Obesity is a key contributor to a group of conditions known as metabolic syndrome. It includes other conditions such as high cholesterol, high blood pressure and diabetes. With these chronic conditions, people are predisposed to developing many diseases including ischaemic heart disease, heart attacks, strokes and peripheral vascular disease.
Obesity is a national health problem. The Singapore Burden of Diseases study found that obesity-related diseases had the largest impact on health in terms of suffering and cost. Obesity is also the largest single contributor to the national disease burden of diabetes. On the social front, obesity can affect your self-esteem and body image, causing psychological stress.
How overweight I am?
For adults, we use a simple calculation called the body mass index (BMI)
BMI = Weight in kg ÷ (height x height [in meters])
According to the WHO,
- Underweight = <18.5
- Normal weight = 18.5–24.9
- Overweight = 25–29.9
- Obese = >=30
In Asian populations (who are in general smaller in size), we should use,
- Underweight = <18.5
- Normal weight = 18.5 – 23.0
- Pre-obese= 23.0 – 27.5
- Obese = >=27.5
While this may not be the perfect indicator of obesity, it gives your doctor a good idea of your weight compared to your height.
In’s and out’s
Weight gain or loss can be explained with the concept of caloric balance (intake vs. output)
If you expend more energy than you take in from food, you will lose weight. If you use 500 more calories than you take in everyday, you will lose about 2kg in a month. You can increase your caloric deficit by dieting and eating healthier, or increasing your physical activity and thus increasing your energy expenditure. Your doctor will discuss this in more detail with you.
What will happen?
During the consult, your doctor will take a history from you about your past medical history, your eating habits and your activity level. Your doctor may choose to do some blood tests such as blood cholesterol, blood sugars and a thyroid test. This is important as weight gain may be due to a medical issue.
Your doctor may also take other measurements e.g. waist/neck/arm circumference and fat fold measurement. Your doctor will also measure your vital signs including your heart rate and blood pressure.
Weight Loss Treatment
Treating obesity must be approached from multiple angles simultaneously, and requires willpower and determination from the patient in order to be successful.
A combination of changing your lifestyle, eating habits and diet, together with regular physical activity is the best and most natural way to lose weight. Your doctor will work with you to come up with an exercise and diet plan. Your doctor may recommend medications if necessary.
Types of Weight Loss medications
It is important to remember that medications are adjuncts to your weight loss regime. It is not meant to be used as a solitary magical pill.
Some of the types of medications we can use are
Orlistat inhibits the absorption of fat into the body. The fat stays in the gut instead of being absorbed into the bloodstream and thus your energy intake decreases. This medication is very safe but the gastrointestinal side effects can be inconvenient to some people – oily stools, diarrhoea, gas, increased bowel movements.
Acarbose inhibits the absorption of carbohydrates into the body. As the carbohydrates stay in the gut and do not go into the bloodstream, your energy intake decreases. As with orlistat, this medication is very safe but can produce gastrointestinal symptoms such as bloating and flatulence.
Duromine works by suppressing your appetite and increasing your metabolism. It comes with its own set of side effects including palpitations, insomnia, high blood pressure, anxiety, dry mouth and nausea. It may also increase gastric pains in some people. Over time, people may develop a tolerance to it and the medication may be less effective or stop working. This medication may not be suitable for some people with existing medical conditions.
Saxenda is the brand name for a prescription-only, injectable medication known as Liraglutide. It is a medication approved for weight management as an adjunct to diet and exercise. Saxenda works by binding to the receptors in the arcuate nucleus of the hypothalamus in the brain, where it stimulates satiety and inhibits hunger neurons. This makes you eat less, leading to weight loss. If you are obese, or overweight with weight-related medical problems (such as high blood pressure, high cholesterol, or type 2 diabetes), this medication can help with weight loss and keeping the weight off. If you are currently on insulin for treatment of Diabetes, Saxenda may not be suitable for you. Saxenda is selling at $131 (price is before consultation) in all our clinics in singapore.
Your doctor will schedule regular follow-ups to track your weight loss, check on your physical health and check on any side effects of the medications. Repeat blood tests may also be necessary.
Speak to our doctors today to kick start your journey to successful, sustained weight loss!
Speak to our Doctor Today!