Why lifestyle medicine is what the doctor ordered

It’s that time when many of us have set New Year’s resolutions or intentions for what’s ahead. For many, improving health and managing weight will be on our list, but before embarking on a weight loss programme or specific diet, consider the programme components.

Too many weight loss programmes promise a quick fix and unrealistic goals such as “Lose 10kg in one month”. They tend to rely on some form of low calorie intake, which in the short term will achieve weight loss, but in the long term is not sustainable nor healthy.
These medically unsupervised restrictive and low-calorie diets have profound effects on our metabolic regulation and hormones, which are all finely tuned. When this balance is disrupted, our body will think we’re in starvation mode and switch on mechanisms that slow our metabolic rate.

We may notice that continued weight loss begins to decrease and stagnate after a period of rapid weight loss. Hormonal disruptions can also negatively affect our metabolism, appetite, and in some women it may impact our menstrual cycle.
Low-calorie diets can also result in nutrient deficiences and loss of lean muscle mass, impacting metabolism, body composition and overall health. We start to feel fatigued and do not have the energy to participate in physical activity.

Lastly, these diets can cause psychological stress such as feeling deprived and developing an unhealthy preoccupation with food. The unrealistic adherence to a low-calorie diet and frustration of stagnant weight loss can leave participants feeling demotivated and frustrated, wondering if their lack of willpower is to blame when, in fact, many physiological factors are at play. The belief that the next diet will achieve the desired effect leads to yet another diet, and so the vicious cycle of yo-yo dieting continues.

Pillars of good health

Weight management is complex, nuanced, and addresses many contributing factors.
Lifestyle Medicine takes a holistic approach to weight management, where realistic goals are set with the understanding that this journey is a marathon and not a sprint; that prioritising and addressing the pillars of good health lays the foundation to overall wellbeing and reduces our risk of chronic disease. Weight loss becomes less of a primary focus but rather a positive outcome of adopting healthy habits as a whole.

Presently, we’re overnourished and surrounded by a calorie-dense and nutrient-low food environment. Many of our jobs are sedentary and stressful, and with technological advancement, we are constantly “connected” to work emails or social media. Having time to switch off, slow down and reflect is becoming increasingly difficult. Many of us are sleep-deprived and pressured to achieve more than we have hours in the day. We turn to substances (such as smoking and alcohol) to alleviate stress, only to find these are short-term fixes with harmful effects in the long run. And with our limited time, purposeful and positive moments spent with friends and family begins to take a back seat.

We cannot ignore that these lifestyle behaviours contribute to our health, wellbeing, and weight. This is where the principles of Lifestyle Medicine can support and motivate patients in realistic and long-term positive changes.

• Nutrition – Switching to unprocessed whole foods that are nutrient-dense, satiating, and predominantly plant-based plays a significant part in weight management. A calorie deficit may be needed to achieve weight loss, but it’s done in a manner that does not disrupt the body’s metabolic regulation and hormones, allowing for a healthy weight loss that maintains energy levels.
• Physical activity – Choosing exercises you enjoy and are accessible, which include a combination of cardiovascular exercise and resistance training, is key. Staying active throughout the day will help maintain your NEAT (Non-Exercise Activity Thermogenesis), continuing to utilise the body’s energy stores when you’re not engaged in exercise.
• Sleep – Disrupted or reduced sleep has a negative impact on our hunger and hormones. It can lead to craving unhealthy food and feeling too exhausted to exercise, all of which contribute to weight gain.
• Harmful substances – Limiting alcohol can be helpful not just for health reasons, but also in reducing the hidden calories in alcohol. Substitute cocktails and mixers that are full of sugar for less calorific options.
• Stress & mental health – Stress drives our cortisol, which can affect insulin and increase our weight. Many of us turn to food and alcohol when we’re stressed or feeling down and anxious, making poor food choices. Managing stress and addressing our mental health is central to weight management.
• Purposeful connection – Getting support from family and friends and being part of a weight loss or healthy living group helps us to achieve goals. A little accountability can be all that’s needed to remain motivated and engaged.

Ultimately, lifestyle changes should be at the core of weight management. Adopting the evidence-based approach of Lifestyle Medicine has sustainable benefits and goes beyond the desired weight loss. We’re here to help!

Written by Dr Sundus Hussain-Morgan (MBBS, MRCP, MRCGP, Board Certified in Lifestyle Medicine)
IMC Jelita and IMC Camden
 www.imc-healthcare.com