As a doctor I see many people who want to reduce their body weight for a variety of reasons including to improve their health, body image or personality. Unfortunately only a few actually achieve their weight goals and succeed in keeping their weight down for prolonged periods. Most have some early gains and then either stop losing weight further or put the lost weight back on despite everything that “they think” they may be doing. They then become frustrated or depressed and sometime totally give up the “battle of the bulge”! Many take solace in food and put on more weight on the rebound. I will put down in this article what I have seen successful weight losers do to achieve their target.

The first part includes some points for you to consider. The second part contains some strategies for weight loss.

Things to consider:

1. As someone said, “failing to plan is planning to fail”! You have got to have a written plan of action to achieve your body weight targets.

a. Set your body weight target (what do you want your body weight to be)- e.g., 10kg less-

   write it down!

b. When do you want to achieve this weight? E.g., in one year’s time 1st March 2021.

c. Put down interim goals – quarterly goals viz 2.5 kg weight loss every 3 months which would be 1 Kg weight loss every month.

Someone also said “the difference between working with a goal and without a goal is…………………….…result”. Consult your doctor and do the necessary tests to certify your cardiac fitness to begin your weight loss programme.

d. You have got to put up an exercise schedule and diet chart. You could consult a dietician to help you plan your meals and the low calorie in-between meal snacks too.

2. “Whatever gets measured, improves” {someone said 🙂 } . Buy a good digital weighing scale and check your weight every Sunday, early in the morning soon after waking, after evacuating your bladder and before you take anything by mouth. You want to definitely do this as half a litre of water taken, will definitely increase your weight by half a kilo! Record each measurement in a book against the date of measurement.

3. You have got to accept that what you have done in the past to reduce weight, just wasn’t enough. You have go to do something quite drastic and consistently to achieve your goals. You would need to cut the calories that you eat as well as increase the amount of exercise that you do (volume of exercise as well as Intensity). This also needs to be documented everyday. You can sum it all up at the end of the week to see how well you have stuck to your plan.

4. If you don’t achieve your weekly goal, be hard on yourself the following week and either go on a stricter/ lesser diet or exercise more or do more of both! Be brutally honest with yourself. Don’t accept excuses for your inability to reach your goal or to follow your own weight loss plan. Achieving these smaller weekly goals will ensure that the larger monthly goals, quarterly goals, half yearly goals and the final goal are all achieved (as planned).

5. Changing your thinking is a given. But you absolutely have to change your lifestyle and habits to achieve your weight loss goals.

a. Separate food from the good times. Don’t attend parties where food is the main draw.

Have a green tea party. Avoid junk food when having alcohol. Don’t sit in from of the TV with junk food to munch on.

b. Eat out less often and when you do, fill yourself up with low calorie salads before going onto the main course. Share your main course with someone else. Avoid eating deserts completely.

c. Don’t keep high calorie snacks at home and if you do take them, buy them one at a time (not an entire box full and a small portion too). A good example is chocolate.

d. Avoid all kinds of bakery foods (bagels/ white breads/ cakes/ pies etc)

e. Take twice as long to eat. Chew each mouthful 30 times before swallowing.

f. Have more of the food that you don’t like and completely avoid what you do! This way you would get all the nutrition without the craving to eat more!

6. Plan your snack and in-between meal foods. Salads, green tea, low calorie fizzy drinks and water will definitely reduce your hunger and help you get by till the next meal. A high protein shake is a good way to reduce your hunger without increasing the risk of weight gain. However you should make sure that you are using a pure protein powder drink rather than a balanced protein supplement drink (which would have less protein and is used as a post-exercise re-fueller).  

7. All habits take 3 weeks to form and 3 months to become permanent. Grit your teeth and stay strong for this period especially during the first 3 weeks. It should become easier after this.

8. Take an Antacid especially if you develop acidity when eating smaller quantities of food. Remember the food you enjoy is the one that is particularly harmful to your goals.

