I receive numerous letters from readers concerned about their weight. Most are primarily motivated by the desire to look good, with health often being a secondary concern.
Let’s begin by clarifying a common misconception: you are not simply “fat” or “thin”. These labels don’t accurately reflect your health status. People of all body types can be either healthy or unhealthy. To assess obesity, one must calculate the body mass index (BMI), which is your weight in kilograms divided by your height in square metres. Additionally, waist circumference matters — ideally, women should maintain a waistline under 34 inches and men under 40 inches. The hip:waist ratio should be 0.85 in women and 0.9 in men.
Obesity comes with several health risks. It significantly increases the chances of developing diabetes, hypertension and heart disease. It can also affect daily living — clothes don’t fit well, energy levels drop and balance may be compromised, leading to falls, and sleep-related issues such as snoring or obstructive sleep apnoea.
People want a rapid solution for weight loss. Unfortunately, sustainable weight loss is a gradual process best achieved through a combination of dietary changes and regular exercise. A realistic and healthy target is to lose about four kilos per month. This may seem slow, especially to those hoping to achieve drastic transformations within a couple of months. People often wish for a miracle cure — something quick and effortless.
A sustainable approach involves creating a daily calorie deficit of 600 calories. For women, this typically means consuming 1,400 calories per day while men can aim for 2,000 calories. In pursuit of fast results, some resort to extremely low-calorie diets — as low as 800 calories per day. This is unsafe and leads to several side effects, such as extreme fatigue, constipation, nausea, muscle loss (causing sagging skin), gallstone formation, electrolyte imbalances and even low blood pressure.
Exercise plays a crucial role and should be done at least six days a week, aiming to burn around 500 calories daily. This can be achieved in many ways: walking for an hour, running for 45 minutes, doing high-intensity interval training (HIIT) for 30 minutes, skipping for 45 minutes or swimming for 40 minutes. The exact calorie burn depends on the intensity of your workout and the effort you put in.
At this point, many ask, “Isn’t there an easier way?”
There is — bariatric surgery. This involves various procedures that modify the digestive system to help reduce weight, often by reducing stomach size or bypassing parts of the intestine. It requires general anaesthesia and carries risks like bleeding and infection. Surgery is generally recommended only for individuals with a BMI of 35–40 or more. Importantly, even after surgery, a restricted diet is necessary.
Many products are advertised as natural or herbal weight loss aids — shakes, powders or capsules. Some contain stimulants like ephedrine or thyroid hormone precursors that increase metabolism. While they might cause temporary weight loss, they also come with side effects such as palpitations, irregular heartbeat and high blood pressure.
Another common question is, “Can’t I just take tablets?” There are medications available for weight loss, but they should only be used under medical supervision and typically after lifestyle changes have failed. Earlier medications focused on appetite suppression or fat absorption. Newer options, like semaglutide (available in tablets or injections), have shown promising results, with some individuals losing up to 90 per cent of their excess weight.
While medication and surgery may seem like easy fixes, they come with risks. The wisest path remains the classic one: a balanced, calorie-controlled diet rich in fruits and vegetables paired with regular physical activity. This way, you not only achieve your goal of looking good but also become healthier.
The writer has a family practice at Vellore and is the author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in