Losing weight and changing behaviours

Transcription

1 Losing weight and changing behaviours information for patients Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit

2 Thinking about losing weight? Body Mass Index or BMI is a commonly used measure that shows if you are a healthy weight for your height. Having a BMI over 30kg/m² (over 27kg/m² for the Asian population) puts a person at greater risk of developing health conditions including type 2 diabetes, heart disease, joint pain, sleeping difficulties and some cancers. Losing just 5 10% of your body weight and keeping it off will have a positive effect on your health. For most people this will be around 3 10kg or ½ 1 ½ stone. To work out BMI, you should measure your height and your weight. Divide your weight in kilograms (kg) by your height in metres (m) Then divide the answer by your height again to get your BMI For example: If you weigh 70kg and you are 1.75m tall, divide 70 by The answer is 40. Then divide 40 by The answer is 22.9kg/m2 this is your BMI. Measuring waist circumference is a measurement of fat around the tummy. Those with a high waist circumference are said to be at higher risk of type 2 diabetes, cardiovascular (heart) disease, high blood pressure and high cholesterol. To measure your waist circumference: find your true waist which is half way between the top of your hip bone and the bottom of your ribs. Use a tape measure, without breathing in and not too tightly wrap it around your waist. You can use a mirror to make it easier. Compare your measurement in centimetres to the table below: European background Male Female Other ethnic backgrounds Male Female Increased risk of diabetes, heart disease, high blood pressure and high cholesterol if; More than 94cm More than 80cm More than 90cm More than 80cm 2 PI_1666_01 Losing weight and changing behaviours Patient Information Leaflet

3 Why try to lose weight? When people decide to lose weight, they can do this for many reasons, ranging from fitting into a favourite item of clothing, feeling good about yourself, being able to walk up the stairs without getting breathless or improving your health (e.g. your blood pressure or cholesterol levels). Research has shown that people, who are overweight or obese, are at an increased risk of cardiovascular (heart) disease, stroke, cancer, osteoarthritis (painful joints), high blood pressure and diabetes. Diabetes can lead to blindness, kidney damage and nerve damage (leading to erectile dysfunction and amputation). This risk is six times greater among Black, Asian and other ethnic minorities. Lifestyle interventions including regular exercise and diet have reduced the rate of diabetes by about 50% among high risk individuals. Think about why you want to lose weight, what is your motivation? This can help you decide what you want to change or even stay on track when things do not go to plan. General principles of weight loss What you eat and drink is energy in. What you burn through physical activity is energy out. An important part of maintaining energy balance is the amount of energy out (physical activity) that you do. People who are more physically active burn more calories than those who are not as physically active. Calories Eaten Calories Burned Calories Eaten Calories Burned Weight Gain Calories Eaten Calories Burned Balanced Weight Weight Loss PI_1666_01 Losing weight and changing behaviours Patient Information Leaflet 3

4 An average healthy man needs 2500kcal energy each day. This is 2000kcal every day for women. Eating food with more than 2500kcal in men and more than 2000kcal in women each day leads to weight gain and obesity. Our daily energy requirement can vary depending on age, daily activity and during illness. Monitoring your progress Losing weight takes time. Remember you have not put on all your excess weight overnight. Aim for a slow and steady weight loss. A loss of kg (1 2lb) per week is a healthy and sustainable rate. Weigh yourself once a week on the same set of scales at the same time of day. To monitor waist circumference hold a tape measure around your tummy, two finger widths above your belly button. This is a useful measure if you are exercising and building muscle. How do we know which foods and drinks to choose? The food labelling system consists of clear colour coded signs to indicate high, medium or low levels of fat, sugar and salt as well as details of how many calories are in each product and guideline daily amounts. You will see the amounts of fat, sugar, salt and calories in more detail. There are guidelines to tell you if a food is high in fat, saturated fat, salt or sugar, or not. These are: Sugars High: more than 22.5g of total sugars per 100g Low: 5g of total sugars or less per 100g Salt High: more than 1.5g of salt per 100g (or 0.6g sodium) Low: 0.3g of salt or less per 100g (or 0.1g sodium) Total fat High: more than 17.5g of fat per 100g Low: 3g of fat or less per 100g Saturated fat High: more than 5g of saturated fat per 100g Low: 1.5g of saturated fat or less per 100g 4 PI_1666_01 Losing weight and changing behaviours Patient Information Leaflet

5 Energy: as a general rule it is better to choose products with lowest caloric values, however, you should look at food labels as even though a food might be low in calories it could have additional sugars or additives added. Should you wish to use counting calories as a method of losing weight, this can be discussed with the dietitian in clinic for support. Behaviour Change and motivation It can help to lose weight with others to keep motivation going by celebrating success and sharing ideas. Ask the Dietitian or your GP if there are any groups in your area. Treat yourself when you achieve a goal make a list of non food rewards, this could be a luxurious bubble bath, going to the cinema/ theatre, buying a new CD to dance to, going to a sports game, even buying your favourite magazine or having a night off from tidying depending on how big an achievement it was! What if I have a bad day? Think about the triggers that have led you to eat, was it an argument, boredom, tiredness, having treats in the cupboard and think about what to do next time. Please read on for more information about cravings. One lapse is not the end of you healthy eating plan. Try to understand what led to your lapse. By addressing the cause you should be able to make more progress with weight loss. You can contact the department s dieticians for their support. Changing behaviours for life Change is not all or nothing; small changes can have big benefits. Below are examples of diet and lifestyle changes to help you to lose weight for good. PI_1666_01 Losing weight and changing behaviours Patient Information Leaflet 5