9. When all else fails, don’t hesitate too much to go under the knife. Bariatric surgery does wonders for many.

Strategies to lose weight

What is most important is to develop a daily calorie deficit. Food intake in terms of calories must be less than calories expended by exercise. If you can reduce your daily food intake by 300-400 KCals and increase the calories spent by another 300-400 KCals you could achieve a 700-800 Kcal deficit which over the week would amount to 3500-5000 Kcals and a weight loss of 1/2 a Kilo of weight per week and a 2 Kg weight loss per month! (if consistently done)

Exercise daily but vary the intensity and duration of exercise. Training is to be done in cycles of increasing volume and intensity of exercise. This not only keep the challenge up but makes exercising more interesting. Make exercise a part of your daily living – walk up the stairs, walk to the neighbourhood shop, take the train or the bus instead of using your car, cycle to work etc. Listen to your body and don’t push yourself when you are tired. Ensure that you get 7-9 hrs of sleep a night.

Eat everything but reduce the intake of carbohydrates (alone) by 25% at each meal. Compensate for the reduced volume of food by eating a lot more of salads and less calorie dense meals and snacks.

You could consult a professional dietician and take a very low calorie diet. (600-900 Kcal/day) Again taking plenty of salads would help a lot in reducing your hunger and keeping you sane.

Try a completely different diet – Keto/Paleo/Atkins etc

Try a 24 hr fast or fast for at least for 16 hrs a day for 2 days a week. There is some evidence that this is equally effective as eating less (dieting) every day. So you would get the pleasure of eating normally on most (except 2 days) of the week.

Reduce your meals to just 2 a day. Skipping dinner would probably be the best. The food that is taken at night gives calories that just stick to the body. Your metabolism is the slowest when you sleep and therefore the food eaten is  not consumed as it might be in the morning. Skipping dinner will therefore help in weight loss.

Essential supplements that you may need when you go on a weight loss diet are the following:

– Multivitamin mineral tablet

– B complex tablet

– Fish oil (omega 3) capsule

So to summarise

Write down your goals, targets and timelines.

Start your diet and stick to the plan.

Do your exercise 6 days a week.

Check and record your weight every week at the same time.

Reduce your food intake and increase your exercise volume if you haven’t reached your weekly target. Continue the same if you are satisfied with your weekly weight loss.

Have someone you should be answerable to – a weight loss coach!

Best wishes for your success!

Here is a interesting YouTube link

All you wanted to know about Diabetic Diet

How to design a Diabetic diet

How do you design a Diabetic diet

1. First fix the number of Calories you will need per day. 20Kcal/Kg of Ideal Body weight (for sedentary life)

Add 5Kcal/Kg extra for underweight persons or if they lead a moderately active life.

Reduce Calories by 5 Kcal/Kg body weight if overweight.

2. Fix the Constituents of Diet:

Carbohydrates – 55-60%

Proteins – 20-30%

Fats – 20-30%

Fibre 25-35 fibre

        Take about half or a little more of the calculated calories as Carbohydrate (boiled or brown rice is preferred over white rice, whole wheat chappathi is preferred over maida rotis and Naans. Take all the

proteins that you would like, add oils to your food (1-2 tablespoons per meal. Take 300-400 gm of vegetable as salads daily. Remember to incorporate as many colours in the salad as possible.

Note: Carbs and Proteins give 4Kcal/gm and fats and oils give 9Kcal/ gm. Therefore if you are advised 1500Kcal of food per day, you will need to take 900 Kcals and 225 gm of Carbs (60% of 900).You can add about 30ml of oil to your meals (2 tbs) and take the remainder of calories as proteins (which would contain fat also).

   3. How are the calories divided between the meals?

Morning meal 40% (Breakfast 25% and 11 AM snack 15%)

Lunch 35% (Lunch 30% and Tea time snack 5%)

Dinner 25% (Dinner 20% and late night snack 5%)

Food is to be taken in 5-6 meals a day.

Roughly 2/3rd of the assigned calories should be taken at meal time

and 1/3rd as an In-between meal snack. If you are used to taking

        3 idlis for breakfast, take 2 at 8AM and 1 at 11AM.

