What’s Happening

What to eat when exercising

I love seeing clients embrace exercise as a fundamental part of their lifestyle. A common challenge I often talk with clients about is striking the right balance between the amount of exercise, and the amount and type of nutrition; especially when wanting to lose weight. I often find myself encouraging clients to eat more to enhance their workouts and overall results. It can feel counterintuitive because many people associate eating less with weight loss, but proper nutrition is crucial for fueling workouts, aiding recovery, and ultimately supporting a sustainable weight loss journey. By focusing on nutrient-dense foods and timing meals and snacks around exercise, you can boost your energy levels, improve performance, and achieve better results.

‍

Behind Pre- and Post- Workout Nutrition - what Science tells us.

Pre-workout nutrition is super important for getting your body ready for exercise. It gives you the energy and nutrients needed to perform at your best. The main goals of pre-nutrition are to boost your energy levels, keep you hydrated, and support your muscles.

TIP: Try to eat a meal 3-4 hours before your workout or have a snack about an hour before to give your body time to digest.

Post-workout nutrition is all about recovery. After a workout, your body needs to replenish energy, repair muscle tissue, and recover.

TIP: aim to refuel properly within 30 minutes to 2 hours after your workout.. This helps you bounce back quicker and get the most out of your workout.

Let's take a look at each of the macros needed for exercise. Oh, the 3 macros are simply carbohydrates, protein and fat.

‍

Carbohydrates

Carbohydrates are your body's preferred source of energy during exercise, especially high-intensity activities like lifting weights or running (1). In your pre-workout meals (at least 3-4 hours before exercise) aim to include complex carbohydrates like whole grains, fruits, and vegetables, which provide sustained energy without causing rapid spikes and crashes in blood sugar levels. Examples could include:

Porridge with low fat milk and fruit. Your body will digest the carbs in this combo slowly, keeping your blood sugars steady and you feel energised for longer.
Fruit and yoghurt smoothie: liquids are easy to digest, so you won’t feel sluggish during your workout. Many store-bought versions are high in added sugar so make your own with high-protein yoghurt, berries and banana for energy-boosting carbs. Blend with milk, a tablespoon of oats and enjoy.
Brown rice with tuna and vegetables. This is a great lunch option if you’re planning to hit the gym on the way home from work. The brown rice and veg provide slow-digesting carbs for sustained energy, while tuna offers lean protein to fuel your muscles and aid in recovery.

‍

If you’re having a snack before a workout (at least 1 hour prior) you should choose easily digestible foods that won't weigh you down or cause digestive discomfort during your workout. Examples could include:

Bananas, these are high in easily digestible carbohydrates and potassium, which help maintain muscle function.
Greek yoghurt with honey, this provides protein and easily digestible carbs. Honey adds quick energy without weighing you down.
Rice cakes with peanut butter, salmon or cottage cheese. Rice cakes are light and easily digestible, while the suggested toppings add a bit of protein and fat for sustained energy.

‍

How much carbohydrate do you need?

The amount of carbohydrates you need varies based on the frequency, type, duration, and intensity of your physical activity. Competitive athletes typically require more carbohydrates than the average gym-goer to match their higher activity levels.

If you engage in physical activity at the recommended levels (150 minutes of moderate activity or 75 minutes of high-intensity activity, plus two muscle-strengthening sessions per week), you can follow general healthy eating guidelines (2). This includes basing meals on starchy carbohydrates and choosing wholegrain and higher fibre options whenever possible. If you’re wanting to quantify this in terms of grams of carbohydrate, the suggested intake would be around 3-5 grams per kilogram of body weight per day (1). For example, if you’re 80kg, that's 240-400g of carbs per day.

As exercise intensity and duration increases, so does the amount of carbohydrate the body requires. If you were following a moderate exercise program, the intake should be 5-7 grams of carbohydrate per kilogram. And if you were doing high-intensity activities of reasonable duration (60 - 90 minutes or more), you would require 6-10 grams of carbohydrate per kilogram: up to 800g per day, if you’re 80kg.

‍

For all of those doing high-intensity exercise for prolonged durations - marathon runners I’m looking at you - the recommended intake is 8-12 grams per kilogram of body weight (1).

‍

Have a look at the table below for how much carbohydrate is in the quantities you might be eating.

Food	Serving Size	Carbohydrate content (g) per serving size
Wholewheat pasta (boiled)	180g	49.5
Couscous	150g	56.3
Rice, wholegrain (boiled)	180g	52.6
Baked potato with skin	220g	49.7
Wholemeal bread	80g	33.6
Banana	100g	20.3
Crumpet, toasted	50g	22.7
Brown rice cakes	18g	14
Sweetcorn	80g	11.1
Broccoli	80g	2.8

‍

Protein

Including protein in your pre- and post- workout meals or snacks helps support muscle repair and growth, reduce muscle breakdown during exercise, and enhance recovery post-workout. Aim to include a source of lean protein such as chicken, beef, fish, tofu, or high protein yoghurt in your pre-workout meal to provide amino acids that fuel your muscles and promote optimal performance.

‍

How much protein do you need?

The current protein recommendations for the general population are 0.75g of protein per kg of bodyweight per day for adults, and most people are already consuming more than this. Therefore, if you are active within the current guidelines of 150 minutes of moderate-intensity activity per week (2), you likely do not need to eat extra protein. However, if you have had weight loss surgery or are taking weight loss medications such as Saxenda (Liraglutide), you will need at least 1g per kg of your current weight, or closer to 1.5g per kg of protein at your adjusted body weight. If you regularly participate in sports and exercise, such as training for a running or cycling event or lifting weights, your protein needs may be slightly higher again to promote muscle tissue growth and repair.

For strength and endurance athletes, protein requirements range from 1.2-2.0g of protein per kilogram of bodyweight per day. The American College of Sports Medicine (ACSM) recommends not only focusing on total protein intake but also on protein timing (3). High-quality protein should be consumed throughout the day, particularly after key exercise sessions and around every 3–5 hours over multiple meals, depending on individual requirements.

