Specialists and dietitians from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH) and from Singapore General Hospital (SGH), both members of the Sin​gHealth​ group, give answers to questions on weight management.​

Question by seonck

I have a friend and his family who are all heavily overweight. I mean probably at least 20 -30kg over per person . All 4 of them are adults between 30-45 years old. Yet their parents are not very heavy. Any advise I could give to all of them that they could act on themselves, or does it sound like they need to see a doctor/specialist? What's the difference in seeing a specialist versus just changing lifestyle habits, etc?

Answered by Dr. Tham Kwang Wei, Singapore General Hospital

Firstly, you must help your friend and his family to identify that obesity is a risk factor for health problems like diabetes, hypertension, even if their parents did not have these medical problems, so that they will be motivated to see the need for change. Having additional support and concern (not nagging and scolding) from friends and family will enhance their efforts...like actually exercising with them, ordering healthier foods when eating with them.

If someone is very overweight, like in your friend's case, it is usually preferable that he/she seeks help from a team of healthcare professionals consisting of a doctor, dieititan and a exercise therapist or even a psychologist who can help to assess and start him/her on a lifestyle modification programme, as well as to monitor his/her progress. Often in such situations, conditions causing unusual weight gain should be excluded as well as conditions associated with overweight/obesity such as prediabetes, high cholesterol, fatty liver. Multiple modalities are required, which may entail prescription medications, supervised exercise, more prescreptive and precise dietary modifications or in selected cases, bariatric surgery.

The healthcare professional team is helping the individual to make concrete and sustainable changes to his/her lifestyle, no different than if the individual were to do it by him/herself. However, with additional professional advice based on the experience of these experts and medical research, this is the additional benefit that the individual will reap. Also the support provided by this team goes a long way too. Ultimately, the individal can be helped to make sustainable and significant, though small, changes that will result in a healthier weight loss and maintenance.

Can mushrooms help me to lose weight?

Many types of mushroom are edible and vary in nutritional profiles. Mushrooms are low in calories, high in protein, fibre and are rich in vitamin D and B complex. They also contain a significant amount of trace elements, especially selenium that acts as a potent antioxidant. Despite various studies suggesting that regular consumption of mushrooms may provide potential health benefits, such as reducing oxidative stress and inflammation, as well as lowering risk of high blood pressure and high cholesterol levels, current accumulative evidence is too weak to provide any clear dietary recommendations.

There has been a rising interest related to the effect of edible mushrooms on weight loss. Interestingly, an animal study published in 2015 reports that mushrooms could slow down weight gain and improve the "good" bacteria in the digestive system of mice. Another study published in 2017 found that participants who consumed mushrooms with their meals reported increased satiety and less hunger pangs when compared to another group of participants who consumed meals containing meat. However, this effect was likely due to the increased consumption of fibre from the mushrooms as both group of participants were provided with the same amount of protein at mealtime.

In conclusion, the combination of diet modification and regular physical activity is still the key essentials for weight management. Additionally, it is recommended to have a healthy balanced diet and not just solely rely on a single food item or nutrient to achieve weight loss effect.

Question by janey

Is it really true that breakfast plays the most important meal of the day, or is it just the total calories intake for the day, regardless of time, to help get healthier and lose weight?

What are the 10 most healthy breakfasts I can chose from locally to eat each day, that is easily available and/or easy to make?

Seems I can only buy muffins or macdonalds breakfast, and I don't like this western' muesli' thing.... Are pancakes and danish pastries healthy/good enough for breakfast? What about the meepok, and pork porridge? Are those okay? Thanks

Answered by Dietitian from KK Women’s and Children’s Hospital (KKH)

