Weight Loss Training
24.4% of men and 25.1% of women in England are obese1. By 2050 the prediction is that 60% of men, 50% of women and 25% of children will have problems associated with weight. Obesity is a good predictor of illness and mortality. Any loss of weight will help to avoid potential complications. Being overweight creates a vicious circle: if weight restricts your movement, you are less able to participate in exercise or sport. This may in turn, exacerbate your weight issue. Part of a physiotherapists remit is to help with the physical activity part of a multi-disciplinary approach to weight management. NICE (National Institute for Health and Care Excellence) recommends a variety of interventions designed to modify the diet, physical activity and behaviour. A physiotherapist adopts a holistic, patient-centred problem- solving approach to weight loss. The skills which may be used in this area are:2
- - Knowledge of anatomy, physiology, and the psychological and social mechanisms of health and disease.
- - Assessment and diagnosis.
- - Behaviour change.
- - Biomechanics.
- - Exercise prescription and therapeutic exercise.
- - Management of long term conditions.
It is important that movement is encouraged at the correct level for each client. Assessment and a treatment plan will help to overcome barriers to exercise. The treatment plan will include: -
- Personalised lifestyle advice. Each client is different, has different beliefs and circumstances, has cultural and social preferences and different degrees of readiness to change.
- Prescription, supervision and progression of appropriate physical activity to encourage muscle strength, flexibility and endurance, and ensure a level of energy output to enhance and maintain weight loss under safe and controlled conditions.
- Careful management of any associated conditions such as back pain or heart disease.
- Care is coordinated with other therapists and medical professionals.
- Physio talking to an overweight client
Based on evidence supporting this approach, a physiotherapist would take a number of steps when devising a weight loss programme. A detailed assessment of your medical history would be taken. Your current level of physical activity would be assessed and an individual programme of physical activity provided. Your progress would be monitored, and when necessary, cardiovascular and resistance exercise introduced. The aim is to build up to 30 minutes of moderate-intensity physical activity each day, on 3-5 days each week. Your body mass index would be calculated in order to monitor progress. Part of the programme would involve education. Ideally the type of exercise you do is sustainable as you enjoy doing it.
Overweight person exercising
Traditional Chinese Medicine believes that weight gain is a symptom of an imbalance in the body, usually a malfunction of the spleen and liver organ systems. Acupuncture, herbs and diet can help weight loss by influencing the “qi” (life-force) of the spleen and liver systems. This treats the root imbalance responsible for weight gain. Disharmony can lead to a slow metabolism, water retention, etc. Stress can have a negative effect on the liver and spleen and as a result trigger cravings and compulsive eating.
Acupuncture involves the insertion of fine flexible needles at specific points on the body. Auricular acupuncture involves needles being put in certain points of the ear. The ear is thought to represent the body, and needles may be inserted at points corresponding to the parts which need treating. When used in combination with Chinese herbs and specific foods, it can promote a healthy digestive system, energise and help produce qi. Qi is our life force which flows through channels called ‘meridians’ in our body. Dietary advice would include the recommendation to eliminate bitter, sour and acrid tasting foods to help with weight loss. Acupuncture would be tailored towards the particular cases of weight gain. The endocrine system and kidneys may be targeted to treat water retention and to stimulate nerve and hormone rebalance. The spleen and thyroid gland would be treated to effect sugar and hormonal rebalancing. If the root cause for weight gain is the menopause or premenstrual syndrome, the adrenal and ovary glands would be targeted. In western terms, acupuncture has been shown to have an effect on the functioning of the nervous system, endocrine system, digestive system, food cravings and the metabolism. The effect is an increase in energy, help control over eating and suppress the appetite. Studies have supported acupuncture as an effective treatment for obesity.4
Client with needles in place
Our bodies are complex, and it is not always clear what the reason for weight gain is. Chiropractors are of the belief that ‘subluxations’ (misalignments) of the spine can contribute to weight gain. Nerve signals can be interrupted, including those controlling hunger and eating. If pain or reduced mobility are preventing a client’s ability to exercise, a chiropractor would examine their spine to look for irregularities. They would treat where necessary, and give diet and lifestyle advice based on the client’s individual needs, comfort and health. Similarly, the expertise an osteopath has will allow any joint or muscle problems to be discovered and addressed, as well as any deeper issues. Massage therapy may be included in a weight loss plan. As well as being beneficial for relaxation, a massage therapist would help to heal any existing injuries by breaking down scar tissue. Muscles will function better, and joint flexibility increased.
- Health and Social Information Centre. Statistics on Obesity, Physical Activity and Diet. 2014.
- Alexander E et al ‘Achieving Consensus on Recommendations for the Clinical Management of Overweight and Obese Adults for Canadian Physiotherapy Practice’. Physiotherapy Canada 2012 64(1) p42-52.
- Cho S-H et al ‘Acupuncture for Obesity: A Systematic Review and Meta-analysis’. Intern. J. of Obesity 2009 Vol33 p183-196.