Week 2 - Eating for weight loss

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Week 1 - Mindset, Goals, Motivation

Week 3 - Cravings

Week 4 - Drinks and Snacks

week 5 - Psychology of Weight Loss

week 6 - YO YO dieting

Week 7 - Activity

Week 8 - Sleep For Weight Loss

Week 9 - Stress

Week 10 - How to maintain weight loss

Introduction

The second week of this series asks the question, “what should I eat to lose weight?”. Spoiler alert - there’s no one best approach, but there are lots of things we can do to change our relationship with food and the way we build our plates to make weight loss more likely and sustainable. We’ll show you how different types of foods affect both our mood and health, and what we can do to make lasting changes to our weight and well-being.

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Written Content

Welcome to week 2 from the Lifestyle Medicine team.

We’re often asked what is the best diet for weight loss. Interestingly, having looked at a lot of recent research, it seems that there is no one best diet for weight loss. Importantly, finding a way of eating that reduces how much high sugar and processed foods you eat as well as high sugar drinks you drink, and more importantly one that you can commit to and enjoy, are key factors to help you lose weight whilst also benefiting your health. This way of eating is suitable long term as it can also help you maintain your weight loss (1).

We’ve written some eating guides that are designed to help you understand a little more about the different eating approaches that support a healthy weight and reduce sugar and processed foods: Low Carbohydrate, Mediterranean and Paleo eating guides. We’ve also created our Boots Online Doctor Core Meal Plan. This combines all the healthy aspects from these eating plans and you can use it as a guide over the first few weeks while you start changing your eating habits. It’s also suitable to follow in the long term.

We’d like to invite you on a journey, to move away from a diet mindset where you’re either “on” or “off” a diet, or being either “good” or “bad”, to change from this old and outdated way of thinking to embrace a new mindset of “eating well for life”.

We don’t expect this to happen overnight; we know that it is challenging to change how you’ve always eaten and that altering your mindset and behaviour patterns will take commitment and determination.

We’re here to support you. We’ve created this series that will not only help you make long lasting changes to your weight, but also to your energy levels and even your mood, plus improving your long term health outcomes.

Take it one step at a time and work through the information at your own pace. You might want to keep a notebook handy for some notes. All you need to do is to start taking some small steps and make one change at a time. We recommend that you download and use our food and symptom diary. Using this diary can help you to gain some insights into how the food and drink you consume makes you feel. Some foods may initially make you feel energised but you may also notice a slump in your mood or energy soon afterwards.

Other foods might keep you feeling full and you may notice that you experience less cravings when you eat these. By noticing how what you eat impacts the way you feel, these insights will help you take control of the food choices you make. In turn, this will help you learn which foods suit you and make you feel satisfied and energised. This can support you to make food choices that help you to lose weight more easily and to feel good.

How to eat

The key to eating for weight loss is to eat food that helps balance your blood sugar levels, keeps you full for longer and balances your energy. When your blood sugars are better balanced you'll notice that you experience less food cravings or energy dips and are less tempted to snack on high sugar foods.

The importance of blood sugar control

Understanding blood sugar balance and how it impacts your eating habits and if you gain or lose weight is a really important concept, so read carefully. When you eat a food, it is broken down into smaller parts (nutrients) and sugars. These are then released into your blood affecting your blood sugar levels.

If you look at the red graph on the left, you can see the impact of eating high sugar, high glycaemic load (GL) foods several times over the course of a day. You can see the blood sugar level is swinging between high and low. On the green graph, on the right side, you can see what happens when you eat low sugar, low glycemic load foods; your blood sugar rises and falls more gently, and stays more balanced.

These graphs show the effect of how the type of food you eat affects your blood sugar over the day. Looking at the red graph on the left side, you can see that when you eat high sugar foods (high GL foods), you have a quick rise in blood sugar as these foods are easily broken down into sugars and absorbed into the blood. This is then followed by a quick fall in blood sugar, creating these spikes.

Some examples of high GL are chocolate, cakes, pasta, fizzy drinks and even white bread and rice.

When high sugar levels circulate in your bloodstream, your pancreas produces insulin in response, to reduce and normalise your blood sugar. High levels of sugar in your blood for long periods of time can cause damage to your blood vessels. If your blood sugar levels become very high, the pancreas can overcompensate by producing more insulin than is needed and so too much sugar is moved out of your blood and into your cells for safe storage and, as we can see from the graph, your blood sugar levels will drop dramatically.

This means you'll feel tired, hungry, irritable, have difficulty concentrating and will find you'll start craving for more high sugar foods and stimulants like coffee to reboot your blood sugar levels.

