Simplyweight staging in Progress

“Weight loss’ is now one of the most commonly discussed topics in workplaces, parties and clinics. More than fifty percent of the people in the western world have been on some form of diets to lose weight. There are several measures to find out whether you are losing weight, these include: body weight, waist circumference, dress size and but not the least comments by close friends and family. 

The number of weighing scales to check body weight available in the market has significantly gone up. Weighing scales come in different forms, including the standard spring-based weighing scale to digital. There is a weighing scale in most people’s bathrooms. These days you can also pick up a weighing scale which also calculates your body composition. Body composition analysers are the machines which determine how much fat, muscle, water, bone, visceral fat you have. Some of these machines can also calculate your body mass index and basal metabolic rate if you input some data like age, height and sex.

Are weighing scales reliable enough to check body weight?

A weighing scale only tells you how much you weigh at that point in time. It does not tell you how much water, fat, muscle or bone you have. So, it is not a good indicator of your metabolism, it is only a guide. Weighing scales help you understand if your weight is increasing or decreasing. It is important to calibrate your weighing scale on a regular basis. This is what happens in good hospitals and clinics where weighing scales are checked regularly and calibrated. Most bathroom scales with time start to show errors and hence it is a good idea to change your weighing scale, if you feel they are not accurate.

According to a study by Marsdens, a weighing scale company, none of the bathroom scales were class III medically approved. A class III approved scale means that it can be used for monitoring body weight, diagnosis and in medical management. This however does not mean it is always accurate. This classification ensures quality and every equipment has to be calibrated on a regular basis, usually yearly.

What are the factors which can affect your weight?

Human body continuously changes from hour to hour, day to day and hence the weight also changes. There are several factors which interfere with body weight. This includes:

Types of food consumed: Your weight fluctuates a great deal depending on the type of food you consume. For example, consuming too many sweets, rice, pasta or bread, this is too much of carbohydrate intake and can lead to significant weight gain. This is not only due to increased calorie consumption but also due to associated water retention. Similarly, salty food can also lead to water retention. If you find that your weight has gone up significantly, recollect what you have been having in the last few days.

In a study published in 2011, in The New England Journal of Medicine by Mozaffarian and colleagues, whilst studying the changes in diet and lifestyle and its impact of long-term weight gain came up with some interesting facts about food. They showed that consumption of processed foods that are rich in starch, refined grains, fats, and sugars can increase weight. They also showed that some foods like vegetables, nuts, fruits, and whole grains were associated with less weight gain even when their consumption was increased. 

Menstrual periods: Women’s weight fluctuates significantly before, during and immediately after their menstrual periods. This is predominantly due to water retention. Weight can sometimes go up in some women up to 4kilograms or eight pounds. Moreover, before menstrual periods some have increased craving for sugar which again contributes to weight gain. Changes in the hormone levels contributes to weight gain, hunger and water retention. During the follicular phase that is the time from the first day of the menstrual period to the time of ovulation, there is an increase in oestrogen. This period lasts for about two weeks. Oestrogen may cause water retention and in some women reduction in appetite. On the contrary, during the luteal phase, that is the period between ovulation and the start of the next menstrual period, progesterone is increased. Progesterone is known to increase appetite and this may be one of the reasons for craving before periods.

Women may experience bloating and/or swelling of face, abdomen, breasts, and limbs. This may not always be due to water retention.

Menopause: When a woman attains menopause that is menstrual periods stop, a lot of hormonal changes occur in the body. This can lead to weight gain, decrease in muscle mass. In addition, women also experience altered moods. Sleep is also altered, which has an impact on hunger and metabolism.

Hydration: Hydration plays a key role in your body weight. NHANES researchers in a study done in 2009, found that people who were inadequately hydrated had a higher body mass index compared to people who were well hydrated.

When you are thirsty or dehydrated your brain may not be able to differentiate between thirst and hunger and you may end up consuming more calories. Whilst measuring weight ensure you are well hydrated.

Alcohol consumption: Alcohol is energy dense, so much so that 1 gram of alcohol has around twice as many calories as a gram of carbohydrate or protein. Moreover, alcohol promotes appetite and impulsive snacking. People who consume an increased amount of alcohol, leads to increase in abdominal fat (visceral and subcutaneous). Alcohol consumption in the long run has an effect on liver and hormone metabolism. There are increased levels of oestrogen which lead to increased breast size in both men and women. In let stages, chronic alcoholics may develop cirrhosis and fluid accumulation. They have pot belly due to increased ascitic fluid, not the beer belly. This is a more serious and life-threatening condition. 

Caffeine consumption: Caffeine is a diuretic that means it can promote urination and water loss. Caffeine is present in coffee, tea, energy drinks and some fizzy drinks. One needs to also remember that high calorie drinks with caffeine can lead to weight gain like full sugar coke.

Exercise: Exercise if strenuous can lead to increased sweating and fluid loss. Checking weight immediately after exercise may show some weight loss. However, after a few days after intensive exertion, there can be muscle injury with micro tears leading to inflammation, water retention and weight gain. So, your weight can change depending upon how soon after exercise you check your weight.

In the long run with continued exercise, more so resistance training there may be an increase in weight due to increased muscle mass.

