The National Institute for Clinical Excellence (NICE) gives guidelines on how we should manage obesity and weight problems. They recommend several different strategies; diet, exercise, behavioural change and where appropriate, pharmacotherapy (medications) and in cases or morbid obesity, surgery.

Types of diets

There are various different types of diets that people can go on. Some are fad diets some have a scientific basis behind them. We would not necessarily discourage people from a particular diet if its proven to work for an individual but the key message about dieting is you will lose weight if you have less calories going into your body than your body needs. So, the traditional method of calorie counting is the main basis of all effective diets.

Why exercise?

Over time, we’re doing less and less activity and less and less exercise. Isolated exercise, a mile walk in the evening, for example, you might only burn up 100 calories and then reward yourself by eating a chocolate bar or a sugary cup of tea that’s got more than 100 calories and the net effect is that you put on weight. However, regular exercise done as recommended by the government 3-5 times a week for 30-60 minutes where you raise your heart rate sufficiently that it gives you a little bit of an aerobic workout.  This can raise your metabolic rate and make a significant improvement to how many calories you can burn up and it’s quite feasible to be able to eat the same amount and still lose significant amounts of weight, amounting to stones in a year, just by exercising on a more regular basis.

Behavioural therapy

One aspect of weight management that NICE does recommend that is underused at the moment is behavioural therapy.  These are ways of changing somebody’s behavior to address the issues of weight. So the best example of this is – if say in the middle of the day, you like to take a break with your colleagues, to have a snack, it might involve a chocolate bar or a few biscuits or a sugary cup of tea, now, you could look at that and say if you still want to have your break with your colleagues change from some biscuits and a sugary cup of tea to an apple and a bottle of water you’re instantly saving several hundred calories. What would be even better is to question whether you do actually need that break in the middle of the day are you really hungry, if you are hungry you should be addressing what you’re having for breakfast and having something that will keep you more full for longer. Whereas if you’re not really hungry, is there something else that you could be doing at that time to take your mind off the fact that your colleagues are having a little bit of a snack and not join in.

These approaches can take the form of Cognitive Behavioural Therapy (CBT) or Neuro Linguistic Programming or NLP.  These talking therapies are going to be increasingly common in the future.

Date posted: 27/01/2009