1. It is the net energy intake (i.e. the energy consumed for the day minus the energy expended through physical activity and for body functions) that determines if we lose weight or gain weight. However, studies have shown that overweight children, adolescents and adults are less likely to eat breakfast than their thinner counterparts. This could be because skipping breakfast often leads to eating a heavier lunch or to having a snack (often high calorie) before lunch. Hence, eating a healthy breakfast can help in weight control. Breakfast is often regarded as the most important meal of the day because it is the time to refuel the body after the long ‘fast’ through the night (unless you wake up for a snack in the night !). A healthy breakfast consisting of slowly-digested carbohydrate and protein foods can provide the energy and nutrients necessary for you to kick-start the day ! A healthy and nutritious breakfast consists of slowly-digested carbohydrate (e.g. fresh fruit,wholegrain cereal, low fat dairy products) paired with protein-containing foods (e.g. egg, reduced fat cheese, tauhuay).
2. Examples of nutritious breakfast ideas include :
• Wholegrain ready-to-eat breakfast cereals with low fat fruit yoghurt or low fat milk
• Sandwich (e.g. wholemeal or multigrain bread) with low fat cheese / tuna or mashed egg with light mayonnaise (add lettuce and tomatoes)
• Instant or quick-cooking oatmeal prepared with low fat milk and topped with sliced fresh fruits or dried fruit (e.g. raisins)
• Tau huay (with less syrup) and raisin bun
• Thosai or iddli with dahl curry
• Low fat yoghurt with fresh fruit (can also be blended into a smoothie)
• Plain crackers with low fat cheese and low fat milk or reduced-sugar soya bean milk
• Fish porridge with chopped spring onions (no fried garnishings or dough fritters)
• Fishball beehoon, kway teow or mee sua soup (no fried garnishings)
• Vegetable pau with tau huay (with less syrup)
3. Both pancake and danish pasty are made mainly from flour, eggs and milk, etc which are either topped with sweet spread (maple syrup, jam, honey, etc) or savoury mixture (e.g. margarine, nuts, etc).​

Danish pastry in addition is very high in fat, to give the flaky texture. Whilst providing energy, fat and carbohydrates, they don’t provide much of other important nutrients. Better choices include lower fat choices like : tuna bun, Japanese style pancake and vegetable pau. Similarly, instead of dry noodles, choose soup noodles and chicken porridge instead of pork porridge.

Question by dave

I want to eat healthily to lose some weight, but what are the healthy options at lunch? Most food seems oily and full of gravy. Surely I can't be eating yong taufu and sliced fish noodles everyday only? As my lunch tends to be high on carbo (rice or noodles), am I supposed to avoid carbo at dinner time? What should I do so I don't get hungry later and end up eating supper instead

Answered by Senior Dietitian from KK Women’s and Children’s Hospital (KKH)

Making healthier choices when eating out does present a challenge, but you can still do so by remembering some basic principles, i.e.: looking out for foods cooked with less oil/ fat, reducing sugar intake, and including more fibre.

1. When having economy rice with dishes
• Choosing steamed, stewed, braised or stir-fried dishes instead of fried dishes like sweet and sour dishes, deep-fried dishes
• Choosing dishes without added fat in the gravy, e.g. avoid choosing curry dishes and asking for curry gravy on your rice
• Choosing vegetables stir-fried with soya sauce or oyster sauce instead of sambal
• Removing the skin from chicken and duck dishes
• Choosing more vegetable-based dishes instead of meat-based dishes, e.g. choosing 1 meat dish + 2 vegetable dishes, and choosing beancurd as a meat option.
• Asking for less rice so that you don’t feel tempted to finish the rice, as most rice stalls give a large portion of rice. Examples of such a meal include:

(i) Steamed tofu with minced pork + shanghai greens in oyster sauce + stir-fried mixed vegetables

(ii) Chicken stir-fried with ginger + long beans stir-fried with sliced red chilli and onions + stir-fried Chinese cabbage

(iii) Stingray in Assam gravy + stir-fried bitter gourd + stir-fried cauliflower & carrots

2. When having noodle dishes
• Choosing soup-based noodles instead of dry or fried noodles. Or asking for no added oil in dry noodles dishes
• Choosing noodle dishes without added fat in gravy, e.g. avoid choosing lemak-based dishes like lontong, laksa lemak
• Choose sliced red chilli or pickled green chilli (but go easy on the light soya sauce to prevent excessive salt intake) as a condiment over sambal chilli
• Asking for sliced meat instead of minced meat
• Asking for no fried garnishings
• Asking for less noodles and more vegetables Examples of such a meal include, other than yong taufu and sliced fish noodles :

