Commentary: Losing weight after festive eating is not just about diet and exercise

SINGAPORE: Before he joined our Weight Management Programme, Mr Yuen* successfully lost weight in the past.

The 37-year-old took time to cook healthy meals and set protected time for exercise daily. He seemed to be doing all the right things.

However, after some weight loss at the start, his weight rebounded, gradually increased and peaked post-Chinese New Year – and he did not even know why and when it started.

It is not uncommon to see patients who lose track of their weight. They know what good weight management is but can’t keep the pounds off. This is why knowing the “hardware” of weight loss (in terms of a meal plans and an exercise regime) is essential but insufficient.

What we also need is the “software” - the skills that help us effectively apply the “hardware”. And to be aware of what behaviours need changing and how to keep track, problem-solve and find a more sustainable solution in the long run.

Using these so-called psychological interventions in managing weight is not new.

The Health Promotion Board-Ministry Of Health Clinical Practice Guidelines set in 2016 state that weight loss programmes should incorporate psychological intervention, namely cognitive-behavioural interventions. Cognitive Behavioural Therapy (CBT) is a form of psychological treatment that identifies and changes the unhelpful thoughts underlying the feelings and behaviours that work against you.

In the US, the American Psychological Association also highlighted in articles published in 2013 and 2020 that a major aspect of weight control involves understanding and managing thoughts and behaviours that can interfere with weight loss.

For example, one may think that rejecting food will upset the person offering it or feel the need to clean off the plate in order not to upset a well-meaning friend who happens to be a great chef who cooked up a delicious meal. Most of us would encounter these incidents, but not everyone can manage such thoughts in a way that do not derail our weight loss efforts.

A systematic review of the effectiveness of psychological intervention for weight management, published in Cochrane Database Systematic Review in 2005, revealed that people who were overweight or obese benefitted from psychological intervention that targeted behavioural change.

For instance, they worked on how people used food to cope with stress or boredom. Or simply felt they deserved a good meal because they worked hard.

By working on our general attitudes towards food, made people more aware of what was stopping them from losing weight.

HOW PSYCHOLOGY KEEPS WEIGHT LOSS ON TRACK

During the festive seasons, these behavioural responses can kick into higher gear. With more socialising, it is common to think there’s simply no time or energy to exercise. Others may go the other way – and say, it’s once a year, let me let go and eat whatever I feel like.

To be sure, there are also those who think celebratory meals will derail their plans and refuse to attend gatherings or eat at all. Naturally, none of these approaches are ideal because they tap into an all-or-nothing mindset.

Keeping one’s weight down is a long-drawn process requiring consistency and flexibility. We need to balance different needs from the different aspects of our lives.

SUSTAINABLE WEIGHT LOSS

For those still struggling with weight issues, my view is everyone needs to start with a plan. While some people succeed in losing weight based on some “off-the-rack” weight loss plans they learnt from the Internet or friends around them, many find it difficult to follow through and eventually give up.

This is because different people have different needs, resources and constraints. No one plan fits all, so customising an effective weight loss plan for yourself will make your weight management easier and improve the odds of success.   

Setting a target that is within your means, deciding when and how to go about achieving it is critical. For example, instead of saying, “I will snack less”, tell yourself you will only eat five pineapple tarts in one sitting.

A goal needs to be realistic. Extreme goals usually backfire because they are hard to execute and maintain, yet we will not maximise our potential for weight loss if the goal is too easy - like if we set the goal to only walk additional 100 steps a day. 

Experts suggest that examining our current eating and exercise habits and making goals that are challenging, but not too far from the baselines work better. Often, it helps to sit down with a healthcare professional and work out what are current eating habits and how much exercise we do – just this chat alone can unpack some of the areas that need work.

Losing weight should be no different from any task you set yourself to do. Think about a deadline or project at work. If you know what you need to do, you will start tracking your progress, ensuring you meet the deadline.

Similarly, evaluating goals and reviewing progress regularly for weight management is vital. People veer off track easily when there is no self-monitoring – no planning or reviewing mechanism, for instance, not weighing regularly, no recording of diet (includes all meals and snacks) or physical activity level, no pre-empting of changes in their daily routine such as during festivals that don’t go well with their current weight management plans; no regular review of plans to check if there are any red-flags.

These result in us being unaware of the need to get back on track, until our clothes feel tighter, or when we belatedly weigh ourselves in the clinic.

CLEAR AND CONSISTENT

In Mr Yuen’s case, setting the extreme goal of preparing every meal on a daily basis was too time-consuming and labour-intensive. 

As he did not set a timeline to resume the weight management routine and did not develop a habit of reviewing his weight loss progress regularly, he put on weight gradually. Consequently, he felt demoralised when he noticed that his weight increased and avoided regularly weighing altogether. The longer he avoided that, the harder it was for him to get back on track. 

Since then however, he has modified his goals and worked them around important celebrations that gave him joy. On some days, he pre-arranged visits between meal times so that he could have his healthy meals before heading out.

He also became more aware of his thoughts and to change the all-or-nothing mindset, to enjoy CNY in moderation and remind himself that weekly weighing would not take much time and was part of his approach to keeping his weight down.

Festive seasons are one of the common pitfalls of weight management plans. But if we are aware of how we think and feel about food and the rationalisations we make to get out of doing something better for our bodies, the better our outcomes will be.

When we complement the “hardware” with the “software” tools of weight management it will mean we can still savour delicious pineapple tarts without tipping the weighing scales.

Mabel Yum Po Shan is Head and Principal Clinical Psychologist of Psychology Service at the Khoo Teck Puat Hospital.

*Pseudonyms were used in this commentary.