Obesity and Weight Loss: Safe, Practical Steps That Work

7 min read · Conditions · By the Asthra Health Care team

What is obesity?

Obesity means having extra body fat that affects health. Doctors often use body mass index (BMI), which is your weight in kilograms divided by the square of your height in metres. For Asian Indians, a lower BMI cut-off is used than in Western countries, because health problems start at lower weights. Generally a BMI of 23 or more is considered overweight and 25 or more obese for Indian adults.

Waist size is equally important. Fat around the belly, called central obesity, is closely linked with diabetes and heart disease. Many Indians have a normal BMI but a large waist. A waist above about 90 cm in men or 80 cm in women is a warning sign.

Why weight gain happens

Weight gain happens when the body takes in more energy than it uses, but the reasons behind this are complex. Genes, hormones, sleep, stress, medicines and our surroundings all play a part. Blaming yourself does not help; understanding the causes does.

Common contributors in Indian homes include large portions of rice or chapati, frequent sweets, fried snacks and bakery items, sugary tea, packaged juices and soft drinks, eating late at night, long hours of sitting at desks or on screens, and little walking. Conditions like hypothyroidism and PCOS, and medicines such as steroids, some antidepressants and some diabetes medicines, can also add weight.

Health risks of obesity

Extra weight affects almost every part of the body. Losing even a modest amount of weight, if kept off, lowers many of these risks and often improves blood sugar, blood pressure and knee pain noticeably. Health problems linked with obesity include:

• Type 2 diabetes and prediabetes
• High blood pressure, high cholesterol, heart attack and stroke
• Fatty liver disease
• Knee and back pain, and osteoarthritis
• Snoring and sleep apnoea
• PCOS, infertility and pregnancy complications
• Acidity and reflux, and some cancers

Food changes that last

Crash diets and skipping meals usually fail, because the weight returns once you stop. Aim for changes you can keep for life. Use a smaller plate. Fill half with vegetables and salad, a quarter with protein such as dal, sprouts, curd, paneer, eggs, fish or chicken, and a quarter with rice, millets or chapati. Eat slowly and stop when you are comfortably full.

Cut sugary drinks, fruit juices and sweets to occasions rather than daily habits. Choose roasted chana, fruit, buttermilk or a handful of nuts instead of fried snacks and biscuits. Cook with less oil, avoid reheating oil again and again, and try not to eat late at night. Drink water through the day.

Move more, sleep better

Physical activity helps you keep weight off and improves health even before the scale moves. Start where you are: a 10-minute walk after each meal is a good beginning. Build up to at least 150 minutes of moderate activity each week, such as brisk walking, cycling, swimming or dancing, plus strength exercises twice a week. People with knee pain can try cycling, swimming or chair exercises.

Poor sleep and stress increase hunger and cravings. Aim for seven to eight hours of sleep, keep screens away before bed, and find ways to relax, such as walks, prayer, yoga or time with family. Late-night screen time often leads to snacking as well.

Medicines and surgery

For some people with obesity, especially those with diabetes or other health problems, doctors may add weight-loss medicines to lifestyle changes. Newer injectable medicines that act on appetite hormones can help, but they are taken only on a doctor's prescription, need monitoring and are not suitable in pregnancy. Weight usually returns if they are stopped without lasting lifestyle changes.

For severe obesity with related diseases, bariatric surgery may be an option after careful assessment by a specialist team. Avoid weight-loss powders, teas, pills or belts sold with big promises. They are not proven and some contain hidden, harmful substances.

Children, pregnancy and support

Children who are overweight should not be put on strict diets. Instead, the whole family can eat healthier home food, limit packaged snacks and screen time, and play outdoors together. Pregnant women should not try to lose weight; instead, ask your doctor about healthy weight gain.

Weight loss is a journey with ups and downs. Track your weight and waist once a week, not daily, and celebrate small wins. For a plan that suits your health conditions and medicines, talk to your doctor or pharmacist, and ask about seeing a dietitian.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.