So you can see that you can end up on a blood sugar roller coaster over the day as your body tries to stay in balance. This blood sugar roller coaster works the pancreas very hard and if you eat a high sugar (high GL) diet over a long period of time you start to become less sensitive to insulin which can lead to insulin resistance, weight gain (2) and ultimately to type 2 diabetes. Symptoms of insulin resistance include experiencing low energy and brain fog and you may find that you need or crave stimulants like sugar and coffee to keep you going. In the long term. This leads to:

weight gain
difficulty losing weight
low energy
low mood
heart disease
high cholesterol

The green side of the chart shows the effect of eating a low sugar (low GL) diet. When you eat this way you're less likely to experience blood sugar imbalances, which will mean you're less likely to have as many cravings. You’ll also notice that you feel fuller for longer, which will help you to eat less with less effort. Eating this way puts less pressure on your pancreas to release insulin and you'll experience more stable blood sugar balance. Energy from what you eat will be released slowly and steadily so you'll find that you'll feel more energised for longer periods of time. As a result you won’t need to eat as regularly and are less likely to get cravings for high energy foods. Take a look at our low carbohydrate diet guidelines to understand more about how to eat in this way. Slow release carbohydrates take longer to break down so the pancreas has longer to react and it can release the correct amount of insulin. This means there are less extreme changes in your blood sugar levels over the day. Releasing sugar more slowly helps you feel full for longer so you can eat less over the day without feeling hungry. So this is great for your weight loss plan and a great way to reset eating habits.

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Written Content

Speed of weight loss

We recommend that you aim to lose weight in a slow and sustainable way, aiming to lose around 1-2 lbs a week. Losing weight quickly means you’re more likely to be losing muscle weight. This can reduce your basal metabolic rate (BMR) and slow down your metabolism. Focus your attention on learning new healthier eating habits that you can enjoy for life. Keeping active while you lose weight, particularly including resistance type exercise (see below), will also help you to maintain your muscle tissue. This means you're less likely to lose muscle weight and more likely to lose weight from your fat stores (3).

Basal Metabolic Rate (BMR)

Your basal metabolic rate or BMR is the rate at which your body uses energy when at rest. Another calculation is needed to provide a personalised daily recommended energy intake for weight loss. This takes into consideration your normal level of activity (Active Metabolic Rate, or AMR). When aiming to lose weight we recommend that you reduce your daily calorie intake by 500 calories (4). To understand your calorie requirements it is important to calculate your BMR - Here is a link to the Diabetes UK BMR calculator - then multiply your BMR number by the level of activity you do (the result is your AMR) to obtain the calorie intake recommended for you to maintain your current weight. Then finally, take off 500 calories from this AMR number to work out a suggested personal calorie requirement for weight loss.

Maintaining muscle mass during weight loss - why this is important

When losing weight, you need to factor in ways to maintain the amount of muscle in your body (your muscle mass). Muscle mass refers to all of the muscle cells in your body including your skeletal and organ (smooth) muscle including your heart (5). Maintaining your muscle mass while losing weight is essential to maintain your BMR and to reduce your risk of rebound weight gain.

Keep active with resistance activity like body-weight squats or simple bicep curls (you can use an improvised weight like a bottle of water or a tin) and aerobic activity like fast walking, or any activity that gets you a little out of breath, to maintain your muscle mass during your weight loss journey. Eating the right amount of protein will also help to preserve your muscle mass. Maintaining (or even increasing) your muscle mass and improving your muscle strength benefits your overall health and metabolism. Having healthy levels of toned muscle can help you to maintain a healthy weight, boost your mobility and reduce age related decline in your health. With activity, start where you are, gradually build up as your stamina and strength increases and seek advice if you're unsure how to begin or what level of exercise is right for you.

Core Meal Plan - Download a copy of our Core Meal Plan

Our core meal plan focuses on eating real, unprocessed food that is naturally low in sugar. The plan also includes small portions of healthy fats, which are essential for overall health and weight loss.

When following our core meal plan you’ll eat 2-3 delicious balanced meals each day. At each meal you’ll be combining a small amount of protein, healthy fats, low sugar vegetables and occasionally fruits. You can also add a small portion of a lower sugar carbohydrate.

We recommend that you eat 2-3 small highly nutritious meals a day. Eating less often can help to reduce the amount of insulin that you produce, which can help with increasing insulin sensitivity and weight loss (6). When it comes to snacking, we advise you to reduce how often you snack. Ideally, only snack when you’re really hungry or when it’s a special occasion.

We recommend that you download and use our “Hunger Scale” to bring awareness to your levels of hunger and to help you with portion size.