(i) Seafood soup with rice or noodles

(ii) Ban Mian with sliced chicken or fish instead of minced pork. Avoid asking for more fried ikan bilis and fried shallots

(iii) Penang Laksa

(iv) Dry wanton noodle with no added oil, and pickled green chilli as condiment

3. When having western meals
• For entrees, choose fresh garden salad or non-cream soups instead of meat-based items (e.g. buffalo wings, calamari rings) and cream-based soups
• For main meals, opt for grilled, roasted or pan-seared items rather than battered and deep-fried items. Ask about changing the French fries to baked potato (but with chives/spring onions and less sour cream and bacon bits)
• For pasta dishes, choose tomato-based instead of cream-based or white sauces, and go easy on the parmesan cheese
• For sandwiches, choose multigrain bread and opt for non-creamy fillings and dressings, e.g. roast chicken instead of chicken mayonnaise, and vinaigrette dressing instead of thousand island.
4. When having ethnic meals
• Chicken rice – ask for steamed white rice and remove the skin from the chicken
• Roti prata, puri or bhatura – choose chappati, thosai or iddli with chickpeas and dahl chutney instead, and omit the coconut chutney
• Lontong, mee rebus, mee siam – choose chicken macaroni soup, bee hoon soto
5. For drinks and desserts
• Choose mineral water or tea/coffee with less sugar and evaporated milk/condensed milk
• Choose fresh fruit and limit desserts to twice a week (choose those without coconut milk and also ask for less sugar)

The food we eat provides energy from carbohydrate, protein, fat and alcohol. As you can see from the table below, gram for gram, fat provides the most energy, followed by alcohol.

Nutrient Energy (kcal per g)

Fat 9

Alcohol 7

Protein 4

Carbohydrate Energy 4

Hence for weight control, it makes sense to control total energy intake through limiting fat and alcohol intakes, whilst moderating protein and carbohydrate intake. So, you can eat rice or noodles for both lunch and dinner, but avoid additional carbohydrate intake through sweet drinks and desserts.

To prevent hunger, you can

(i) increase your fibre intake by consuming more vegetables, choosing brown rice instead of white rice, or wholemeal bread instead of white bread,

(ii) have a bowl of non-cream soup at meal-times, and

(iii) ensure you have a moderate serving of protein (meat, fish, chicken, tofu, beans) as protein foods have a satiating effect

Question by ken

Hi, Would like to check if a frozen banana contains the same nutritional value as a fresh banana. Hope to receive your reply soon. Thanks and best regards,

Answered by Senior Dietitian from KK Women's and Children's Hospital (KKH)

Fresh and frozen fruit may be nutritionally similar in macronutrients (e.g. carbohydrate, protein,fat), fibre and minerals except for certain water-soluble vitamins like folic acid and vitamin C which may degrade rapidly after harvest and continue doing so during handling and storage. Frozen fruit can be a better choice if it the ripe fruit is frozen quickly after picking due to its higher nutrient content. This is because the freezing process seals in the nutrients and slows down the breakdown of vitamins and other phytochemicals which occur during storage and transportation of fresh produce.

Question by sek.joshua

I have gained about 10 KG since last year and last i checked my BMI, it is at a overweight level. I just started my exercise regimen. What can I control in my diet ? I've heard of this diet of do not take meat with carbohydrates. Will this segregation of food helps?

Answered by Senior Dietitian from KK Women’s and Children’s Hospital (KKH)

The best and safest proven way to lose weight is by reducing your energy intake whilst increasing your energy output, i.e. ‘eat less energy and burn off more energy’.

As far as your body is concerned, the energy-giving nutrients are (in order of decreasing energy per gram, except for carbohydrate and protein which have the same energy per gram): fat, alcohol, carbohydrate and protein.

