Luke Coutinho on weight loss for Indians: ‘Food is no longer a choice, it’s medicine’

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Do you think the weight loss drug Mounjaro can dramatically alter the weight loss scenario in India?

Nothing is a magic pill. What most people do not want to understand is that novel weight loss pills like Mounjaro work on one fundamental principle — reducing your appetite. In other words, this is based on denial and suppression, a drastic step intended to help you get off the weight loss plateau, a stage when the body fat gets too stubborn to be lost through the diet-exercise routine and exposes you to a high risk of type 2 diabetes, heart disease, sleep apnea and certain types of cancer. These pills can help you lose up to 22.5% of your body weight over 72 weeks. Then you have to continue the medication and still maintain the weight drop with lifestyle changes. If people don’t learn how to change their behaviour around food and lifestyle before the pill or while taking the pill, then they may regain body weight.

At the same time, it doesn’t work for everyone. Many people get fantastic results, some experience minimal effects. So it’s not a 100 per cent guarantee of weight loss. Mounjaro is an absolute lifesaver when it’s given to the population that it was actually meant for, like people who weigh over 120 kg. Question is if it is psychologically motivating enough for them too to make lifestyle changes that matter subsequently. They must take care of their muscle mass with strength training exercises. They must firm up their gut health, change their protein and fibre intake, balance out their macronutrient pie and look out for vitamin and mineral deficiencies.

What’s the commonest myth around Mounjaro?

That you can use it to knock off five to ten kilos because you are too lazy to make lifestyle changes and then get back to your life as if it’s a disease you cure. Stopping weight loss drugs means your hunger returns that much stronger. The reward centres in the brain still want you to consume, the drugs are just hiding this desire. A medicine is a medicine. It’s not something that we fool around with. We should take it with the right intention, the right guidance and with the mindset that we still need to change our lifestyle.

Is the 70-30 (70 per cent diet and 30 per cent exercise) formula the ideal way to lose weight?

It’s easier to control calorie intake than to burn a large number of calories through exercise alone. So diet is indeed a key pillar of any weight loss strategy.

What’s the link between gut health and weight loss?

Your gut is everything. It controls how food is broken down into energy, amino acids and fatty acids and is then absorbed into the body. It controls your mind, anxiety and neurotransmitters. It regulates almost 75 per cent of your immune system and hormonal balance. A healthy gut can burn up food for energy, making it easier to lose weight. If not, unused calories get absorbed, affecting hormones that regulate appetite and trigger inflammation.

There are millions and millions of strains of bacteria, fungi and micro-organisms in the gut. But probiotic supplements pick up one strain of lactobacillus as your immunity shield. It’s like looking at only one sapling in the Amazon forest. The gut microbiome is a forest where both good and bad bacteria live in balance. But if we feed the bad bacteria through our lifestyle, junk food and sugar, then the good bacteria can’t do their job and get outnumbered. What we call gut cleanse or gut reset is really about starving the bad bacteria to death by going off sugar completely for two weeks. The cravings vanish, you start to lose weight, you feel lighter and your gut starts to get better.

Most of us have problems suppressing hunger pangs during any weight loss journey. How do we manage cravings?

We were never supposed to suppress hunger, which is a protective mechanism of the human body. The body makes us hungry because at that point it’s looking for certain vitamins, minerals and macro nutrients like carbs, proteins and fats. Unfortunately, we feed it the wrong thing and the body becomes hungrier for what it wants. When you have mostly refined carbs, the body’s need for protein or good fat is not met and your burger bun is no substitute. Never ever try to follow diets which advocate suppressing hunger. Instead, eat a nutrient-dense meal which gives you the bulk needed for satiety like whole grains, legumes, fruits, vegetables, lean proteins and nuts.

The second reason we do not experience satiety even while eating the right food is because we are eating to feed our emotions. We eat when we are angry, sad, stressed or bored, seeking relief in food. Eat mindfully, not mindlessly.

What causes food addiction?

Sugar, salt and fat. These trigger the pleasure centres of the brain and release “feel-good” chemicals such as dopamine and serotonin, affecting the same area of the brain as drugs and alcohol. Even restaurants play with these three ingredients. That’s why you keep ordering a particular dish. That’s how food companies work.

What’s the biggest diet mistake that Indians make?

People eat their last meal at 10 pm and sleep by 11 pm. You need three hours to digest food, which will be unused and become extra calories.

Why are fruits and ghee under the diet scanner?

Only influencers say fruits are making you fat. I can guarantee that no human being can ever become fat because they eat fruits unless they’re diabetic and have a fatty liver that cannot absorb fructose. Other than that, you can eat fruits and not put on weight because they have no fat and are rich in fibre.

Ghee is often mistaken as a saturated fat but there are good saturated fats and bad saturated fats. The bad saturated fats are your bakery products, junk and processed food. Good saturated fats can help you with heart disease, brain health, even cancers. These include pure ghee, cold pressed mustard oils or wood churned oils. Ghee is rich in Omega 3, and used in moderation, has great uses. Our most common foods like amla, the strongest source of vitamin C, guavas, moringa, ginger, turmeric and other spices are grossly under-rated.