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In May it was announced that GPs would be paid to tell their patients if they were obese.  There was the usual outcry about such schemes from either those believing that GPs are paid too much as it is or by others who had understood this to mean that GPs would be taking responsibility for the weight loss.

There is no doubt about the fact that weight loss in isolation is harder than weight loss within a proper group or network or structure. This means that you have a better chance of losing weight, whatever the method, if you have proper help.

There is also no doubt about the fact that many people are not always properly confronting their weight issues.  One
client recently admitted that even though she had been obese for many many years the trigger that made her pick up the phone to us was the moment when her doctor wrote obese in his letter to the specialist at hospital on a quite
unrelated matter. It was facing up to the reality of the situation that gave her the push to make a real change.

I think in many ways being a smoker is not so different to being obese.  Giving up the weed is not easy.  It really is about changing your habits. For many it is not going to the pub for a bit so that you break the association between alcohol and the fag.  For others it might be not going to the regular coffee break at work to stop the fag break
outside or it might be replacing the fag with the patch or the false cigarette but whatever the change
it will only work if you keep the change for life.   However, most diets  don’t really make any fundamental changes to
the way people eat or think about food. And without change – real change you can be sure that it will not last.

The low or reduced calorie diets, and boy there are a lot of them, try to make you eat less and by doing so help you lose weight. Apart from the slightly dodgy science which underpins these regimes (think metabolic rate) they also argue
that they teach you portion control. If that were true the world would be a thinner place now. We have had these diets
around for over 30 years and most fat woman today have tried them at some point.  Eating less doesn’t work in
isolation because often we will eat less but eat more often as the food we are eating is making us more hungry more regularly ( see the effect on blood sugar levels of certain foods).  Also eating less is seen as part of a diet and when the diet is over…guess what we go back to piling the food back onto our plate in abundance. Diet over ! Now let living and eating begin.  With low calorie diets the principal is that nothing is off the menu but just eat less. The Marjorie Dawes character from Little Britain is the perfect example of how to eat less but have more.  In addition this approach teaches nothing about the effects of different foods on the body. How some foods will actually stop you wanting to eat more and others will drive your body to want more.  Very salty or sweet foods will drive hunger.  Protein drives satiety. Fibre has been associated with fullness but actually performs poorly when compared with protein.

And so we see ladies on and off these well known low /reduced calorie diets blaming themselves for not losing weight and constantly paying for overpriced “diet foods” which have little or no nutrients and teach them nothing.

The next category of diet is the extreme version called the very low calorie diet or shake diet.  Their brilliant idea is
that we get you thin through starvation (think metabolic rate again but far worse) and then say, after depriving you of  food, that it  is ok but you must only ever eat up to 1200 calories a day! Well no surprises that this sort of regime
doesn’t work either. Think all of the above but now add additional problems with fear of food, deprivation and metabolic mess up!

So to really change a person’s shape you need to change what they eat and help them change for life.  This does not mean eating the same food when you were fat and when you are thin. It does not mean a little less of the same. A diet is not just for January as the famous saying goes.


30 May 2011

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