It doesn’t matter whether these nutrients are eaten in combination or separately; the total energy provided is the same. Having said this, protein foods have a satiating effect, hence you are less likely to feel hungry after a meal containing protein compared with a meal without protein, even if the total energy intake of the two meals are similar.

Moreover, having more fibre also helps make you feel full, and again helps with weight control through regulating food intake. So, to lose weight, reduce the fat/ sugar/alcohol in your diet, moderate the portion sizes of protein and carbohydrates, and increase the fibre content of your diet.

Simply-put cut down on

1. fried foods, sweet drinks and alcoholic beverages,
2. control your meat, fish, chicken, tofu portion to about 1 palm-size and control your rice, noodles, starchy vegetables (potato, sweet potato, yam, tapioca, pumpkin, sweetcorn) to ½- 1 rice-bowl
3. eat more non-starchy vegetables. Lastly, for heart-health, when preparing meals at home, choose healthier cooking oils e.g. monounsaturated (olive, canola, peanut) or polyunsaturated oils (corn, canola, sunflower) instead of using butter / animal fat in cooking.

Question by sharon467z

My BMI is at overweight level, am now in planning IVF progam together with TCM. Need your advise on weight loss. Thank you

Answered by Senior Dietitian, KK Women’s and Children’s Hospital (KKH), in association with Dr Ong Wee Sian, Head and Consultant Sports Physician, Sports Medicine Service, KK Women’s and Children’s Hospital

The best and safest proven way to lose weight is by reducing your energy intake whilst increasing your energy output, i.e. ‘eat less energy and burn off more energy’. Limiting high-calorie foods, choosing lower calorie alternatives and cutting down on your portion sizes can help to reduce calories and improve weight control. Here are some strategies to assist weight loss:

1. Eat regular meals

Avoid skipping meals because regular meals will energize you through the working day and prevent hunger pangs, which leads to snacking and tends to make you lose track of portion sizes

2. Limit snacks

Snacking on deep fried, oily or sweet foods (e.g. cakes, kuehs, pastry, etc) contributes extra calories to your diet. Choose lower calorie options like fresh fruit, low fat yogurt and wholemeal bread, as they are more filling and nutrient-dense if you experience hunger pangs.

3. Reduce fat

Cutting back on fat is an effective way to reduce energy intake as fats are a concentrated source of calories.

• If you cook at home, remove visible fats from foods before cooking
• Choose low-fat cooking methods such as steaming, grilling, baking, roasting, boiling or pan fry with less oil to keep your dishes lower in fat and energy
• Avoid oily and deep fried foods, dishes cooked with coconut milk and gravies that have oil floating on the surface
4. Reduce added sugars

Sugar contributes energy but little other valuable nutrients. Limit candies, desserts, cakes, kuehs and sweet pastries as they contain a lot of added sugars. You should also watch your beverages – choosing plain water over sweetened drinks and juices. They not only contribute calories, but also increase your risk of dental caries !

Food Item	Energy (kcal)	Fat (g)
Coffee with condensed milk	113	5
Coffee, with sugar	66	2
3-in-1 cereal	89	3
Coffee, mocha ice, blended with full cream milk	341	8
Tea, bubbles, with milk	160	0
Juice, watermelon, fresh	95	0
Juice, honeydew, fresh	105	2

Nutritional information from Health Promotion Board (www.hpb.gov.sg).

5. Fill up on fibre

Fibre helps to absorb water and swells in the stomach making you feel full faster. So include a variety of minimally-processed plant-based foods such as whole grains (e.g. brown rice and wholemeal bread), vegetables, fruit, beans and lentils to increase bulk to your diet.

6. Eat a little less

Even healthy foods eaten in abundance can load up the calories and cause weight gain. So, it is important to eat all foods in moderation.

