Here are some of the ways of
reducing body weight based on my own experience when I conducted a nutritional
experiment on myself. With the Chinese New Year of The Snake just two days
away, people tend to overeat. So, I thought it is an appropriate time to share
my experience on how to manage body weight to a healthy level.
I shall then summarize it
after this in another easier-to-understand essay
I was overweight when I first
started working. I remember my body weight was about 150 lbs. (68 kg). My
height was 5 feet 3 inches (1.6 meters) giving my body mass index (BMI) as 68 /
1.6 ^2 = 26.6. The BMI for males within the healthy weight range should be
between 18.5 and 24.9.
As
nutritionists and medical doctors, we know obesity from overeating leads to
breathing difficulties that stop many times during the night (sleep apnoea),
cardiovascular diseases such as coronary heart disease, cerebrovascular disease
like CVA (stroke). type 2 diabetes, arthritis, certain types of cancers
Hence,
I decided to bring my weight down to a healthy range.
However,
figuring out exactly how many calories an individual should eat can be tricky,
as it depends on various factors, including your age, sex, size, occupation and
physical activity.
The
recommended caloric intake for a sedentary adult in Malaysia is 2,000
calories per day for men and 1,500 calories per day for women. This
recommendation is based on the 2010 Malaysian Dietary Guidelines.
Foods
that are low in calories are mainly the vegetables, especially leafy ones. One
example I used for my nutritional experiment on myself was the leafy sawi
(mustard green). The nutrient contents of sawi
per 100 grams are: kilocalories 27, total carbohydrate 4.7 g, dietary fiber 3.2 g,
sugar 1.3 g, protein 2.9 g, total fat 0.4 g, potassium 384 mg,
sodium 20 mg.
So, I chose to eat only a bowl
of leafy sawi every day, and nothing else. The sawi was boiled with meat to
extract the B-group of vitamins, together with its minerals and meat flavours.
I ate the bowl of sawi (the meat was discarded) only for dinner with no
breakfast or lunch except for at least 1.5 litres of tea with a little milk,
but no sugar to take care of my daily fluid intake. I worked in air-conditioned
medical research laboratories anyway, and I don’t sweat a lot. The diet I
designed was adequate in other nutrients, except in energy content, fats I do
not want, a slight dip in protein content. All the water-soluble B-group of
vitamins except vitamin B12 were also leached from the meat into the vegetable
soup. There was no shortage of retinol (vitamin A) from beta-carotene and
carotenoids serving also as antioxidants. There was also no problem with
deficiency of vitamin D in a tropical country like Malaysia. Vitamin
D comes in two forms (D2 and D3) which differ
chemically in their side chains. These structural differences alter their
binding to the carrier protein vitamin D binding protein (DBP) and their
metabolism, but in general the biological activity of their active metabolites
is comparable. Vitamin D3 is produced in the skin from
7-dehydrocholesterol by UV irradiation, which breaks the B ring to form pre-D3.
Pre-D3 isomerizes to D3 but with continued UV
irradiation to tachysterol and lumisterol. D3 is preferentially
removed from the skin, bound to DBP. The liver and other tissues metabolize
vitamin D, whether from the skin or oral ingestion, to 25OHD, the principal
circulating form of vitamin D. So was mustard green (sawi) rich in vitamin K and
tocopherol (vitamin E). There was also adequate potassium, magnesium and iron
in all vegetable, except low in calories, and proteins especially leafy
vegetables unlike legumes and pulses like soya and lentils
I estimated my total daily
intake was only 2092 kilojoules (500 kilocalories) a day. I did that for one
month. Neither was extra protein or calcium needed short-term for only a month.
The
recommended daily caloric intake depends on many factors, including age,
sex, weight, height, activity level, and body composition. On average,
adults need around 8,370 kJ (2,000 kilocalories) per day to maintain
a healthy weight.
(1 kilocalorie = 4.184
kilojoules)
On this experimental dietary
regimen, I lost about 0.5 kg every day. My initial weight before my experiment
was 68 kg (150 lbs.). After a month, my weight dropped to 51.7 kg (114
lbs).
How did I feel during the
one-month nutrition experiment on myself?
Here are the symptomatic
episodes I experienced.
There was initial hunger for
about 3 -4 days
There was mild
gastrointestinal upset with some initial diarrhea
There was lethargy for about 2
weeks, an initial natural response by the body to conserve physical energy to
conserve body mass loss
Some people have resorted to
social media to advise others to consume a totally fat diet instead of a
carbohydrate diet like rice and bread in order to reduce weight.
Let me take this opportunity
here to explain what happens when we go into a totally fat diet.