Timing of protein consumption is crucial for recovery after training. It is recommended to consume 15-25g of protein, along with some carbohydrates, within 30 minutes to 2 hours after training (3). While protein supplements can be convenient for meeting protein needs around exercise, they cannot provide all the different components found in protein-rich foods. Therefore, a ‘food first’ approach is best. For example, a whey protein shake contains around 20g of protein, which can also be obtained from half a chicken breast or a small can of tuna. For more information refer to the table below.

Food Source	Serving Size	Protein Content (g) per Serving Size
Chicken breast grilled	120g	38.4
Salmon fillet grilled	120g	29.5
Rump steak grilled	130g	40.3
Tuna canned in brine	60g	15.0
Baked beans	200g	10.0
Almonds	20g	4.2
Eggs	120g	16.9
Half fat cheddar cheese	30g	9.8
Trim milk	200ml	7.0
Broccoli	80g	2.8

‍

Healthy Fats

Don't overlook the importance of healthy fats. Fat is crucial for the body in small amounts, but it is also calorie-dense. Excessive fat consumption can lead to a surplus in calorie intake, potentially resulting in weight gain, which is a concern if you’re trying to manage your weight.

The type of fat consumed is equally important. Research indicates that replacing saturated fat with unsaturated fat in the diet can lower blood cholesterol levels, thereby reducing the risk of heart disease and stroke (4). Fat-rich foods typically contain a combination of saturated and unsaturated fatty acids, but it is better to choose foods that are higher in unsaturated fats and lower in saturated fats. Sources of healthy fats include nuts, seeds, avocados, or olive oil. Add these to your meals and snacks to help provide sustained energy and enhanced satiety, keeping you fuelled throughout your workout.

That brings us to the end of the macros. But what about fluid?

‍

Hydration

Staying properly hydrated is key for exercise performance and recovery. Make it a habit to drink water throughout the day before your workout, and have some fluids with your pre-workout meal or snack to ensure you’re hydrated. Skip sugary drinks and too much caffeine, as they can dehydrate you and affect your performance.

The more you sweat, the more you need to drink. On average, people lose about 0.5 to 2.0 litres of sweat per hour during exercise. For those who are very active, it’s vital to manage hydration around training by drinking fluids before, during, and after exercise. Generally, you should aim to drink about 1.25-1.5 litres of water for every kilogram of body weight lost through sweat (1). For intense workouts lasting over 60 minutes, consider drinks with carbohydrates and electrolytes, like sodium, to replenish energy and sodium lost through sweat. This is especially important for activities like marathon running, rugby, or endurance events like IronMan or Coast to Coast.

Ramping up your exercise is exciting! If you're looking for additional support in creating a personalised nutrition plan, consider scheduling a consultation with one of our experienced dietitians at rfynd.

‍

By Kylie Russell, Dietitian at rfynd.

‍

Get in touch with us

‍

Why is it so hard to lose weight? What is metabolic adaptation? (Part 1/2)

Kylie Russell and Dr Peter Carr-Boyd

Ever wondered why you can lose weight to a point, but then it all goes back on, and then some?😩 If so, you need to understand ‘metabolic adaptation’. And to do this, we’re going to need to take a quick review of the science.

Let's get our nerd on and dive into some science to understand why losing weight is more complex than just cutting calories. The first law of thermodynamics tells us that energy in a closed system can’t be created or destroyed, only transformed from one form to another. This principle is often cited by proponents of the calories in/calories out theory, suggesting that reducing calorie intake should directly lead to weight loss. However, the human body isn't a simple closed system. While we do consume and expend energy, our bodies also store it, and this storage mechanism—along with metabolic adaptation—complicates weight management.

Consider how our bodies store energy. After consuming food, once glycogen stores are replenished (glycogen being a readily available energy source that can be quickly converted to glucose), excess energy is stored as fat. This is an evolutionary adaptation designed to help us survive during periods of food scarcity. Unfortunately, this efficient fat storage means that if we don’t use these reserves, over time, they can lead to weight gain.

Many diets claim that adhering to the principle of reducing energy intake through various strategies—like calorie counting, portion control, or intermittent fasting, will lead to sustainable weight loss. So ofcourse it's natural to think that cutting back on calories would prompt the body to burn stored fat for energy, leading to weight loss. The reality is more complicated as we all know. You might have tried several of these methods and seen some initial success, but what often happens?

‍

Why does the weight go back on?

When we restrict our energy intake, a series of homeostatic and metabolic adaptations begin including changes in mitochondrial efficiency (the body’s energy power stations)², and alterations in the levels of circulating hormones¹. These are designed to prevent the body from shedding all its energy stores. Remember, from an evolutionary sense, we need to be ready for the next famine so we try very hard to hang on to energy. This is called metabolic adaptation and refers to the body's way of adjusting its energy expenditure in response to reduced calorie intake and weight loss.

‍

So what happens when we try to lose weight?

Your body slows down its Resting Metabolic Rate (RMR) which is the amount of energy the your body expends at rest to maintain basic physiological functions like breathing, circulation and cell production.
Your body increases its energy efficiency, meaning it requires fewer calories to perform the same activities. Would be great if your car did this, but not great if you’re trying to lose weight.
The level of certain hormones that regulate hunger and energy expenditure in your body change. For example, Leptin levels drop which increases your appetite, while ghrelin levels rise, which stimulate hunger. That’s right, we get more hungry!

‍

The extent of these changes depends on several factors.

1. The length of the caloric-restriction period, with longer durations leading to greater adaptations.

2. The size of the energy deficit, with larger deficits triggering more substantial homeostatic responses.

3. The initial body composition, with lower body fat levels before the intervention causing more pronounced metabolic adaptations^3,4..

‍

But why does the body do this? Isn’t weight loss a good thing if I’m living with excess weight?

To answer the second question first, absolutely it is! Especially in today's society with such high rates of overweight and obesity. We know that if we have excess weight, even small to moderate amounts of weight loss can improve our health. For example, 5% to 10% weight loss is associated with improvement in glycaemic control, systolic and diastolic blood pressure and cholesterol profiles. If you lose 10% to 15%, this can result in improvements in sleep apnoea and non-alcoholic steatotic hepatitis (NASH)⁵. If you are overweight or obese and you lose more than 15% of your weight, the benefits can be greater again. There is evidence to say you are likely to even live longer! But the point is, any improvement towards a healthy weight is fantastic for our health.