7. Guard against Festive Feasting

Many festive treats are packed with sugar and fat. Some of these snacks can even contain calories similar to a small meal. So, be conscious to take the festive occasion to catch up with friends and relatives, and moderate your intake of festive treats. Some tips to try include :

• Limiting the amount of festive goodies you buy, as you will be tempted to finish up the leftovers after the festive season
• When visiting, limit your intake by portioning out the festive treats onto a small plate rather than onto a large plate
• Choose fresh fruit such as mandarin oranges and less of festive treats
• Have low-calorie drinks like diet soft drinks, water, unsweetened green tea/fruit tea instead of sweetened drinks

The table below shows the calories of some New Year goodies as well as the equivalent amount of physical activity needed to expend them:

Food (per serving)	Calories (kcal)	Jogging	Duration (min)
Bak Kwa, Pork	(1 slice, 94g)	370	55
Love Letters	(3 rolls, 39g)	168	24
Peanut Crackers	(1 small plate, 88g)	418	63
Pineappple Tarts	(3 pieces, 20g)	246	36
Twisted Cookies	(3 pieces, 12g)	201	30

Nutritional information from Health Promotion Board (www.hpb.gov.sg).

• Based on a 60kg man
8. Exercise regularly to increase your energy output

Start with low impact exercise such as 30 minutes of brisk walking, 3 to 5 times a week, and gradually increase the duration or distance of your walk. Other activities such as cycling, swimming or dancing are also good form of aerobic exercises for weight loss.

Question by John

Why is it that it seems so easy to gain weight, but so hard to lose it? Is it true that where you gain weight first is where you lose it last? Why is that so? My friend told me that altho he is flabby, his cholesterol is very low, so he is safe from heart problems. Is that correct? I'm only medium overweight, but my cholesterol is about 230. Does this mean I am in higher danger of heart attack and stroke? What should I do to reduce my risk. If I go for liposuction to get rid of my fats, does that mean my risk of heart probelm is automatically reduced? Could that be a quick and fast way to better health?

Answered by Senior Dietitian from KK Women’s and Children’s Hospital (KKH) in association with Dr Colin Tham, Visiting Consultant, Department of Plastic, Reconstructive & Aesthetic Surgery, KK Women’s and Children’s Hospital, Dr Ong Wee Sian, Head and Consultant Sports Physician, Sports Medicine Service, KK Women’s and Children’s Hospital

1. Why is it that it seems so easy to gain weight, but so hard to lose it?

There are several factors that determine weight loss: decreased metabolism (due to aging), genetics, sedentary lifestyle and over-consumption of energy (e.g. diet high in fat and sugar). Anyone who consistently consumes more energy than he or she needs will gain weight.

Moreover, your body shape is genetically pre-determined, i.e. if you are an endomorph (i.e. usually round and soft with curves), even if you lose weight, you will be a slimmer endomorph and not an ectomorph (i.e. usually slender with long arms and legs).

Most people gain weight when they consume more calories than they expend. It is always easy to over consume calories e.g. eating up 5 pineapple tarts within a few minutes (total 400 calories), than to perform sufficient physical activity to burn off the excess intake.

For example, an adult who weighs 70kg will need to walk briskly (4km/hr) for close to 2 hours to burn off 400 calories.

Body shape - Ectomorph

• Long arms and legs
• Delicate bone structure
• Long narrow fingers and toes Examples: Fann Wong

Body shape - Mesomorph

• Heavy bone and muscle development
• Broad hands and muscular chest
• Broad shoulders Examples: Michelle Yeoh

Body shape - Endomorph

• Round and soft
• Slender wrists and ankles
• Relatively small facial features Examples: Mariah Carey

​Answered by Senior Dietitian from KK Women’s and Children’s Hospital (KKH), in association with Dr Ong Wee Sian, Head and Consultant Sports Physician, Sports Medicine Service, KK Women’s and Children’s Hospital

2. ​ ​Is it true that where you gain weight first is where you lose it last? Why is that so? ​​

   Men tend to gain weight around the tummy, whilst women tend to gain weight around the hip areas.

However, with age, women become similar to men and gain weight around the tummy as well. With increased exercise and controlled energy intake, weight will be lost from all areas of the body, and not only from the ‘troublesome’ areas – hence, for a female, you can’t lose weight from the tummy area without losing some fat from the bust area as well! However, although spot reduction is not possible, it is possible to tone up the muscles, giving the impression of weight loss through exercising target muscles.