As nutritionists, we know that
on a diet high in fats and low in calories ketones are formed. To be more
precise and technical for medical and biomedical readers, ketone
bodies are formed in the liver from fatty acid oxidation and in humans consist
of three molecules, acetoacetate (AcAc), 3-β-hydroxybutyrate (3HB) and
acetone.1,2 AcAc is produced when carbohydrate stores are low and fatty acids
are metabolised to produce acetyl CoA, which overwhelms the hepatocyte
mitochondrial capacity to remove acetyl CoA.1 Two acetyl CoA molecules combine
to form AcAc, which can be reduced with NADH to form 3HB.1 Acetone is formed
from the spontaneous degeneration of AcAc.2 The liver is the only organ that
produces ketone bodies but it cannot utilise ketones itself.
Let me
explain this further. Ketogenesis occurs in the liver during periods of
low carbohydrate availability and ketones are an important fuel source for the
brain and cardiac and skeletal muscle during starvation. Ketones also reduce
the amount of glucose and protein utilised for energy production when glucose
levels are deficient. When carbohydrate and glucose levels are low, fatty acid
production is stimulated by the release of adrenaline and glucagon. Acetyl CoA
is produced from β-oxidation of fatty acids and can enter the citric acid
cycle. However, acetyl CoA has to combine with oxaloacetate in order to be able
to enter the citric acid cycle. Oxaloacetate is produced from pyruvate during
glycolysis and hence if glucose levels are low there is not enough oxaloacetate
production, and the remaining oxaloacetate is preferentially used for
gluconeogenesis. The abundance of acetyl CoA that then remains forms
ketone bodies.
Having
explained that, symptom-wise, I was completely free from ketosis with my
experimental diet even though I expect my body to utilize my stored body fats
for energy.
I was not presented with all
those signs and symptoms of ketosis such as bad breath,
increased blood and urine ketones except initial short-term lethargy. I did not
bother to measure the levels of ketones in my blood and urine anyway. Since I was working at the Institute for Medical Research then, I had ample facilities and opportunities to ask my medical colleagues to run all sorts of biochemical haematological tests that I wanted for me. Surprisingly, they were all normal including the blood glucose levels that were constantly above fasting levels, but has never shot up to prediabetic or diabetic readings. They all constantly stayed within low normal range despite such severe caloric restrictions.
After two weeks on the restricted caloric routine, I felt very light and agile as I accommodated to an adjusted new body weight that tallied with a much lowered energy intake. The lighter the body, the less energy (food) was needed. This is physics, physiology, biological adjustment and accommodation for continuing survival of the body. We can’t add something (food) resulting in nothing (weight loss). It contradicts the laws of physics on the conservation of matter and energy. Initial lethargy followed by hyperactivity can mimic as part of evolution to adapt for the fittest, so to speak.
I am
fully aware of physical exercise to burn up the calories. But I was then
lethargic for exercise. It was a natural body response not to exert further to
conserve energy in such a restricted energy scenario. There is a risk of a
collapse with exercise for those who are obese or on a severely restricted
diet. See here my explanation:
Do You
Think Exercise and Jogging are All Health Beneficial? Think Again and Read On:
https://scientificlogic.blogspot.com/search?q=Risk+of+exercise+
It
would be perhaps safe for those on an adequate diet to lightly exercise, but
not when the body itself tries naturally to prevent you from spending energy
when you could ill afford this. This will inevitably cause the weight to
dangerously drop further which I don't think is advisable. So not listen to
anyone advising you to take slimming pills and drugs or thyroid hormones to
increase the metabolic rate. Some doctors even resort to daily injectable GLP-1
medicine liraglutide that is in the same class as semaglutide for weight loss
that was meant for the management of type 2 diabetes
even though semaglutide, tirzepatide and iraglutide will be big markets for
generics for rapid weight drop. Drugs do far more harm than good. Let the body
weight drop naturally and slowly through caloric restriction. In fact, many
studies have clearly shown caloric restriction increases longevity here:
Reasons
for Our Limited Human Life Spans
https://scientificlogic.blogspot.com/search?q=caloric+restriction+and+longevity
Dietary
modification and adjustments are the only safe and effective method. But are
obese and overweight individuals willing? They treat their stomachs as garbage
bins by throwing excessive food into their stomachs instead of into the
garbage bins outside the kitchen. Drugs may do far more harm than good
instead of adopting a healthy lifestyle.
