5•1
Chapter 5
Going for an MoT
(How a trip to the doctor’s can help you to achieve your weight-loss goals)
Contents
Assessing your fuel intake . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 To get the most from your visit, follow a few simple rules . . 3
Getting a jump start . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Visiting an ‘obesity bodyshop’ . . . . . . . . . . . . . . . . . . . . . . . . 4
The importance of regular maintenance checks . . . . . . . . . . 2
• Secondly, high-fat convenience foods (eg, vegetables) are calorie-
1 Assessing your fuel intake foods such as pizzas, burgers, chips and sparse, meaning that even large portions
deep-fried chicken meals have become are not likely to result in substantial
extremely popular. These foods are now weight gain.
part of the nation’s staple diet, and their
cheap, super-size portions mean that, on
average, people are now consuming
Strange but true
more calories than ever.
There are more calories in a small
3 Bearing this in mind, it is not difficult
(50 gram) bar of chocolate than
to understand why so many people are
there are in three bananas.
1 Obesity is one of the fastest growing now overweight.
medical conditions in the UK. In 1980, 4 The simple facts are:
only 6% of men were clinically obese. • If you take in more calories than your
Now, as many as 21% of UK men fit into body needs, you will put on weight. 7 To get a true picture of the number of
the obese category1. Conversely: calories in a food, it is important to read
2 There are a number of possible • If your body uses up more calories the food’s nutrition label.
reasons. than you take in, you will lose weight. 8 This will not only provide information
• Firstly, we have all become less 5 Put simply, a calorie is the amount of about the calorific value of 100ml/100g
active. The birth of the computer age has energy that is contained within a food. of the food (or a typical serving size), but
meant that we can all enjoy a wide The higher the number of calories, the will also usually tell you:
variety of home-based entertainment, in more energy that is locked away inside • The amount of protein (in grams).
the comfort of our armchairs. The it. • The amount of sugaring and non-
popularity of digital television, DVDs, 6 Unfortunately, by judging portion size sugaring carbohydrates (in grams).
video game consoles and the internet alone, it is very difficult to tell how many • The amount of saturated and
has resulted in fewer people taking calories a particular food contains. unsaturated fat (in grams).
regular exercise. This means that, on Certain foods (eg, chocolate) are very • The amount of fibre (in grams).
average, people are now burning fewer calorie-dense, meaning that even a small • The amount of salt [sodium] (in
calories than ever. portion is very high in calories. Other grams).
5•2 Going for an MOT
Calculate your body mass • Assess how much weight you need to
index (BMI) 2 The importance of regular lose.
maintenance checks • Suggest a sensible weight-loss rate
This is simply your weight in kilograms,
(usually around 0.5 to 1 kg (1 to 2 lbs)
divided by the square of your height in
per week).
metres: 1 If you are prone to putting on weight, • Help with a plan of action to help you
you should make regular checks to lose weight (eg, balanced diet, exercise
Weight (kg) ensure that your weight is not getting out regime, weight-loss medication).
Height (m)2 of hand. Even losing small amounts of 4 Your doctor or practice nurse will be
weight can have a significant positive able to provide a number of weight-loss
Example: impact on your overall health. For services. The exact services offered will
example, losing some excess weight will vary from practice to practice, but most
Joe weighs 70.5 kg, and is 1.82 m tall. substantially reduce your chance of doctors can provide:
His BMI is therefore: contracting cancer and heart disease2. • A series of tests to make sure that your
2 If you think you will find it difficult to weight gain has not caused an
70.5 = 70.5 = 21.3 lose weight on your own, your doctor is underlying condition such as diabetes.
1.82 x 1.82 3.3124 ready, willing and able to help you • A healthy eating plan.
achieve your weight-loss goals. When • A sensible exercise regimen.
What the results mean you visit your doctor for the first time, he • Expert advice and support.
or she will probably run a series of tests. • Anti-obesity drug treatment.
BMI Weight Status These tests are rather like an MoT, as
Below 18.5 Underweight they tell the doctor all he needs to know
18.6 to 24.9 Normal about your excess fat levels and the way 3 To get the most from your
25.0 to 29.9 Overweight they are affecting your overall health. visit, follow a few simple
30.0 and above Obese 3 Using the results of your MoT, the rules
doctor will be able to:
Make weight loss the sole
reason for seeing your doctor
Weight in kilograms
1 Losing weight is an important clinical
40 50 60 70 80 90 100 110 120 130 140 150
6’4 issue. If you only mention it at the end of
1.92 a consultation about something else,
6’3 1.90
6’2 1.88 your doctor may mistakenly believe that
6’1 1.86 you are not committed to losing your
6’0 1.84
1.82 excess weight. Reducing obesity is a
Height in feet and inches
5’11 1.80 priority for the NHS, so you should give
5’10 1.78
your doctor enough time to be able to
Height in meters
5’9 1.76
1.74 discuss your weight loss in detail.