‍

Now, to answer the first question: Why does the body do this? And why does the body not want to be in a healthy weight range and resist weight loss? The answer is due to our evolutionary past. Not surprising, natural selection favoured those who survived famines, and over thousands of years, this shaped our genetic make-up⁶. That’s right, our genes control our weight a lot! In today's environment with food-a-plenty, this once beneficial trait now contributes to weight gain. Simply put, our ancient saviour has become our modern issue. Another reason lies within the brain region called the "hypothalamic feeding centre”. This area of the brain has direct line communication with our organs and regulates food intake^7,8. The hypothalamus in our brain receives signals from hormones (like leptin, ghrelin, and insulin) from the gut and adipose tissue, in addition to neural input from the vagus nerve. It uses this information to establish an energy reserve set-point and also a “weight” set point. This energy reserve is mainly in adipose tissue with some as glycogen^9,10. When there is variation away from the set-point, most pronounced when energy stores go down, the hypothalamus directs our behaviour, often in the form of seeking more food. You may be thinking then why does this system allow weight to be gained if it’s unhealthy? The hypothalamus is less concerned with excess energy: for thousands of years of human evolution, it never really had to. It eventually adjusts the set point ‘up’ and the body then defends a higher weight.

‍

What hope is there then for me to lose weight and keep it off?

Don’t panic. Although we now understand that we are fighting against our own biology to lose weight, there are nutritional and exercise strategies that can be used to address these adaptations to body mass loss. Check out our blog here (hyperlink to ‘Strategies to tackle metabolic adaptation’).

‍

This said, we need to be realistic about how much weight loss we can achieve on our own. The LOOK AHEAD study is the largest study looking at lifestyle interventions for weight loss in patients with diabetes (11). Whilst weight loss was 8.6% at one year, this was only 4.7% at 8 years. At rfynd, we recommend a great place to start is our Essentials program (hyperlink to this webpage), where you receive dietitian advice, regular coaching support, and access to 4000+ exercises through our partners at Centr. But if you’ve already had a couple of serious weight loss attempts using these supports, you may want to consider complementary therapies such as weight loss medications or surgery (link to webpages). Check out our other blogs to see if these might be right for you. Also, feel free to complete the quiz today to see if you qualify (CTA quiz).

‍

By Kylie Russell, Dietitian and Dr Peter Carr-Boyd, Surgeon

Lifestyle Strategies to tackle metabolic adaptation. (Part 2/2)

Kylie Russell and Dr Peter Carr-Boyd

This is part two of our discussion on Metabolic adaptation. Link here for part one.

‍

To develop effective strategies for combating the weight-regain effects of metabolic adaptation during weight loss, we need to address the primary issues: increased hunger and decreased energy expenditure¹. Nutritional strategies like high protein intake, fibre and low glycaemic index have shown promise in supporting sustained and successful weight loss. Increasing physical activity is crucial too for maintaining diet-induced weight loss and minimising the body's compensatory responses².

‍

The rate of weight loss matters

The rate of weight loss is important in minimising metabolic adaptations and other undesirable effects during caloric restriction. Moderate-to-slow rates of weight loss are suggested to lead to greater fat mass (FM) reductions and less decline in fat-free mass (FFM) and resting energy expenditure (REE) compared to rapid weight loss³. We know that rapid weight loss may negatively impact on specific health biomarkers⁴, although it could improve others^5,6 . A recent systematic review found that gradual weight loss was associated with greater reductions in FM and body fat percentage, as well as better preservation of REE⁷. So, although those very-low-calorie-diets (VLCD) may work in the short-term, they will be triggering metabolic adaptation mechanisms, which means you need to be careful.

‍

Protein

Increased appetite during energy restriction is largely due to FFM loss, which increases central signalling (through hormones like leptin) for hunger⁸. Protein is the most important macronutrient for maintaining FFM and overall health, especially during dietary restrictions⁹. To maintain or increase LBM (lean body mass), muscle protein synthesis (MPS) must exceed muscle protein breakdown (MPB). And without adequate dietary protein intake, the body cannot achieve this¹⁰. In addition to maintaining LBM, it's known that protein has a satiating effect¹¹ and a higher thermic effect after consumption¹². Therefore increasing protein intake can help reduce hunger and appetite during dietary restrictions, as well as preserve LBM.

‍

Exercise

Exercise plays a crucial role in maintaining FFM and sustaining energy expenditure (EE) during weight loss. In a randomised controlled trial by Verreijen et al.¹³, 100 overweight participants followed a 10-week hypocaloric diet with either high-protein (1.3 g/kg) or low-protein (0.8 g/kg), combined with or without resistance exercise. Only the group combining high protein intake and resistance exercise significantly preserved FFM. A recent meta-analysis¹⁴ further supports this, showing that resistance exercise slightly outperforms endurance and aerobic exercise in boosting EE.

‍

Carbohydrate and fat

When aiming to reduce metabolic adaptation and prevent weight regain, the carbohydrate-to-fat ratio in a diet is thought to play a role. The glycaemic load (GL) of a diet, which combines the glycaemic index (GI) of individual foods on a meal (the effect of food on blood glucose levels¹⁵), has been linked to health outcomes¹⁶. High-GL diets can cause insulin spikes that increase food cravings, potentially leading to overconsumption and weight gain and re-gain, supporting the "carbohydrate-insulin" model of obesity¹⁷.

‍

Studies comparing low-carbohydrate (LC) and low-fat (LF) diets show mixed results. One trial found more weight loss with LC diets due to glycogen and water depletion but noted long-term adherence was tough for both groups¹⁸. Another study by Ebbeling et al. compared LF, low GI, and LC diets, revealing that diet type significantly affects metabolism during weight-loss maintenance¹⁹. The LF diet led to changes that predicted weight regain, while the LC diet improved energy expenditure but increased stress markers like cortisol and CRP. The low-glycaemic index (low GI) diet provided similar metabolic benefits as the LC diet without raising stress and inflammation. Thus, focusing on reducing glycaemic load rather than dietary fat may be more effective for weight-loss maintenance and resisting metabolic adaptation.

‍

Fibre

Epidemiological studies indicate that higher fibre intake is associated with better body mass control, increased satiety, and lower overall food intake²⁰. High-fibre foods generally have a high satiety index due to longer chewing times and low energy density²¹. High-fibre meals can also increase satiety by modulating postprandial concentrations of anorexigenic (hunger reducing) peptides like GLP-1 and PYY²³ and slowing gastric emptying rates (72).

Fibre intake may remodel gut microbiota, affecting food intake regulation and overall health, though more research is needed²⁴. None-the-less, increasing dietary fibre can lower diet energy density and allow for larger food volumes without significantly increasing calories, making it a useful tool for achieving an energy deficit and potentially mitigating metabolic adaptation effects during weight loss. Check out our blog dedicated to fibre here (hyperlink to blog titled ‘The benefits of high-fibre foods for weight management’).

‍

By Dr Peter Carr-Boyd, Surgeon and Kylie Russell, Dietitian at rfynd.

‍

The Benefits of High-fibre Foods for Weight Management

When trying to improve your food and weight, it's easy to get caught up in the latest fad diets and trendy supplements. However, one simple and effective strategy that often gets overlooked is increasing the intake of high-fibre foods. Fibre is an essential nutrient that offers a wide range of health benefits, including aiding in weight management.

‍

Understanding Fibre:

‍

Fibre is a type of carbohydrate found in plant-based foods such as fruits, vegetables, whole grains, nuts, seeds, and legumes. Unlike other carbohydrates, fibre cannot be broken down by the body's digestive enzymes, so it passes through the digestive system relatively intact. There are two main types of fibre: soluble fibre, which dissolves in water and forms a gel-like substance, and insoluble fibre, which does not dissolve in water and adds bulk to the stool. Both types of fibre play important roles in supporting digestive health and overall well-being.

‍

Promotes Satiety and Fullness:

‍

One of the key benefits of high-fibre foods for weight management is their ability to promote feelings of satiety and fullness. Fibre-rich foods take longer to digest, which helps to slow down the emptying of the stomach and prolong feelings of fullness after a meal. This can lead to reduced hunger and decreased calorie intake throughout the day, making it easier to control portion sizes and avoid overeating. Studies have shown that increasing fibre intake is associated with lower body weight and reduced risk of obesity over time.

‍

Regulates Blood Sugar Levels:

‍

Another important benefit of high-fibre foods is their ability to help regulate blood sugar levels. Soluble fibre slows down the absorption of sugar into the bloodstream, preventing rapid spikes and crashes in blood sugar levels. This can help stabilise energy levels and reduce cravings for sugary foods, which can contribute to weight gain. By promoting steady blood sugar levels, fibre-rich foods can also help prevent insulin resistance and reduce the risk of type 2 diabetes, a common complication of obesity¹.

‍

Supports Digestive Health:

‍

In addition to aiding in weight management, high-fibre foods also support digestive health. Insoluble fibre adds bulk to the stool and helps to prevent constipation by promoting regular bowel movements. Soluble fibre acts as a prebiotic, feeding the beneficial bacteria in the gut and promoting a healthy balance of gut microbiota. A healthy gut microbiome has been linked to a reduced risk of obesity and metabolic syndrome, further highlighting the importance of fibre-rich foods in supporting overall health and well-being².

‍

Examples of High-Fibre Foods:

‍

Now that we understand the benefits of high-fibre foods, let's take a look at some examples that you can incorporate into your diet:

Fruits: Berries, apples, pears, oranges, and bananas.
Vegetables: Broccoli, spinach, kale, carrots, and Brussels sprouts.
Whole Grains: Oats, quinoa, brown rice, barley, and whole wheat bread.
Legumes: Lentils, chickpeas, black beans, kidney beans, and edamame.
Nuts and Seeds: Almonds, chia seeds, flaxseeds, pumpkin seeds, and sunflower seeds.

‍

Tips for Increasing Fibre Intake: Here are some tips to help you increase your fibre intake and reap the benefits for weight management:

Start slowly: Gradually increase your fibre intake to allow your body time to adjust.
Choose whole foods: Opt for whole fruits, vegetables, grains, and legumes rather than processed foods.
Read labels: Check the nutrition labels on packaged foods to choose options that are high in fibre.
Snack on fruits and vegetables: Keep fresh fruits and vegetables on hand for convenient and nutritious snacks.
Experiment with new recipes: Try new recipes that incorporate fibre-rich ingredients to keep your meals interesting and satisfying.

‍

So why not start today with our Wellness Essentials Program? Experiment with new recipes courtesy of our partnership with Centr. On the app you’ll have access to over 1000 health and delicious recipes that have the full nutrient breakdowns. Get inspired and make fibre a priority in your diet. Your body will thank you for it!

‍

By Kylie Russell, Dietitian at rfynd.

‍

Find your happy weight: Get Started

What is obesity?

Dr Peter Carr-Boyd and Dr Cinthia Riguetto

Hi! Let's start by getting on the same page about what obesity really means. Clearing up any confusion is crucial for understanding your own situation and helping others.

‍

Obesity is more than just a number on the scale, it is a chronic multifactorial disease. This means it often persists for years and is caused by a multitude of interplaying factors such as gender, genetics, home and work environments, economic status, physical activity, stress, and nutrition. It’s not simply what you eat!

Obesity is defined by excess body fat typically measured as a Body Mass Index (BMI) greater than 30 kg/m2. The healthy range is considered 18.5 to 24.9kg/m2. It’s simple to calculate: divide your weight in kilograms, by your height in metres squared.

‍

For example: a 90kg person who is 160cm tall has a BMI of: 90kg / (1.6m x 1.6m) = 35kg/m2.

‍

Different BMI cut-off points may be more appropriate based upon gender, race, ethnicity, and menopausal status. For example, among Asians, a BMI >23 kg/m2 may indicate pre-obesity, a BMI >27.5 kg/m2 may indicate class I obesity. Body composition studies to determine the percentage of body fat, and Dual X-ray Absorptiometry to determine the distribution of fat is far more accurate, but is not routine in most clinical practice. Furthermore, most clinical studies on obesity and weight loss interventions use BMI.

‍

Obesity is a ‘disease’ because excessive body fat results in functional and/or structural abnormalities resulting in increased risk of developing a vast array of medical complications and increasing the risk of dying. Body fat is stored in cells called adipocytes. Termed “adiposopathy “or “sick fat”, excess body fat can lead to endocrine and immune dysfunctions and contribute to many diseases such as type 2 diabetes, high cholesterol, cardiovascular disease, cancer, gallstone formation, fatty liver disease, gout, kidney stones, polycystic ovarian syndrome and hypogonadism in men. Excessive body fat can also cause physical stress to other body tissues due to damaging physical forces. This is termed “fat mass disease”. This may contribute to: congestive heart failure, varicose veins, blood clots and stroke, obstructive sleep apnea, immobility, osteoarthritis of the knees and hips, low back pain, impaired balance, hernias, gastro-oesophageal reflux, the list goes on…

Although it's common to manage these conditions individually—such as by taking blood pressure medication or diabetes drugs—it's essential to address the root cause, which is often obesity, to achieve more effective and comprehensive treatment.

We know now that the problem with obesity centres on excess body fat and its effects on every organ system. So why is treating obesity so hard? Please see our blog on metabolic adaptation (Link) which dives into this topic, but cutting calories and exercise doesn’t guarantee weight loss because your body fights to keep the weight on. Your fat tissue and biology work against you here, and most people regain the weight even if they were able to lose some weight. Genetics, our home and work environments play a big role in this process also, influencing both how much you eat and how much energy you use. Whilst nutrition and exercise are important, they are often not enough for treating obesity.

‍

People gain weight for many reasons and while focusing on preventing obesity with healthy habits like eating well, exercising regularly, getting enough sleep, and avoiding harmful substances is really important, these strategies by themselves often don’t result in significant sustainable weight loss for most people with obesity.

‍

Weight loss is not just about willpower! And willpower isn’t an infinite resource. Your body's drive to store and re-store energy levels, especially after dieting, eventually overrides most people's efforts to keep the weight off. This is a physiological and adaptive human response. For the vast majority who cannot manage to lose weight and keep it off, treatments including weight loss medications including GLP-receptor agonists (liraglutide, semaglutide, and tirzepatide, for example) and/or bariatric surgery can be an option for patients, as these interventions target the hormones that are dysfunctional in people with obesity, with surgery also offering additional mechanical, and with some procedures, absorptive restrictions.

‍

Obesity is an escalating global issue, and recognizing it as a chronic disease is the crucial first step toward addressing it effectively.

‍

By Dr Peter Carr-Boyd, Surgeon and Dr Cinthia Riguetto, Endocrinologist.

‍

Managing the Side Effects of Weight-Loss Medications

Weight loss medications can be a valuable tool in achieving your health goals, but like any medication, they can come with side effects. Many people simply stop taking the medications because they don’t have the knowledge or support to manage these challenges as they commence treatment. Understanding the side effects and how to manage them can help you stay on track. Let’s dive into some common side effects associated with GLP-1 receptor agonists (GLP-1s) and practical tips to manage them.

Nausea and Vomiting

Nausea and vomiting are frequent side effects when starting GLP-1s and other weight loss medications. These symptoms are usually temporary and tend to improve as your body adjusts.

Tips to Manage Nausea and Vomiting:

Start Low, Go Slow: Begin with a lower dose and gradually increase it as your body adapts. This approach can help minimise nausea.
Eat Small, Frequent Meals: Instead of large meals, opt for smaller, more frequent meals to ease digestion. For example, try having five to six small meals throughout the day.
Anti-Nausea Medications: Sometimes, over-the-counter or prescription anti-nausea medications may be necessary. Consult your healthcare provider for recommendations.

Diarrhoea

Diarrhoea can occur, particularly when you first start taking GLP-1s.

Tips to Manage Diarrhoea:

Stay Hydrated: Ensure you drink plenty of water to prevent dehydration. Herbal teas and clear broths are also good options.
Avoid Fatty and Spicy Foods: These can exacerbate diarrhoea. Opt for bland foods like plain rice, bananas, and toast until symptoms improve.

Headaches

Headaches are another possible side effect and can be managed with simple strategies.

Tips to Manage Headaches:

Hydrate: Drink plenty of water throughout the day. Dehydration is a common cause of headaches.
Regular Meals: Maintain regular eating schedules to keep your blood sugar levels stable.
Pain Relievers: Over-the-counter medications like paracetamol can help relieve headaches.

Hypoglycaemia (Low Blood Sugar)

GLP-1 medications can sometimes lower blood sugar levels, particularly if you're also taking other diabetes medications like insulin.

Tips to Manage Hypoglycaemia:

Monitor Blood Sugar: Regularly check your blood sugar levels, especially if you’re on other diabetes medications.
Carry Sugar: Always have a source of sugar, such as glucose tablets or a small juice box, to treat low blood sugar episodes quickly.

Injection Site Reactions

GLP-1 medications are administered via injection, which can cause reactions at the injection site.

Tips to Manage Injection Site Reactions:

Rotate Injection Sites: Change the injection site with each dose to reduce irritation. For instance, alternate between your abdomen, thigh, and upper arm.
Change Needles Regularly: Use a new needle for each injection to minimise the risk of irritation and infection.

Other Potential Side Effects

Weight loss medications may also have less common side effects, including constipation, abdominal discomfort, gallbladder disease, or allergic reactions.

General Tips:

Monitor Symptoms: Keep track of any new or unusual symptoms and report them to your doctor promptly.
Stay Informed: Discuss potential side effects with your healthcare provider and know what to look out for.

By being proactive and informed, you can effectively manage the side effects of weight loss medications and stay on track towards achieving your health goals. Remember, always consult with your rfynd team for personalised advice and support.

‍

By Dr Cinthia Riguetto, rfynd Specialist Endocrinologist

‍

Bariatric Surgery for weight loss, metabolic health or both

What is Bariatric Surgery?

Bariatric surgery, commonly referred to as weight loss surgery, involves reducing the size of the stomach or bypassing a portion of the digestive tract. Simply put, these procedures limit food intake and decrease the absorption of nutrients, ultimately leading to weight loss.