Many obese and overweight
individuals are unwilling to go undergo such a caloric-restricted treatment as
I did. They like to continue eating as they habitually do, giving an excuse
they will get ‘gastric’ and become very hungry if they don’t continue to eat,
and that they will suffer from hypoglycemia
when their blood sugar (glucose) level drops without constant eating. No
doubt glucose is the body's main source of energy, and we need to maintain it
with periodic eating. If the blood glucose drops far too low below the normal
fasting range - between 70 mg/dL (3.9 mmol/L) and 100 mg/dL (5.6
mmol/L) there may be initial hunger, rather than looking pale, tremors on the
hands, tingling or numbness on hands, lips, tongue or cheeks, sweating, nausea,
irregular or tachycardia (fast heart beats), anxiety and irritability, loss of
concentration that are signs and symptoms of extreme hypoglycemia
Normally
as long as we eat, whether we overeat or under consume, the normal blood
sugar levels are maintained for hours, and we don’t actually feel hungry until
the blood sugar drops drastically. Any excessive eating will not prevent hunger
as insulin will regulate the maximum blood sugar level to be less than 180
mg/dL (milligrams per decilitres) and a minimal basal level of 70 or 80 mg
/ dL for most adults, typically within 1-2 hours in a non-diabetic
individual. Any excess calories will not be utilized to prevent hunger. It will
be stored in the liver instead, primarily as fat in the form of triglycerides,
which builds up as a result of the body converting excess calories from
carbohydrates and proteins. In other words, whether we eat excessively or little
in one sitting, hunger will still return after 3 -4 hours.
Hence,
it is not an excuse that we will get hungry and go into hypoglycaemia or even
get symptoms of ketosis by substituting carbohydrates and sugars with fats if
we don’t eat more than what our body needs. This is not true at all through my
own experience and deliberate self-nutrition experiment. I only felt lethargic
and listless for only the initial two weeks only to become much more physically
active than before when I was overweight that forced my body to carry
unnecessary extra weight around everywhere. It was like carrying two or
more heavy luggage everywhere I went, every step I took. But when I took
off those unnecessary “internal body luggage” suddenly I felt like a bird with
light hollow bones and light feathers flying about that I could never do when
burdened with those excessive “body luggage”.
My
advice to all intending to lose body weight is to do it very slowly. The
key and the safe way to reduce body weight is to reduce caloric intake
gradually, bit by bit, taking each small dietary step over a period of a few
days spread over a few months as the body begins to adjust and
accommodate to new changes. This is like coming down from a tall building
step-by-step using a staircase, and not suddenly jumped down from the top.
Jumping down from a height will only land up in instant death. Reduce body
weight by taking the “dietary staircase” – slowly, step by step over several
months, and we are sure to see results. The difficulty with most people is to
maintain a weight-losing dietary regimen. They tend to return to their
excessive dietary lifestyles when they see food aplenty. Overeating, or eating
even after you’re full, is fairly common. We overeat at parties; family
gatherings and holidays like in the upcoming 2025 Chinese New Year.
Overeating contributes to obesity and the development of eating
disorders.
Reduce
food intake gradually to allow the body to accommodate and adjust gradually
without it realizing it. Don’t do it like I did. I was only carrying out a
‘dangerous’ medical experiment on myself.
As
expected, several months after ending my experiment I slowly regained slightly
those body weight by “over-eating”
Let me
now write a summary using easier to understand language of what I have just
written above:
A Safe
and Effective Approach to Reducing Obesity
Obesity
is a significant health concern worldwide, linked to numerous health
complications such as sleep apnoea, cardiovascular diseases (e.g., coronary
heart disease, stroke), type 2 diabetes, arthritis, and even certain cancers.
As a medical professional and researcher, I have explored a variety of
approaches to combat obesity, including conducting a self-directed nutritional
experiment. This article outlines my personal experience and provides practical
recommendations for safe and effective weight management.
Understanding
the Problem: My Starting Point
When I
first began working, I weighed 68 kilograms (150 pounds) at a height of 1.6
meters (5 feet 3 inches), giving me a body mass index (BMI) of 26.6, which is
classified as overweight. A healthy BMI for males typically ranges between 18.5
and 24.9. Recognizing the health risks associated with my weight, I decided to
take steps to reduce it.
The
Caloric Intake Dilemma
Determining
an individual’s caloric needs depends on various factors, including age, sex,
weight, height, physical activity, and occupation. For example, the recommended
caloric intake for sedentary adults in Malaysia is 2,000 calories per day for
men and 1,500 calories per day for women, based on the 2010 Malaysian Dietary
Guidelines.
To
address my weight, I adopted an extreme caloric-restriction diet for one month.
While this approach was effective for me, it is not recommended for others due
to potential health risks. Instead, gradual and sustainable adjustments to
caloric intake are safer and more effective for long-term weight management.
