being overweight or obese has been proven to trigger long-term health problems but it is never too late to lose weight. For more advice we have self-help tips below that can help you get on the right track to leading a healthier and happier lifestyle.

There is also proven weight loss treatment available in the UK in the form of Xenical tablets. To be used in conjunction with a healthy lifestyle, it is available online after a free consultation with our partner doctor.

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What is obesity?

Obesity cannot be categorised by sight alone, although that is often a good indicator. Due to the varying methods of measurement it may not always be an accurate gauge of how healthy an individual is. The NHS described obesity as simply a term used to described someone who is very overweight, with a lot of body fat. [2] The main reason this condition is stressed so highly is due to the various health complications that could occur as a result of excess fat in the body especially in regards to cardiovascular health and liver function.

Obesity is a gradual process that you may often be aware of in terms of your clothes getting tighter and fitness levels deteriorating, but it can still feel like you have a lack of control. Obesity can affect a person's self-confidence as well as posing serious risks to your health - often a vicious circle with a lack of self-esteem leading to binge eating and additional weight gain - luckily there is help readily available for those looking to change to a healthier lifestyle with support from medical professionals and prescribed medication.

How do I know if I am obese or overweight?

Most people can tell by looking at themselves in the mirror to have a vague indication whether they are overweight or obese. Coupled with this, there are other techniques that can be used to assess the amount of body fat or weight that you have in relation to your height the most popular method being your BMI (Body Mass Index) score.

Your body mass index is the primary indicator for medical professionals to check your weight in comparison to your height. Your GP can also calculate your body mass index accurately and swiftly. The algorithm determines whether you are within a healthy ratio. Whilst this is very important, other factors should be considered, and should be considered by your doctor before any real figure is given. The standard scale suggests that your BMI score should be between 18.5 and 24.9 which is deemed an acceptable 'health' range, according to the World Health Organisation (WHO)[3]. If it is over 25, the individual is classed as overweight and if over 28 then the individual may fall into the 'obese' category.

Body Mass Index The classification is the same for both sexes, however these figures can be age dependant.

BMI Men & Women

A BMI score over 30 is clinically classed as obese, and individuals are liable for additional help in the form of weight loss medication, to be taken in conjunction with a healthy lifestyle. If you are unsure, you can calculate using the calculator below before seeking further medical help.

Calculate Your BMI

Causes of obesity

There can be many causes of obesity that will vary from person-to-person dependant on lifestyle choices and possible hereditary links. It all comes down a healthy balance of calorie intake and energy eluded over a long period of time. The two most significant factors are poor eating habits – a diet consisting of low nutrients and high calorie intake – as well as a lack of exercise but there are other contributing influences too.

Obesity is a long-term - or chronic - condition, and any one or a number of these factors could be contributing:

Binge eating - overeating is one of the most common causes for obesity. Those that tend to binge eat frequently, and especially on a daily basis, do so with fatty, sugar foods that give the individual a sugary high, but then a sudden low that needs refilling with more of the same.

Food frequency - there has been much debate about how many times you eat a day being linked to obesity. Studies have shown that eating smaller meals more frequently will reduce cholesterol and blood sugar levels, however there is no concrete proof your food frequency rate has a significant affect on your size.

Psychological factors - do you tend to eat when sad, angry or stressed? Just like smoking or alcohol, your relationship with food can become an addiction often leading to obesity.

Lack of exercise - this can include the smaller aspects such as walking up the stairs instead of taking the escalator as well as more physical exercise such as heading to the gym or playing sports. The majority of us have jobs with minimal movement required meaning it can be difficult to find the time to exercise our calorie intake away.

Hereditary - it is not 100% proven that obesity runs through genetics or if it is just a lifestyle factor, but research has shown that children of obese parents tend to develop the same condition. This can be due to genetic deficiency such as a lack of the hormone leptin that controls your weight by telling you when you are full.

Social factors - in particular, if your parents or close family members are overweight or obese, the likelihood that you are is much higher. The influence of your peers filters through to many aspects of your life, including your dietary habits.

Medication - certain medications such as antidepressants can cause weight gain that, when teamed with other weight gain causes, can lead to obesity.

Hormones - an underactive thyroid and polycystic ovarian syndrome can both contribute to your weight gain.

Obesity in the UK?

