The National Institute for Clinical Excellence (NICE) provides guidelines on how healthcare professionals should manage obesity and weight problems. They recommend the following strategies:

• Diet

• Exercise

• Behavioural change

• Pharmacotherapy (medications) - where appropriate

• Surgery - in cases of morbid obesity

Types of diets

There are various different types of diets to achieve weight loss. Some are considered fad diets, whereas others have a scientific basis to them. Healthcare professionals would not necessarily discourage people from a particular diet if it is has a proven track record.

The key message for people who would like to lose weight is to consume fewer calories. For this reason, traditional diets that include calorie counting are the most effective diets.

Exercise

Over the years, and for several different reasons, the amount of exercise a person does has decreased dramatically.

To lose weight, exercise should be done regularly and alongside a calorie-controlled diet. Occasional exercise, such as a walk in the evening that burns 100 calories, followed by a calorie-filled reward totalling more than 100 calories will still cause a person to gain weight.

Top tips for weight loss

The government recommends regular exercise, 3-5 times a week for 30-60 minutes, raising a person’s heart rate sufficiently to give them an aerobic workout. This can raise your metabolic rate and make a significant improvement to how many calories you can burn up. With this type of regular exercise it is quite feasible to eat the same amount of food but still lose significant amounts of weight.

Just by exercising regularly it is possible to lose several stones in a year.

Behavioural therapy

A newer strategy in helping people to lose weight is behavioural therapy. However, despite being recommended by NICE as part of their strategy to combat obesity, behavioural therapy is not often used by healthcare professionals to treat their obese patients.

Behavioural therapy involves changing an individual’s behaviour to address the issues of why they are obese.

Obesity specialist, Dr Matthew Capehorn uses the following example: “If in the middle of the day you like to take a break with your colleagues and have an unhealthy snack, such as a chocolate biscuit and sugary drink, a behavioural therapist would look at that behaviour and suggest that if you still want to have your break with your colleagues then change from some biscuits and a sugary cup of tea to an apple and a bottle of water. Then you are instantly saving several hundred calories. The behavioural therapist may then go one step further and question whether you actually need that break in the middle of the day, asking if you are really hungry, and if so then you should be addressing what you are having for breakfast and having something that will keep you more full for longer. Whereas if you are 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 snack and you are not joining in.”

Using behavioural therapy to lose weight can be done through Cognitive Behavioural Therapy (CBT) or Neuro Linguistic Programming (NLP). Talking therapies as a strategy to combat obesity are likely to be increasingly common in the future.

Dr Matthew Capehorn, Obesity Specialist
Chairman of the Yorkshire and the Humber region of the National Obesity Forum