What is intentional weight loss?
Intentional weight loss is the process of consciously making and executing a plan to decrease total body weight. This usually entails the reduction of total body fat. Ideally, dieting should be done by eating a nutritionally balanced low–calorie diet and increasing physical activity.

What do the terms overweight or obese signify?
The terms ‘Overweight’ or ‘Obese’ are used to describe excess body weight. Overweight typically refers to weight 10% above the expected body weight for height and build. Obese refers to being 20% over the target. The greater the excess, the more significant the health risk.

How to determine what is desirable?
There are chart and tables that are used to determine what one’s target weight should be. They vary according to gender, height, age, and bone structure. A simpler and more useful piece of information is Body Mass Index (BMI). The BMI is calculated by dividing your weight (in kilograms) by the square of one’s height (in meters). To fall within the ‘Healthy range’ on the BMI, the result should be within 20 and 25. Results, both, lesser and greater than these values are associated with significant health risks.

Who should lose weight?
Adults can benefit from weight loss if they are moderately to severely overweight. Adults who are overweight and have weight–related medical problems or a family history of such problems can benefit from weight loss. Some weight–related health problems include diabetes, heart disease, high blood pressure, high cholesterol levels, or high blood sugar levels. Even a small weight loss of 10 to 20 pounds can improve one’s health. One does not need to lose weight if one’s weight is within the healthy range on the weight–for–height chart.

How to lose weight?
Intentional weight loss is a deliberate attempt to lose weight. Although there are many programmes to help lose weight, the only proven long–term and safe method is to burn more calories than are ingested. This is achieved either by reducing the caloric intake (eat less food or healthier food) or by increasing the energy expenditure (exercise more). Often, behaviour modification techniques like eating smaller portions are also used to help control eating habits. Once the weight is lost, these habits can be modified slightly for weight maintenance.

One pound of fat contains approximately 3,500 calories, so to lose one pound a week, a person should consume approximately 3,500 fewer calories per week. This can be done by reducing the daily intake by 500 calories per day (500 x 7 days will provide a deficit of 3,500 calories per week). To lose 2 pounds per week, a deficit of 1,000 calories per day is required. If this seems impossible, physical activity also contributes significantly to weight loss. The deficit of 500 to 1,000 calories can come from a combination of increased physical activity and reduced intake on a daily basis. Therefore, one does not need to experience significant food deprivation. The lowest intake per day recommended for females is 1,200 calories, unless they are in a medically–supervised, very low–calorie regimen which may have a daily level of 500 to 800 calories per day. The lowest level recommended for males is 1,500 calories per day. A very low–calorie diet can also be used by males if they are in a medically–supervised programme. A key to weight maintenance and weight loss is to increase daily activity – things like taking the stairs, rather than the elevator or walking rather than driving when possible make a real difference.
Few tips to bring about weight loss as well as ensuring good health:

1. Eat plenty of vegetables, fruits, and grain products like wheat.
2. Increase the consumption of complex carbohydrates like whole wheat, millet (jowar) and barley (bajra).
3. Restrict refined products such as flour (maida) and its products such as bread, noodles, macaronis and pastas in regular diet.
4. Restrict fat and cholesterol rich foods. Only non–vegetarian foods (like eggs and dairy products) are good sources of cholesterol, however saturated fatty acids present in butter, ghee, vanaspati and coconut get metabolised to cholesterol in our body.
5. Reduce the amount of sugars consumed.
6. Consume raw fruits and vegetables in form of salads and raitas in every meal. These provide adequate vitamins, minerals and fibre. Fibre is essential as it aids in digestion, has an effective role in managing obesity and cardiovascular problems.
7. Limit salt intake.
8. Have small portions of food at a time.
9. Do not skip meals.
10. Have regular meal timings.
11. Do not eat while cooking and watching television.
12. Drink plenty of water (6–8 glasses) in a day.
13. Exercise regularly. Do brisk walking at least for 20–40 minutes in a day.

The best exercises that are sustainable and safe to loose weight are aerobic exercises. Aerobic exercises usually involve vigorous exercises sustained over a period of several minutes and their effect is to increase the efficiency of the lungs, heart and blood circulation, which are collectively known as the aerobic system. Short and sharp bursts of activity which rely on the body’s reserves of oxygen do not produce a similar improvement. Exercises should increase strength and mobility and also aid relaxation. You can choose walking, swimming, bicycling as per your fitness level and increase gradually. You should plan on 20–minute sessions at least 3 times per week. Gradual changes in eating habits will help encourage a permanent lifestyle change. A slow weight loss of 1 or 2 pounds a week, until the desirable body weight is reached, is best.

What are the types of weight–loss programmes?
To lose weight one should also be aware of the different types of programmes available and the important parts of a good programme. The three types of weight–loss programmes include: do–it–yourself programmes, non–clinical programmes, and clinical programmes.

• Do–it–yourself programmes
  Any effort to lose weight by oneself or with a group of like–minded others through support groups, worksite or community–based programmes fits in the “Do–it–yourself” category. Individuals using a do–it–yourself programme rely on their own judgment, group support, and products such as diet books for advice.
• Non–clinical programmes
  These programmes may or may not be commercially operated, such as through a privately–owned, weight–loss chain. They often use books and pamphlets that are prepared by health–care providers. These programmes use counsellors (who usually are not health–care providers and may or may not have training) to provide services. Some programmes require participants to use the programmes’s food or supplements.
• Clinical programmes
  This type of programme may or may not be commercially owned. Services are provided in a health–care setting, such as a hospital, by licensed health professionals, such as physicians, nurses, dietitians, and psychologists. Clinical programmes may offer services such as nutrition education, medical care, behaviour change therapy, and physical activity. Clinical programmes may also use other weight–loss methods, such as very low–calorie diets, prescription weight–loss drugs, and surgery, to treat severely overweight patients.

Are weight loss drugs safe?
Prescribed weight–loss drugs should be used only if one is likely to have health problems caused by weight. One should not use drugs to improve one’s appearance. Prescribed weight–loss drugs, when combined with a healthy diet and regular physical activity, may help some obese adults lose weight. However, before these medications can be widely recommended, more research is needed to determine their long–term safety and effectiveness. Whatever the results, prescription weight–loss drugs should be used only as part of an overall programme that includes long–term changes in the eating and physical activity habits.


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