6 Eat regular meals Enjoy a breakfast, lunch and dinner daily at regular times. Missing meals may seem like an obvious way to cut calories and lose weight but being hungry will lead to you making the wrong food choices later in the day and this can lead to a pattern of missing meals then binging. Top tip: People are more likely to pick up a high energy snack when hungry, plan your meals and snacks ahead so that you make the healthiest choice. Choose reduced fat options Opt for lean meat, skinless chicken and reduced fat versions of foods such as dairy products, spreads and salad dressings. Top tip: Change from full cream to skimmed milk and save 99 calories a day (based on consuming 300mls of milk a day). Fill up on fibre Swap to high fibre starchy foods such as wholemeal bread and pasta, brown rice, oat cakes, porridge or other high fibre cereals. Fibre helps to keep you feeling fuller for longer and reduces the amount you need to eat before feeling satisfied. Top tip: Bran and oat based cereals tend to contain more fibre than those made with rice or corn and set you up for the day. Just watch your portion size! Sweet foods Sugar provides the purest form of energy that can very easily turn into fat. Avoid sugary foods such as cakes, biscuits and sweets. A two litre bottle of fizzy drink contains around 56 teaspoons of sugar. Lots of sugary foods can also affect your blood glucose levels and your mood. Top tip: Swap to water, sugar free squash or flavoured water, or diet/ zero/free fizzy drinks to save on calories. 6 PI_1666_01 Losing weight and changing behaviours Patient Information Leaflet

7 Five a day You should eat at least 5 portions of a variety of fruit and vegetables a day. A portion of fresh fruit or vegetables is around a large handful, dried fruit is a tablespoon. Top tip: Fill half of your plate with cooked vegetables or salad to reduce the amount of calories but make you feel full. An average portion of protein food should be the size of a deck of cards and a portion of starchy carbohydrate the size of your fist. Pack a healthy snack When hungry we often go for a high fat or sugar option but having healthy snacks on hand will reduce energy intake and provide other valuable nutrients. Look for snacks under 100kcal this could be fruit, yoghurt or a cereal bar. Chewing non sugary gums can also reduce the sense of hunger. Top tip: A banana has half the calories of a standard chocolate bar. It is not just food Choose water or sugar free squashes. Unsweetened fruit juice is high in natural sugar so limit it to one 150ml glass per day. Alcohol is also high in calories. Having a glass of water before a meal can make you feel full more quickly. Avoid fizzy drinks or consider diet versions as an alternative. Energy drinks such as protein shakes, Lucozade and Red Bull can be extremely high in calories with little other nutritional benefit. Before taking any nutritional supplement drinks, please speak with your dietitian and/or pharmacist in clinic to discuss using them as part of your diet. Top tip: A pint of ordinary strength beer (3 4%) has two units of alcohol and 182 calories, reducing alcohol will make big difference to your energy intake. Burning more energy than you take in Add exercise for minutes into your day. This should be enough to increase your heart rate and make you slightly sweaty. Think about different activities that you might enjoy Zumba, brisk walking PI_1666_01 Losing weight and changing behaviours Patient Information Leaflet 7

8 around your local park, cycling, swimming, exercise DVD or skipping at home. Top tip: Standing up on the bus or train burns an extra 70 calories an hour Focus on your food Slow down when eating and put down your fork between mouthfuls. Do not eat on the go or while watching TV. Avoid eating while walking, wait until you get there. Eating meals at the table will help you focus on the amount of food you eat Top tip: Using a smaller plate can help to reduce portion size and leave a little bit of your meal to show that you are in control of how much you eat. Curbing your cravings Often we eat due to cravings, habit or feelings such as sadness, anger or tiredness rather than feeling truly hungry. Think about if you really require food and try to distract yourself for 15 minutes. Top tip: Why not go for a walk, read a magazine, paint your nails, have a bath, play a game, clean out a cupboard or phone a friend. Make a list of things you enjoy doing and choose one when cravings occur! Be prepared Having healthy options to eat at home and at work, makes following a healthy diet easier. Plan meals ahead and make a shopping list. Do not shop when feeling hungry to avoid impulse buying. Top tip: Use a food and activity diary to monitor your energy intake and output if you do not lose weight this week this will help to show what changes you could make for the next week. 8 PI_1666_01 Losing weight and changing behaviours Patient Information Leaflet

9 My Plan Date:... Now that you have read the leaflet please use the following form to summarise how you plan to make changes for a healthier life style; On a scale of 1 to 10 (10 being the post important), how important is it to you to lose weight? On a scale of 1 to 10 (10 being the most confident), how confident do you feel that you can lose weight? Two positive things about losing weight; The changes I am prepared to make now are PI_1666_01 Losing weight and changing behaviours Patient Information Leaflet 9

10 I think that the barriers to making these changes will be I think I can overcome these barriers by doing the following I intend to start my changes on:... To monitor my progress I will measure:... I will review my progress every:... As well as losing weight I will also aim to achieve the following; PI_1666_01 Losing weight and changing behaviours Patient Information Leaflet

11 Please use the space below to write down any questions you may have and bring this with you to your next appointment. PI_1666_01 Losing weight and changing behaviours Patient Information Leaflet 11

12 The Trust provides free monthly health talks on a variety of medical conditions and treatments. For more information visit HIV/GU Queen Elizabeth Hospital Birmingham Mindelsohn Way, Edgbaston, Birmingham B15 2GW Telephone: PI15/1666/01 Author: Rajinder Pabla, Rachel Watson, Kaveh Manavi Date: October 2015 Review date: October 2017