WEIGHT LOSS

ACHIEVING WEIGHT LOSS

Weight is gained when more calories are consumed than the body needs for daily activities and cell maintenance; excess energy is stored as fat. Weight is lost when the body uses its stores of fat, i.e. when:

• fewer calories are eaten,and/or

• activity is increased.

Eating 300-500 calories fewer/day should achieve a loss of 1-2 lb/week and >3 stone in a year. A healthy body weight is more likely to be achieved and sustained through a gradual change in patterns of eating and activity than it is with crash diets and bursts of extreme exercise. Key points are:

• Make small, permanent dietary changes - eat fewer calories, e.g. limit high-fat food, sugar-rich food and alcohol - reduce portion sizes of carbohydrate (potatoes, pasta and rice) - have a balanced diet with plenty of fruit and vegetables, unrefined foods with more fibre, lean meat and low-fat dairy products

• Monitor waist circumference

• Ensure regular physical activity; this is especially important in maintaining weight loss

• Enlist support of family and friends.

See also BMI; nutrition; obesity; physical activity; waist circumference.

NON-INTENTIONAL WEIGHT LOSS

A non-specific symptom that can indicate a serious underlying pathology. Weight loss will occur with:

• Inadequate food intake (eg, loss of appetite, difficulty eating, anorexia nervosa)
• Malabsorption (eg, coeliac disease, cystic fibrosis, crohn’s disease)
• Increased metabolism (eg, thyrotoxicosis)
• Type 1 diabetes (although appetite often increases)
• Malignancy
• Chronic disease
• Aids

or a combination of factors. Any suspicion of cancer as the underlying cause should prompt urgent referral for further assessment in secondary care.