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Get Help to Win the Battle of the Bulge

 
  Source: Article first appeared in Singapore Health Ref. V10, a bi-monthly publication of SGH and SingHealth Group. Original title: "When Bigger Is Not Better"  
     
 

Keep your burgeoning waistline in check before it compromises your health

Ms Margaret Foo gets a helping hand from Senior Physiotherapist Eric Ho at SGH LIFE centre, who helped her regain her svelte figure via a customised weight-loss programme

A year and a half ago, Ms Margaret Foo Seck Lan, 43, could not climb a flight of stairs without gasping for breath.

At 81kg, the mother of three had a body mass index (BMI) of more than 31, well over the healthy weight range of 18.5 to 22.9. This meant that her obesity put her at high risk of developing medical conditions such as heart disease and diabetes. Her excess weight made her feel “ugly” and she couldn’t fit into the clothes she liked. She snored at night, and suspected that this was weight-related. Worried about her condition, she turned to the LIFE (Lifestyle Improvement and Fitness Enhancement) Centre at Singapore General Hospital (SGH).

The LIFE Centre is a one-stop shop for people with lifestyle-related medical conditions such as obesity and cholesterol (lipid) problems. Such cases have been increasing, and last year, the Centre saw 600 new patients seeking treatment for obesity and related diseases, said Dr Tham Kwang Wei, Consultant, Department of Endocrinology, SGH, and Director, Obesity and Metabolic Unit, LIFE Centre. Based on a 2004 National Health Survey, 6.9 per cent of Singaporeans are obese (with a BMI of 30 or more), compared to only 5.2 per cent in 1998.

Born to gain weight?

Certain medical conditions such as hypothyroidism – a condition in which the body produces insufficient thyroid hormones and which Ms Foo suffered from – can cause weight gain or difficulty in losing weight. Part of the weight problem may also be due to genes. However, the real culprit is often bad lifestyle habits.

“It’s true that genetics predispose you to obesity. However, if you live in an environment
which requires you to walk 5km every day just to get your meal, you would most likely not be obese even if you were genetically predisposed,” said Dr Tham.

Ms Foo, who used to weigh 51kg before her first pregnancy, agreed that environment is a factor, and that the availability of all kinds of food everywhere is a constant temptation. “Like any Singaporean, I love my chicken rice and laksa. Whenever my kids can’t finish their food, I end up eating their leftovers.”

Lifestyle and diet changes

At the LIFE Centre, patients go through a holistic approach to manage their weight. Existing medical conditions are addressed by the Centre’s multidisciplinary team of doctors, dietitians, physiotherapists and occupational therapists, who then create a weight-loss programme for the patient. A psychologist may also be called in to address any psychological issues.

“The first part of treatment is always the hardest because patients have to make lifestyle changes,” said Mr Eric Ho, Senior Physiotherapist and Clinical Coordinator of the Obesity and Metabolic Unit at SGH.

Still, patients should take heart, said Dr Tham. Studies have shown that an obese person who loses just 10 per cent of his original body weight can dramatically improve obesity-related chronic conditions such as high blood pressure, high cholesterol and diabetes.

Mr Ho added that in general, people should aim to lose weight using a “slow and steady” approach, which means losing about half to one kg a week. This is much safer than following overzealous weight-loss programmes, which can have devastating effects including cardiac arrest from mineral loss and heart palpitations. “If you crash diet or go on a very low-calorie diet, you’re sure to lose weight, but maintaining the weight loss is another matter,” he said. Losing weight does not mean having to join a gym, either. A simple walking programme has been shown to be one of the most effective ways to lose weight. Regular physical activities such as sports and home exercise programmes are also good alternatives.

Since keeping her thyroid condition under control and changing her lifestyle habits, Ms Foo has shaved more than 15kg off her frame. “I thought I was going to faint when I first started exercising. But now, I’m so much fitter that I took part in a 10km walkathon recently,” she said.

Big Bundles of Joy

Even babies aren’t spared from weight issues. According to Associate Professor Tan Kok Hian, Chairman of the Division of Obstetrics and Gynaecology at KK Women’s and Children’s Hospital, the heaviest baby delivered there weighed a whopping 5.58kg in 2002.

A baby who weighs more than 4kg at birth is considered big by Asian standards. Assoc Prof Tan noted that the increasing incidence of obesity and diabetes in mothers raises the chance of them having heavier babies. However, the mean weight of newborns here remains at 3.2kg, unchanged from a decade ago. This has been attributed to better antenatal care, improved diabetes management and the practice of delivering heavier babies earlier.

 
   
   
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