Photo above: Eshwari was morbidly obese prior to her virtual sleeve gastrectomy in 2009. She lost up to 58 per cent of her weight through continuing portion control, healthy eating and exercise, as can be seen by her standing in her old skirt recently.
MALAYSIA - Willpower is paramount in the fight against fat, and an unconventional tool might help provide more 'fire power'.
While some are probably blasé over their unhealthy weight, there are many who do realise that they need to do something about losing their extra kilos.
As everyone knows, there are only two sure-fire non-invasive ways of losing weight: controlling your diet and exercising.
The main problem that many people face in practising these two methods is plain and simple willpower.
It is undoubtedly difficult controlling one's diet and eating portions when there are so many delicious dishes available all around us, all the time.
As anyone who has tried to diet knows, it is all too easy to make excuses to have "just one" piece of chocolate or cake, or "just one more" piece of fried chicken or bowl of rice, while promising themselves they will eat less at the next meal to "make it up".
Or for those who try to start an exercise programme to say, "I had such a long day, I'll just exercise tomorrow" or "I forgot to bring my exercise bag, so guess I'll just skip today's session", also usually with the often-unfulfilled intent of making it up later.
It is always easy to find excuses to avoid doing something we find difficult, so at the end of the day, it all boils down to having the willpower to resist temptation and sticking to your proscribed diet and/or exercise plan, no matter what.
Keeping up the momentum
Vertical sleeve gastrectomy (a surgical weight-loss procedure in which the stomach is reduced to about 25 per cent of its original size, by surgical removal of a large portion of the stomach) patient V. Eshwari shares a telling example of this.
"Of the six patients who underwent surgery (with me) on the same day, the two who had gastric bypasses lost weight; of the other four, only two lost weight (including me), while the other two initially lost weight, then put it back on," she says.
"The only guy of the six of us, when he went back for his follow-up, couldn't recognise me because of how much weight I had lost, but I could recognise him because he looked exactly the same (as before the surgery)."
This was around four months ago when the professional trainer went for her follow-up appointment at the obesity clinic in Taiping Hospital, three years after her operation.
Prior to that, the 34-year-old was well aware that she needed to lose weight.
In fact, weight issues have followed her her whole life. "I was a chubby baby, a fat kid, an overweight teen, and a morbidly obese young adult," she shares candidly.
"When I went for the operation, I was 161.5kg and 162.5cm. My BMI (body mass index) was in the morbidly obese range.
"The obesity clinic that I went to told me that my weight was shortening my life."
But she still had to be strong-armed into seeing the doctors at the clinic at first.
Despite being told and reminded to make an appointment at the monthly obesity clinic, she kept delaying doing so, insisting that "I should lose weight on my own".
Finally, her cousin made the appointment for her, and simply told her to go. "I was so furious," Eshwari recalls. "Why was everyone interfering in my life?!"
She had already been experiencing symptoms from her excessive weight, like constant fatigue from obstructive sleep apnoea, an aching back, knees that were threatening to give out, being unable to bend over, and increasing difficulty in driving, among others.
But two things finally scared her into doing something serious about her weight: seeing a photo of herself overflowing a chair at a friend's wedding, and seriously panting and sweating after simply bending down to pick up something.
Although she was recommended to undergo a gastric bypass surgery, she opted for a vertical sleeve gastrectomy instead, as she felt that the disadvantages of a gastric bypass outweighed the advantages in her case.
This form of gastrectomy involves removing most of the stomach so that it only has a volume of about 125ml. This causes the patient to feel full after consuming only a small amount of food or fluid.
The main disadvantage of this operation is that the stomach can stretch and expand back to its normal size after awhile.
As such, patients need to adhere to exercise and diet plans given by their physiotherapists and dieticians in order to continue losing weight, or maintaining their weight loss.
Currently, Eshwari weighs 68kg, a 58 per cent decrease from her pre-operative weight, and aims to go down two more kilogrammes to her ideal weight of 66kg.
She religiously allocates at least 30 minutes everyday for exercise, and it has become second nature to her to always look out for the healthier food option while eating or grocery shopping.
Her dedication and willpower to stay the course stems from a thought that is constantly at the back of her mind, "that I could go back to what I once was; after all, it has happened before".
That extra push
As can be seen from Eshwari's experience, the willpower to stick to dieting and exercise can be the difference between losing weight or gaining it all back, even with the help of weight reduction surgery.
