13 Mar 2011
As obesity levels rise, weight-management programmes at hospitals have become popular
This will be Ms Nurul Huda Abdul Mutalib's fifth attempt at losing weight and she is determined to make it happen.
The 25-year-old clinic assistant, who weighs 96.2kg, has tried appetite suppressants and meal replacements but never managed to shed those extra kilos.
This time around, she has signed up for a four-month weight-management programme at Alexandra Hospital, which is run by Jurong Health Services.
Another big difference is that the eyes of many Singaporeans will be on her battle of the bulge – LifeStyle will track her progress and provide regular updates.
By the end of the programme, the 1.65m-tall Ms Nurul hopes to lose at least 10kg.
But the ultimate goal is to weigh around 63kg for her wedding in December. She met her husband-to-be, Mr Mohamad Khairi Aziz 27, a supervisor in the shipping industry, when they were at Singapore Polytecnnic studying engineering.
Ms Nurul says she was overweight even as a child and had to join the Trim And Fit club in school.
Her housewife mother, 50, is also overweight and has diabetes, high blood pressure and high cholesterol.
Not wanting to go down that path, Ms Nurul, an only child, has been exercising regularly for the past year, but her weakness is food, especially chicken.
"Fried chicken, curry chicken, it's like they are calling out to me," she says.
At fast-food restaurants, she can eat two whole chickens in a sitting, and this happens as often as once every two weeks.
So now, she is seeking professional help.
"I can and I will lose weight," she says determinedly.
People like her are heading for weight-management programmes at private and public hospitals.
For example, at the Singapore General Hospital (SGH), patients visited the obesity management programme for consultation 1,572 times in 2005, compared with 5,233 patient visits in 2009.
Alexandra Hospital was unable to give statistics on the increase in patients between 2002 and 2008, but said it saw an average of 800 new patients each year at its weight-management programme.
At Changi General Hospital, the programme is running at full capacity. It has about 200 patients each year.
But doctors say more people should come forward for help, as the incidence of obesity rises in Singapore.
One in 10 people here is obese – defined as having a Body Mass Index (BMI) of 30 and above – according to the National Health Survey 2010, compared with about one in 15 just six years ago.
BMI is calculated by dividing your weight in kilograms by the square of your height in metres.
A senior consultant at Alexandra Hospital's (JurongHealth) department of medicine, Dr Tey Beng Hea, says that if the obesity problem is not rectified, it could, by 2030, reach American levels, where three in 10 people are overweight.
"Every year, the numbers shoot up, we cannot be complacent about it," he adds.
The issue of weight was in the news recently as a result of the death of Mr Ong Joo Aun, 54, who took part in reality TV programme Lose To Win's fitness assessment.
Following the tragedy, the Health Ministry announced last month that a panel of medical experts will review the weight-loss programme developed by the Health Promotion Board. Doctors say that while obesity is sometimes caused by hormonal disorders, brain tumours or selected drugs, the majority of obesity cases are caused by a combination of genetic, environmental, and cultural factors.
In particular, Dr Ben Tan, head and senior consultant at the Changi Sports Medicine Centre and Singapore Sports Medicine Centre, which runs a weight-management programme, says rising obesity rates are due to people eating more and doing less physical activity.
Dr Tey says that a family could be overweight not only because of genetics, but also because of diet and lifestyle.
Dr Stanley Liew, a specialist in endocrinology at Raffles Hospital, says the principle of weight loss is simple: Eat less and exercise more.
But not everyone knows how to go about it, or has enough discipline to carry it out. That is where weight-management programmes come in.
Such programmes, which use methods based on medical evidence, last anything from four to six months, during which participants see doctors, dietitians, physiotherapists and sometimes occupational therapists.
Alexandra Hospital's four-month programme includes a visit, with a dietitian, to the supermarket to read food labels and an introduction to gym equipment by a physiotherapist.
Out of 100 participants recently, about a third achieved weight loss of between 5 and 10 per cent.
Over at SGH, it has what it calls a Lifestyle Improvement and Fitness Enhancement Centre. Within that is an obesity and metabolic unit.
At least 10 per cent of patients lose at least 5 per cent of their weight after three months, says a consultant at the hospital's department of endocrinology, Dr Tham Kwang Wei.
The programmes at various hospitals cost between $500 and $900.
Checks with hospitals show a person must have a BMI of at least 23 to be admitted to the programme. But the cut-off is higher at some hospitals.
Those with a BMI of 27.5 and above have a high risk of developing health problems including diabetes, high blood pressure, and heart disease, among others. A BMI of 23 to 27.4 indicates moderate risk.
While exercises and diet control can help, some who are morbidly obese – with a BMI of above 32.5 – may turn to surgery.
The more common procedure here is Lapband surgery which involves putting a ring around the upper part of the stomach, making it seem smaller, forcing the person to eat less.
Dr H.G. Baladas at Raffles Hospital, who has done the procedure on about 400 people, says about 95 per cent of his patients lose more than 10 to 15 per cent of their body weight in six months.
As for side-effects, he says the $16,000 surgery will cause some mild deficiency in vitamin B.
But he adds that it is only for those who are morbidly obese and have been unsuccessful in losing weight through exercise and diet control.
For others, moderated eating and exercise are still the top options.
For example, Mr Soh Teck Wah, 47, lost 16kg in four months.
He signed up for a weight-management programme at Khoo Teck Puat Hospital, started watching his diet, exercising and doing more household chores.
The financial services consultant, who weighed 106kg at the start of the programme last September, says he now feels more energetic during the day.
"I also had to punch new holes in my belt to tighten it," he says with a beam.
LifeStyle will check in with Ms Nurul Huda on April 3.
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