Q Whatever I do I never seem to be able to lose weight. Do you recommend medication for weight loss?

A The key to the weight issue is exercise and I wish people could get away from the focus on weight and pay more attention to fitness and well-being.

People want to lose fat and the way to do that is to raise the metabolic rate. The only way to do this is to exercise regularly - that means every day doing at least 20-30 minutes of something that gets your muscles working and your heart and lungs going.

When you do this you develop muscle and what most people don't realise is that by volume muscle weighs much more than fat. So very often you don't lose weight at the start of an exercise programme but you do start to feel better, have more energy and feel stronger for life in general.

Then, after a while, maybe eight to 12 weeks of regular exercise, you find the weight coming off because muscle that is regularly worked burns off calories even at rest. That's to say the metabolic rate is increased.

Then, in association with a low sugar and low fat healthy diet, you can lose weight in a steady healthy way with a healthier and more active lifestyle.

That's the way to do it - fads and crash diets don't work. It needs to be steady weight loss which is the result of a change in lifestyle.

Good luck. I should mention that I do find medication useful for some people if they are able to demonstrate an ability to lose some weight by fat-free dieting and are motivated to take exercise on a regular basis.

Updated: 08:47 Monday, October 07, 2002