Weighing in

Is calorie counting the best way for patients to lose weight on a body–contouring programme? Jennifer Irvine breaks down the science

JENNIFER IRVINE

Jennifer Irvine is a food health writer and entrepreneur who founded The Pure Package for London-wide meal deliveries in 2003. In January 2013 she successfully launched The Pure Package’s sibling, Balance Box, developing her business into a UK-wide venture.

Lockdown-related weight is a concern for many patients, with a lot of us having gained weight during the pandemic, leading to an increase in the popularity of body contouring and fat-freezing treatments. These are often expensive, and clients have high expectations. And, unless lifestyle changes are made, the fat will probably come back somewhere. When it comes to eating there are many fad diets and clients expect clinics with a weight-loss or lifestyle intervention offering to help them identify fact from fad, often asking questions about what they should be eating to support their weight management.

At The Pure Package we have 18 years of experience managing clients’ weight and we work with many aesthetic clinics that offer treatments in this realm. Unsurprisingly, they all report enhanced and longer-lasting results if their patients also improve their diets, which is why they often refer those who need help with their dietary intake to us. So, how can you support your clients on their journey?

Theoretically, weight loss isn’t rocket science: if you eat more calories than you burn, you’ll gain weight. If you eat the same number of calories that you burn, your weight will stay the same. And if you eat less calories than you burn, you’ll lose weight. It sounds simple, and this is exactly why so many people who adopt a solely caloriecounting approach to weight loss find themselves confused and frustrated. Every bit of food we eat has a calorific value; a unit of measurement representing how much energy is stored in a mass of food.

If you look at food packaging, you’ll see calories are indicated by “kilocalories”, or kcals. One calorie equals a kcal. A single calorie is defined as having approximately the amount of energy needed to raise the temperature of one kilogram of water by 1C. On this basis, it might surprise you to know that an apple contains enough energy to boil a litre of water. Another example: a croissant contains around 400 calories – the same as a large jacket potato with baked beans.

This is why most of us think: “I need to lose weight, so I’ll just make sure whatever I eat is less than what I burn.” Well, not quite. If your goal (or clients’) is to lose weight in a healthy and controlled way, you’ll need to focus on more than just calorie counting. If all you do is count calories and choose foods based on how much energy they contain, there’s a high chance you won’t see results if you don’t focus on a nutritious, balanced diet which is essential for good health. To maintain weight, an average man needs around 2,500kcal a day, and an average woman around 2,000kcal. If you want to gain weight, or lose weight, then these figures will go up or down and will need to be adjusted for any exercise you do, because of course, exercise burns more calories.

THE ROLE OF METABOLISM

In addition to the calories we burn during exercise, we also need to consider our basal metabolic rate (BMR) which is the minimal energy required for your body to function during rest. Even when you’re sleeping, your body needs exercise for automatic processes such as keeping your heart pumping or your lungs breathing. Your BMR accounts for anything between 40% and 70% of your body’s daily energy requirements, depending on your age and lifestyle. Any extra energy you consume above your BMR will either be used by your body when you exercise or be stored as fat.

But not all calories are created equal. Some foods might have the same calorific value but vary in their “metabolic efficiency”. This means certain foods (with poor metabolic efficiency) make the metabolism work harder to digest them, and other foods (with high metabolic efficiency) glide through your digestive system with minimal effort. Cooked foods, especially carbohydrates such as pasta, have a far better metabolic efficiency compared with raw fruit and vegetables. But it’s the foods with a poor metabolic efficiency that have the advantage for weight loss.

You may have heard the urban myth that celery contains negative calories. Although this isn’t proven, it no doubt stemmed from the concept that the body has to work really hard to digest something with a relatively low calorific value. Our cave-dwelling ancestors would have preferred cooked, fatty meats to survive the winter over celery sticks, but things are different in our modern society where so many people consume more calories than they need and end up with excess fat stores.

BALANCE IS KEY

A balanced diet is just as important to weight-loss as calorie counting. Ideally, we need to factor in both; choose foods wisely based on how much energy they will give you, as well as the macro and micronutrients they will provide. A diet high in fibre, fresh fruit and vegetables is a safe bet, because unprocessed foods will give you a metabolic advantage. In addition, whole foods will provide plenty of roughage which will keep you fuller for longer without an energy surplus that will ultimately turn into fat stores.

However, it’s also important not to cut out food groups when looking to lose or maintain weight. Many popular diets try to cheat the metabolism by swerving certain types of foods, but this can lead to problems. The keto diet for example, is based on the idea that if you cut carbohydrates from your diet, your body will be forced to draw energy from your glucose reserves, stored as fat. This is called ketosis. But be warned – you can’t cheat your body for long. A low-carb diet can lead to nausea and bad breath as well as kidney disease and kidney stones. Instead, complex carbohydrates such as wholegrains will release their energy slowly and reduce the risk of heart disease and stroke.

So, do calories matter? For weight loss, the answer is yes, calories do matter. If you consume more calories than you burn, you’re going to put on weight. However, there is a “but”. If we choose foods based solely on how many calories they contain, instead of aiming for a healthy, balanced diet, we’re inevitably going to run into issues. Instead, patients need to nourish their body with a diet rich in fruit, vegetables, good fats, protein and complex carbohydrates. If they’re determined to achieve their weight goals, advise them to choose a healthy, balanced diet taking this information into account, and with suitable, regular exercise, they can watch the pounds drop off.

Sometimes, though, no matter how much weight someone has lost, stubborn areas of fat just won’t shift, and that’s where fat-loss procedures can help achieve or enhance the body the client desires. Just ensure they know that maintaining this new physique with a balanced and nutritionally rich diet is key to long-term results, leading to a healthier and more vibrant person.