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Weight Management

Weight Management - Conditions & Treatments | SingHealth

Weight Management - What it is

weight management conditions and treatments

Overweight and obesity is a leading concern in the world, increasing the risk of a wide range of diseases and illnesses including coronary artery disease, type 2 diabetes mellitus, high blood pressure and certain cancers.

The average life expectancy is reduced by up to nine years for an individual who is obese.

A weight loss of 5-10% in obese people can achieve significant health benefits.

Therefore, successful implementation of a weight management programme can have significant and positive impacts on resources and health.

Our Weight Management Programme is a comprehensive, multidisciplinary, coordinated, and closely-supervised
programme.

The programme comprises consultations with an assigned sport and exercise medicine (SEM) physician and a dietitian, and supervised gym sessions with an exercise physiologist. Your SEM physician will screen you for medical and musculoskeletal conditions, mutually agree on goals, and customise a dietary plan and exercise programme for you.

Who should be referred?

Definition of obesity in adults

  1. Body mass index > 27.5 kg/m2 for Asians or > 30 kg/m2 for Caucasians
  2. Waist circumference > 90 cm (male) or > 80 cm (female) for Asians or > 102 cm (male) or 90 cm (female) for Caucasians

Comorbidities that can be improved with weight loss / diet / exercise

  • Diabetes mellitus (DM)
  • Obstructive sleep apnoea (OSA)
  • Fatty liver disease
  • Polycystic ovarian syndrome (PCOS), male hypogonadism
  • Hyperlipidaemia, hypertension
  • Osteoarthritis (OA)
ClinicProgramme/Treatment​Criteria
​Sports Medicine Clinic (Weight Management Programme)​Sports Physician-led Weight Management Programme

​BMI > 23 (overweight and obese) without comorbidities

OR

With comorbidities other than those listed for referral to the Metabolic Clinic

Metabolic ClinicEndocrinologist-led Weight Management Programme

​Has one or more of the conditions below:

  1. DM on insulin or with HbA1c > 9%
  2. Fatty liver
  3. PCOS
  4. Hypogonadism
  5. Ischaemic heart disease
  6. Endocrine conditions needing management (e.g., newly diagnosed thyroid disease)
​Obesity Surgery ClinicBariatric Surgery

​Considering surgery and meets the following criteria:

1. BMI

> 37.5 or > 32.5 with DM / high blood pressure / OSA / fatty liver / hyperlipidaemia / OA knee requiring total knee replacement

AND

2. Weight loss failure

Lost < 5% weight in 3 months or regained weight or unable to exercise


Do I need this Weight Management Programme?

The Weight Management Programme is a closely-supervised programme over six months. Not everyone needs close supervision, and some individuals can lose weight on their own without outside support. If you have attempted to lose weight but found the results unsatisfactory, or do not know where to start in making the change, then joining this programme may be a good next step.

What can I learn from this weight loss programme?

  1. Safe and sustainable weight loss strategies
  2. How to make healthier food choices
  3. Exercise plans to keep fit and lose weight
  4. Skills to prevent weight regain


How much weight can I expect to lose when I enrol in the Weight Management Programme?

Your SEM physician will discuss with you your weight loss targets and determine a mutually agreed target. In most cases, the weight loss target is 5-10% of your starting weight. On average, our patients lose 7.3 kg and shed 8.3 cm off their waistline by the end of our six-month programme.

Note that we report our average results – this gives you a more accurate picture, rather than selectively highlighting the results of only our star performers, which can be deceiving. The rate of weight loss is planned at 0.5 kg to 1.0 kg per week. Most importantly, we equip you with effective weight management tools so that you
continue to lose weight and effectively maintain your weight loss after the programme.

What is the difference between our programme and a slimming centre?

We run a hospital-based weight management programme that is medical evidence-based and designed to achieve fat loss safely and effectively. Being a mainstream healthcare institution, we audit and publish our results, and report them accurately, rather than cite anecdotal results.

I have serious medical conditions and pre-existing injuries. Is it safe for me to enrol in the Weight Management Programme?

Being a medically-based institutional programme, the Weight Management Programme is designed to handle difficult and complex cases which commercial gyms may not be equipped to manage. The programme starts with a medical screening performed by our SEM physicians, to identify existing diseases or injuries.

Our SEM physicians will ensure that your medical conditions will be taken into consideration when diet and exercise are prescribed. Exercises prescribed will be individualised to minimise injury risk and impact to the injured part of the body.

Will the Weight Management Programme take up a lot of my time?

Our programme requires a commitment on your part. This includes a time commitment, especially for the exercise sessions.

Your exercise prescription will be individually-tailored but typically, our patients are expected to exercise 5-7 days a week, up to an hour per session, although this can be divided throughout a day. You will exercise at our gym during supervised sessions with the exercise physiologist. In between these sessions, you are expected to exercise at your own home, gym or neighbourhood.

Will I be taking weight loss drugs?

Generally, we do not use weight loss drugs as a first-line treatment for obesity. Our focus is on the three pillars of weight loss, namely diet, exercise, and increased incidental daily activities.

For patients who lose weight but hit a plateau after some months, we may selectively introduce weight loss drugs after discussion with patients as an adjunct to our three pillars. The majority (80-90%) of our patients go through the whole programme successfully without having to take any weight loss drugs.

What are 5 tips that I can try on my own before I decide on a weight management programme?

  1. Balance food choices
    • Exercise portion control by using a smaller serving plate
  2. Get active
    • Choose a suitable workout programme
    • Achieve at least 300 minutes of moderate exercise a week to lose weight
  3. Build strength
    • Resistance training can help increase your resting metabolism, and improve balance, coordination and posture
  4. Be mindful of what you eat
    • Focus on a diet comprising ‘real food’ – rich in vitamins and minerals, with no chemical additives and mostly unprocessed (e.g., tomatoes, apples, broccoli, whole eggs, salmon, unprocessed meat)
    • Avoid refined grains and go for wholegrain foods
    • Choose food and beverages with no or less sugar
  5. Have regular meals
    • Skipping meals will not help you lose weight; you could end up snacking more throughout the day because you feel hungry
    • Eat breakfast to fill your stomach first thing in the morning

Weight Management - Symptoms

Weight Management - How to prevent?

Weight Management - Causes and Risk Factors

Weight Management - Diagnosis

Weight Management - Treatments

Weight Management - Preparing for surgery

Weight Management - Post-surgery care

Weight Management - Other Information

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth