Learn about causes of weight gain, self-help treatment options, medication and when to seek medical help

What is Weight Management?

There are many tips and advice for how to prevent weight gain and/or reduce your weight. This article will cover medications and supplements which may help you to manage your weight.

What are the possible causes of being overweight?

The most common reason for weight gain is when you consume more calories than your body uses on a day-to-day basis. The amount of calories that your body needs daily will differ based on your gender, age and activity level. You may refer to a calorie calculator such as the one on Healthhub (Make Healthy Food & Grocery Choices (healthhub.sg)) to find out your ideal caloric intake. 

Certain factors may also cause you to gain weight more easily:

• Quitting smoking: During the initial stages of quitting smoking, your metabolism slows down and your appetite increases. However, in the long run, quitting smoking will have a greater benefit on your health
• Eating out frequently: Food from restaurants and hawker centres generally have more oil, sugar and fats
• Pregnancy: While weight gain is expected in pregnancy, the decrease in ability to move around and pregnancy cravings for food may cause some women to gain more weight than is necessary and face difficulty losing it after giving birth
• Lack of sleep: Your body produces more ghrelin (hunger inducing hormone) and less leptin (hunger suppressing hormone) when you lack sleep, leading to an increase in appetite
• Ageing: As you age, your metabolic rate decreases,  your ability to move around and energy level may also decrease, leading to lower activity levels.
• Social and economic factors: Your job and lifestyle may prevent you from having the time to exercise or to prepare healthy, home-cooked meals. 

Weight gain may also happen as a result of a medical condition. A small percentage of people have genetic conditions that cause them to gain weight easily. Other medical conditions such as depression, polycystic ovary syndrome, diabetes, hypothyroidism and Cushing’s syndrome may also cause you to gain weight quickly.

Finally, several medications can also increase your risk of weight gain. Some examples of these include but are not limited to:

• Birth control pills
• Insulin
• Oral steroids
• Anti-depressants
• Anti-psychotics
• Beta-blockers
• Sulfonylureas

What are the symptoms of being overweight?

We use the Body Mass Index (BMI) to tell if you are overweight. This is calculated as body weight in kilograms over height in meters squared. For Asians in Singapore, the table below shows the BMI categories:

Do note that BMI is less accurate as a measurement tool for those who are very muscular, in people with a condition known as sarcopenia, children and pregnant women.

What medications and supplements can I use to lose weight?

The main method to lose weight involves changing your lifestyle to reduce your caloric intake and increase your activity level. However, if you are obese (BMI ≥ 30), or overweight (BMI ≥ 28) and have a history of high blood pressure, diabetes or high cholesterol, you may approach a pharmacist to get a medication which reduces the absorption of fat from the food that you eat.

• Orlistat

While there are many supplements being sold to help to lose weight, do note that none of them have enough studies to prove their effectiveness. Most of these supplements claim to work by:

• Increasing the metabolism of fat cells (african bush mango, green tea, raspberry ketone)
• Increasing the metabolism of carbohydrates (green tea, green coffee, raspberry ketones, alpha lipoic acid)
• Reducing appetite (green tea, conjugated linoleic acid)
• Increase bowel movement (senna, aloe vera)

Do also note that some of these supplements may have potentially harmful side effects. For example, supplements containing senna, a kind of laxative, may cause diarrhoea that leads to potentially dangerous dehydration (losing too much water from the body). Do consult your healthcare professional if you are in doubt as to whether a supplement is safe to consume for weight loss. 

Finally, do take note that healthy weight loss should be no more than 0.5 to 1kg a week. Losing weight too quickly can lead to:

• Dehydration
• Electrolyte imbalance
• Loss in muscle mass
• Slowing down of metabolism
•  Poor nutrition
• Irregular menstrual cycles 
• Osteoporosis (in the long run)

When do I need to see a doctor?

Although healthy weight loss may be achieved without a doctor’s consultation, there are times where the condition might be more serious. 

If you suspect your weight gain may be due to a medical condition or medication, speak with a doctor to determine how to manage it appropriately. Never stop a long-term medication abruptly without first consulting your doctor.

You may also consult a doctor if you feel that you require further medical assistance to lose weight.

What else can I do to manage this condition?

Lifestyle changes are very important in weight management. Two lifestyle changes you should try to include:

1. Reducing your caloric intake
   • Use the calorie counter in HealthHub to calculate your daily caloric intake
   • Have a healthy and balanced diet which does not exceed your recommended caloric intake
   • Refer to tools such as My Healthy Plate when planning your meals
   • Refer to nutritional labels and choose food and drink options which are lower in fats, salts and sugar
      
2. Increasing your physical activity level
   • If you have a long-term medical condition, check with your doctor if you are fit and able to increase your activity level
   • Start slow and increase the intensity of your activity gradually
   • Choose exercises which are conveniently located and fun for you so that you will be able to continue the activity in the long run
   • Aim to have a  mix of cardio and strength building exercises
   • For cardio exercises, aim to reach at least 150 minutes of moderate intensity exercise per week
   • For strength building exercises, aim to do them on at least two days per week, with at least one day apart (not two days in a row).

Disclaimers

"This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

The content above is solely for informational purposes only and is not intended as a substitute for the advice provided by your physician, pharmacist or other healthcare professional. You should not use the information for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. Always speak with your physician, pharmacist or other healthcare professional before taking any medication or supplement, or adopting any treatment for a health problem."