Important terms explained

Simple carbohydrates: are those that are digested very quickly to yield glucose molecules such as fruits, milk and milk products, sugars, sweets, syrups and soft drinks.

Complex carbohydrates: are those that take a longer time to get digested and release glucose slower such as peas, beans, whole grain, vegetables and whole grain bread.

Glycaemic Index: refers to the ranking of food according to how they raise blood glucose levels. They are classified into

Low GI foods – <45

Mid GI foods – 46-59

High GI foods ->60

What are the determinants of Gylcaemic Index?

The following factors are important

how refined the carbohydrates are

how the food is cooked

how quickly it is digested and absorbed – like rice

how much simple carbohydrate it contains

how much of fibre it contains

how much of fat and proteins it contains – fats slow down gastric emptying and proteins stimulate Insulin secretion and reduce blood glucose levels.

So a Diabetic person must avoid or eat very sparingly High GI foods, eat moderately of Medium GI foods and eat plenty of Low GI foods.

4. Foods that don’t require Insulin for metabolism in the body are Fats and Proteins. So you could have a steak or add oil to your food without having to worry about your blood sugar levels. A diabetic person needs to reduce the intake of Rice, wheat and other cereals and tuberous vegetables such as Potatoes, Carrots, beetroot, Colacasia, tapioca etc (Onions and Radish are ok). Unlimited green vegetables of all types must be taken.

5. Getting into the habit of weighing the food would go long way in understanding how much and what type of foods affect the blood sugars. A simple kitchen scale can be bought for as less as Rs.350/-.

General Advice for Diabetic patients regarding their Diet and food intake!

2. Have small frequent meals, 5-6 meals per day.

3. Have a heavy breakfast, lighter lunch and a very light dinner. Fit in 2 low carbohydrate snacks at 11PM and 5PM. The snacks could have a high protein or fat content!

4. Know how much to eat (total calories per day) and how much of each food item to eat at each meal. (Count your Idlis and estimate the amount of rice eaten)

5. Never overeat and avoid deserts. Have a fixed helping of Rice and count of Chapattis.

6. Snack on nuts, sprouts and salads.

7. You don’t need to reduce your intake of Oil and meat unless you have high blood cholesterol levels.

8. Supplementing an optimal diet is “compulsory” for all Diabetic patients as the reduced food intake doesn’t allow adequate micronutrient intake. Please contact your doctor for a suitable vitamin supplement.

9. If you are eating out, have a large salad before starting your main course. Share your main course with someone else and avoid the desert completely if possible. You can have all the non-veg kebabs you want.

10. If you are a vegetarian, have just one helping rice or a limited number of breads (Chappatis/Rotis etc)

11. Always avoid Calorie dense foods e.g., a piece of cake has more calories than a Idli!

Useful tips:

1.Eat before you are hungry so you are not tempted to overeat.

2. One way to eat more without running the risk of increasing your blood sugars is to add your Rasam/Sambar to your Salad and to eat your salad before your main course.

3. You should increase your intake of salads especially if you are always feeling hungry. Metformin as advised by your doctor would also reduce your appetite.

4. Take veggies of as many different colours as possible every day.

5. Your fruit intake should be limited especially if your blood sugars are elevated. Fruits must be taken as an in between meal snack and not as desert after a meal.

Food that are bad for an Diabetic

While I might have touched upon this topic, I think that it would be worthwhile to reinforce it to you. The food that must be avoided are:

Sweets – chocolates, Indian sweets, ice creams etc

Sugar and sugar containing foods

Beverages – all juices, fizzy drinks (unless zero calorie)

Tubers – Potato, Beet root, Carrots, Tapioca and others

High GI foods

Calorie dense foods – Cakes, pies, tarts, pastries or anything nice by any other name!  

How do you adjust your meals according to your blood sugar values?

Your doctor may ask you to check your sugars before a meal and 2 hrs after. You will also need to measure the exact amount of food that you consume in terms of (katori/cup) or pieces of bread. If your post meal sugars are high, you may have to reduce the helpings of rice/bread and increase intake of vegetables or fats with your meal. In time, you will know exactly how much or how little you can take to keep your post meal sugar values under control.

