On the Internet, there are thousands of miracle recipes, tutorials, infallible diets, and that’s not to mention the support groups for overweight people. This is good, because it promotes reflection, commitment and can even lead to a self-controlled weight loss of 10 to 15%. But for how long? That’s a different story.

It is indeed easier to lose weight than to keep it off. Small victories are therefore often short-lived. To avoid “playing yo-yo” on the scale for years, you must therefore modify your lifestyle in a determined, adequate, and sustainable way.

Before resorting to medication or bariatric surgery, it is necessary to act on three facets: nutrition, physical activity, and mental health.

Towards a healthy and balanced diet

Forget miraculous and complicated diets! The basic principles are simple: eat less, eat better. Avoid empty snacking and processed foods. Eat balanced meals on a regular basis. Finally, a serious step against obesity will be to resort sooner or later to the support of a nutritionist. They are your first ally.

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Exercise first

Only 15% of Canadians get enough exercise. It’s a shame, because it’s the best way to lose fat and gain muscle, a high calorie burner! It’s not that hard to get started, but the obstacles often seem insurmountable. A kinesiologist, your second ally, is there to help you!

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It also happens in your mind!

Too much stress? Sleep problems? A lack of confidence, an old inner pain that you obsess over. Whether you rarely feel on top, or that you can only think of filling your plate to better empty it, it may be the sign that you have psychological issues you need to deal with. Do not wait, meet with a psychologist!

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Il y a deux périodes de l’année très prisées pour la perte de poids: après les fêtes de fin d’année et juste avant les vacances d’été. C’est alors que l’on entend parler des ces régimes-minceur permettant de perdre 10 kg en une semaine, sans regrossir ni subir d’effet secondaire. Pour la moyenne des ours à la recherche du dernier look à la mode, pas de problème. Pour les personnes à risque ou souffrant d’obésité, malheureusement, c’est beaucoup plus compliqué que ça et c’est un souci permanent pour lequel toute solution doit obligatoirement s’inscrire dans la durée.

There is no miraculous recipe

Human beings need food to live, and, for this purpose, they need a supply of various nutrients. Severe restrictions or the exclusion of certain classes of food are not sustainable over time. They are mostly associated to abstract choices rather than to medical and nutritional reality.

Obesity experts will tell you that fad diets often backfire on their original purpose. Instead of overcoming overweight or obesity, compulsive fasting disrupts the metabolic regulatory mechanisms of taste and satiety. They thus lose all food control and succumb to the Sirens of bulimia, regaining the lost weight with, as a bonus, a discouraging feeling of failure.

Tell me what you eat...

There are, however, basic principles recognized by modern science and validated by the experience of billions of human beings, from antiquity to now:

  • Cook at home, healthy food that you love
  • Prioritize food quality over quantity
  • Avoid industrial dishes and fast food as much as possible
  • Follow Canada’s Food Guide recommendations. This guide offers all the tools necessary to meet nutritional needs, reduce the risk of obesity and better resist diseases associated with overweight and malnutrition.
  • Be wary of fads and media hype. Publications based on serious scientific sources are more likely to contain genuinely useful and beneficial information. For example:

 Freely translated: 

“A good diet does not normalize eating. Each individual is different. (…) We must also give back the control of food to the individual and make him responsible for the solutions. There are many avenues: improve your knowledge of food and how to prepare it, learn to perceive and respect your body’s internal signals (hunger, satiety, taste), stop feeling like a victim deprived of everything that is good. Sometimes all it takes is small changes. The important thing is to arrive at a solution that is acceptable to the individual. “

— Réjeanne Gougeon 

Tell me how you eat...

Here again, the popular (and even scientific) literature is sometimes quite confusing. The conditions surrounding meals vary from one country, one type of environment, one family, and even one individual to another, so much so, that it is difficult to correlate them very precisely with the risks of overweight, and obesity. Each case remains specific, but some principles seem to be well established:

It is better to eat according to the effort to be provided, before rather than after. In theory, you should therefore take 4 to 5 “meals” per day: 

  • a good breakfast (20 to 25% of daily energy intake), 
  • a hearty lunch at noon (30 to 35%), 
  • one or two snacks in the morning and/or afternoon (±15% each) 
  • and a light diner at the end of the day, at least two hours before going to bed. It is clear that this is not really the norm in Quebec, and this explains, in large part, the increased prevalence of overweight and obesity that has been observed there over the past 40 years.  

