05 Jan 2012
By: JOAN CHEW
Chocolate addict wants to kick habit
The problem: Not a day passes that Mrs Sherley Servos does not reach for a bar of milk chocolate.
The 40-year-old adjunct teacher eats an average of four bars a day, which add up to at least 1,000 of her daily recommended caloric intake of 1,700 kilocalories.
After lunch and dinner, she has an “uncontrollable” urge to go to the supermarket to get her chocolate fix, she said.
Mrs Servos has never dared to stock up on candy bars in her home or workplace. She said: “I would eat everything in one go. I have the willpower for anything except chocolate.”
Milk chocolate is full of sugar and milk and very little real cocoa, and that is how the kilos pile up.
To burn them off, the mother of two children, aged two and 10, works out at the gym four times a week. She admitted: “I exercise religiously so I can indulge in chocolate.”
But even so, she is struggling to reduce her weight of 91kg, which makes her obese for her height of 1.65m.
Her body mass index (BMI) – a measure of the amount of fat based on weight and height – is 33.4, which puts her at high risk of obesity-related diseases like diabetes.
While she has no health problems, she said she can feel the strain of all those extra kilos. She had to give up kickboxing, for instance, because the moves hurt her knees.
It was not always like this, said the Singaporean, who is married to an American. In 2007, when her family relocated to Seattle in the United States, her love for chocolate intensified. She was smitten with the wide variety that was available there, including chocolate-covered peanut butter.
Setting up home in a new country also presented challenges, which led her to seek comfort in chocolate.
Unable to adapt, the family moved back in 2009. But Mrs Servos did not surrender her twice-daily treat. In fact, she said: “I just wish I can replace all my meals with chocolate and still get all the fibre and nutrients my body needs.”
The only time she stopped wanting it was during her second pregnancy in 2009. She ate less than a bar a day.
Now, however, she feels like she cannot do without it. She said: “If I don’t have it, it is as if I have lost a part of my body. I feel as though I am missing out on something in my life.”
This year, however, Mrs Servos wants to give up chocolate for good and bring her weight down to 75kg, “primarily to keep health issues at bay so I can live a long and happy life with my children and husband”, she said.
It is the first time she has made such a resolution but she is hopeful. She said: “By making this a very public effort, I’ll be spurred to stick to it. The whole of Singapore will read about it and there will be tremendous pressure on me to keep to it.”
The experts say: The good news is that Mrs Servos’ love affair with chocolate is not a clinical addiction, which would require medical intervention. Instead, it resembles more of a type of compulsive behaviour which she feels she is unable to stop, said Mr Danny Ng, a clinical psychologist at Raffles Hospital.
Compulsive behaviour can be changed by breaking the ritual that leads to it, Mr Ng said. In Mrs Servos’ case, it is going to the supermarket after a meal to get a bar of chocolate.
He advised her to draw up a specific plan to go from four bars a day to three, two, one and then half, in four or five weeks. The plan should have realistic goals as an overly ambitious aim to give it all up right away is apt to fail.
To have something in her mouth while she lets the craving pass, she could suck on an ice cube instead, he suggested.
As motivation, she could remind herself not to overeat by writing its consequences on a card and carrying it with her.
At the same time, Mrs Servos should drill down to the triggers that set off her chocolate cravings, said Ms Lois Teo, a psychologist at KK Women’s and Children’s Hospital (KKH).
She could start a behaviour diary in which she notes when the cravings occur. They could come at a specific time of the day, under certain situations or if she is feeling stressed or bored.
The diary would help her reflect on and understand the reasons for her cravings, and perhaps deal with those too.
She should not deny herself chocolate nor perceive it as a forbidden food, which could make it seem all the sweeter.
Ms Teo said: “Treat herself to a moderate amount of chocolate at an allocated time of the week. This may help to prevent cravings later that may result in over-indulgence.”
Even the way she eats chocolate could have a bearing on how much is eaten.
Ms Teo advises mindful eating habits. This means not gobbling down the treat but taking small bites and enjoying every tasty morsel. She said: “By slowing down, one is likely to feel that the chocolate cravings are satisfied faster and will be less likely to over-indulge.”
