Finding evidence-based weight loss strategies

Finding weight loss strategies that are based on evidence is Professor Garry Egger’s research passion.

The Southern Cross University Professor of Lifestyle Medicine will be sharing his insights from a lifetime of research in this area, at the upcoming second annual Australasian Lifestyle Medicine Association (ALMA) Conference, being held at the Manly Pacific Hotel, in Sydney, from March 12-14. The University is the major sponsor of the conference.

Lifestyle medicine is a relatively new area of science. It is defined as ‘the application of environmental, behavioural, medical and motivational principles to the management of lifestyle-related health problems in clinical practice’.

Topic areas to be covered at the ALMA conference include inflammatory process and lifestyle-related diseases; physical inactivity; nutrition/food and fluids; sleep; addictions and mood states. The conference features world-renowned speakers in these fields (see list below).

Keynote speaker Professor Egger’s topic is ‘Overshooting the sweet spot: Medicine, the environment and economics at the crossroads’.

Professor Egger said that with over one in two Australians now overweight or obese, urgent attention needed to be targeted at the problem by Australian governments. He said even a five-to-10-per cent reduction in a person’s weight could result in a 35 per cent decrease in their health risk.

Calculated over an entire population, this health improvement could lead to a saving of millions of dollars annually while also offering people an improved quality of life.

“We know that weight loss is difficult for patients to achieve and maintain. However, new developments have resulted in a number of strategies and methods with a good evidence base,” he said.

“What we know is that all successful strategies include some form of lifestyle change resulting in a reduction of the energy consumed versus the energy expended.

“Obesity treatments with good evidence include counselling and behavioural approaches, exercise-based programs, pre-prepared low energy meals, meal replacement and bariatric surgery (the most effective for long-term weight loss).”

Bariatric surgery, also known as gastric banding, is a relatively simple reversible procedure where a flexible band is fastened around the upper stomach to create a small pouch which restricts the amount of food that can be consumed. It is the most widely used weight control surgery.

Professor Egger said that weight loss creams, body wraps, acupuncture, aromatherapy, and the majority of over-the-counter medications had no convincing evidence of efficacy. One notable exception is the weight loss drug Orlistat, which prevents the absorption of fats from the human diet, but it needs to be taken in conjunction with other diet and lifestyle changes.

“The most effective treatments are likely to involve combining and matching various strategies and tailoring them to the individual characteristics of the patient,” Professor Egger said.

“Energy balance is the core of all successful weight loss instruction. The best treatments involve a change in the balance of energy ‘volume’ – or the amount of calories/kilojoules consumed, in relation to those expended.

“The modern diet provides far too many energy dense foods and our modern lifestyle provides too few natural opportunities to use the calories that these foods provide.

“Energy dense foods are generally those that are highly processed, high in fats, high in carbohydrates and high in sugars. In terms of human evolution, they are a new addition to the human diet. Biscuits, cakes, soft drinks, many processed cereals, chocolate/sweet bars, packaged snacks like chips, fried foods, and many take-away foods are energy dense foods, to name a few.”

Professor Egger said that for exercise alone to be effective as a weight loss technique, a person needed to exercise for a minimum of 3.5 hours a week.

“Using a pedometer (a little portable device that counts each step you take), this equates to around 90,000 steps per week for an 80kg person.

“While exercise is a necessary component for any weight loss program, it is usually not sufficient without being combined with a weight loss diet. All successful strategies include some form of lifestyle changes.”

Photo: Professor Garry Egger, who will speak on the intersection between medicine, the environment and economics at the upcoming ALMA conference.

Media opportunity: There are many experts available to speak on various aspects of lifestyle medicine. Interviews can be arranged with conference presenters by first phoning Zoe Satherley, Southern Cross University media officer, 6620 3144, 0402 009 361.

Topics being featured on the conference program include:

• Prof Boyd Swinburn (Deakin University; International Obesity Taskforce): Is obesity just the 'canary in the coalmine’ signalling bigger consequences for health and lifestyle medicine?
• Prof Adrian Bauman (Sydney University): New findings on exercise and physical activity and the implications for lifestyle medicine.
• Prof Ron Grunstein (Woolcock Institute, Sydney): The latest on sleep, and its implications for lifestyle medicine.
• Prof Malcolm Battersby (Flinders University): Self management as the cornerstone of lifestyle medicine.
• Dr Tim Sharp (Happiness Institute, Sydney): Bringing happiness into health.
• Prof Michael Cousins (Royal NS Hospital, Sydney): Managing chronic pain.
• Dr Andrew Binns (Lismore GP and inaugural ALMA President): Indigenous health: Where to now? And: Social status, health and lifestyle medicine.
• Prof John Stevens (Southern Cross University School of Nursing): The role and health of the practice nurse in lifestyle medicine.
• Prof Marc Cohen (RMIT): Introducing wellness and the physical therapies - the link with lifestyle medicine.
• Dr Chris Hayes (John Hunter Hospital Newcastle): Whole person management in chronic pain.
• Gary Webb/Andrew Pitkin (AlphaOne, NSW): Managing pain in the workplace.
• Prof David Calhuoun (Uni of Queensland): Evidence-based complementary medicines and heart disease.
• Dr Julian Henwood (pharmacologist, Sydney): Lifestyle medications: what does (and doesn't) go with what.
• Martin Flood (pharmacist, SA): What pharmacists can add to lifestyle medicine.