Dieting, weight loss and infertility

If you are a patient of mine you have probably been told — or nagged — to go and exercise, to lose some weight. Right? (And has the doctor ever looked at himself? I am not even pregnant yet, but his belly has already overtaken mine and looks about ready to deliver. 555)

The other day I was about to do an ultrasound on a patient. We said hello, the usual. Then, just as I was starting the scan —

• Patient: That belly is huge.
• Me: Do you mean my belly or your belly? 5555

We had a good laugh ................ and to this day I am still not sure whether she meant me or herself.

Broadly speaking, weight-loss diets come in three camps.

1. The #LowCarb camp

Eat less starch and less sugar. There are many versions of it — Ketogenic diet, Atkins diet and so on — differing in how much carb they cut. The point is to bring down the making of the hormone insulin, so the body should pull more of its energy out of fat and store less of the excess. Sounds good, doesn't it.

The downside is that it may raise the waste products of burning protein and fat — ketone, ammonia — which in the long run may be bad for health.

On top of that, some low-sugar products have to put in sweeteners that carry no energy, so the taste stays as good as before — and people with certain genetic diseases cannot eat those, my dear. It could kill them.

2. The #LowFat camp

Eat food with a low proportion of fat. This one comes from the knowledge that ischaemic heart disease, stroke and the like are caused by cholesterol sitting high in the blood vessels for a long time, together with arteries that have lost their elasticity with age.

These days the shelves are full of low-fat and fat-free products. What has happened is that some of them turned to plant fats, which contain trans fat — the body cannot use it, and it may block the blood vessels up more easily than animal fat does.

And to all my patients of reproductive age, men and women alike, let me tell you this, darling: you need #cholesterol. It is the starting material for every sex hormone in the body — estrogen, progesterone, testosterone, the lot.

It will grate a little at first. But after two or three plates of crispy pork over rice from that famous shop, or two or three omelettes fried in lard, you may change your mind. 55555

3. The #LowCal camp

This is the one I think makes the most sense. Everything you eat, whether carb or fat, is energy all the same, and our body can balance itself out. This group covers the various ways of counting cal, including all the apps that count cal for you and work out how much energy the body needs. Intermittent fasting is half in this group too.

The weight goes up because of:

1. #EatingMoreThanTheBodyNeeds
2. #UsingTooLittleEnergy

So: eat less, and go and exercise more.

Some people cut the food only and never exercise. The body then thinks we are starving, and the weight may not come down at all, because the metabolism goes down along with it.

I have a sweet tooth, you know. Bad habit. Well... it is delicious, isn't it — sweet, easy to keep going, and it just feels so good.

My grandfather never used vegetable oil at all. He cooked with lard and nothing else, because he said vegetable oil does not taste good — especially the Chinese-style fried noodles we eat at Chinese New Year, which had to be lard, full stop. His figure was perfect, and he died past ninety, with hardly any illness.

Sweet dreams, and good night. — Dr. Patsama

Read next: The fertility diet — the foods and vitamins that help with conceiving.

• #LowCarb
• #LowFat
• #LowCal
• Ketogenic diet
• Atkins diet
• intermittent fasting
• insulin
• cholesterol
• trans fat
• sex hormones
• weight loss
• exercise
• #FatIsGood