Obesity is a growing problem in the UK, with statistics showing an almost quadrupled rate in the last 25 years alone, with the Midlands having the highest rate of overweight people in the country. But why is there such a boom in increasing obesity? There are various suggestions and reasons as to why this is the case, some being[4]:

  • the majority of adults do not eat the recommended minimum of five portions fruit and vegetables per day
  • 'Amercianisation' and globalisation of easily accessible fast foods
  • sedentary lifestyles
  • the average proportion of food energy obtained from saturated fat is higher than the maximum recommended
  • increased sugar intake

Obesity can often run in families suggesting a hereditary link, however a lack of physical exercise and lifestyle habits results in a similar attitude running through families, so there has been no concrete evidence to prove it is hereditary. If parents have poor dietary and exercise habits, this has been recorded to seep through the younger generations.

Effects of obesity

Other than certain psychological effects, such as a severe dip in your self-esteem and confidence levels, obesity can have a significant and serious effect on your health that shouldn't be left untreated:

  • symptoms Breathlessness
  • symptoms Chest pain
  • symptoms Tiredness
  • symptoms Increased sweating
  • symptoms Difficulty sleeping
  • symptoms Back and joint pains

Mental effects of obesity

There is a lot of evidence out there that suggests there is a clear link between an individual's weight and mental health problems. This is an area that is considered to be rather unrecognised amongst nutritional experts. However, over time more and more evidence has surfaced to further prove that mental health has an affect on weight and vice versa. There are a number of mental health issues that are proven to be very influential when it comes to weight gain and obesity.

Depression is a psychological problem that develops due to low self-image or self-confidence. It is being linked to obesity by researchers. So, it is very important to treat psychological problems as and when these develop to avoid further complications.

Individuals who are classed as obese may have an association with depression and those who normally remained depressed are likely to become obese. This has been the revelation of researchers who carried out a study to find a relation between the two serious conditions.

"Obesity is the norm with depression, so it is pretty hard to separate the two. It is akin to saying that people who are depressed have more marital problems and people with more marital problems have more depression. You would need a pretty sharp knife to separate the two." Gregory E. Simon, MD, MPH, Seattle psychiatrist

The 19-year study linking depression with obesity

A 19-year study conducted by study researcher Mika Kivimaki, PhD, of the University College London followed over 4,000 British civil servants between the ages of 35 and 55 when they first enrolled in the study during the mid-to-late eighties. The study looked to discover if there was a link between mental health disorder (including depression) and obesity. The study found that the participants who showed symptoms of one or more mental health disorders three times during the course of the study were twice as likely to be classed as obese during the final screening.

Mika Kivimaki, PHD followed this conclusion up by stating that; "The more times mental health symptoms were reported, the greater the risk for becoming obese by the end of the study. This points to a dose-response association between mental disorders and weight gain."

However, it can be difficult to decipher if it's depression that can cause obesity, or if it's the other way round. This is because there are very plausible explanations to support each theory. Gregory E. Simon, MD, MPH, a psychiatrist from Seattle, has supported this by suggesting "There are very plausible reasons why depression could increase the risk for obesity and very plausible reasons why obesity could increase the risk for depression. I think it is likely that both of these things are happening." He went on to say that an increase in appetite and less exercise are known symptoms of depression that can cause obesity, while on the other hand, the stigma that goes hand-in-hand with obesity can cause depression.

Binge eating

Binge eating is when a person overeats in a short time period. Those who binge on food will often have no control over what they are doing, or a limited urge to stop, until after they have finished.

According to the NHS binge eating is when 'a person feels compelled to overeat on a regular basis'. This means an individual who consumes a large amount of food in one sitting, even if they are not hungry. Studies estimate that 1.3 million Brits, which is approximately 1 in 30 to 1 in 50. Young adults tend to be affected the most but delay treatment until they reach their 30s and 40s. Slightly more women suffer than men, but it's pretty even across the board in terms of gender.

Why Do People Binge Eat?

Some researchers believe it's a reaction to stress and emotional upset, others think it may be a genetic issue, whilst some believe it's due to how easily available food has become.

  • Depression or anxiety
  • Low self-esteem
  • Feelings of stress, anger, boredom or loneliness
  • A past history of stressful or traumatic events
  • A family history of eating disorders
  • Dissatisfaction with their body

The extra calories from binge eating lead to excess weight and potentially type 2 diabetes, gallbladder disease, heart disease, and high cholesterol problems. We know that obesity is bad for the body as it contributes to heart disease, diabetes and some cancers, but a new study shows that it's bad for your brain too. Not only will your self-confidence take a tumble if you are obese, but research has shown that your memory worsens, especially in comparison to the thinner peers.