You may have also heard this type of surgery referred to as ‘Metabolic’ surgery. This is because bariatric procedures not only lead to weight loss but also have profound effects on metabolism. These surgeries can alter hormonal and neural signalling, improve your gut microbiome, and alter metabolic pathways in the body. For instance, procedures like sleeve gastrectomy and gastric bypass have been shown to affect gut hormones such as ghrelin, leptin, GLP-1 and peptide YY, which play crucial roles in appetite regulation and energy balance. Additionally, these surgeries can improve insulin sensitivity and glucose metabolism, leading to remission or improvement of type 2 diabetes in many patients. As a result, the term "metabolic surgery" is often used to reflect the broader metabolic changes that occur as a result of these procedures, emphasising their impact beyond just weight loss.

Why might you consider bariatric surgery?

The primary goal of bariatric surgery is to help individuals lose weight and improve their overall health. Obesity is a major risk factor for many chronic conditions, and weight loss surgery can significantly reduce these risks. Beyond weight loss, bariatric surgery can lead to improvement or resolution of obesity-related diseases, such as diabetes, fatty liver disease and high blood pressure, making it a life-changing procedure for many. Patients often choose bariatric surgery, compared to medical and endoscopic options, because of the greater and longer-lasting impact on weight and obesity-related diseases.

Recent international guidelines recommend bariatric surgery for individuals with a body mass index (BMI) of 35 or higher, or for those with a BMI of 30 or higher who have weight-related health conditions like type 2 diabetes, hypertension, or sleep apnea.

Types of Bariatric Surgery

There are several types of bariatric surgery offered by rfynd, each with its own advantages and considerations:

Sleeve Gastrectomy: In this procedure, a large portion of the stomach is removed, leaving a banana-shaped tube. This limits food intake and reduces the production of the hunger hormone Ghrelin, making patients feel full with less food. Average total weight loss is around 30% at 3 years.. It has a proven improvement in survival as well as reduction of weight associated diseases. The procedure is simpler to perform when compared with a gastric bypass with less risk of operative complications and nutritional deficiencies. It’s important to remember that the procedure is non-reversible. It also has a higher risk of weight regain compared to gastric bypass procedures. It may not be suited for patients with severe reflux as these symptoms can be made worse by this surgery.
Gastric Bypass Surgery: These procedures reduce the size of the stomach and bypasses a section of the intestinal tract. The excluded stomach is not routinely removed thus the procedures are technically reversible. There are two common forms of gastric bypass procedures. The ‘One Anastomosis Gastric Bypass’ and the ‘Roux-en-Y Gastric Bypass’. As the name suggests, the One Anastomosis Gastric Bypass has only one connection (called an ‘anastomosis’) rather than two as for the Roux-en-Y gastric bypass, and is therefore a simpler version of the two. Both have excellent weight-loss results on average compared to other treatment options, with an average 30-35% total weight loss at 3 years. Bypass procedures carry a higher risk of nutritional problems than a sleeve gastrectomy and overall have higher risk of oher complications related to the connections that are created.

What Are the Risks of Bariatric Surgery?

Modern bariatric surgery is safe when compared to other commonly performed operations like gallbladder surgery and other abdominal surgery. Like all surgeries though, bariatric surgery carries risks, including infection, bleeding, blood clots, and complications from anaesthesia. Specific risks related to weight loss surgery include conditions like dumping syndrome (where food moves too quickly through the digestive system), bowel obstruction, hernias, and nutrient deficiencies. Your bariatric surgery team will discuss with you the potential complications of surgery as well as potential alternatives so you can decide whether surgery is right for you.

What to Expect After Bariatric Surgery

After surgery, patients often lose a significant amount of weight, but the recovery process can be challenging. A strict bariatric diet is required, starting with liquids and gradually progressing to pureed foods, soft foods, and eventually solid foods. Patients may experience side effects like nausea, vomiting, and diarrhoea during the early stages of recovery. Bariatric surgery is not a magic bullet that fixes obesity forever, though. Patients require lifelong adherence to dietary and lifestyle changes in order to achieve the best results They also require regular medical follow-ups to monitor for potential complications and ensure optimal health outcomes.

When Weight Loss Surgery Doesn’t Work

In some cases, patients may not achieve their desired weight loss or may experience weight regain after surgery. If this happens, other treatments such as diet adjustments, exercise, or medication may be necessary. Occasionally revision surgery may be required. Weight loss surgery is not a guaranteed solution, but with programs like rfynd that offer comprehensive support with lifestyle changes provided by multidisciplinary team, your chances of longer-term success are higher.

‍

To recap, there are numerous factors to weigh before deciding on bariatric surgery. Here are the things that I think are important to consider:

Commitment to Lifestyle Changes: If you really want to make a positive change in your life, ready yourself for long-term diet and exercise changes. Accept this commitment will fluctuate however; we’re all human, nobody's perfect.
Potential Risks: Understand the surgical risks and possible complications. The risk of surgery ought to be balanced with the risk of not having surgery. This is very individual.
Mental and Emotional Preparedness: Whilst having surgery can be very rewarding physically and emotionally, it can also be challenging at times. Bariatric surgery rarely needs to happen ‘right now’, so you have time to think about whether it’s right for you.
Support System: Having a strong group of family, friends, and healthcare providers will definitely help you on this journey. Gather them up!

‍

By Dr Peter Carr-Boyd, rfynd Surgeon.

‍

Getting Started with Exercise: A Friendly Guide for Beginners

Starting an exercise routine can feel like a big step, especially if you haven’t been to a gym before or used a fitness app. But don’t worry, you’re not alone! Many people feel the same way, and the good news is that you’re taking a positive step towards better health. Let’s break it down into manageable parts to make your journey smoother and more enjoyable.

‍

What to Wear

First things first, let’s talk about what to wear. Comfort is key! Choose breathable, moisture-wicking fabrics that keep you cool and dry. A good pair of supportive sneakers is essential to protect your feet and joints. If you’re unsure about what to wear, many fitness stores have knowledgeable staff who can help you find the right gear. Remember, you don’t need fancy clothes to get started—just something comfortable that allows you to move freely. Always remember to carry a gym towel with you to wipe down the equipment you use for sanitary purposes.