Dr Brian Yeo, a consultant psychiatrist at Mount Elizabeth Medical Centre, said Mrs Servos was unlikely to find an “equivalent pleasurable alternative” to chocolate that is considered healthy. It would be just as detrimental if she switched to eating sweets.
Ms Lim Siew Choo, senior dietitian at the department of nutrition and dietetics at KKH, said Mrs Servos could train herself to eat only when hungry and not out of boredom or habit. Eating high fibre food, such as vegetables and brown rice, during meals would also give her less space for sweets.
It is not surprising that pregnancy diminished Mrs Servos’ craving for chocolate, said Dr Ong Wee Sian, head of the sports medicine department at KKH. The female sex hormones, oestrogen and progesterone, which are produced in large amounts during pregnancy, can cause changes in one’s food preference, appetite and energy intake.
To lose a significant amount of weight, Mrs Servos would have to both exercise and reduce her food intake, Dr Ong said.
Low-impact water-based exercises like swimming, aqua-aerobics or water walking would be easy on her knees.
She should do them at a moderate intensity for between 30 and 60 minutes – either continuously or in small bouts of 10 minutes – four to six times weekly.
She should also do resistance training with an elastic band or on gym machines twice a week to reduce the loss in muscle mass that results from ageing, Dr Ong said.
As her fitness improves and her weight starts to decrease or her knees feel stronger, she can increase her exercise intensity, duration and frequency gradually, Dr Ong added.
If the knee pain continues, she should consult a sports physician, an orthopaedic surgeon or a physiotherapist.
His growing beer belly worries him
The problem: In the last two years, the waistline of civil servant Liang Hein Fock (left), 62, expanded by two inches.
At 1.72m and 72kg, he has a body mass index (BMI) – a measure of his weight in relation to his height – of 24.3.
This puts him as slightly overweight and at moderate risk of chronic diseases such as heart disease, stroke and high blood pressure, which he is on medication for.
This year, he hopes to shed 5kg to get in the healthy range of between 18.5 and 22.9.
He also has osteoarthritis, a degenerative disease caused by cartilage loss in the joint, and the extra weight is hurting his left knee.
In July last year, the father of a 30-year-old airport engineer had replacement surgery for his right knee. He knows it may be a matter of time before he needs surgery for the other knee.
He said: “I can walk but not carry heavy things. My exercise options are also limited.”
Over the last year, he lost 2kg from swimming fortnightly and doing taiji, a traditional Chinese martial art.
He has also begun eating less carbohydrate and consuming more fibre. He now eats one bowl of rice, instead of two, and two slices of bread for breakfast, instead of five or six.
He is also eating more fruit.
The experts say: As people age, they should cut back on how much they eat or they will gain weight, said Dr Ong Wee Sian, head of the sports medicine department at KK Women’s and Children’s Hospital.
The body loses muscle mass after the age of 20 and needs less energy from food to sustain itself at rest.
To lose weight, an older person has to adjust his or her food intake and increase the daily expenditure of energy through exercise, focusing on resistance training to slow down the decline in the metabolic rate, Dr Ong said.
Dr Tham Kwang Wei, director of the obesity and metabolic unit at Singapore General Hospital, said it is reasonable for Mr Liang to aim for a 5kg weight loss, which is 7 per cent of his current weight, over a year.
It is important that he gets all the necessary nutrients while cutting back on his intake, and have adequate fibre, minerals and vitamins, she said. He should read food labels to avoid hidden fat and sugar in processed food.
Dr Tham said: “If he still finds it difficult to lose weight, Mr Liang may consider a meal replacement that is medically tested and studied, for one of his three meals. This will reduce caloric intake without compromising on nutrients.”
Swimming is a good sport for him and he should aim to gradually increase the duration to two hours a week while continuing with taiji, she said.
Given his medical history, he should consult a physiotherapist for a suitable exercise regimen, she said. Most public hospitals offer such services and have gyms for patients to exercise under supervision, she added.
Gym owner Keith Tan said resistance exercises would strengthen the joints, relieving pain and improving mobility.
Mr Tan encouraged Mr Liang to do reverse crunches to strengthen his abdominal muscles, which would help him maintain a good posture to avoid straining his hips and knees. He should lie on the floor, flex the knees and raise them towards his chest, bringing the hips off the ground. He should perform 15 repetitions of this for up to four sets.
Email: joanchew@sph.com.sg
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