Pharmacists can help as patients consider weight management in the New Year, write Dr Esther Lau and Professor Lisa Nissen
The statistics are sobering—Australia is one of the fattest nations in the developed world. Australian adults are becoming increasingly overweight and obese, and so are our children.
Being overweight or obese can contribute a significant burden of disease as it negatively impacts upon health outcomes of many chronic conditions.
The upside is that moderate weight loss e.g. 5-10% of body weight can have considerable benefits for managing conditions such as dyslipidaemia, diabetes, hypertension. A more significant degree of weight loss can even resolve some conditions such as sleep apnoea.
The formula for maintaining a healthy weight is actually very simple… it is all about balancing the energy in versus energy out. The amount of energy intake someone needs is dependent upon their daily lifestyle e.g. sedentary versus significantly active lifestyles; and whether or not the body is still growing i.e. children and adolescents.
See the daily energy requirements calculator by the Australian Government Department of Health https://www.eatforhealth.gov.au/node/add/calculator-energy).
So weight loss is about energy in < energy out. However, this balancing act is in fact easier said than done, and the trick is also how to maintain the weight loss.
Many people can lose weight in the short term, but not many can maintain this in the longer term e.g. more than two years.
Unrealistic goals about expectations of weight loss programs mean people are not aiming for realistic or achievable weight loss goals. Small wins, and positive reinforcement helps with negotiation of ongoing weight maintenance goals.
Pharmacists can also assist patients with navigating the confusing labyrinth of messages that we are bombarded with in advertisements for “health foods” or the latest celebrity fad diet.
The Australian Dietary Guidelines provide recommended daily intakes of the five core food groups each day for a balanced and nutritious diet for most healthy people. The amount of energy delivered by the nutrients in food is:-
- Carbohydrates – 16.7 kj per gram
- Protein – 16.7 kj per gram
- Fat – 37.7 kj per gram
- Alcohol – 29.3 kj per gram
As pharmacists, we are also aware that weight gain can occur as a side effect of some medicines e.g. some antipsychotic agents. Antipsychotic agents impact upon other metabolic effects such as abnormal glucose tolerance and increased lipid levels, and patients taking these medicines require advice about monitoring and managing their cardiovascular risk factors.
Similarly, some people may be reluctant to quit smoking due to fear of weight gain. Reassurance that any increases in weight is usually minimal (average five-year weight gain less than 3kg), and the benefits of smoking cessation.
These discussions with patients are important for alleviating and addressing concerns or misconceptions.
Dr Esther Lau and Prof Lisa Nissen are from the School of Clinical Sciences, Queensland University of Technology.