How to use the hunger scale to optimise weight loss

Use the hunger scale to help you to learn to tune into your appetite and to only eat when you physically need to. As we’ve mentioned before, people often eat for many other reasons than hunger. Eating because of low energy, low mood, tiredness or boredom are some of the reasons that may trigger you to reach for a snack or some food. For many, these non-hunger related triggers can be one of the root causes of weight gain. It’s useful to understand your triggers, as you may not be eating just because you're hungry or have cravings. This awareness can help you choose healthier ways to meet these needs other than eating. Before you eat make sure that you’re in the hunger scale range of 1 to 4 and that you eat only until you reach between 5-7 on the hunger scale (7). Stop when you’re comfortably full. Follow the attached guide as best you can.

Foods to enjoy and why you should eat them

We recommend that every time you eat that you create a balanced meal by combining the following ingredients.

Protein

We recommend that you add a small, fist sized portion of high protein containing food to every meal. Including protein helps to balance your energy, keeping your blood sugars stable. Eating protein also helps to reduce cravings and increase your sense of fullness. We recommend that you choose lean meats, fish or eggs as animal protein options (if you eat these) and include vegetarian options such as tofu, lentils, beans, nuts and seeds in your regular diet (8). Including variety in your daily and weekly food intake also supports getting a wider range of nutrients and making meals more interesting.

Fats

We recommend that you include some healthy fats in each meal. Aim to have two to three portions of oily fish - such as salmon, sardines, mackerel, trout, or pilchards - a week (if you eat these). Add a tablespoon of extra virgin olive oil, or a small portion of nuts, such as 6 walnut halves, or a ¼ of a cup of mixed seeds (pumpkin, sesame, chia and/or sunflower), or occasionally half an avocado, to each meal. Some of your important vitamins - such as vitamin D and minerals such as calcium - are fat soluble, which means they are only absorbed when you eat some fat (9).

Fats are vital for your body to work effectively. They support cell to cell communication. Essential fats are a type of healthy fats that need to be eaten as our bodies can’t make them (you’ve probably heard of omega 3 which is the most important one). So if you don’t eat them your body will become deficient in these essential fats.

Vegetables and Fruits

We recommend that you fill half of your plate at every meal with lots of colourful veg! The more variety and the more colours the better. Focus on eating vegetables that grow above ground and include as many different colours as possible.

Vegetables that grow below ground (like potatoes and beetroot) contain a lot more natural sugars so it’s best to limit these. Natural vegetable colours are due to phytonutrients. Phytonutrients have many benefits for your body and are naturally created by these fruits and veg (10).

Aim to eat as many different coloured fruit and vegetables as possible across the week. We recommend that you include 5 different vegetables and fruit a day, with more vegetables than fruit. As a challenge, see if you can build up to 30 different vegetables, herbs, spices and fruit in a week. The main thing is to start from wherever you are now and gradually increase the variety of colours and types you eat. Try new vegetables you may not have eaten before - diversity is really important as you’ll then get a variety of phytonutrients in your diet.

Carbohydrates

Carbohydrates' main role in your body is to provide energy (11). As your cells can create energy from any food you eat, as well as from nutrients stored in your body, you only need to eat a small amount of carbohydrates. The best carbohydrates to eat are the low sugar carbohydrates found mainly in vegetables, beans and lentils. These contain slow release energy and will have less of a dramatic effect on your blood sugar than high sugar carbs.

Carbohydrates in the form of grains or starchy vegetables can be included in 1-3 meals a day. If you enjoy potatoes we recommend having potatoes that are lower glycemic options such as 2-3 new potatoes or a small sweet potato. Alternatively you could have 2-3 tablespoons of brown rice, barley, buckwheat or quinoa.

Hydration

Drinking enough water can aid weight loss. One research paper suggests that if you stay hydrated it can help you to burn fat. Interestingly, this research also reported that if you’re dehydrated you’re more likely to gain weight (12).

On average, it is recommended to drink 1.5-2 litres of water a day. How much water do you drink? Are you drinking enough water? Stop and write down your water goal. If you aren't good at drinking water, try setting an hourly alarm on your mobile phone during the day, to remind you to drink a small glass of water when it rings.

If you aren’t keen on drinking water we recommend that you add flavour by adding slices of fruit such as lemon or lime, or try adding a few slices of cucumber or some mint leaves. Or, you can drink some, or all, of your water intake as caffeine-free herbal teas, infusions, or even weak green tea, if you prefer something hot. Mix and match as suits you.

Time restricted eating

Time restricted eating is an eating style that recommends that you restrict the number of hours during which you eat in a 24 hour period. Recent research has found that time-restricted eating is helpful for both long term health and weight loss and in some cases may prevent the onset of type 2 diabetes (13).

Common patterns of eating include 12:12 (where you don’t eat for 12 hours, or have a “12 hour fast” and then can eat during the other 12 hours, also called “a 12 hour eating window” , 14:10, ( where you have a 14 hour fast and a ten hour eating window), and 16:8 (where you have a 16 hour fast and an eight hour eating window).

