13-19 December 2013 #685

Biggest losers

Dhanvantari by Buddha Basnyat, MD

Nepal has very few obese people, but as young, urban Nepalis adopt increasingly unhealthy food and working habits we together with the rest of South Asia are set to be an overweight nation. Overweight is defined as a body mass index (BMI = kg/m2) of 25 to < 30 and obesity is defined as BMI of 30 or more.

Forget about having rippling, abdominal muscles. Just keep your weight in the normal range. Shedding even a few kilos and increasing physical activity can help prevent plenty of medical complications like high cholesterol, diabetes, heart disease, arthritis, and increase a person’s lifespan.

Patients on a diet generally lose about five per cent of their body weight over the first six months, but by 12 to 24 months they are back to ‘mangal man’ ( square one). The long-term ineffectiveness of diets may be due to compensatory changes in energy expenditure that oppose the maintenance of a lower body weight as well as genetic and environmental factors. Here are some common diets used for weight loss.

The Atkins diet which lets you eat fat and protein to your heart’s content with very low carbohydrate is probably impractical in Nepal because of the lack of variety of meat and fish. The LEARN (Lifestyle, Exercise, Attitude, Relationships, and Nutrition) diet is based on intensive lifestyle modification and may be too ‘idealistic’ for many but very beneficial if you can bring about these changes in your life. The Zone diet comprises of 40 per cent carbohydrate and 30 per cent each of protein and fat.

My favourite, however, is the vegetarian-based, fat restricted Dal Bhat diet also known as the Ornish diet, named after Dr Dean Ornish, a professor of medicine from the University of California in San Francisco. But I think even the good doctor would be stunned at seeing the mountain of rice that many Nepalis consume here twice a day with minimal exercise. Probably the only group of people in Nepal that can efficiently deal with this vast amount of rice-eating are porters along the Himalayan trails. A modification of the Ornish diet with controlled rice consumption but plentiful dal, vegetables, and a side of tasty achar, may be a very suitable and practical option for the Nepali palate.

Some diet programs are easier than others. Therefore, it is crucial to have a diet plan tailored to your individual needs. Setting attainable targets is equally vital in ensuring successful weight loss. Getting advice from nutritionists and joining self-help groups can help make it easier to keep up with diet regimes.

Very few people are able to just exercise and lose weight without controlling their calorie intake. Breaking the bad eating habits that led to weight gain in the first place requires immense will power and months, even years of hard work. Slow results often dampen people’s resolve. But there is no silver bullet for weight loss. Being patient, sticking to a suitable diet plan of your liking and gradually decreasing calorie intake, exercising sensibly, and keeping a positive attitude will go a long way in losing weight.