For those who need a bit of help bolstering their willpower, there might be aid in a non-conventional technique - hypnosis.
Psychologist and certified hypnotherapist Joyce Hue is quick to point out that the hypnosis we see in entertainment shows or movies is not really hypnosis.
"We don't ask patients to stare at a swinging object, or stare into our eyes," she says.
Instead, she first sits down with her clients to get to know them and understand their motivations and reasons for the behaviour they wish to change.
Hypnosis, she says, will only work in those who are willing to change.
"You must cooperate with me, and you will be in charge the whole way. My role is to facilitate the process," she says.
She adds that there are no negatives in hypnosis, and no hypnotist can really make someone do something they do not want to do.
"For example, if you really love to eat chocolate, but I tell you to hate chocolate, your subconscious will reject it, and you might become depressed, or just continue eating chocolate anyway."
Hue explains that the process of hypnosis involves getting the client to that relaxed transitional state of mind between consciousness and unconsciousness that occurs right before sleep.
In that state, she says, "Your subconscious is open, and conducive to suggestions." And that is the time hypnotherapists implant suggestions and reinforce behaviours that help the client achieve the goal that they want.
These goals can range from managing stress to self-motivation, and quitting smoking to losing weight, among others.
While Hue has always offered general weight management programmes through hypnosis, she recently decided to go a step further and introduce the Hypno-Band Weight Loss System.
In this system, the hypnotherapist creates a state of mind where the client believes that they have had a gastric band fitted on their stomach.
Just like an actual gastric band surgery, the client should feel that the band has reduced the size of their stomach, resulting in them feeling full after eating smaller portions.
The gastric band surgery is similar in effect to the virtual sleeve gastrectomy, except that the band can eventually be removed, while a gastrectomy is irreversible.
In addition, the client's will to diet and exercise will be reinforced through hypnosis during their sessions. (See Subconscious weight loss)
Take 38-year-old Veronica Lim for example.
She was first referred to Hue two years ago by her doctor to help her overcome her depression through hypnosis.
While she did start to feel better after a few sessions of hypnosis, unfortunately, a side effect of her depression remained with her - 8kg of unwanted extra weight.
Her eating habits did not help - having one-and-a-half bowls of rice during meals, eating nasi lemak with extra ingredients regularly for supper, skipping breakfast, drinking around six cans of beer and a can of Coke daily, and eating out all the time.
The effects were starting to affect her health, as she developed high blood pressure, her blood sugar levels shot up, and her skin started developing problems.
Initially, Lim tried the various slimming programmes offered by beauty centres.
"But they really didn't help, and I suffered quite a lot as they gave a lot of restrictions, like only eating one meal a day - I got gastric (pains), no oily food, no eggs or eating steamed food only; or using things like hot blankets or diet pills."
Then at the beginning of the year, she went back to see Hue, as her weight was causing her to lose confidence in herself. "I had to change all my clothes; I couldn't wear my pants or shirts. And I didn't want to go out to meet people at all," she shares.
That was when Hue told her about Hypno-Band, and she decided to try it.
Within three months, she had gone from 68kg to 63.5kg, and a brand-new wardrobe of clothes.
But she admits, it wasn't easy that first month. "For the first one month, I still felt hungry, that's why I drank Milo (to fill my stomach)," she says, adding that she also had to force herself to eat vegetables as part of a healthier diet during that time.
But seeing her skin start to clear up after one month really spurred her on to keep eating healthily.
"Now, I eat less, and also, different things." She has started having more home-cooked meals, where she can control the portions, and also opt for healthier dishes like steamed fish and vegetables.
Where she previously loved to snack on sweet things like chocolate, she now doesn't feel the urge to eat them any more, or when she does, goes for the sugar-free option.
She no longer feels the urge to have tea and supper every day, has started eating breakfast, eats dinner before 6pm, and has cut down her rice intake to half a bowl per meal.
And if she is still really hungry outside of mealtimes, she opts for a cup of Milo or a bowl of soup instead of her favourite nasi lemak.
With her restored confidence, Lim started to go out and join more activities.
In particular, she took up ballroom dancing, where she gets the exercise that she needs.
Now, she not only goes for her own classes three times a week, but also teaches music movement to children twice a week.
Despite having completed her hypnosis sessions, Lim continues to maintain her motivation and willpower to continue eating healthily and exercising regularly.
All she needed was that little push to get her started.