However, it is possible to improve your habits:

  • Snacks and other industrial delicacies with a high sugar or salt content that are eaten at any time are to be avoided. 
  • Fruit or carbonated beverages, including those marketed as “diet,” are to overweight people what tobacco is to asthmatics—poison. 
  • Taking care of your daily nutrition is good but accompanied by a regular exercise regimen is better. Without forgetting to sleep well because sleep disorders are also often associated with eating disorders. 

The contribution of the nutritionist

As we have seen above, there is no miracle solution, but nutrition is one of the keys to limiting overweight and overcoming obesity. In order to avoid pitfalls and abuses, it may be useful to consult a professional specializing in these issues. Regarding the bariatric course of patients with severe or massive obesity, it is even an essential resource, both before and after the operation.

Essentially, a nutritionist will collaborate with their patients to set realistic goals to improve their quality of life. He will teach them to listen to the signals of hunger and satiety sent by the body and help them rediscover the pleasure of eating.

He will also give them lots of advice on the choice and preparation of food. In short, he will put the science of nutrition at their service in a human and personalized way, both theoretical and practical.

Furthermore

Consult the Weight Management and Health and Nutrition pages of Extenso, the nutrition reference center of the Université de Montréal.

Watch the video on weight loss published by the Professional Order of Dietitians of Quebec.

1 Quote from Réjeanne Gougeon, then researcher in nutritional science at McGill University and president of the obesity treatment committee of the Ordre professionnel des diététistes du Québec, published in October 2000 on servicevie.com.
2 Source: Differences in meal patterns and timing with regard to central obesity, Cambridge Open Access, September 2017

Physical exercise is the second pillar of a healthy lifestyle. It consolidates the benefits of a good diet by burning a number of calories and building muscle mass. It reduces the risk of heart disease, diabetes, or depression. Finally, combined with good nutrition, physical activity is the most effective way to not regain the pounds lost after a weight loss diet or bariatric surgery.

However, it is not necessary to register at a gym or spend a fortune on equipment. To run or walk, all you need is a good pair of shoes and cans are much cheaper than dumbbells. The most important thing is to find in yourself the motivation to get started and, above all, to persevere.

Freely translated:

Exercise does not have to be hard to be beneficial. The main thing is to move regularly with PLEASURE.”

— Laure Schlup, Swiss specialist in adapted physical activity 

Exercise is health!

Physical inactivity is the main cause of overweight and many diseases in our society. Health authorities therefore agree to recommend a minimum of 30 minutes of moderate to intense exercise per day, throughout life.

In a medical paper published in 2008, the Kino-Québec organization highlighted a dozen statements resulting from rigorous scientific analysis. Here are a few:

  • Increasing physical activity is the only way to increase energy expenditure over which we can exercise voluntary control
  • Increasing physical activity while reducing caloric intake is the best strategy for losing weight 
  • Maintaining a high caloric expenditure is the key to stabilizing weight after weight loss 
  • High aerobic capacity reduces the risk of developing type 2 diabetes 
  • Physical activity lowers blood pressure in people with hypertension
  • Physical activity improves the lipid profile of people who lose weight. 

Exercise is accessible

Knowing all this, we must recognize that there are plenty of bad excuses for putting off until tomorrow the exercise that we should do today: “Too much work… I’m late… The weather is bad… I’m not equipped…” the exercise seems as complicated as eating well, when in fact it is just as simple – just a question of motivation and organization.

When you decide to make it a life goal, in fact, you realize that exercise can bring real pleasure and that it does not cost more than you want to invest in it. From there, all you have to do is let yourself go and count the disappearing calories.

Calorie outlay by physical activity and by weight: 

ACTIVITY 57 Kg 70 Kg 85 Kg
Bowling 90 cal 112 cal 133 cal
Bodybuilding (moderate) 90 cal 112 cal 133 cal
Walking (5,6 km/h) 120 cal 149 cal 178 cal
Walking (6,5 km/h) 135 cal 167 cal 200 cal
Dancing socially 165 cal 205 cal 244 cal
Stairs Climbing 180 cal 223 cal 266 cal
Bodybuilding (heavy) 180 cal 223 cal 266 cal
Running (8 km/h) 240 cal 3298 cal 355 cal
Biking (20 km/h) 240 cal 298 cal 355 cal

Find your rhythm and persevere

While it is true that regular physical exercise can stabilize weight, make you healthier and reduce the risk of disease, it presents quite a challenge for obese people. Intense training could expose them to the risk of injury and joint or cardiovascular complications. As for moderate exercise, you might as well have realistic expectations. It would take 63 hours of brisk walking to burn a single kilo of fat!