Medications: Medications can cause weight gain or weight loss. Below are some of the medications which cause weight gain:

  • Blood sugar lowering medication like insulin and gliclazide
  • Antipsychotics like haloperidol, risperidone and olanzapine
  • Antidepressants like amitriptyline, paroxetine, and sertraline
  • Antiepileptics like carbamazepine and gabapentin
  • Steroid hormones like hydrocortisone and prednisolone
  • Contraceptive pills or Hormone replacement therapy
  • Antihypertensives like beta-blockers
  • Migraine preventer like pizotifen

Medications can also lead to weight loss. Diuretics like furosemide and spironolactone lead to increased urination, water loss and thereby weight loss. Some medications which cause nausea, vomiting, altered taste, dry mouth can all lead to weight loss. There are several medications which cause reduced appetite which includes Glucagon like peptides, phentermine, topiramate which leads to weight loss.

So, while checking your weight please take account of the medications you are on.

Medical conditions: There are several medical conditions which result in weight fluctuation. Some of them can be life threatening, which are

  • Heart failure
  • Kidney failure
  • Liver failure
  • Right heart failure due to lung disease
  • Cancers

Other medical conditions which alter weight and are not related to the food you eat or the exercise you do include:

  • Overactive thyroid (Thyrotoxicosis) – leads to weight loss
  • Underactive thyroid (Hypothyroidism) – leads to weight gain
  • Cushing’s syndrome – leads to weight gain
  • Insulinoma – leads to weight gain or weight loss
  • PCOS (Polycystic Ovary Syndrome) – leads to weight gain
  • Diabetes, poorly controlled – leads to weight loss

There are several other medical conditions, which lead to alteration in weight and have not been listed above.

Why do you want to check your body weight?

Before I answer how often you need to check your weight, you need to establish why you want to check your weight. These days very few people are on a weight gain journey. 99% of people monitoring their weight do so if they are on a weight loss journey. 

If you are on a weight loss journey there must be a goal weight and a motivation to lose weight. People want to lose weight for several reasons. Success depends on how strong your motivation to lose weight is. You may want to lose weight for any one or all of the above reasons:

  • Get ready for a beach holiday
  • Wear a bikini this summer
  • Play with children or grandchildren
  • Get into a wedding dress
  • Improve self-confidence and self esteem
  • Improve health
  • Get blood sugar under control
  • Be fit for knee surgery
  • And many more.

So, if you want to be successful and need to learn how often to check your weight, you need to have a clear motivation and a goal weight.

How often should you check your weight?

Do you check your weight hourly, daily, monthly or not at all? Some of my patients are so obsessed that they would check their weight first thing in the morning, again after opening their bowels and again after going for a short walk. They would check if they have had a cake and also just before going to bed. This does not help and in fact can be counterproductive. Most people are impulsive and are looking for a quick fix solution. This is the sole reason for the thousands of diets in the market. Despite a new diet coming out every week, in the UK, the prevalence of adult obesity has increased from 15% to 29% in the last 24 years. This clearly shows that these fad diets are not working.

Frequency of checking your weight will not alter the end outcome. Even If your motivation is to just lose some weight to wear a bikini this summer.

In the journal of academy of nutrition and dietetics, Steinberg and colleagues concluded from their study that weighing every day led to greater weight loss and greater adoption of weight control behaviour. Weighing every day creates a process, a habit or builds a system in your day to day routine which helps in weight loss and maintenance. I ask my patients to weigh every day. More so whilst brushing their teeth, so that they do not forget.

What time of the day should you weigh yourself?

As you make it a habit you know clearly if you are slipping or if your weight is not budging. Some say they may become anxious. You are more anxious when you do not weigh yourself for a long time. You are more scared to know what has happened to you after that long weekend where you were naughty and indulged in excessive alcohol and pizzas. People do not become anxious when they brush their teeth every day? In fact, weighing every day gradually helps you overcome the fear of weighing and you are able to deal with any change appropriately.

So, weigh daily, whilst brushing your teeth in the morning.

As mentioned above, why you weigh yourself is the key. If you are on a weight loss journey and you wish to lose weight and keep it off then you need to weigh yourself daily. However, you need to set a process that is, build a habit within your day to day routine.

Weighing daily, in the morning before you eat or drink is recommended. More importantly be consistent with the time. Our body changes constantly due to diurnal alteration in hormone secretion. In addition, body weight also changes based on all the factors mentioned above. So, by weighing first thing in the morning you could avoid all the factors interfering with your weight and body composition.

What are the risks of weighing frequently?

All the information provided in this article is relevant to people who are planning to lose weight. People who have anxiety, depression or eating disorders like bulimia or anorexia should refrain from weighing regularly and consult their health care professional.

When you are trying to lose weight, initially there is significant weight loss due to fluid loss and glycogen (sugar stores) in the liver getting used up. In addition, your body is also affected by external factors including stress, sleep, medications, food composition and hormones. Do not get perturbed by small changes in weight. However, if you think your weight loss is unexpected contact your doctor. Watch this video on read this article for more information: Unexpected weight 

Summary of advice on weighing yourself

Weight loss is a journey. However, if you are looking for a quick fix, be prepared for weight regain. Weight is a symptom of a problem. Find out the underlying issues leading to weight gain. Irrespective of the goal and motivation follow the below steps for successful weight loss and maintenance:

  • Get a good weighing scale
  • Calibrate your weighing scale regularly and after you have moved it
  • Place your scale on a hard surface and avoid moving
  • Weigh first thing in the morning before eating or drinking
  • Weigh preferably at the same time of the day
  • Avoid weighing around menstrual periods
  • Weigh daily if you want to lose weight and maintain weight loss

Author:  Dr C. Rajeswaran FRCP (UK); MSc

                   Consultant Endocrinologist & Bariatric Physician

                   simplyweight & The London Obesity Clinic

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