Answered by Senior Dietitian from KK Women’s and Children’s Hospital (KKH)

3. ​ My friend told me that although he is flabby, his cholesterol is very low, so he is safe from heart problems. Is that correct?

   High cholesterol level is only one of the risk factors for coronary artery disease (blocked blood vessels in the heart). Other important factors include: smoking, obesity, sedentary lifestyle, diabetes and high blood pressure.

   Although low cholesterol level is considered good in terms of reducing the risk of heart disease, it is also important to look at his lipid profile in more detail. Components in the blood, which affect heart disease risk, consist of good cholesterol (HDL cholesterol), bad cholesterol (LDL cholesterol) and triglycerides. High HDL cholesterol is protective against heart disease, whilst high LDL and high triglyceride levels increase heart disease risk. So, having very low cholesterol level is not necessarily good if his HDL cholesterol level is also low.

   In addition, it is also important to assess Body Mass Index (indicate overweight if 23 kg/m2 or higher). Having a high body mass index increases your risk for developing other chronic diseases such as diabetes and high blood pressure, which also increase the risk of coronary artery disease.

   Answered by Senior Dietitian from KK Women’s and Children’s Hospital (KKH), in association with Dr Ong Wee Sian, Head and Consultant Sports Physician, Sports Medicine Service, KK Women’s and Children’s Hospital

4. I'm only medium overweight, but my cholesterol is about 230. Does this mean I am in higher danger of heart attack and stroke? What should I do to reduce my risk?

   Your total cholesterol level exceeds the healthy range of 200 mg/dL, which indicates a higher risk for heart attack and stroke. However, it is important to look at the individual components of your cholesterol (i.e. the LDL and the HDL cholesterol levels as well. Moreover, your risk level is also determined by the presence of other factors such as a family history of heart attack, smoking, obesity, gender, age, lack of exercise, etc. Whilst some of these risk factors cannot be modified, namely gender, age, family history, you can work on your diet and lifestyle (increase physical activity, stop smoking).

   Apart from reducing weight, you should also reduce your LDL cholesterol level. Different types of fat affect LDL cholesterol differently. In order to reduce LDL cholesterol, you should reduce your intake of saturated fat and trans fat and replace them with mono- or polyunsaturated fats.

   Here are some dietary strategies to combat LDL cholesterol.

   • Replace saturated and trans fats with mono- and poly-unsaturated fats. However, whilst this is beneficial for heart health, all fats provide 9 kcal of energy per gram, so for weight control, it is still important to limit total fat intake, even when having healthier oils.

     *Monounsaturated fat: Some vegetable oils (e.g. olive oil, canola oil and peanut oil), most nuts (e.g. almonds, cashew nuts and hazelnuts) and avocados are great sources of monounsaturated fats. These oils not only lower LDL (‘bad’) cholesterol, they also increase HDL (‘good’) cholesterol levels in the body.

     **Polyunsaturated fat: This can be further divided into two categories: omega-3 and omega-6 fats. - Omega-3 fats reduce blood clotting in the arteries and protects them from hardening. Cold water fatty fish such as salmon, sardine, longtail shad (terubok)and Spanish mackerel (tenggiri papan), walnuts, vegetable oils (canola and soybean oils) are some sources of omega-3 fats - Omega-6 fats lower both LDL (‘bad’) and HDL (‘good’) cholesterol levels in the blood. Sources of omega-6 fats include vegetable oils (e.g. corn oil, soybean oil and sunflower oil) and seeds (e.g. sunflower seeds and sesame seeds).

   • Other than using the ‘good’ fats (monounsaturated and polyunsaturated fats), it is important to incorporate wholegrain foods (e.g. brown rice, wholemeal bread and oats), vegetables, fruit and beans in your diet to lower blood cholesterol levels. Most of these foods are good sources of soluble fibre, which has the ability to bind cholesterol in the gut, reducing absorption and increasing excretion. These food are also rich in vitamins, minerals and phytochemicals which all work together to reduce the risk of heart disease.

