Obesity management requires a multi-disciplinary approach: careful history and risk-factor assessment, dietary and physical activity interventions, selective pharmacotherapy for eligible patients, and close follow-up. Evidence-based patient education improves safety and long-term outcomes.
Causes of weight gain
•Combined hormonal contraceptives: large reviews show no consistent, clinically important weight gain attributable to combined oral contraceptives, although individual reports of weight change occur — clinicians should evaluate coexisting causes. I find additional information from Cochrane Library+1
•Behavioral factors: excess calorie intake, poor nutrition, shift work/late nights, and physical inactivity.
•Medical conditions: PCOS is strongly associated with insulin resistance and increased risk of weight gain and metabolic disease. PMC+1
•Mental health: depression can alter eating and activity patterns leading to weight change.
Nutritional strategy — portioning the plate
Use a “Nutritional proportion plate” concept (examples: Harvard Healthy Eating Plate / USDA MyPlate):
•Vegetables & fruits ~ 50% of the plate (fiber, low energy density). The Nutrition Source+1
•Whole-grain complex carbohydrates ~ 25% of the plate.
•Lean protein (fish, lean meats, eggs, legumes, tofu) ~ 25% of the plate.
•Healthy fats in moderation; avoid sugar-sweetened beverages.
Adjust proportions to individual energy needs, sex, age, activity, and weight-loss goals.
Meal replacements and protein shakes
•Solid meal replacements often promote greater satiety and lower post-meal hunger and some appetite-regulating hormones compared with liquid replacements in certain studies. Liquid formulas can be useful but should be nutritionally complete. PMC+1
•Protein shakes are convenient but many lack fiber; without fiber and other nutrients they may produce short-lived satiety and can influence postprandial insulin responses depending on composition. They are not an ideal long-term replacement for balanced meals unless specifically formulated and supervised. ScienceDirect
Practical Thai food swaps
•Khao Kha Moo (braised pork leg): can still be eaten — choose leaner portions, remove skin, request less sauce, add vegetables.
•Pad Kra Pao (stir-fried basil pork with fried egg) → swap to basil with lean pork slices and a boiled egg (reduce frying/oil).
Drinks — recommendations
•Water is the best choice.
•Black coffee (no sugar) is preferable to sugar-containing drinks.
•“Zero sugar” artificially sweetened drinks have mixed evidence — some studies suggest associations with metabolic changes; evidence is not definitive. Favor water and minimize sweetened beverages.