The recommendation is to eat 2-3 meals during your eating window and to avoid snacking. If you want to try this, start with 12:12 until this feels easy to you, and then you can work up to the longer fast time over a few days or even weeks. Or, it’s fine to keep to 12:12 long term.

Intermittent fasting

Intermittent fasting has been found to be a simple and effective method to support weight loss. When intermittent fasting, you eat ‘normally’ with no calorie restrictions for 4-5 days a week and have very low-calorie days (500-600 calories/day) on the other 2-3 days. We have written a short guide on intermittent fasting that you can read here.

Understanding why you put on weight can help you keep the weight off

An important part of our approach to weight loss is to help you to start to understand yourself and think about your eating habits that have led you to gain weight. Understanding this can help you to interrupt these same habits that led to weight gain and help to make it easier to change your habits and avoid putting weight back on. Changing your snacking and eating habits can mean that you'll lose weight for good. Take part in our quiz - this can help you to start recognising the habits that led you to gain weight.

Our top tips to help you have a great weight loss week

Tip- Menu plan - menu planning can help set you up for a successful weight loss week - it can also be a great way to avoid food waste, saving you money.

Tip- Set an alarm on your phone every hour to remind you to drink some water.

Tip- Use the free Food and Symptom Diary to take stock of your eating habits that may have led you to gain weight. Once you've made a list of habits, check in and ask yourself - Am I ready to make changes to these? We suggest that you pick one, and start with a behaviour that’s easiest for you to change. Any success, however small or easily won, will help motivate you to keep going and make more positive changes.

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References

1. Soeliman FA, Azadbakht L. Weight loss maintenance: A review on dietary related strategies. J Res Med Sci. 2014 Mar;19(3):268-75. PMID: 24949037; PMCID: PMC4061651.
2. Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, Roberts SB. High glycemic index foods, overeating, and obesity. Pediatrics. 1999 Mar;103(3):E26. doi: 10.1542/peds.103.3.e26. PMID: 10049982.
3. Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, Roberts SB. High glycemic index foods, overeating, and obesity. Pediatrics. 1999 Mar;103(3):E26. doi: 10.1542/peds.103.3.e26. PMID: 10049982.
4. Carels R, Young K, Coit C, Clayton A, Spencer A, Hobbs M. Can following the caloric restriction recommendations from the Dietary Guidelines for Americans help individuals lose weight?. Eating Behaviors. 2008;9(3):328-335.
5. Cava E, Yeat NC, Mittendorfer B. Preserving Healthy Muscle during Weight Loss. Adv Nutr. 2017 May 15;8(3):511-519. doi: 10.3945/an.116.014506. PMID: 28507015; PMCID: PMC5421125.
6. Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson CM. Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell Metab. 2018 Jun 5;27(6):1212-1221.e3. doi: 10.1016/j.cmet.2018.04.010. Epub 2018 May 10. PMID: 29754952; PMCID: PMC5990470.
7. Madden CE, Leong SL, Gray A, Horwath CC. Eating in response to hunger and satiety signals is related to BMI in a nationwide sample of 1601 mid-age New Zealand women. Public Health Nutr. 2012 Dec;15(12):2272-9. doi: 10.1017/S1368980012000882. Epub 2012 Mar 23. PMID: 22443858.
8. British Nutrition Foundation - Protein (Link)
9. British Nutrition Foundation - Fat (Link)
10. Liu R. Health-Promoting Components of Fruits and Vegetables in the Diet. Advances in Nutrition. 2013;4(3):384S-392S.
11. Harvard Nutrition Source Carbohydrates (Link)
12. Thornton S. Increased Hydration Can Be Associated with Weight Loss. Frontiers in Nutrition. 2016;3.
13. Cienfuegos S, McStay M, Gabel K, Varady K. Time restricted eating for the prevention of type 2 diabetes. The Journal of Physiology. 2021;600(5):1253-1264.

Meet Our Lifestyle Team

Dr Samantha Wellappili

GMC no. 6122437

Dr Sam is a GP, yoga and nutritional therapist, writer and meditation teacher. She believes in taking a holistic approach to care and is joint Clinical Lead for Lifestyle Medicine with a focus on weight loss.

Ruth Taylor

NMC no. 82K1692E

BANT Registration: TAY0111269

Ruth is a BANT Registered Nutritionist®, health and wellness coach and registered nurse. She is passionate about lifestyle medicine and supporting people to improve their health and quality of life.

Dr Sarah Baker

GMC no. 7042545

Dr Sarah is a GP and trained physiotherapist. Joint Clinical Lead for Lifestyle Medicine, she’s committed to helping patients improve the quality of their health and wellbeing through positive lifestyle change.