How Do I know if I Binge Eat or if I Simply Eat Too Much?

  • Feeling out of control when eating
  • Feeling powerless to stop even when you're full and uncomfortable
  • Eating until you're sick
  • Thinking about food constantly
  • Eating in secret
  • Feeling ashamed and angry after you've binged
  • Eating to deal with emotions
  • This is a frequent occurrence for the condition to be classed as 'binge eating disorder'

All About the Study

The study, published in the Quarterly Journal of Experimental Psychology, didn't find that obese people are less likely to remember general knowledge because that aspect of memory was unaffected. It was more specific than that. The obese study participants had worse episodic memory - which is the ability to recall past experiences. Researchers suggested that the worse episodic memory may lead to overeating - because the person can't recall their most recent meal as easily.

50 participants with body mass indices (BMIs) ranging from a healthy 18 to a very obese 51 took part. They all performed a memory test that asked them to hide objects on a computer screen at differing times and scenes. Later on, they were asked to recall where they had hidden their objects. The obese participants performed worse - their scores were 15% lower than the people with healthier BMIs.

Researchers from University of Cambridge concluded that a higher BMI was having an impact on the 'vividness of memory' but it wasn't causing amnesia. What it might reveal is that obesity may have a weaker memory of recent meals and be unable to regulate how much food they consume as well as thinner people can.

Tips for combatting binge eating

Frequent binge eating affects your state of mind but can also lead to obesity, high blood pressure, heart disease, diabetes and erectile dysfunction. It's important to seek out help if you binge eat because it's treatable. The basic treatment is often to begin disassociating food with emotions and learning to treat food simply as nutrition.

Treatments include self-help programs, medications such as SSRI's, or psychological treatments. Some self-help programs are available online, which is beneficial for those suffering from anxiety or depression.

  • Clear out the cupboards removing foods such as crisps, ice-cream and desserts.
  • Figure out the difference between hunger and emotional need. Tummy rumbling indicates real hunger. Drinking a big glass of water and wait for the craving to pass will help to identify the difference.
  • Keep a diary of emotions and binge responses to identify what emotion, if any, results in a binge.
  • Pay attention to food and enjoy the flavours. Bingers should eat slowly, without the distraction of TV or internet.
  • Eat regularly because hunger can trigger a binge. Stock up on healthy snacks such as fruit.
  • Avoid strict diets that cut out regular meal times.
  • Boredom can trigger bingeing. A new hobby, phoning a friend and reading are good distractions.
  • Exercise and make sure you get enough sleep to ensure good body health.
  • Manage stress levels at home and work. Stress and pressure are binge eating triggers.
  • Be kind. A slip up does not mean it's game over. Identify what went wrong and start over again.

Benefits of losing excess weight

Successfully losing weight can lead to a number of benefits, both physical and psychological. If you maintain a healthy weight after your initial weight loss, all of these benefits can be achieved and will help you accomplish a better quality of life. For example, you may find the thought of exercise to be fun, along with other lifestyle choices.

  • Breathing is eased
  • Sleep patterns improved
  • Blood pressure decreases
  • Confidence improved
  • Improvements in body image / self esteem
  • Immune system improved

Some research has been conducted into the improved memory when losing weight. Shedding extra pounds can make your brain more active and improve memory. Some individuals that have seen a dramatic change in their weight loss have found that their taste buds have improved whilst others have reported their eyesight improving due to lower levels of antioxidants and zeaxanthin in the eye tissue.

Weight loss can also lower the risk of cancer, including breast cancer and bowel cancer, due to cell changes. It also reduces the risk of diabetes, stroke and heart disease.

Methods to lose weight

When deciding to fully commit to losing weight, it is important to weigh up the available options and decide which option is the most effective. Below are some weight loss options that are available.

Over-the-counter medicines and mental therapies

There are over-the-counter medicines, pills and herbal remedies that can help with your weight loss. However, there hasn't been much conclusive research to prove that they are sufficient in achieving weight loss. Over-the-counter medicines are not proven to be effective, therefor money could be spent on medication that has little-to-no effect on weight loss. Similarly, mental therapies, such as hypnotherapy, haven't been studied enough to definitively state that they can help people to successfully lose weight. Therefore, these treatments and therapies (e.g. hypnosis) aren't the most reliable treatment for obesity, and could turn out to be a waste of money.