My
Experiment: Extreme Caloric Restriction:
For one
month, I restricted my daily caloric intake to approximately 500 kilocalories
(2,092 kilojoules). My diet consisted of:
- A bowl of boiled sawi (mustard greens):
Nutritional content per 100 grams includes 27 calories, 4.7 g
carbohydrates, 2.9 g protein, and 0.4 g fat.
- Tea with a little milk but no sugar: To maintain
hydration.
I
boiled the sawi with meat to extract flavours and nutrients but discarded the
meat itself. I consumed this meal once a day, skipping breakfast and lunch,
while ensuring fluid intake of at least 1.5 litres daily.
Over
the month, I lost approximately 0.5 kg daily, reducing my weight from 68 kg to
51.7 kg (114 pounds). However, I experienced the following side effects:
- Initial hunger for 3-4 days.
- Mild gastrointestinal upset, including diarrhoea.
- Lethargy for two weeks as my body adapted to the
caloric deficit.
Why
Extreme Measures Are Not Recommended:
Extreme
caloric restriction can lead to nutritional deficiencies and physiological
stress. Moreover, some individuals resort to ill-advised diets, such as
high-fat, low-carbohydrate regimens, which may induce ketosis.
Ketosis
Explained: When carbohydrate intake is severely restricted, the body produces
ketones—acetoacetate, 3-β-hydroxybutyrate, and acetone—as an alternative energy
source. While ketones can fuel the brain and muscles during starvation,
excessive reliance on them can cause symptoms such as bad breath, fatigue, and
nausea.
In my
experiment, despite significant fat utilization, I did not exhibit symptoms of
ketosis, likely because my carbohydrate intake, though minimal, was sufficient
to prevent it.
The
Physics and Physiology of Weight Loss:
Weight
loss follows basic principles of physics and physiology. A lighter body
requires less energy to function, creating a positive feedback loop for
continued weight reduction. However, rapid weight loss can shock the body,
leading to fatigue and other adverse effects. A gradual approach is safer and
more sustainable.
Recommendations
for Safe Weight Reduction:
- Set Realistic Goals: Aim to lose 0.5-1 kg (1-2
pounds) per week. This gradual approach allows the body to adjust without
undue stress.
- Monitor Caloric Intake: Reduce daily caloric
intake by 500-1,000 calories, depending on your baseline consumption and
activity level.
- Choose Nutrient-Dense Foods: Prioritize
vegetables, lean proteins, and whole grains while limiting processed foods
and sugary beverages.
- Stay Hydrated: Drink plenty of water to support
metabolism and prevent dehydration.
- Incorporate Physical Activity: Regular exercise
complements dietary changes, enhancing calorie expenditure and improving
overall health but take care as already with strenuous exercises on a
restricted diet as already explained
- Maintain Consistency: Avoid drastic changes or
fad diets. Instead, focus on sustainable habits that fit your lifestyle.
Addressing
Common Myths:
Myth 1:
“I will get hypoglycemia if I don’t eat constantly.”
- Fact: The body maintains blood glucose levels
within a normal range, even during caloric restriction, through glycogen
stores and fat metabolism.
Myth 2:
“I need to eat to prevent hunger.”
- Fact: Hunger is a natural response and does not
necessarily indicate a lack of nutrients. Eating excessively will not
prevent future hunger; it only leads to fat storage.
Conclusion:
A Step-by-Step Approach:
Weight
loss is a journey that requires patience and discipline. Gradual caloric
reduction, combined with healthy eating and regular physical activity, ensures
sustainable results. Drastic measures, like the extreme diet I experimented
with, are neither safe nor advisable for the general population.
Think
of weight loss as descending a tall building using a staircase—one step at a
time—rather than jumping from the top. By adopting a slow and steady approach,
you can achieve and maintain a healthy weight without compromising your health.
A Very
Blessed and Bountiful Chinese New Year on 29 January 2025 to all who
appreciates this
1 comment:
Professor Dr Lim.
My colleagues have just passed on your write up to me on your personal journal with weight management to be shared among other doctors.
I greatly admire your intellectual mind and vast knowledge in writing this medical experiment you conducted on yourself, and a plethora of all sorts of assorted articles from A to Z in your blog.
Your thoughts in all your essays reflect brilliantly your postgraduate and doctoral university training at London, Reading, Oxford, Cambridge and at MIT and your work at the Institute for Medical Research. I am very impressed by your prolific mind, seeped and enriched with knowledge and wisdom. It is just next to none.
I look forward to more thoughts from you.
Gong Xi Fa Cai and Cheers to you Prof Lim.
Marilyn Li
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