As Ireland looks set to be the fattest nation in Europe, we are all looking for ways to fight the flab. But where do we start? We talk to Ireland's foremost obesity expert Professor Donal O'Shea to separate fact from fad

1 The Energy-in, Energy-Out formula isn't as simple as you think

Eat less and move more - it's an important guide, but over-simplistic, believes O'Shea.

"Everyone thinks that the simple equation of energy-in, energy-out should mean that if you eat less and move more, you lose weight.

"However, as you lose weight, your body moves into a defence against the weight-loss because it sees it as a threat and conserves energy so it turns down its energy burn. Thus, the initial changes you make to lose weight stop being effective after a while. People need to know and understand that, and not be surprised when the weight loss stops after the first few weeks of change in diet and physical exercise.

"They need to understand that they will have to keep their weight steady until the body is ready to lose weight again or until they are ready to amend their energy-in, energy-out routine."

2 Each person deals with a calorie differently

A calorie taken in by a fit, lean person is processed more efficiently than a calorie taken in by a very underweight person or a very overweight person, says O'Shea.

"The body functions very well at a healthy weight, but as soon as you go outside that healthy weight, it functions less efficiently in terms of how it handles calories.

"The lining of the gut is full of bacteria which has a lot to do with how your food is processed.

"We know that overweight, obese people have a very different bacteria in their gut to that of lean individuals, and this affects how they handle calories.

"It seems that the obese individual is getting more energy than a lean individual from the same meal - the lean person has a different gut microbiome processing that energy."

3 twenty minutes less time sitting around per day will give you a longer, healthier life

"Physical activity is very good for you, but it also turns out that physical inactivity is bad - so less sitting around will improve your health, quality of life and longevity," advises O'Shea.

4 The cause of obesity is 70pc environmental - and 30pc personal

The challenge, believes O'Shea, is that the solution is the reverse - 70pc personal and 30pc environmental.

"People blame themselves or their parents for their weight, but it's not that simple. Seventy to 80pc of the problem is the environment in which we live. This means that obesity can be primarily an environmental issue.

"The big change over the last 30 or 40 years in obesity rates is being driven almost exclusively by the environment in which we live. People must understand that the environment around them is a major cause of their obesity, and that they need to have enormous personal responsibility and will-power to buck that trend.

"Childhood obesity is also a social class problem - children aged three from the lowest socio-economic group are three times as likely to become obese than children from a high socio-economic bracket."

5 Don't just focus on sugar

When you're focusing on weight loss, total energy content, not just sugar, is the most important information on a food label. "Too many people only look at the sugar content of a food when they are trying to lose weight," warns O'Shea.

Instead, he advises, study the total energy content - sugar, fat and protein together.

6 Check your weight regularly

Checking your weight regularly is one of the best things you can do to help yourself if you're trying to lose weight, he says.

"Research has shown that weighing yourself once a week and tracking your weight is a major factor in weight loss and maintaining that weight loss. It works because it develops weight awareness and a commitment to tracking weight. You must know your weight and what happens to it in order to manage it."

7 Select replacement foods carefully

The replacement foods you eat matter as much, if not more, than the foods you cut out when you're trying to lose weight.

"Therefore, for example, replacing a full-fat yoghurt with a low-fat yoghurt will not, on its own, help you to lose weight because the energy content is the same. The low-fat yoghurt has a lot of sugar making up the different in the total energy content.

8 90pc of weight gain is irreversible

Ten percent weight loss is the most that 90pc of individuals can achieve - and while that is great for overall health, says O'Shea, it's simply not enough for the people attending weight-management clinics. "Once you have put on weight, it is 90pc irreversible for 90pc of people and that underlines the importance of preventing weight gain.

"Do not allow your child to put on weight - because it is simply too difficult to lose," he warns.

9 Cultivate Mindfulness

Mindfulness has been shown to significantly help in managing lifestyle changes for people. "Eat mindfully and more slowly - eating with the TV on or while on the move is part of today's culture but it is really bad for you. It's important to be sufficiently in tune with the body to know when it has had enough to eat."

10 We need More Obesity Surgery

Ireland carries out about 90pc less surgery for obesity than other countries in Europe, despite the clear benefits to health and saving on healthcare expenditure, he warns. "In Scandinavian countries of our size, they are doing between 2,000 and 4,000 obesity operations, such as the gastric bypass, per year - last year in Ireland, we did 80, between our unit and Dr Francis Finucane's unit in Galway."

11 Develop a healthy sleep routine

Regular sleeping helps with weight loss. Ideally, seven to eight hours per night, Dr O'Shea recommends. How well you sleep is a major predictor of how well you will manage your weight, he explains.

This is because your body has a circadian rhythm, which is a physiological cycle or rhythm, and, like any well-oiled machine, your body runs best when it's in rhythm. "A key part of weight management is regular sleeping for an appropriate length of time. In our weight management clinic, the people who do best are those who sleep between six and eight hours a night and get up at a reasonable hour in the morning."

12 The younger you put on weight, the heavier you will be as you grow

The younger you put on weight as a child, the bigger you are likely to be as an adult, says O'Shea.

"People who put on weight under the age of five are the people who come to our clinic weighing the most. We cannot allow an environment to continue in which 25pc of our three year olds are overweight or obese."

13 The incidence of extreme obesity is increasing

There has been a 1,200pc increase in the extreme end of obesity in the last 30 years in Europe, says O'Shea.

"The extreme end, which is a BMI of over 50, shows that we have a systems failure in action. As you put on weight, you switch off your energy burn, handle calories differently and get into a vicious cycle of adding weight."

14 Don't 'gameify' food

The food and drinks industry all around Europe has the same mantra - "Moderation, more physical activity and individual responsibility" - says O'Shea, pointing out that, at the same time, the food industry 'gameifys' snack-food consumption with offers of free flights and free holidays, or by challenging consumers to play 'roulette' games with snack foods.

"It takes the hunger and the satiety out of the dynamic - the consumer is thinking about eating as a game. It's brilliant marketing, but it's a disaster that they can do that."

15 Weigh children regularly - and know what they should weigh

A healthy focus on weight in childhood does not increase eating disorders, says O'Shea.

"It's really important for parents to grasp the nettle on the fact that a child should be weighed once or twice a year. Parents should know their child's weight and also what it should be.

"In physical terms, having a child with a healthy weight has benefits for their long-term health and the country as a whole. You can easily work out what your two-year-old weighs by standing with the child on the scales and subtracting your own weight.

"The Irish College of Psychiatrists has clearly stated that a healthy regard for weight in children will not result in eating disorders and that the low self-esteem and mood problems that come with obesity in childhood far outweigh the problem of eating disorders."

Health & Living