Common targets for Diabetics

Fasting Blood Sugars – 90-110mg/dL

Post prandial Sugars – 140-160 mg/dL for those under 60.

160-180 mg/dL for those between 60-75 yrs

                 180-200 mg/dL for those >75 yrs of age.

200-250 mg/dL for those with frequent hypoglycaemia

HBa1c values – <7% for those <65 yrs of age

7-7.5% for those 65-70 yrs of age

7.5-8% for those 70-80 yrs of age

8-8.5% for those >80 yrs of age.

Useful Links:

Food exchange list – Dieter’s manual –

Hunger and how to kill it!


I suddenly realised that it would be good to write about hunger and how to control it when I started writing about diets in general and Diabetic diet in particular. It is quite obvious that if someone can’t control his hunger, he won’t be able to control what he eats and therefore won’t be able to achieve his health goals. So quite often when you repeatedly fail in your attempts at controlling hunger, you just give up. So let us talk about what is hunger, why it happens and how it can be controlled.


Hunger is a sensation that represents the need to eat food. It is that uncomfortable feeling in the pit of your tummy that tells you that you need to fill your tummy with food. Satiety on the other hand is the absence of hunger and a feeling of fullness. Appetite is the desire to eat food.


It is said that hunger is essential for survival, development and evolution. If there was no hunger (as it might be in heaven), there would be no sadness, no misery, no greed, no ambition, no development, no competition, no lifestyle disease, no change, no migration, no violence etc etc.


So while hunger is essential for our own survival, like every other urge of the body and mind, it should be controlled for us to live happy healthy and fuller lives. Hunger management is most important for those trying to lose weight or for those living with diabetes. Let us look briefly at the hunger mechanisms and at things that one can do to control it.



There are many different mechanisms by which we become aware of hunger.  You can look at them as Gastric, Intestinal/hormonal, Neurological/ psychological and others.



Empty stomach increase hunger.

Increased Gastric acidity


High Glycaemic index foods

 Low protein and fat in diet

 Low ruffage/Fibre diet

 Fast foods or anything that you  eat out of a package or parcel foods.


Poor sleep can increase hunger (Ghrelin levels increase by 28% and Leptin reduce by upto 18%)

 Life stress can increase  hunger

 Although exercise can increase hunger in the long term, exercising when hungry can make you forget your hunger.

 Having an unsatisfactory meal can also trigger increased hunger.

 Having too much alcohol the previous night and dehydration can increase hunger.


Insulin peaks after a high carb diet or sugary meal (especially in diabetics), cholecytokinin, Neuropeptide Y levels and increases Hunger

 Low blood sugars even in non-diabetics can increase hunger.

 Glucagon and Adrenaline reduce Hunger (during stress anger rage etc)

 Leptins produced in fat cells reduce hunger. Leptin secretion increases with increased food intake and reduces with fasting or starvation.

 Ghrelin produced by the stomach stimulates hunger.

 Hyperthyroidism can increase your hunger.


Hypothalamus area of the brain controls hunger and strokes affecting the hypothalamus can cause uncontrolled hunger or reduce appetite depending on the part of the hypothalamus affected.

 Dopamine induces satiety and reduces appetite

 Serotonin also reduces appetite by acting via neuropeptide Y and Agouti related peptide (AgRP) and Pro-opiomelanocortin (POMC)



 Thinking about food or smelling food or partying can increase hunger. Food is very closely associated with fun and friends.


Tricyclic antidepressants , steroids and antipsychotics increase hunger.


 Suggested ways to combat Hunger


Fill your tummy with a large quantity of water when hungry.

 Eat a healthy snack one hour before your meals.

 Split your meals in 2 and have them 20-30 mins apart.

 Avoid a high Glycaemic index meal. Avoid large deserts (cakes/ ice creams etc)

 Incorporate more proteins/fats into your meal.

