Weight Loss

Obesity is a condition where an excessive amount of fat tissue in the body presents a risk to an individual's health. A 2019 NHS report found that 36.2% of UK adults are overweight, and 28% are obese.

Obesity is correlated with serious health issues, such as diabetes, high blood pressure, heart disease, and certain cancers. It is a result of taking in more calories than are burned through daily activities, but is also influenced by lifestyle, environment and genetics.

How is obesity diagnosed?

Obesity is diagnosed through a number of measurements and tests.

The most commonly known test is body mass index (BMI), a rough measurement which is used to determine whether a person's weight is healthy in proportion to their height.

BMI measurements are classified as follows:

• Below 18.5 - Underweight
• 18.5 – 24.9 - Normal or Healthy Weight
• 25.0 – 29.9 - Overweight
• 30.0 and Above - Obese

Medical professionals use BMI as a screening tool, however it is not sufficient for an obesity diagnosis, as it does not take other factors, such as body composition and fat distribution, into account.

Your doctor will use other tests, such as waist circumference, blood tests (including cholesterol and liver function tests), as well as information about your health history and a general physical exam to guide treatment decisions.

Obesity can be caused by a number of different lifestyle, genetic, and environmental factors. These factors will differ from person-to-person, however, the driving factor behind obesity usually involves consuming more calories than are used.

Influences that contribute to obesity can include:

• psychological factors – feelings of sadness, stress and anger can negatively influence your relationship with food
• environmental factors – lack of access to healthy foods can negatively influence your diet
• medications – some medications (e.g. antidepressants) can cause weight gain as a side effect
• medical conditions – conditions like polycystic ovary syndrome or an underactive thyroid gland can be contributing factors to significant weight gain

Obesity can increase the risk of developing other health conditions, including:

• type 2 diabetes - while the association between obesity and diabetes is not completely clear, excess weight may make cells less responsive to insulin, a key factor in the development of diabetes
• high blood pressure - excess weight can put more strain on your heart, leading to high blood pressure
• high cholesterol - obesity is associated with increases in LDL cholesterol (bad cholesterol) and decreases in HDL cholesterol (good cholesterol)
• erectile dysfunction - excess weight is associated with ED, with one study finding that men with a BMI of 28.7 and over had a 30% increased risk of ED compared with men who had a normal BMI - conditions associated with obesity, such as diabetes, are also correlated with ED
• stroke - obesity increases your risk of stroke by 64% - high cholesterol, high blood pressure and diabetes, conditions associated with obesity, are also all risk factors for stroke
• asthma - obesity is associated with a higher prevalence of asthma, especially in women
• certain types of cancer - excess body fat can lead to increased inflammation and hormonal changes which can damage cells and increase the risk of cancer, especially cancer of the breast, bowels, kidneys, pancreas, gallbladder and ovaries
• gastro-oesophageal reflux disease (GORD) - this is a chronic form of acid reflux, with studies finding that GORD symptoms increase as BMI does
• gallstones - higher levels of cholesterol in bile, as is the case with obesity, can cause gallstones

In addition to the serious health conditions listed above, excess weight can make it difficult to carry out daily activities. People with obesity may experience increased tiredness, joint pain and breathlessness. Weight loss can improve quality of life as well as overall health.

A balanced diet combined with regular exercise can help you maintain a healthy weight long-term. Speaking to a doctor or dietitian can help you develop a diet and exercise plan that best suits you.

Diet

It is important to consume a diet full of nutrient-dense, high fibre foods and lean proteins.

Healthy eating habits are the key to long-term change. While there are many fad diets that claim to help you lose weight more quickly, a safe rate of weight loss is 0.5kg and 1kg, or 1lb and 2lbs a week.

Rigid diet plans are not necessary to lose weight. Try to consume a well-balanced diet that includes:

• high-fibre grains, including: brown rice, bulgur, whole-grain pastas and breads and porridge
• foods high in protein, including: lentils, legumes, fish and lean meat
• a variety of leafy and starchy vegetables, including: spinach, rocket, carrots and beans
• different types of fruit, including: apples, berries, pears and oranges
• healthy oils and fats, including those from nuts, seeds, oily fish and vegetable oils

It is also important to keep in mind portion control. You do not need to weigh or count everything that goes on your plate, but it can be helpful to read labels and understand serving sizes. Drinking water with meals, eating food more slowly and using smaller plates can also help you reduce your calorie intake.

