Why can't I control my weight?

It’s the magic question to which we all wish we had an answer!

New research from a study conducted at the University of Sheffield has addressed the problem of using a single classification of people who have a weight problem. They are suggesting that this restricts the effectiveness of treatment options. They propose a number of classifications each of which will require a different approach.

Below I have taken their classifications, adapted them to reflect the demographic I see in my work as a physical therapist and then suggest solutions:

1. Young healthy females displaying the most positive health characteristics.
   These are typically called yo-yo dieters, they are interested in health and fitness and follow the latest trends in exercise and popular diets. They are able to lose weight quite quickly but maintaining the weight loss over a long period is harder. They join the gym or a fitness class at the beginning of the year but find it hard to keep attending once ‘life’ gets in the way. It’s not their main priority in a busy life so is easily dropped.
   
   For these people, I would recommend a monthly session with a motivational trainer or nutritionist/exercise professional, booked and paid up well ahead. This will keep interest and motivation levels high by suggesting new exercises, new techniques, and help and encouragement in developing healthy eating habits with recipes and nutritional advice.
   
2. Males who are unable to control their weight despite having high levels of physical exercise.
   Lifestyle factors are likely to include high levels of food and alcohol consumption. This group can cover a huge age range from mid-30s to retirement. They may be gym members enjoying a weights based training programme on a regular basis, they may get exercise from dog walking or be golfers. The excess weight comes from the excessive intake of food and/or alcohol and the lack of enough cardiovascular exercise.
   
   I would recommend completing a food diary to capture exactly what is consumed over a month long period. Alongside this find a nutritionist/personal trainer to review the amount and type of exercise. They can then ensure there is enough cardio work to encourage fat burning rather than developing further muscle mass. A tracker to follow activity and monitor heart rate will check actual activity levels. Looking at portion control, meal content and reducing alcohol intake will ensure the best chance of success.
   
3. Middle aged females interested in exercise and weight management, although suffering from anxiety, insomnia, depression and fatigue maybe also with low self-esteem.
   This is another big group, many of whom are somewhere along the menopausal curve. Along with the symptoms listed above, weight gain is common as hormones fluctuate. Previously successful weight and exercise regimes no longer work.
   
   Support during this time is essential, recognizing that many others feel the same way. Exercise classes with a social element offer enjoyable exercise which is more likely to be continued as the people in the class become as important as the exercise content. Community venues or small private centres, rather than big leisure complexes, are more likely to offer this type of class. Look for pilates, yoga and general exercise to music with instructors specializing in this age group.
   
4. The affluent healthy elderly, many of whom have high blood pressure.
   Age was not specified so I’ll assume that they mean 65+ although that’s hardly old these days. I think this group is struggling with their weight as a result of changes in life style and in their body as it ages. Food choices have developed enormously during this group’s lifetime and their affluence can lead to indulgent choices with foods high in fat and sugar. This group of people are at risk, if they do not address their weight issues they will soon find themselves in the next category, ie with chronic health conditions.
   
   This group needs exercise which takes account of their age and high blood pressure as well as a carefully structured eating plan. They also need encouragement and support in keeping to the life style changes required. Exercise combined with a social element is a good solution in this case. Also look for an instructor specializing and qualified in exercise for older adults.
   
5. The physically sick but happy elderly with chronic health conditions such as arthritis, diabetes and high blood pressure but low levels of anxiety.
   This group of people are probably in a vicious circle, the chronic health condition has limited their ability to exercise and this has resulted in weight gain, which in turn adds more chronic health issues.
   
   It is very difficult for these people to keep doing exercise since they have to endure levels of pain to stay active. Unfortunately, without undertaking some exercise, the situation will get worse faster. Basic mobility exercises will get this group into better health, together with dietary advice to cut calories and look at foods which ease the inflammation of arthritis. Small classes designed for people with painful conditions can be helpful, providing support and encouragement from a position of empathy and understanding. Look for an instructor with a GP referral qualification, and ask for a one to one session first.
   
6. The elderly deprived who do not have healthy behaviours and have the highest BMI readings.
   These people are likely to have been overweight with unhealthy diets for their whole life. Exercise will not have featured in their lifestyle, and they may have no desire to change. Any cost of treatment is probably an issue, limiting their choices.
   
   This group are the hardest to help. Approaching GP surgeries to see what they offer is the best way forward. For example they might hold exercise sessions funded by the NHS, they should at least offer dietary advice.