   Answered by Senior Dietitian from KK Women’s and Children’s Hospital (KKH), in association with Dr Ong Wee Sian, Head and Consultant Sports Physician, Sports Medicine Service, KK Women’s and Children’s Hospital

5. If I go for liposuction to get rid of my fats, does that mean my risk of heart problem is automatically reduced? Could that be a quick and fast way to better health?

   Liposuction is a surgical procedure that removes fat under the skin e.g. thighs, chin, buttocks, abdomen, breast, etc. To reduce your risk of heart disease, you need to lose fat from around your vital organs (visceral fat) as well as under the skin (subcutaneous fat). This can only be achieved by combining diet and exercise. Moreover, as the amount of fat that can be safely removed through liposuction is limited, it is not intended as a procedure to remove fat to achieve weight loss or to reduce the health risks of being overweight. It is an aesthetic procedure to shape and contour the body (remove bulges), and to remove ‘stubborn’ fat, which remains despite exercise, and weight control.

   Lastly, liposuction has no effect on the other important factors which affect your risk of heart disease, e.g. blood cholesterol level, smoking, sedentary lifestyle, diabetes and high blood pressure.

   ​Answered by Senior Dietitian from KK Women’s and Children’s Hospita​l(KKH) in association with Dr Colin Tham, Visiting Consultant, Department of Plastic, Reconstructive & Aesthetic Surgery, KK Women’s and Children’s Hospital

Question by miki

Good Evening, I'm of average weight but i'm hoping to lose some weight to prepare myself for my wedding. What are the most effective way to lose weight before tonning? I'm tryin to keep up with a schedule on jogging twice a week, each time 30mins. Was wondering is it enough or should I make it thrice a week and roughly about 45 mins? Is it true that fats will only start to burn after 30 mins of exercise, before that is only dehydrating? What should I do for my diet wise? Normal diet or should I cut down on the intake of carbo? I heard that fats take 3 days to build up, is it true?

What are the exercises that you strongly recommended to lose weight? I'm thinkin of doing jogging and swimming at the same time, or should I wait till I lose some weight before I go on swimming? I think swimming makes my shoulder look broad. which of the exercises that are effective to lose fats along the arms and tummy?

Thank you for answering my queries =)

Answered by Dr. Tham Kwang Wei, Director, Life Centre Singapore General Hospital

The most effective way to lose weight in any situation is to reduce caloric intake and to increase your activity. So it has to start from the baseline that you’re at now. If you want to lose weight with exercise alone, then you need to achieve about 250 minutes of moderate intensity exercise a week.

Aerobic-type exercise eg. Briskwalking, playing sports, cycling, roller-blading, swimming at a moderate intensity, aerobic dance, is the best form of exercise in weight loss. It doesn’t matter whether you swim, briskwalk or jog, as long as you do it in a moderately intense pace and the total amount is significant (as stated). Of course if the activity is something you like then it is easier for you to sustain in the long term. You must ensure that the exercise / activity you pick up doesn’t make any existing injury worse. You may choose to tone up at the same time, i.e introduce resistance training like weights or static exercises at the same time. To tone up the abdominal (tummy) area, you may do core exercises like Pilates, which will incorporate sit-ups.

For toning of arms, you may choose exercises that focus on the triceps, biceps either with weights or static exercises; these are best taught with demonstration. For most people, it is unlikely that you will bulk up with such exercises unless you are concentrating on resistance training that are tailored to do so. If you are concerned that swimming will bulk your shoulders up, then you may alternate the swimming with other forms of exercise like jogging or a cross-trainer at the gym.

It is generally rather challenging for most people to achieve 250 minutes of moderately intensive exercise a week so to combine this with dietary restriction is more feasible and practical.

The best way to reduce caloric intake is to reduce portion size, increasing non-oily vegetable intake and reducing total fat intake. Fat has the most number of calories per gram compared to carbohydrates and protein. It is best not to completely cut out a particular food group (eg. Completely no carbohydrates) as that is generally not sustainable in the long run and you may run into nutritional deficiencies; one can see rapid weight regain when that particular food group is reintroduced back in the diet if not done properly.