Weight loss surgery

Surgery is always an extreme measure when it comes to your body, however, if your obesity is causing you health complications then it could be an option for you. For weight loss surgery, a gastric band can be fitted to restrict the amount of food you eat. Other common weight loss surgery includes gastric bypass, bilopancreatic diversion and sleeve gastrectomy that do exactly the same thing. Be prepared for a hefty bill though – private operations can cost as much as £20,000 – as well as a few risks and side effects to consider including scarring, bruising and swelling. This should be considered as your last port of call. For more information and resources on surgery options for obesity, check out the NHS.

Prescription weight loss treatment

Yes, you can order prescription weight loss treatment online. The only prescription medication for treating obesity that has been clinically proven to work is Xenical, available at HealthExpress. Xenical is the most reliable weight loss pill for patients with a BMI over 27. It is also clinically proven to be the most effective obesity treatment. To be supported with a healthy lifestyle, this oral medication works in the digestive system by blocking the absorption of fats in the body. Using Xenical tablets alongside effective diet and exercise plans will give you the best chance possible in treating obesity and successfully achieving weight loss.

Further help for obesity

The best way to lose weight is to follow a balanced, nutritious diet and lifestyle, with regular exercise and smaller portions. It is important to create a plan that thinks long-term, rather than a quick fix that will never last.

Here are some additional exercise and diet tips:

Diet

  • Drink plenty of calorie free drinks - when your stomach starts grumbling, this could be a call for water, not food.
  • Snack wisely - swap the sugary chocolates, fatty crisps and other alternatives with tasty low calorie options that don't rely on carbs. Nut butters mixed with fruit, or whole grain bread, or raw carrots with hummus are delicious substitutes.
  • Pack up on protein and fibre - create a balanced diet plan full of recipes that aim for these two categories, as well as eating your five-a-day.

Balanced diet

Exercise

  • Don't deny yourself the little pleasures - cutting out chocolate when you're the ultimate sweet tooth will have your sugar cravings hitting the roof. Allowing yourself time to enjoy your vices within moderation will help you to maintain your motivation for weight loss in the long run.
  • Spring clean your cupboards - clear all fatty, sugary foods from your cupboard for a fresh start.
  • Pace yourself - there is no quick fix to losing weight, and rapid weight loss simply isn't achievable. It takes time and determination. You will start to see the difference soon enough.
  • Adjust your portion sizes - get savvy and reduce your portion sizes to up to half your original diet. With the right exercise plan, you'll find your stomach will get used to less food resulting in you being fuller for longer.
  • Increase your physical exercise - the recommended amount of exercise for adults is 30 minutes every day to help speed up your metabolism and lose weight – adjust depending on your calorie intake.
  • Create a relatable exercise plan - the majority of us claim we don't like the gym or exercising, but there is bound to be a workout regime out there best suited to you. Grab your personal trainer to tailor fit a plan best suited to your needs and objectives.

Are there any side effects to losing weight?

Skin Sagging

When you put on weight your skin stretches to accommodate it. This also happens during pregnancy. Building up muscles beneath sagging skin can help to sculpt your body, and surgery can also remove excess skin folds if they are excessive.

Mood Changes

Some research has been conducted regarding the link to weight loss and depression. They found that those who lost at least 5% of their overall body weight were 78% more likely to report depression. This could be because people may view weight loss as a key to happiness. The underlying reasons for unhappiness should be addressed alongside weight loss.

Relationship Changes

Weight loss can display some possible changes in your attitude, lifestyle choices and behaviour that could impact negatively on your relationships, whether this is romantic or platonic. You may also find you skip social occasions based on food and alcohol you don't wish to consume, or because plans clash with your fitness routine.

Gallstones

An abrupt change in weight can lead to gallstones due to the gallbladder not working as frequently as it use to. The gallbladder works by removing bile from your body due to excess fat.

How can I get help with my weight loss?

Trying to lose weight can be a frustrating experience. The dieting and exercising can prove ineffective – it's easy to become disheartened. Over-the-counter slimming pills, and herbal supplements are easily available, however their weight loss credentials are uncertain. It's always best to discuss your weight issues with a licensed medical professional who will be able to give you all the information you need about weight loss medications like Xenical. This prescription treatment has been clinically proven to be more effective in weight loss than over-the-counter treatments and less invasive than surgery. Obtaining Xenical is a simple process - complete our short, no-obligation online consultation where one of our partner doctors can see if this treatment is right for you.

Dr Hilary Jones Independent Medical Adviser

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