 Chewing your meal well (15-30 chews of each mouthful) can reduce your hunger and food intake.

 A meaty meal can suppress your hunger more effectively.

 Plan your meal in advance. Take a healthy in-between meal snack.

 Take in a large bowl of high fibre vegetables with every meal. Veggies slow down gastric emptying and therefore keep the stomach full for a longer period thereby suppressing hunger.

 Avoid ultra-processed foods – the feel good/tasty/palatable foods!

Avoid high salt and sugar contains foods. This would include virtually all fast and  processed foods. (nearly everything that is not cooked at home on a regular basis)


Contact your doctor for any medication that could help you reduce your appetite.  Metformin/ Liraglutide/ Setmelanotide can be useful in helping you manage your hunger.


 The following natural foods are believed to be able to suppress Hunger!

 Food additives


 Cayenne pepper


 Hot sauce



 Dark chocolate

 Flax seed


Oat meal


 Veg soup

 Whole Salads

 Greek yoghurt

 Vegetable juice





 Green tea

 Skimmed milk

Fruits and Vegetables

Avocados in moderate quantities

 Apples – rich in pectin and fibre

 Green leafy vegetables


Whey Protein


 I hope that the information given above is of some use to you. My intention is not to write a comprehensive all including essay on hunger but just to give you enough information to stimulate your curiosity to begin your own research into your hunger, to experiment and see what would work for you and to change your eating habits to achieve your best health.


A hundred years ago, the concept of food storage wasn’t existent in most parts of the world. People hunted and gathered food that they cooked immediately and ate (unless it was rice that was harvested and stored for a while). In today’s world, most of us in the city do not face food shortages as we have the means to store food for long periods. Our food culture has also changed so much that we have also started eating very high salt/sugar containing calorie dense foods that are very addictive. Having easy access to these addictive foods promotes this dependance and we end up eating more than we want, to put on more weight than we need and then suffer more from “lifestyle diseases” than we should.  

Benefits of a high Fibre diet

Fibre or roughage refers to the undigested vegetable matter containing substances like cellulose, lignin and pectin which are not completely broken down and digested by the intestines. Most of the fibre is removed from cereals when they are processed and polished. Good carbs refer to carbohydrate foods that are high in fibre and not in sugar. High fibre and whole-grain intake have been shown to significantly reduce mortality and chronic illnesses. It has been estimated that the average dietary fibre intake in adult American men and women is 18gms and 15gms (when the recommendation is 33.6gms and 28gms per day). Given below are some of the benefits of a high fibre diet:

– 15-30% reduction in all cause and cardiovascular mortality including the incidence of heart attacks, strokes, diabetes and colon cancer.

– High fibre reduces body weight, blood pressure and total cholesterol.

– Decreased body weight in turn reduces risk of diabetes, cardiovascular disease and many cancers.

– Fibre reduces intestinal transit time by bulking up the stools and improving the emptying of the colon. The higher incidence of colon cancer in Western society is attributed to the lack of adequate dietary fibre. In contrast, rural African communities consuming traditional meals of high fibre, low meat and low fat have very low colon cancer rates.

– High fibre cereal intake is associated with improved insulin sensitivity, lipid profile, endothelial function and reduces inflammation.

– High fibre intake has been shown to reduce the incidence of prostate, lung, colorectal and ovarian (PLCO) cancer and has an inverse relationship with cancers of the head and neck region, especially oral cavity and pharyngeal cancers. This happens independent of whether they are smokers and alcohol drinkers or not.

– The benefits of fibre are not only due to the fibre itself but also due to the other nutrients accompanying it. Metabolites of fibre, particularly butyrate can prevent cancer in any part of the body. Phyto-nutrients that accompany dietary fibre in food have additional health benefits. People who eat a high-fibre diet tend to be more health conscious and have a better life style.

– It is believed that fibre in any form (even as a pill) is good for health.

– Fibre rich foods are wholegrains, green vegetables, legumes, whole fruit with skin, etc.

Author’s note:

You would do very well to incorporate a salad with every meal.