You may seek help from your doctor for weigh loss medications if your BMI is > 27kg/m2 and if you find yourself not losing significant weight with dietary measures and increased physical activity. Meal replacements are also an effective and healthy way to lose weight yet sustainable (and safe to sustain) in the long run. It is best to do partial meal replacement (i.e. replacing 1-2 meals a day). Ensure these have adequate protein and not excessive in fat and calories (eg. < 200kcal per serving) and have proven research for efficacy too.

Question by limenggek

What is the best method to reduce the tummy fat? Running has assisted in my weight loss but the tummy fat still exist. Doing more sit-up will help?

Answered by Dr. Tham Kwang Wei, Director, Life Centre Singapore General Hospital

The best method to lose fat in any area is to lose overall fat (i.e. to lose weight). The conventional methods of weight loss still are the best – reducing caloric intake and increasing physical activity.

Liposuction is the best way to sculpt one’s body including to lose excessive subcutaneous fat in the abdomen. However, this is best performed by an experienced plastic surgeon and should only be considered after reaching your ideal weight and maintaining that weight for a period of time.

Question by sbdtys

I am a Polyarteritis Nodosa (PAN) patient whom still under treatment.

Before diagnosed PAN, my weight was not more than 46kg (my height is 160cm). After the Prednisolone treatment for about 2 years which started from 40mg per day & gradually cut down the dosage.Then, me weight keeps on going up until now is 62kg even though I had stopped the Prednisolone (under Dr's advise) for about a year; and yet just diagnosed with Fatty Liver, High Cholosterol , Diabetes & Hypertension (under medication - Stamblo 5mg per day).

I can't do any exercise even though Yoga which I have tried before because I have been diagnosed Complex Regional Pain Syndrome Type II which I was on wheelchair for 2 months. I am on Methadone & Lyrica for 3 years.

Recently, I have stopped these 2 medicines for about 1/2 year but still on Amitriptyline for my headaches & insomia problems.

As per my understanding, those medication would caused weigh gain; but I have controlled & reduced my diet as follows:

1. Morning - Fresh milk with clonflakes
2. Afternoon - 1 cup of coffee / tea with 2 slices of bread
3. Evening - half bowl of rice with some chicken (no fried chichke) & vegetables (but no pork - because I didn't take pork)

But, yet I still over weight & doctor want me to control my weight & diet as well. What should I do now to control my weight gain ?

* Repost with permission from our member. Sensitive personal information has been omitted to respect the privacy of the member.

Answered by Dr. Tham Kwang Wei, Director, Life Centre Singapore General Hospital

A quick assessment of your dietary food recall shows that your intake is not excessive though lacking in protein. However, it seems that you activity level is quite minimal with your chronic pain so the energy that you burn up is not a lot either. In such situations, what you consume is more than what you burn up each day and hence, your weight gain.

Therefore, it will be helpful to increase your physical activity in small bouts even if you cannot exercise eg. Walk around more in short intervals – walk 15 minutes 3 times a day as tolerated. You may also do some home-based exercises of stretching. Seeking help from the physiotherapist would be helpful in this case. Aqua exercises are helpful for people with joint pain as there is no weight bearing stress on the joints.

Dietary wise, you may consider increasing your fiber and fruit intake. If you are taking snacks and other beverages in between meals, you should also pay attention to these too. You may consider taking meal replacements which can provide you with adequate protein without increasing your caloric intake. It is best to do partial meal replacement (i.e. replacing 1-2 meals a day). Ensure these have adequate protein and not excessive in fat and calories (eg. < 200kcal per serving) and have proven research for efficacy too.

Chronic pain and insomnia is a stress to the body and may contribute to the weight gain so dealing with these factors is of utmost importance too.

You may want your doctor to check you out for certain conditions like hypothyroidism or excess cortisol production if you are still gaining weight quite rapidly eg. 1-2 kg a month. Overall. it is best for you to seek help from a team of healthcare professionals.

Ref: O17​