Background
If you have been constantly dealing with weight fluctuations, then this blog post is for you. My name is Dr. Rizvi, and I am a board certified family physician who specializes in weight loss through hormonal balance. I have personally dealt with weight issues my entire life and have some solutions for you to finally see the numbers decrease on the scale.
I teach my patients the importance of timed interval eating, and in fact have written a book about intermittent fasting (Fasting As Medicine) as a solution to help reverse diabetes and metabolic syndrome. Both of these diseases are associated with obesity.
Hormones play a key role in fat storage, and your physician can help you look into these factors when it comes to weight loss. Insulin resistance, thyroid, and adrenal issues are amongst the most common causes of hormone related weight gain, but before diving deep into those aspects, we need to understand how our daily activities impact the scale.
Understanding The Scale
I am a big believer in obtaining data to help reach your goals. This means checking your weight often. I am not saying obsessing over the scale, but truly understanding how your weight fluctuates throughout the week will give you a good understanding of how your lifestyle and fluid intake affects your weight.
We need to take a serious look into our intake of daily calories. The more you research this topic, the more you will realize that not all calories are metabolized the same in our body. The combination of foods also plays a role in how these calories cause hormonal responses. For the sake of simplicity, I suggest you download a calorie calculator to have a general idea of what your daily intake is. (Disclaimer, the accuracy of calculating calories has been questioned, but this doesn't mean that it isn't a good tool to understand what you are consuming on a regular basis)
Second, understand how much calories your body requires for you to live optimally and perform basic life-sustaining functions. In science, we call this the basal metabolic rate (BMR). There are many formulas used to calculate the BMR, but for the sake of this article we will utilize the Harris-Benedict Formula.
After this step, it is important to understand how your activity level plays a role in how many calories you can consume. This is called your Total Daily Energy Expenditure. There are many calculators online but a simple rule of thumb is:
Sedentary = BMR x 1.2 (little or no exercise, desk job)
Lightly active = BMR x 1.375 (light exercise/ sports 1-3 days/week)
Moderately active = BMR x 1.55 (moderate exercise/ sports 6-7 days/week)
Very active = BMR x 1.725 (hard exercise every day, or exercising 2 xs/day)
Extra active = BMR x 1.9 (hard exercise 2 or more times per day, or training for marathon, or triathlon, etc.
Once you have figured out how many calories you can consume in order to maintain your body weight, then we need to figure out a good deficit to help you lose some weight.
A common approach to weight loss is a 500 calorie deficit, whether it is through diet, exercise, or preferably a combination of both to help you start your weight loss journey.
A pound is roughly 3500 calories, meaning a 500 calorie deficit equates to approximately 1 pound per week. We think this a healthy approach to weight loss because the goal should be to eat the maximum daily intake to allow for gradual weight reduction. Diets that are too strict, or cause too much deficiency in caloric intake tend to be difficult over a long period of time.
Weight loss will take time, so be patient and frequently adjust your expected calories as the weight is reduced. The choice of diet that you want to use is completely up to you. We all have our own food preferences, so I think as long as the overall energy expenditure is greater than what you consume, then you are heading on the right path.
Macronutrients
Your diet will consist of three main food groups. Proteins, Fats, and carbohydrates. Each macronutrient is associated with different caloric amount.
Carbohydrates and proteins provide approximately 4 calories per gram, while fats provide 9 calories per gram.
As you space out your meals throughout the day, play with these numbers to ensure you are able to perform optimally and remain satisfied with your diet.
Stick to natural whole foods and try to avoid highly processed foods and artificial sweeteners. When eating naturally, you add more fiber to your daily intake, keeping you full and allowing you to receive all the associated micronutrients in natural foods. These foods are easier to digest in our bodies, and help ferment the good bacterias in our guts.
For those exercising, utilize proteins to aid in muscle repair, and don't shy from healthy carbohydrates to give you energy for the day.
Medical Tips For Weight Loss
There are many programs out there, and fitness gurus that discuss weight loss. This can often become confusing because everyone is pushing their own opinion. But what does conventional medicine say based on the evidence?
Weight loss should be about 1 to 2 pounds (0.5kg - 1kg) per week.
All adults should set a long term goal to exercise at least 30 minutes a day, or perform moderate-intensity physical activity most days of the week.
Combined interventions of behavioral therapies along with calorie restriction and physical activity provides most success when it comes to weight loss and weight maintenance.
There is no clear difference between diets in terms of weight loss or other outcomes over a long period of time (Low-Fat/Low-Carb/Mediterranean, etc)
There are medications available that aid in weight loss, but are associated with cardiovascular and cancer risks
Bariatric surgery is an option for patients who are severely obese (BMI >40 or BMI >35 with serious comorbidities)
Conclusion
There are many ways to approach weight loss, but I feel that this simple approach of truly understanding where we stand, and manipulating the caloric intake will help move the scale.
Incorporate what I teach in my book, Fasting as Medicine, to optimize your weight loss and provide hormonal balance naturally.
Stay active! Getting older comes with more responsibilities, but like they say: "If you don't use it, you lose it." Maintaining muscle mass helps improve our metabolism, mood, and sleeping habits. All of these help with weight loss, so focus on improving your overall environment to achieve the best results.
Join a support group! You can learn a lot from each other, and use the support to motivate you to reach your goals. There are many ways to stay active besides working out alone. Group activities are fun, supportive, and help ease the difficulty of strenuous activity.
Visit us at Florida Advanced Medicine, where board certified family physicians can help you achieve your goals. We can look into hormonal disturbances that can make weight loss difficult and help teach you more ways to achieve a healthier you!