‍

Eating and Drinking Around Workout Sessions

Fueling your body properly is important for a successful workout. Try to eat a balanced meal 1-2 hours before exercising, including carbohydrates for energy and protein for muscle support. Hydration is crucial, so drink water before, during, and after your workout. If you’re exercising for longer periods, consider a small snack like a banana or a handful of nuts to keep your energy levels up.

‍

Safety and Checking with Your Family Doctor

Before starting any new exercise routine, it’s a good idea to check with your family doctor, especially if you have any existing health conditions. Safety should always be a priority, so listen to your body and avoid pushing yourself too hard too soon. Start slow and gradually increase the intensity and duration of your workouts. If you feel unsure, feel free to reach out to any of our coaches who will gladly be of assistance to you.

‍

What to Expect

Starting something new can be both exciting and a bit intimidating. It’s normal to feel a mix of emotions. In the beginning, you might experience some muscle soreness as your body adjusts to new movements. This is completely normal and should subside as you continue to exercise regularly. Speak to your coach about a range of stretches that you could do after your workouts that could help manage your muscle soreness. Remember, progress takes time, and every small step counts. Celebrate your achievements, no matter how small they may seem.

‍

By taking these steps, you’re setting yourself up for a successful and enjoyable fitness journey. Remember, the goal is to find activities you enjoy and to move your body in ways that feel good for you. You’ve got this! 🌟

‍

By Anthony Müller, rfynd Exercise Phsyiologist

‍

How to overcome emotional eating and food cravings

Dr Minthali Price and Kylie Russell

Embarking on a weight loss journey often involves more than just changing what we eat and how much we exercise. It requires a deep understanding of the psychological factors that influence our relationship with food and our eating behaviours, and often involves looking toward our inner thoughts, feelings, and sensations. The good news is, when you are willing to look inward and develop this deeper awareness of what makes you tick, you can take steps to better look after yourself in ways that promote positive health and wellbeing

The Connection Between Emotions and Eating:

For many of us, food is more than just fuel – it's tied to our emotions, memories, social and cultural traditions and experiences. Emotional eating refers to the tendency to turn to food in response to unpleasant emotional experiences with the function of providing ourselves with comfort, soothing, or stress relief, and as a form of distraction. Whether it's reaching for a bowl of ice cream after a bad day at work or indulging in a bag of chips when feeling lonely or bored, emotional eating can sabotage our weight loss efforts and contribute to negative emotional states such as guilt and shame, which in turn may lead to further emotional eating – it can be a vicious, and subconscious, cycle!

Understanding Food Cravings:

Food cravings are intense desires for specific foods, often high in sugar, fat, or salt, that can feel irresistible. While cravings are a normal part of being human, they can sometimes be driven by emotional triggers or physiological factors such as hormonal fluctuations or nutrient deficiencies. Cravings can also be reinforced by environmental cues, such as seeing or smelling a favourite food, which can activate reward centres in the brain and lead to compulsive eating behaviours.

Strategies for Overcoming Emotional Eating:

Understanding your triggers: Identifying the major life events or, more commonly, the daily life stressors that trigger unpleasant or aversive emotional experiences is important in the life cycle of emotional eating. Such triggers could include work stress or conflict, health issues, or financial stressors. It could also be a certain time of day, such as the afternoon slump at work when you feel fatigued, or the period of time after you have navigated the chaos of your kids dinner and bedtime.
Emotional Awareness: Learning to ‘notice and name’ our emotions and then regulate these without immediately turning to food is a crucial step in overcoming emotional eating. Carrying out a daily emotion ‘check-in’ with yourself using an emotion list or chart is a helpful step in increasing your emotional awareness – research indicates that we sometimes only need to ‘name it to tame it’ to get some relief from the heat of an emotion. Journaling and talking to a trusted friend, coach or therapist are also ways to develop your awareness of the underlying emotions driving our cravings and open the door to developing healthier coping strategies.
Emotional regulation: Once we are consciously aware of our triggers and the emotions that arise from these, we can move on to regulating, or managing, the unpleasant or aversive emotions in ways that promote positive health and wellbeing. Engaging in relaxation techniques such as deep breathing or muscle relaxation, or using mindful meditation to ‘ride the wave’ of the emotion can be helpful. Having a go-to list of other forms of distraction is useful, such as engaging in hobbies, reading, going for walk, or calling a friend, or just generally keeping your hands busy doing something else (there will always be chores to be done!). Keeping a list of emotion regulation strategies that work for you in a place where you can see them in times of vulnerability, such as on the fridge or pantry wall, is a top trick that many clients use.
Mindful Eating: Mindfulness involves paying attention to the present moment without judgement, including our thoughts, feelings, and sensations. By practicing mindful eating, we can become more aware of our hunger and fullness cues, as well as the emotional triggers that lead us to overeat. Taking the time to savour each bite, chew slowly, and tune into our body's signals can help us make more conscious choices about what and how much we eat.
Building Resilience: Building resilience involves cultivating coping skills and resources to deal with life's inevitable challenges and setbacks. Engaging in regular physical activity, getting enough sleep, and prioritising self-care activities that bring us joy and fulfilment can help bolster our resilience and reduce our reliance on food as a source of comfort.

Strategies for Overcoming Food Cravings:

Balanced Nutrition: Ensuring that our meals and snacks are balanced and nutrient-dense can help stabilise blood sugar levels and reduce cravings for unhealthy foods. Aim to include a variety of whole foods such as fruits, vegetables, lean proteins, and healthy fats in your diet to support overall health and well-being.
Planning Ahead: Planning meals and snacks in advance can help us make healthier choices and avoid impulsive eating behaviours. Keep nutritious snacks on hand, such as fresh fruit, nuts, or yoghurt, to satisfy hunger between meals and prevent cravings for less healthy options.
Distraction Techniques: When faced with a craving, distracting ourselves with an engaging activity or taking a short walk can help redirect our attention away from food and reduce the intensity of the craving. Finding alternative ways to cope with stress or boredom, such as listening to music, practising a hobby, or spending time with loved ones, can also help diminish the urge to eat.

