January is the peak month for new memberships at gyms and slimming clubs as the overweight and unfit attempt to make good their New Year resolutions.
Unfortunately, by the end of the month many will have fallen by the wayside.
But the reality is that the majority of UK residents need to lose weight and improve their fitness. A timely reminder of this is next week’s National Obesity Awareness Week.
According to the Department of Health up to 62 per cent of adults and 28 per cent of children aged between two and 15 are either overweight or obese.
Data from the Health and Social Care Information Centre shows that in the last decade obesity has risen from 13 per cent to 24 per cent in men and from 16 per cent to 26 per cent in women. And half of all obese adults have high blood pressure. What’s more, nearly 10 per cent of children entering school at the age of four or five are classed as obese.
Just this week the European Society of Cardiologists published a report which shows a strong link between poor fitness levels in adolescence and heart disease later in life. The long-term study of 750,000 European men also found being overweight produced a significantly higher risk of a heart attack.
In fact, the findings suggest it is better to be slim and unfit than overweight and fit.
The Department of Health estimates that obesity costs the NHS around �5bn every year. Being overweight is a risk factor for everything from breast cancer and strokes to type 2 diabetes. And that all comes on top of the cost in terms of unhappiness and loss of quality of life.
The Government has put resources into what is described as an NHS ‘evidence-based alternative to the barrage of fad diets that swamp the weight-loss market every New Year.’
Developed in partnership with the British Dietetic Association, the web-based plan (www.nhs.uk/livewell/weight-loss-guide) offers advice and information on healthy eating, how to deal with cravings and exercise suggestions.
At the core of the plan is the familiar mantra “eat less, be more active”. There are no gimmicks and no earth-shattering new ideas.
But is this sort of initiative enough?
“At the end of the day, it’s not rocket science,” says Dr Deborah Pufal, course leader for nutrition and health at the University of Huddersfield, “it’s about reducing the amount of energy you are taking in. For some people, however, it’s a lot more complicated than this and if they don’t address the psychological reasons why they eat then they’ll always struggle.”
What the NHS plan does offer is a guide to healthy eating, avoiding the pitfalls of short-term restrictive fad diets.
As Dr Pufal points out some types of dieting can be risky and counter-productive. She explained: “There are all sorts of diets that claim to work and if you are eating less, you will lose weight, no matter what. But if you are losing more than 2lbs a week (approx 1kg) then you are losing body protein (muscle mass) and water, and once you go back to normal eating you will replace the lost weight plus a little bit more because your body has gone into semi-starvation and will store a little extra energy for the future.
“If this is repeated then it becomes yo-yo dieting and once you get into that cycle it’s very difficult to get rid of the weight.”
Dr Pufal believes that the current obesity epidemic is being driven by societal changes and a lack of awareness in families of nutritional values.
Children, she says, are not being taught what constitutes a healthy diet, either at home or at school. “They are not being shown how to cook either,” she added. “And if you think about how lifestyles have changed you can see the problem. You come home from work and the last thing you want to do is cook a meal so people are relying on ready meals and takeaways. Their priorities have changed and food is pretty low down on the list.”
She also believes that society is starting to become more accepting of obesity, seeing it as a norm, as the numbers of overweight people increase.
“When I was at school there was one overweight child in my class, now it’s almost a majority. The National Child Measurement Programme has found that obesity doubles in children between reception year and year 6, which is pretty horrifying.”
Dr Pufal would like to see obese patients offered long-term support by dietitians as well as psychological counselling for the morbidly obese.
Endocrinologist Dr Chinnadorai Rajeswaran, who runs NHS obesity clinics for the mid-Yorkshire region, which includes Dewsbury and Huddersfield, and is chairman of the National Diabesity Forum, agrees that not enough is being done to support those with chronic and severe weight problems.
“Weight management has been portrayed as a short-term thing,” he explained, “you lose weight and go away. But obesity is a chronic disease. With other chronic diseases such as heart disease or diabetes you may end up taking tablets for the rest of your life. “We need more money for long-term nutritional support and psychological services. Everyone is different – patients need someone to talk to and to understand them and offer long-term support. Government policies along these lines would be hugely helpful.
“A lot of the people I see have usually been through all the programmes currently available – low-calorie diets, shakes, bars and diet plans. They have the knowledge but after a few months get bored and put the weight back on. Or they lose weight but believe that their target is so far away they won’t be able to sustain it.
“At this time of year people are making resolutions and my concern is that every time they fail, it further reduces their self-esteem. They become suspicious about new programmes.”
Dr Rajeswaran, who is appearing in the new series of Channel 5’s Big Body Squad, which looks at how the health service is coping with rising obesity levels, says many of his patients have a history of abuse or psychological trauma.
“Unhappiness can be a factor in obesity,” he said. “Obesity and depression are bidirectional, one can come before the other. Sometimes it can be the drugs for depression that cause the obesity. A lot of people I see are on anti-depressants and eat more to reward themselves. You can’t just perform weight loss surgery on these people, you have to address their psychological needs.”
The scale of the problem is often hidden from public view. Dr Rajeswaran’s largest-ever patient, a 380kg man (59 stones) ended up housebound and was initially too big to have bariatric surgery (a stomach bypass).
