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Friday
Dec102010

"What should I weigh?" - the ideal approach to lifestyle change and weight loss

When clients ask "well - what should I weigh?"   I often have trouble articulating my views on the ideal weight and how to get there.  Dr. Arya M Sharma says it perfectly:

“Best weight” is a non-statistical goal that is easy to set and easy to explain to patients. Patients can diet themselves down to any weight they put their minds to, but to maintain that weight, they need to actually enjoy the lifestyle that got them there.

A patient’s best weight is therefore whatever weight they achieve while living the healthiest lifestyle they can truly enjoy. There comes a point when a person cannot eat less or exercise more and still like their life. The weight they attain while still liking their life is thus their “best” weight, as without the addition of pharmacotherapy or a surgical intervention, no further weight loss will be possible.

We need to remember that in modern society, eating is not simply about survival. We use food for comfort and for celebration and, with the exception of religious prohibitions, there should be no forbidden foods. If your patient cannot use food to comfort or celebrate, or if they consider certain foods “forbidden,” then they are likely on a diet, and unfortunately diets are known to fail over 95% of the time. For sustainable weight management, a patient should be consuming the smallest number of calories that still allows them to enjoy each day. Some days will simply warrant more calories, such as birthdays, anniversaries, religious holidays, and days when injuries, illness or fights with loved ones occur. Simply put, ice-cream and cookies and their cultural and ethnic equivalents are vital parts of a rich life experience.

With exercise, a patient should be encouraged to be as physically active as possible and include as much additional exercise as they can enjoy each day. Some days obviously will allow for more activity than others, but there is a maximum, above which the patient would run out of time or energy, hurt themselves or come to hate exercise. That is when they quit.

Eating less and exercising more within the context of a life the patient does not enjoy is the very definition of a diet, which is why diets almost always fail over the long-term. If a patient does not enjoy the way they are living while they are losing weight, they will almost certainly revert to “normal” practices and gain the weight back.

Dr. Arya M. Sharma, MD/PhD, FRCPC is Professor of Medicine & Chair for Cardiovascular Obesity Research and Management at the University of Alberta, Edmonton, Canada. He is also the Medical Director of the Edmonton Capital Health Region’s interdisciplinary Weight Wise Program.

Dr. Sharma is also the Scientific Director of the Canadian Obesity Network funded through the federal National Centres of Excellence program.

His past appointments include positions as Professor of Medicine and Canada Research Chair (Tier 1) at McMaster University (2002-2007), Professor of Medicine at the Franz-Volhard Klinik - Charité, Humboldt University Berlin (2000-2002) and the Free University of Berlin (1994-2000). His research focuses on the evidence-based prevention and management of obesity and its complications.

He is a member of several scientific associations, including the Canadian and International Societies of Hypertension. He is a fellow of the Council for High Blood Pressure Research of the American Heart Association and on the editorial board of several academic journals.

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