Navigating the psychological aspects of weight loss, including emotional eating and food cravings, requires patience, self-awareness, and compassion. By understanding the underlying causes of these behaviours and implementing effective strategies for managing them, we can develop a healthier relationship with food and achieve our weight loss goals more successfully. Remember that progress is not linear, and it's okay to seek support from friends, family, or professionals along the way.

At rfynd, we believe in the transformative power of psychological change when individuals are provided with the right support and resources. That's why we offer a comprehensive support system that includes dietitians, health coaches and psychologists to guide and empower our clients on their weight care journey. We believe that sustainable change is not only possible but achievable for everyone.

‍

By Dr Minthali Price, Psychologist at rfynd and Kylie Russell, Dietitian at rfynd.

The Four Mechanisms of Action in Coaching for Lasting Change

Health and wellness coaching is a transformative process that empowers individuals to achieve sustained change in their lives, leading to a biological transformation of mindset and behaviour. This transformation is facilitated through four key coaching mechanisms: fostering growth-promoting relationships, eliciting self-motivation, building confidence, and guiding the process of change. Let's delve into each of these mechanisms and explore how they contribute to lasting change.

‍

Mechanism 1: Growth-Promoting Relationships

At the heart of effective coaching lies the establishment of a growth-promoting relationship between the coach and the client. This relationship is grounded in the principles of humanistic psychology, which emphasise the inherent potential of individuals to be creative, resourceful, and resilient. Rather than viewing clients as broken or needing to be fixed, coaches adopt a strengths-based approach, recognizing the client's capacity to optimise health, well-being, and performance in life and work.

In a safe, nonjudgmental, and invigorating space, skilled coaches help clients discover what they truly want and need. They assist clients in carving away the layers of life's clutter to reveal their best selves, much like Michelangelo's famous quote, "I saw the angel in the stone and carved to set it free." This process involves valuing the client's learning journey more than the coach's expert knowledge, fostering a partnership where both coach and client learn and grow together.

A crucial aspect of this relationship is the coach's mindful presence. Coaches support clients in developing new behaviours and mindsets by facilitating client-directed neuroplasticity, which is the brain's ability to grow, adapt, and change. This involves rewiring the brain by forging new neural connections and networks, a process that can take months or even years to solidify.

Through coaching conversations, clients focus their brain's attentional resources on personal ambitions and growth, enhancing their brain's ability to learn and adapt. In today's distraction-filled world, undistracted attention is a rare and valuable state, enabling the brain to enter an integrated, coherent state where creativity and learning thrive.

Coaching is inherently a creative process, helping clients imagine new possibilities and develop new mindsets. This creativity is supported by seven brain activation states identified by Carson (2010), which include absorbing new information, intense reasoning, envisioning outcomes, brainstorming, experiencing a flow state, and evaluating options to implement action plans.

In essence, coaching relationships engage, arouse, energise, and challenge clients to do the work needed to change their brains. Coaches employ both "doing" skills, such as listening and inquiry, and "being" skills, such as mindfulness, empathy, and authenticity, to promote brain learning and growth.

‍

Mechanism 2: Elicit Self-Motivation

Motivation is a critical driver of change, and coaching helps clients tap into autonomous motivation, which leads to sustainable change. According to Deci and Ryan (2002), motivation can be categorised into two types: external and autonomous. External motivation involves external influences, such as doing something to avoid conflict with others, and is often short-lived.

In contrast, autonomous motivation is future-oriented and aligned with personal values and desired identities. It involves connecting behaviours to meaningful future outcomes or the identity one wishes to project. For example, a client may be motivated to become fit and strong to have the energy to make a difference daily or to prevent future health issues that could burden loved ones.

Autonomous motivation also includes activities that produce flow experiences, where individuals engage in activities they love for their own sake. Although finding such activities can take time, they provide a powerful source of motivation for health behaviours.

Coaches support clients in developing future-oriented, positive identity-based motivation by exploring the "why behind the why." By digging deeper into their motivations, clients can tap into longer-lasting, meaningful reasons for change that sustain them through the challenges of daily life.

Authentic motivation enhances cognitive function, attention, emotion regulation, and creativity, providing a reliable source of energy for the change journey. It taps into intrinsic and biological energy sources, such as the drive to help others, be a role model, and make life meaningful.

‍

Mechanism 3: Build Confidence

While motivation is essential, it must be accompanied by self-efficacy or confidence in one's ability to overcome obstacles. Confidence is built through diligent efforts over time, and small successes contribute to an upward spiral of motivation and confidence.

Many individuals face challenges that have led to failed change attempts, resulting in low self-efficacy or chronic contemplation. Coaches help clients overcome this by leveraging positive emotions to enhance resilience, creativity, and problem-solving.

Coaches also tap into Deci and Ryan's (2002) self-determination theory, emphasising the importance of competence. People are more successful when they apply their strengths, talents, and values, leading to quicker mental processing and creative solutions.

The Transtheoretical Model of Change (Prochaska, 1995) provides coaches with tools to assess client readiness for change, self-efficacy, and processes of change. This model helps clients identify their stage of change and develop personalised plans to navigate challenges.

Coaches engage clients in creative brainstorming and relational flow, generating new insights and increasing hope and optimism. This process empowers clients to find new paths around obstacles and harvest valuable learning from setbacks.

‍

Mechanism 4: Process of Change

The final mechanism involves guiding clients through the process of change, similar to structured projects with strategies, goals, and timelines. Coaching often begins with assessments to track progress, followed by envisioning the ideal future and designing experiments and action plans to achieve goals.

Behavioural or SMART (Specific, Measurable, Actionable, Realistic, and Time-bound) goals provide clear targets for clients to work toward. Clients may set skill-building, performance, or habit-based goals, with regular progress reports and milestones to celebrate achievements. Accountability is a crucial aspect of the change process. Clients determine how they want to be accountable, using tools like mobile apps for tracking and reporting progress. Coaches also connect clients with other health experts and resources as needed.

‍

While coaching sessions may follow a structure, coaching is not formulaic. The heart of coaching lies in relational flow, where both coach and client engage in intuitive, creative exploration. These peak moments lead to shifts in perspective and insights that drive lasting change.

‍

By Margaux Pelletier, Health Coach at rfynd

‍