“We put a balloon inside his stomach and six months later he had lost a significant amount of weight and was able to have the surgery,” said Dr Rajeswaran. “He has lost 20 stones up to this point.”
The cost of morbid obesity to the NHS and social services is growing and although it has been said that performing more bariatric surgery could save money in the long term, it is now becoming clear that this is not necessarily the case.
Dr Rajeswaran added: “This group of people need post-operative care, they have psychological problems, nutritional difficulties, relationship problems and often require plastic surgery. We simply can’t afford to operate on 25 per cent of the population. It’s a no-win situation.”
The NHS Weight Loss Plan advises that women should consume 1,400 calories a day and men 1,900 in order to shed weight safely.
A calorie counter can be found at nhs.uk/caloriecount
Other tips include:
Using a smaller plate. Portion sizes have risen over the past 30 years so many people are now consuming more calories than they realise.
Fill your dinner plate with vegetables so there is less room for higher-calorie foods.
Eat slowly. It takes 20 minutes for your stomach to tell the brain that you are full. It is easier to over-eat when guzzling food quickly.
Weigh your food in order to work out an accurate calorie count. There is a surprising difference in calories between a small baked potato and a large one, for example.
Choose wholegrain products over white bread, flour and rice, as this increases the amount of fibre and keeps you feeling full for longer.
Pulses and beans such as chickpeas and lentils are cheap and healthy foods – buy them canned for convenience.
Snack on fruit – fresh, dried or canned – to increase fibre consumption without the sugar and fat from cakes and biscuits.
Get a pedometer and aim to increase your daily activity. Start by using stairs instead of lifts and walking more.
Eat porridge for breakfast – oats are low in calories and high in fibre. Make with semi-skimmed milk or soya milk and top with dried fruit. A 40g portion of oats is 182 calories. With milk and fruit the total is a healthy and long-lasting 350 calories.
Food cravings can be tackled by drinking water, keeping busy, chewing sugar-free gum, brushing your teeth, or having a low-calorie drink.
Avoid sugary drinks, smoothies, fruit juices and milky coffee, replace with water, herbal teas and tea or coffee with reduced-fat milk.
Beware of salads masquerading as healthy food. Some dressings are laden with calories. A typical serving of mayonnaise, just two tablespoons, has 220 calories, while a blue cheese dressing has 228.
Learn to recognise when you are comfort-eating and do something to take your mind off food. Boredom, depression, stress and loneliness can all lead to overeating.
For some dieters, the way to achieve a healthy weight and maintain it is to join a slimming group pic of Nicola before and after.
Nicola Rhodes, 28, from Milnsbridge, has lost 65lbs (29kgs) with Weight Watchers, transforming herself from a 20st 3lb, a size-22 heavyweight, to a much healthier size 14/16.
After years of reduced mobility she is finally fit and active and says the key has been the support and group therapy of belonging to a slimming club.
Nicola, who is a warranty administrator for a Crosland Moor company, had been overweight from childhood and says she faced bullying at school because of her size.
But even when her mum Linda died from a heart attack at the age of 45, she continued to overeat.
She explained: “My mum was overweight, my entire family has always been overweight.
“I thought about food all the time. My grandma used to make a joke that I had one meal and it lasted all day. I was constantly nibbling and used to have takeaways all the time. I would have a large stuffed crust pizza and eat it all by myself. And I had tons and tons of chocolate.
“I just ate whatever I wanted but it wasn’t just the bad things. I also ate a lot of salad as well. My mum said she didn’t understand why I was so big because I ate salad all the time.”
But a couple of years after losing her mother, Nicola started to realise that she was facing a lifetime of ill health and incapacity because of her size.
“My mum had all sorts of things wrong with her and I was struggling to walk without stopping to rest. I thought ‘I shouldn’t be like this’.
“At 25 I couldn’t walk and at that age I should have been able to run, skip and jump.”
Her GP asked if she’d like to join Weight Watchers and three years ago she began attending meetings accompanied by a friend. The organisation operates a patient referral system, whereby it offers the NHS a 12-week subsidised weight loss course and feedback to health professionals.
Learning to eat healthily and in smaller portions has enabled Nicola to regain her life. The days when she could barely walk without being out of breath or in pain are gone. Today she’s become a gym addict and works out at exercise classes up to seven times a week.
“I’m as healthy as a horse now,” she says. “I’m still not entirely happy with my weight but I’m a lot happier than I was.”
Nicola, who now helps out at the WW meeting led by Lisa Cartman-Kenny in Crosland Moor, aims to lose more weight and become a maintaining ‘gold’ member.
“I will still go to meetings because I love going. It’s really encouraging,” she said.
During her weight loss journey she has also had the support of her partner Rob Hanks.
“He has never complained about my weight he just wants me to be happy,” she said.
Lisa Cartman-Kenny, who runs Weight Watchers classes in Huddersfield, Halifax and Rastrick, says many would-be slimmers need support.
“For a lot of people it is about finding the right support,” she explained. “At meetings, everyone in the room knows that everyone else understands and has the same problem. They share ideas and support each other.
“We always see a lot of new members in January and there are some who lapse because they get to a certain weight and think that’s it. They might have wanted to lose weight for a special occasion or event. But those who stay make permanent changes to their diet and lifestyle.”