It can be helpful to keep a food diary to begin with so that you have a record of your starting point and can better monitor your progress.

In addition to focusing on healthy food choices, you should also try to reduce your intake of certain foods.

Try to limit:

• simple carbohydrates, like those found in sweets, sugary beverages, and white bread, instead opting for complex carbohydrates which contain fibre and nutrients, such as fruit or whole grain bread
• processed foods, like crisps, ready meals, pies, and cakes
• saturated fats, typically found in fatty cuts of meat (e.g. bacon) and full-fat dairy products, opting instead for unsaturated fats, such as those from nuts or seeds

Eating a healthy diet can help keep your body nourished while helping you manage cravings.

Exercise

You need to burn more calories than you consume in order to successfully lose weight, making regular physical activity an important component of weight loss.

NHS guidelines recommend at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week.

Moderate intensity activities include:

• brisk walking
• swimming laps
• cycling
• dancing
• tennis
• hiking

Vigorous intensity activities include:

• jogging or running
• walking up the stairs
• martial arts
• gymnastics
• skipping rope
• hiking uphill or carrying a heavy backpack
• playing an intense sport, like football, rugby, or netball

Start off with just a few minutes of physical activity per day. As your fitness improves, you can increase the time that you spend exercising.

Strength training is also important to maintain your muscle mass as you lose weight.

A strength training routine will usually involve exercises such as:

• squats
• lunges
• push-ups
• planks

These can be done with added weight or as bodyweight exercises.

While there are some forms of exercise which claim to speed up fat loss in certain areas, fat will generally be lost evenly all over the body.

Prescription medication

If diet and exercise have not been enough for you to lose weight, you may be prescribed a medical weight loss treatment.

euroClinix offers three different prescription weight loss treatments:

• Saxenda
  Saxenda is delivered via injection and reduces appetite in addition to providing glycaemic control.
• Xenical
  Xenical comes in tablet form and works by binding to lipase, an enzyme that breaks down fat, in your stomach. It can prevent up to a third of fat from your diet from being absorbed.
• Mysimba
  There are two active ingredients in Mysimba tablets: bupropion, which reduces appetite, and naltrexone, which reduces food cravings.

By reducing your appetite or preventing calories from being absorbed, these medications help you absorb fewer calories. While prescription medication can help, it is essential that you continue to maintain a healthy diet and exercise program while on prescription weight loss treatments. These treatments work by preventing your body from absorbing the foods you consume, or by preventing you from eating as much food, meaning that you will need to continue to maintain these healthy habits in order to maintain your weight loss.

Surgery

Weight loss surgery, also called bariatric surgery, is used to treat people with severe obesity.

The most common types of weight loss surgery are:

• gastric band surgery, where a band is placed and tightened around the stomach
• gastric bypass, where the top part of the stomach is attached to the small intestine
• sleeve gastrectomy, where a portion of the stomach is removed

All forms of weight loss surgery work by restricting the amount of food that can be eaten.

Surgery is highly invasive and expensive and involves long recovery times, which is why it is only available on the NHS to those who fit certain criteria.

Over-the-counter options

There are many over-the-counter treatments which promise an easy weight loss. While some can help, others may do nothing or even be harmful.

Some over-the-counter options include:

• Alli - this contains orlistat, the same active ingredient that is in the prescription weight loss drug Xenical, but in a lower dose and is the only obesity medication that is available over-the-counter
• meal replacement shakes - there are many different brands available - while they may provide quick results for some, weight can come back over the long term as it hard to stick to as they can be expensive, repetitive or boring
• apple cider vinegar - proponents of apple cider vinegar say that drinking some before meals or taking a supplement will aid weight loss, but there is no evidence that it is beneficial in supporting weight loss
• slimming teas - also called detox teas or diet teas, slimming teas promise to burn away stomach fat, but none have been recognised as being effective for weight loss, and the ingredients used, such as laxatives or diuretics, can lead to severe side effects

You can buy Saxenda, Xenical and Mysimba online from euroClinix. To order online, you will need to complete an online consultation, which will be reviewed by one of our registered doctors.

If they feel that the treatment is appropriate for you, a prescription will be issued. Our UK pharmacy will then dispatch your medication in discreet packaging via our next-day delivery service.

Can I buy weight loss treatments over-the-counter?

Prescription-only weight loss treatments are not available over-the-counter. Only an authorised UK-qualified doctor will be able to prescribe these to you. Our doctors will review your consultation and prescribe an appropriate dose if they feel that this medication is suitable for you.