It is therefore advisable to start gently, to listen to your body and not to impose more on it than it can endure. Three daily episodes of about ten minutes are sufficient, initially, to get moving. After a few weeks, it will be easier to extend the duration, even if it means practicing “interval training” by alternating 5 minutes of more intense effort and one minute of moderate effort. It is over time that this physical hygiene will bring all its benefits, toning the body, reviving inner strength, self-esteem, and the determination to take charge.

For go further

1 Voir à ce sujet les Directives canadiennes relatives à l’activité physique, Société canadienne de physiologie de l’exercice.
2 Source: L’activité physique et le poids corporel, Kino-Québec, March 2008 (PDF, 2,7 Mo).
3 In the sports world, the term “aerobic” refers to endurance efforts that consume oxygen and release heat.

Nutrition and physical exercise are not the only problems obese people have to overcome to improve their quality of life. They also have to deal with immense psychological difficulties which are linked in particular to the stigmatization to which they are subject, their inability to control their weight and the resulting loss of esteem.

These difficulties commonly translate into addictions resulting in hunger and satiety regulation mechanisms and social reclusion leading to anxiety and depression. To achieve a lasting reduction in weight, as to pass through the trials of the bariatric course, it is necessary to understand and overcome all these problems.

Obesity on a daily basis

People who are overweight or obese, regularly experience embarrassing situations that affect their self-esteem. A fitting of clothes that are too tight in a store, a cruel passenger in the metro, embarrassed or even mean looks at the grocery checkout… all of this can hurt them and affect their morale.

What about the fate of a person suffering from morbid obesity? To tie their shoes is an ordeal to them. They can’t exercise for more than five minutes a day without their heart racing. For them, travel by bus or plane is uncomfortable, overpriced, and complicated. When they shows up at the restaurant, everyone looks at them with calorie calculators in their eyes. As for the love life, it is an inaccessible dream.

Vicious circle

It is difficult to realize how society has enormous prejudices against excess weight. Yet these are expressed everywhere – in the street, at school, at work and even in the family. In the long run, it doesn’t take much – a breakup, professional stress, more discrimination – to trigger a complex pathology leading in particular to the loss of food control and withdrawal.

The psychological evolution of an obese person is a vicious circle. The gaze of others affects their self-esteem. Rightly or wrongly, they feel it as a condemnation. They then compensate for the shame and guilt by developing an addiction to food, increased isolation, and a sedentary lifestyle. As a result, they gain even more weight. The gaze of others is even more difficult to bear, especially since they have even more reason to feel guilty. And it goes on like this until they find the strength and support to take charge of themselves.

Food Addict

It is difficult to realize how society has enormous prejudices against excess weight. Yet these are expressed everywhere – in the street, at school, at work and even in the family. In the long run, it doesn’t take much – a breakup, professional stress, more discrimination – to trigger a complex pathology leading in particular to the loss of food control and withdrawal.

The psychological evolution of an obese person is a vicious circle. The gaze of others affects their self-esteem. Rightly or wrongly, they feel it as a condemnation. They then compensate for the shame and guilt by developing an addiction to food, increased isolation, and a sedentary lifestyle. As a result, they gain even more weight. The gaze of others is even more difficult to bear, especially since they have even more reason to feel guilty. And it goes on like this until they find the strength and support to take charge of themselves.

How to stop it?

Like all addictions, these behaviors are not voluntary. They are forced, irrepressible, imperious. It takes an iron will to get rid of it, but fortunately, there are solutions. Self-help groups, which promote socialization and externalization of the problem, can support individual willpower. It is also possible, today, to prescribe medication to control bulimic episodes and reduce emotional shocks.

Psychological help is undoubtedly the safest way. It can take the form of occasional support or more systematic cognitive and behavioral therapy, or even psychotherapy. The main thing is that it is adapted to patients so that it is experienced as a positive exploration giving them the strength and confidence necessary to overcome their difficulties.

Furthermore

1 Read on this subject: Qui a des préjugés? On the ÉquiLibre website.
2 For more details, read the WHO paper:  Weight bias and obesity stigma: considerations for the WHO European Region (2017).