Live Chat Transcript We spoke to Dr Ian Campbell, GP and specialist in weight management and Chair of the National Obesity Forum, on March 31, 2004, about weight loss for men and weight management. Read the transcript of the chat below...

Judith Jenkins: I need to lose 4 stone in weight; I have a severe back problem and am in constant pain. Can you help me?

Dr Ian Campbell: Weight loss requires both an increase in your exercise levels and a reduction in your dietary intake, clearly someone who has a back problem will have difficulty exercising but the good news is that even small amounts of increased activity will make a difference. Find the exercise that suits you best - it might be walking, or swimming, or simply playing with the kids but whatever you do, find the one that suits you and do it as often as possible, building up from occasionally, to as frequently as possible.

Girlie1234: What sort of diet would you suggest for a 13 year old boy who is marginally over weight and is on medicated drugs?

Dr Ian Campbell: Well, without a doubt for most 13 yr olds the best form of diet is a well balanced and healthy diet. Weight loss is not necessarily a good thing at 13, rather we aim to keep the weight the same and as the child grows taller so their relative "fatness" decreases. Basic principles are to cut out unnecessary sugars, avoid snacks between meals, aim for 5 portions of fruit and veg a day, make the "diet" fun and interesting, and explain to the teenager why you are trying to control their weight. For any children who are on medicated drugs, it depends entirely on what the medical condition is and what drugs he is taking.

Darren Martinson: Hi, I'm 31 and currently weigh 25 stones. Could you tell me how many calories I should eat a day and what type of exercise I should be doing to lose weight. (I have no medical conditions)

Dr Ian Campbell: Traditionally a man needs 2500 calories a day to keep his weight the same. However, a chap who is as heavy as Darren will need more calories, maybe as many as 3500, to keep his weight the same. What we aim for generally is to drop the calorie intake by one fifth - in this case to between 2500 and 2800, plus increase activity and then you should start to see some weight loss.

Sandeep: My problem is that I want to increase my weight. Can you help me to increase my weight?

Dr Ian Campbell: Being underweight can be as distressing as being overweight for some people. If it's the result of recent and unexplained weight loss you need to seek medical advice however, if it is long standing, my advice is to increase your daily exercise level and make sure your diet is well balanced. Increase consumption of complex carbohydrates e.g. pasta, potatoes and rice - this is the best way of increasing energy intake. But watch you don't increase the total fat intake too much. I can't overstate how important balance is in a healthy diet.

Kay: Can you provide more details on insulin intolerance?

Dr Ian Campbell: Insulin resistance is a common finding in people who have excess weight and it is this which we believe is linked to problems with high blood pressure, diabetes and raised cholesterol. There are a few drugs which slightly improve insulin resistance but by far the best way of doing it is by weight loss! Insulin resistance is not easily measured and therefore its presence is more an assumption than a specific or chemical finding.

Dear Dr, I want to know how I can lose the weight off my stomach. I am a girl but my stomach always stays very fat. Can you help me?

Dr Ian Campbell: Well the reasons for that maybe several, if you are of fairly normal body weight it may be due to lack of muscle tone and therefore abdominal muscle exercises will help. However, if it is due to excess fat, you should know that fat around the waist is the most dangerous type. My advice is to take a tape measure and measure around your waist - one centimetre below your navel - if it is below 90 cm (35 inches) you're probably ok, if it's above, you need to lose some weight.

Adrian: Why did you do a diet specifically for men?

Dr Ian Campbell: Because only 1 in 5 of my patients were male, only 1 in 100 going to weight loss clubs are male, and yet we know as many men as women need help with their weight. What I found was that men preferred to try and lose weight on their own, in private, and to keep control of what they were doing. That's what fatmanslim.com tried to do and that's why it was created.

Bryan - If your doctor isn't sympathetic to your weight problems, where can you go to get advice?

Dr Ian Campbell: This is a common problem. Many doctors don't yet understand that being overweight can be a serious medical problem that requires a doctors help. My advice would be to consider using a local weight loss group, talking with your practice nurse or even finding which doctor in your practice would be more sympathetic.

Jan - Does being overweight really mean a huge health problem? Isn't this just another scare?!

Dr Ian Campbell: Unfortunately no, it's not a scare - it's true. Being clinically obese increases your risk of heart disease 4 times and type 2 diabetes 12 times on average, you'll die 9 years too early and be more prone to cancers and depression. This is why I became involved in it in the first place, as I was concerned about what it was doing to my patients.

Eleri - What's your best tip to someone who just can't stick with a diet?

Dr Ian Campbell: My advice is don't diet! The problem with diets is that they are hard to stick to and therefore are quickly abandoned. Far better, is to aim for a healthy diet that is low in fat, low in sugar and to become more active in your daily life. The best form of exercise is the one you'll still be doing in a year's time!

Claire - Can a pill help you to lose weight?

Dr Ian Campbell: Yes it can, but only if supported by long term lifestyle change. Many patients I work with have tried their hardest to lose weight and have done all the right things and for some of them the tablets Reductil or Xenical, prescribed by their doctor, can make a big difference.

Paula - Are kids eating more of the wrong foods today? And how can you encourage them to eat 'good' foods?

Dr Ian Campbell: Healthy eating needs to start at home, needs to be encouraged at school and parents need to lead by example. Kids who know why a healthy diet is important are more likely to go along with you, but keep it interesting and fun, and never make them feel isolated - also take a long term view.