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Latest Update: Thursday4/12/2008December, 2008, 11:43 PM Doha Time
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Losing and maintaining weight
Ravinder Mamtani
MD Professor of Public Health, Weill Cornell Medical College-Qatar

MAINTAINING optimum body weight is ideal. But I should hasten to add that losing even a relatively small amount of weight results in significant benefits. These health benefits persist if such modest weight loss is maintained.
Losing weight is easy. Keeping it off is a challenge. Obesity is a complex and a multifactorial problem. Its control requires a comprehensive plan. Such a plan should consist of a healthy diet, physical activity and lifestyle changes.
Healthy diet
A low fat diet with complex carbohydrate such as whole-wheat and brown rice, and legumes, fruits, vegetables, dairy products and grain is a healthy diet with many benefits.
One gram of fat has 9 calories as compared to only 4 calories in one gram of carbohydrate or protein. So when you eat a diet low in fat your caloric intake is lower, and you still get to enjoy your meal without having to compromise much on its quantity.
In general, the goal of every overweight individual should be to lose ½ to 1 pound a week. This can be achieved by reducing 250-500 calories in your diet a day. Weight loss from very low caloric diets is not well maintained, and a diet of less than 800 calories a day may lead to health problems.
A brief comment about high-protein high-fat diet, which has been in the news recently and has become quite popular among many people in the US. A variety of similar  options are also available in the Gulf Arab nations. While you may temporarily lose weight on such diets; they have a potential of producing negative effects.
Physical activity
Physical activity burns calories, builds lean muscle mass and helps in weight maintenance. It improves fat distribution and improves psychological functioning.
The Centers for Disease Control recommends, “Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all days of the week”.
The goal should be a gradual increase of activity over the current levels, and progression to a level that achieves cardiovascular and physical fitness over several weeks. Walking briskly (at the rate of 3-4 miles an hour) for about 30 minutes a day is all you need.
For most healthy people desirous of initiating a moderate level physical exercise programme, consulting a physician is not necessary. However, men older than 40 years and women older than 50 years who plan to embark on a rigorous exercise and those with chronic health problem should consult their doctor to help them design a safe programme.
Physical activity should be medically safe, enjoyable and convenient. The effort and time should go into the activity and not in its preparation.
Behaviour and other lifestyle changes
Behaviour therapy is known to be helpful. Stress reduction techniques such as meditation and relaxation have long-term beneficial effects. Focus on positive changes such as “feeling good” and “having more energy”.
Other methods
Appetite suppressant medications have been successfully used for short- term weight loss. The effects, however, are limited to periods when medications are taken. The medications are not without side effects. Surgical techniques such as gastric bypass and  gastroplasty may benefit only select grossly obese patients, but they are not without complications.
Caution for individuals with medical problems
Many individuals with obesity, and chronic health problems may require medical evaluation. Pregnancy state and unstable mental illness warrant temporary exclusion from weight reduction programmes. Also, weight loss is not indicated in problems such as anorexia nervosa and terminal illness.
It is beyond the scope of this column to discuss the role of government and private sectors in controlling the obesity epidemic. However, it should be mentioned that  government policies aimed at prevention, education, and other initiatives such as those related to nutrition could be very helpful in controlling the problem of obesity. Partnerships with private and non – governmental organisations should also be encouraged to address the problem.
Overweight individuals have available to them many self-help effective approaches. Simple and focused dietary, physical activity and behavioural interventions have been  proven to be beneficial. Use them to your advantage to control your weight and stay healthy all your life.
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The medical information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. If you have or suspect that you have a medical problem or condition, please contact your physician.
Tips for weight loss/maintenance strategies:
Discipline yourself on a low fat and portion controlled balanced diet.
Don’t deny yourself the foods you enjoy. Eat them in moderation.
Avoid irregular eating habits.
Find ways and means to remain active.
Gradual changes in dietary patterns and physical activity are more
likely to be beneficial than quick and drastic changes.
Monitor your physical activity and eating habits.
Weigh yourself once a week.
Don’t be discouraged if you fail; the only way
to succeed is to keep trying.
Don’t be alarmed if you see marginal fluctuations in your weight.
Seek support from friends, family and your health
care provider, when needed.
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