Weight loss vs Fat loss – our modern day dilemma.

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In my many years of consulting patients on weight loss and fat loss management, I have noticed that a lot of us gets confused with the two separate issues. The ironic thing is that many women who require a complete weight and fat loss regimen are more concerned about fat loss, where as most women who requires fat loss are more concerned about the weight on the scale. There is a marked difference between the two and so I decided to just talk about it a bit so that you can understand the difference and thus manage expectations better.

Weight Loss

When we talk about weight loss, we are talking about losing weight to the ideal. However, what is really ideal in this current day and age. As we know, the BMI is not really the best indicator to say if a person has perfect weight for their built but it does serve as a good guideline especially to cut off from the overweight to the obese. The moment you are obese, i.e. BMI > 30 (now they’ve reduced to 28) you definitely need to lose weight. Unfortunately, the only way to really lose weight is to cut on your dietary food intake which not only involves calorie cutting but also switching certain food groups to achieve the ideal. Despite what you read on calorie counting being an inefficient way, again it serves as a good guideline for people who want to lose weight. If you were to reduce your caloric intake by 20% a day, you can lose up to 0.5-1kg a week. Other more extreme methods would be to go into programs like weight loss HCG diets, Atkins, Cambridge, Cohen and many more. Personally, I am a believer of HCG diet for weight loss – but it has to come with the right advice and maintenance phase which means discipline for at least 1-3 months. Losing weight does not mean you will lose the size of certain body parts that you want. Many a times, you tend to lose the already lean areas like face or arms, breasts, and less likely thighs and buttocks. Thus this causes a lot of frustration in achieving the result you want.

The next thing you will need is exercise to tone up the muscles whilst losing weight so that the skin sags less. However, sometimes when you start building more muscle tissue from the repetitive exercises, your weight may stall and you may think that you are not making progress. However, bear in mind that skeletal muscles help maintain weight loss, as muscles burn fat for energy when you sleep.

For people with extremely high BMIs i.e. >35 you may want to consider bariatric surgery. Bariatric surgery is a procedure done by the gastro surgeon to reduce the volume of the stomach so that you are not able to consume too much food at a time. This is a mechanical way of limiting intake and is very effective for quick weight loss. There are various procedures from the temporary gastric balloon or gastric banding to the more permanent removal of the gastric fundus, gastric bypass or other methods. With advancement of medical science and technology, the procedure has become safer and less invasive with better success rates. But contrary to belief, post surgery you will need to do a complete revamp of your dietary habits and lifestyle not to mention the cost incurred. Talk to your doctor and get a proper consult with a surgeon to get a better picture and learning about the risks and lifestyle modifications that follows. In 1 year you can expect around 20 kg loss from this procedure. This is actually a life saving procedure that has helped to save many people from complications of long term obesity such as diabetes, cardiovascular heart disease, spinal problems, joint problems etc etc.

Photo by Cris Saur on Unsplash

Fat Loss

When we talk about fat loss, this where the medical devices and lipolytic injections come to play. Although, there is only one catch – in order for it to be effective, you have to target areas of fats and the cost can be pretty expensive. Some newer machines are designed to kill off fat cells and thus reducing the number without much side effects but no one can guarantee that the remaining cells do not expand in size later in the future. Lipolytic injections do the same thing by the doctor carefully injecting the solution into the fat cells to cause the cells to break and then later be metabolised in the liver.

Fat loss is all about reducing the fat cell numbers. The principle behind this is that we have the same amount of fat cells at birth till the day we die. So by reducing the numbers, we can have less fats in the body. Sounds incredible yes except for 1 catch. Fat cells have the capability to expand very well, and the size of one fat cell can be as big as a group of fat cells. So even though you remove or reduce fat cells, a stable healthy diet is required to maintain that loss or appearance of loss. This is evident in people post liposuction procedures who gain back the same size despite fat cells being manually removed.

Methods of fat loss can be as simple as mesotherapy injections which requires multiple sessions and a drainage method – i.e. lymphatic massage or other devices like radiofrequency, or microcurrent that stimulates movement of fat cells or can involve machines like Coolsculpting, Cool lipo, Vanquish, Almabody or other focused ultrasound or radiotherapy devices which are considered as non-invasive. Some people want a quick fix and would rather go under the knife and do either laser liposuction or waterjet liposuction, and some clinics even offer VASER. For all surgical methods, there is still a 1-3 week downtime with need to use compression garments and post care. My advice to all patients is to go to a really qualified surgeon because a lot can go wrong during these procedures. Some doctors who are not trained surgeons also offer these surgical solutions after attending a few training courses. They can be really good due to experience and a steady hand but did not pursue surgical training due to lack of placement (yes, we have this problem in this country). These doctor may charge cheaper than the surgeons but you really need to do your homework and decide in order not to end up with a botched job. The more invasive the method the higher the risk of things going wrong and bigger damage. Maybe this is why I keep to mainly the non-invasive stuff.

Whether it is weight loss or fat loss, the most important is to do your research and understand what goal you are trying to achieve. Consulting with a doctor who specialises in these procedures would give you a better understanding of what you need to do and how long the process of transformation would take. The end goal should be clear for both parties to avoid disappointment.

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