Dear Dr Jennifer: How do I curb my binges and start losing weight?

Question: I am so fat and out of shape I don’t know where to start. I eat well enough during the day but I binge rubbish at night. I don’t even want to estimate how many calories I take in.

I just cannot stop, and my husband says I need medical help to get it under control. Is there such a thing? Is there a safe pill or something that could curb my urges?

Answer: Ah the quick easy fix — sure if it was out there, we’d all be taking it! The reality is with strict dietary, lifestyle and behavioural modification, a weight loss of 5-7pc of your total current body weight is achievable, with gradual weight loss of 1-2lb per week, but that is often difficult to maintain over time.

The basic tenets involve a low-calorie, low-fat but high-fibre and high-protein diet, with a minimum of 150 minutes of exercise per week, for example brisk walking for 40 minutes a few days per week.

You don’t need to do cardiovascular exercise every day. Your body will thank you for a few rest days every week.

Remember, monitoring your diet is more important. I am a firm believer in weight-resistance training, not just to aid weight loss, but to build and maintain muscle mass over your lifetime.

Much like our metabolism slows with age, roughly by about 2pc per decade, our muscle mass also declines with age. This is really evident when someone fractures a bone and needs to rest the bone, for six or more weeks, to allow bone healing. The muscles around the bones degenerate fast without use.

There are many ways to build muscle and burn fat. One effective way is to ensure you are in a fasting state before you go weight training. That means you must fast for at least two hours before your weight training session. Training first thing in the morning before you eat anything is ideal, as you harness the benefits of your prolonged overnight fast.

Here’s the crunch: you should maintain your fast for about two hours after weight training. Don’t forget to hydrate and maybe enjoy a tea/coffee — but only add a drop of milk, and go without any sugar/sweetener.

When you have achieved your target weight loss, you may then start taking high protein shakes/food after training.

I suggest you do weight-resistance training for only 20 minutes, ideally three days per week, and focus on the buttocks and legs, the largest muscle groups in your body. But remember you must calorie-restrict throughout the whole day in order to lose weight. You cannot out-train a bad diet.

You mentioned that the evening time is your weakest point. It’s common to hear about people who skip breakfast or eat very little all day but make up for lost time at night.

It boils down to healthy eating throughout the day. This will prevent the insatiable hunger in the evening time. You should aim to have three modest healthy meals during the day and eat very little at night.

You should aim to stop eating by 7pm every night and look forward to a decaffeinated drink before bedtime. This needs to become your new lifelong routine.

It sounds like at cliché, but people who manage to cut their calories to 1,600 per day notice weight loss within a few weeks as they start to use their own stored energy within their body. Muscle will break down too and it is difficult to shed the stubborn fat cells, but with determination and professional help you can do it.

Dr Jennifer Grant is a GP with Beacon HealthCheck

Health & Living

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