We all want that figure that makes us feel the most confident in our own body. We want the best version of ourselves, do we not. But how do we go about it then? How to lose weight?
Honestly, we doesn’t love good food, right? Good is like a safe haven. When we are stress, or happy, sad or angry, we eat. This is why sometimes it can be difficult to control our dietary intake.
“If you’ve experienced the same difficulties as me, you’re not alone. In my years in medicine, I’ve come across many patients who have failed to lose weight countless times” says Dr. Christopher Chan, an aesthetic doctor from Cheongdam Aesthetics Clinic.
The golden formula in weight loss: Energy output > Energy input. Energy output involves our metabolism rate and the daily tasks we do at work or school. Individuals who regularly exercise would have a much higher energy output. Energy input simply means the food we eat.
While the formula seems so straight forward, eat less and workout more, this is much easier said than done. Commonly recommended diets such as the Atkins diet or Mediterranean diet can be difficult to follow, especially since we Asians grow up with a carbohydrate rich diet.
It is now well known that obesity significantly increases the risk of contracting diseases such as coronary heart disease, stroke, diabetes, hypertension and many more disorders that can negatively impact your everyday life.¹
We should aim to have a healthy BMI of 22-24 for males and 21-23 for females in Singapore. We understand that it can be very difficult for certain groups of people to lose weight despite putting in the effort to exercise and control their diet. Thankfully, with medical advancements in weight loss, we have medical therapy to assist with weight loss. But before we get into weight loss medicines, let us understand a little bit about how diet and exercise can affect weight loss.
To lose weight, you need to create a calorie deficit by consuming fewer calories than you burn.
Aim to reduce your daily calorie intake by 500 to 1,000 calories. You can do this by eating smaller portions, choosing healthier food options, and avoiding high-calorie foods and drinks.
Your diet should also be healthy and balanced. This should include a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats. Avoid processed foods, sugary drinks, and high-calorie snacks!
Regular exercise can help you burn calories, build muscle, and boost your metabolism.
Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week. You can also add strength training exercises to build muscle mass and increase your metabolism.
To make exercising more fun, consider joining a sports group. There are various groups/clubs available in Singapore that meet regularly to play.
We have put this into a mnemonic SOP so that it will be easy for you to remember!
The two most commonly used medicines that are also both approved by the FDA for long term management of obesity are Saxenda and Phentermine. Both medicines have been shown to induce convincing weight loss of 4.5–5.6kg when compared to placebo.²,³ This is achieved by suppressing your appetite and hunger pangs. While on either of one, individuals would find it much easier, and more comfortable, to stick to a lower caloric diet.
In order to be started on one of these medicines, you would need a medical consult to assess suitability, because these medicines are not for everyone. Phentermine, the most commonly used weight loss management medication in the US and Australia, cannot be used in patients with heart diseases. Contrastingly, Saxenda is well suited for patients with heart diseases and has even been shown to decrease risk of death from heart attacks.⁴ This is likely due to the benefit of weight loss, which tends to result in lower risk of metabolic syndrome and diabetes.
The other weight loss medicine that has been proven to reduce risk of diabetes is Orlistat. In fact, it works so well that it has been shown to decrease incidence by up to 37% over 4 years when used in obese patients. Orlistat helps you achieve weight loss by blocking absorption of dietary fat. The downside is that you have to be able to tolerate oily diarrhoea and smelly farts.
The SOP medicines have been medically proven to work in obese patients. However, it is important to consult your trusted doctor or healthcare provider before starting on them.
Finally, we cannot emphasise enough the importance of a good diet and an exercise regime. Weight loss has to be sustainable and the best way to do it is to incorporate healthy lifestyle changes. We are rooting for you!
[1] De Lorenzo, A., Gratteri, S., Gualtieri, P. et al. Why primary obesity is a disease?. J Transl Med 17, 169 (2019). https://doi.org/10.1186/s12967-019-1919-y
[2] Aronne, L., Wadden, T., Peterson, C., Winslow, D., Odeh, S. and Gadde, K., 2013. Evaluation of phentermine and topiramate versus phentermine/topiramate extended‐release in obese adults. Obesity, 21(11), pp.2163–2171.
[3] Pi-Sunyer X, Astrup A, Fujioka K, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med 2015;373(1):11–22.
[4] Marso, S., Daniels, G., Brown-Frandsen, K., Kristensen, P., Mann, J., Nauck, M., Nissen, S., Pocock, S., Poulter, N., Ravn, L., Steinberg, W., Stockner, M., Zinman, B., Bergenstal, R. and Buse, J., 2016. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. New England Journal of Medicine, 375(4), pp.311–322.
[5] Torgerson JS, Hauptman J, Boldrin MN, Sjostrom L. XENical in the prevention of diabetes in obese subjects (XENDOS) study: A randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 2004;27(1):155–61.
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