5’8 1.72
5’7 1.70
5’6 1.68
1.66
5’5 1.64
5’4 1.62
5’3 1.60
1.58
5’2 1.56
5’1 1.54
5’0 1.52
4’11 1.50
4’10 1.48
6 7 8 9 10 1112 13 14 1516 17 18 19 20 21 2223 24 25
Weight in stones
Underweight Very overweight
Normal weight Seriously overweight
Overweight
H45398
H45419
BMI graph
This applies to both adult men and women, but not sportspeople as muscle is Your doctor will assess how weight is
heavier than fat affecting your overall health
Going for an MOT 5•3
Show your doctor that you are
serious about losing weight
2 Losing weight needs a commitment
from you too. Explain that you are
determined to lose weight, and that you
fully understand that this will entail
sensible eating and regular exercise. You
could also take this opportunity to ask
about the various treatment options
which will help to aid the weight-loss
process.
Tell your doctor about your
previous weight-loss
experiences
3 You need to be totally honest with
your doctor, in order to receive the
advice and support that is right for you.
Openly describe your eating habits and
current levels of physical activity, and tell
your doctor about any previous weight-
loss attempts. It is important for him to
understand why these attempts failed,
so that you are successful this time.
Tell your doctor or practice
nurse about how being fat is
making you feel
4 Although it may seem difficult at first, H45403
it will help your doctor or nurse if you
could explain how being fat makes you Does your weight problem make you comfort eat?
feel. Be as open and as honest as you
can. Don’t just describe the physical • Thinking about the main reasons why that can help to boost your weight loss
repercussions (eg, shortness of breath, you have become overweight. attempts. Both of these medications
frequent tiredness), also try to describe • Thinking about how losing weight will must be taken alongside a sensible diet
how you feel on an emotional level (eg, improve your health and quality of life. and exercise programme, and are only
does your weight problem leave you • Monitoring food intake and physical suitable if your BMI is more than 27 and
feeling depressed, do you ‘comfort eat’?). activity. if you have other obesity-related
• Developing a basic understanding of conditions, or if your BMI is greater than
4 Visiting an ‘obesity nutrients and food groups. 30.
bodyshop’ • Learning techniques for staying in 3 These two medications are called
control when you are eating out. sibutramine and orlistat.
• Reading and interpreting food labels to • Sibutramine works by helping you
1 Some practices also offer dedicated help identify healthy and unhealthy learn to eat less. You are therefore
weight-loss clinics. This type of clinic foods. able to eat smaller meal portions
provides frequent motivation and • Identifying your trigger foods (foods without feeling hungry. When used in
continuous advice. that you have trouble stopping eating) conjunction with a low-calorie diet and
2 Clinics usually last around and planning to avoid them. exercise programme, studies have
20-30 minutes and are held at fortnightly • Developing an appropriate programme shown that most people on
intervals. The person who runs the clinic for increase in physical activities. sibutramine achieve initial weight
may be your doctor or your practice nurse. losses of at least 5-10% (eg, a
3 The itinerary is designed to be 5 Getting a jump start minimum of 5-10 kg in a 100 kg man)3.
educational and varied, and will help to • Orlistat impedes absorbtion of up to a
keep you motivated as you strive to lose third of the fat you take in from your
your excess weight. You should be diet4. It is important that people on
prepared to commit to attending the 1 If you are finding it difficult to lose orlistat stick to a low-fat diet.
clinic for at least one year. weight, your doctor can also prescribe 4 If you feel that you would benefit from
4 Activities at these weight-loss clinics special weight-loss medications. taking either of these medications, you
may include: 2 There are currently two medications should visit your doctor.
5•4 Going for an MOT
References problem. General Practitioner July 4 Sjöström L, Torgerson JS, Hauptman J
Written by Dr David Haslam 2001; pp 31-32. et al. Xenical in the prevention
1 National Audit Office. Tackling Obesity 3 James WPT, Astrup A, Finer N et al. of diabetes in obese subjects: a
in England. Report by the Comptroller Effect of sibutramine on weight landmark study. Abstract presented at
and Auditor General, HC 220, Session maintenance after weight loss: a the 9th International Congress on
2001-2001. randomized trial. Lancet 2000; 356: Obesity, São Paulo, Brazil, 24-29
2 Haslam DW. Obesity - the scale of the 2119-2125. August 2002.