A healthy daily diet makes for a healthy person. We really are what we eat and eating badly sets you up for an unhealthy life later on.
For those who don't think their weight is too important, see what medical insurance companies think: after all, they're not going to insure a person if it's not worth their while?
It's important to get a healthy lifestyle off to a great start in childhood, by setting a good example.
Prevention is better than cure, and healthy eating starts in the womb! What a mother eats affects her fetus! Please don't be offended by the honesty of this discussion. Doctors are often embarrassed to suggest that patients are overweight for fear of offending them. Some patients see that as reassurance that everything is OK, and nothing can be changed. Some patients look at their parents and imagine they cannot change anything because it's in their hormones.
The reality of the fact is that in 99% of cases, it is too many calories and not enough exercise that causes obesity, even though we'd all like to think we are the 1%, because that gets us off the hook, and take no responsibility for it, or for changing things.
Those of you reading this who might be thinking that I'm just lecturing and don't have any idea how hard it is to eat healthy only have to meet me and observe my weight!
The fact of the matter is that, as children, we've learned to overeat and eat bad food because our parents either did so. And even if our parents are slim, they may have encouraged us to over eat or eat sweet things to show us love, or simply because they didn't have the time to enforce healthy eating because of having to rush off to work or even being afraid to be the more unpopular of two estranged parents! Of course, a child is always going to prefer a parent or grandparent who offers the cakes over boring vegetables! Sometimes it is just easier to give in and feed a child what they want. We all do this from time to time. It is harder to be strict. And generally, refusing to eat is a child's strongest power over a parent, because it is instinctive for a parent to feed his/her child.
Teachers and society in general have had to stand back and let parents decide about the welfare of their children. They have had to respect parents rights about how their children have been brought up. This, of course, includes discipline and respect of authority figures. However, many people do think that as a result, children have become less self-disciplined and more obese. As a parent, I realize it is a big responsibility to place on parents, but with rights and choice come responsibility. And we are responsible for our children.
Of course, lots of us would argue that with both parents having to work, there is much less time to prepare healthy meals. There are less places for kids to exercises, and a perceived danger of being outdoors. But lots is being done to encourage and support parents to maintain the diet and health of their children. Check out at Change4Life
Rather than switch off and get cross about being blamed, some parents will take a positive approach and try to change ingrained attitudes. And of course, lots of parents will have had the idea already, and have healthy active children who know self-discipline through sports. These parents themselves may not be in the best condition, but they have made that worthwhile effort for the most precious little children in their lives.
Healthy Eating as Adults
Ok, so you're now a young adult. You enjoyed sports at school. You may even play 5-aside at the weekends. You've resisted the peer pressure to smoke. You are at the prime of your life. But it's up to you know. You're parents job is over.
It's not uncommon for grown ups to 'fill-out'. Perhaps too many chocolates for consolation after relationship break ups or too much convenience foods due to awkward working hours. It could be too much comfort food from boredom because you are between work or trapped at home with little children and feeling unfulfilled.
It is hard to remain focused throughout these times and remain self-disciplined and respect your body. But some people manage it, to their credit. The rest of us will just say it is too difficult at this moment, and i'll go on a diet when things are a little less pressured. Some of us will just feel defeated and have no motivation to change. Some of use will just delude or fool ourselves into thinking that it's normal to fill out, and what's all the fuss about? Much more important to worry about money and put food on the table. It's becoming fashionable for middle aged men, even fit weekend footballers, to have a beer belly. Unknown to most people, that is the highest risk for heart disease.
It is very difficult to bring up these topics with individual patients for fear of upsetting them. And quite rightly, doctors need to be sensitive to patients. It sometimes seems offensive to bring up weight when the patient has come for some other reason and the 10 minute appointment is over.
Everyone has a story. Perhaps they are depressed, bored, busy, ill, immobile or just too proud to admit that they are overweight. Personal Trainers will tell you that the biggest step in becoming healthy is the admitting that it is really important, above anything else. That it is a priority, among the many pressing priorities of life.
How to lose weight
The above advice was for people of average expected weight and proportion. Keeping healthy and a healthy weight is hard enough these days.
But what about those of us who are overweight already?! It seems an impossible task to lose that excess weight, and then maintain it.
- Eating AllBran or Branflakes with skimmed milk for breakfast
- Avoiding any sweets/chocolates or other snacks, but instead having fruit between meals.
- Avoiding actually buying those temptations at the shops in the first place.
- Not going shopping hungry. Buying food to cook, rather than pre-prepared convenience foods.
- Drinking a large glass of water before every meal will fill you up.
- If you are at home during the day, making lunch bigger than dinner.
- Cooking lots of veg. Having lots of fruit on the table. That way you will eat it. It can be kept in the fridge and reheated for those who work late.
- Having lots of fibre.
- Exercising before dinner: even if it means climbing stairs at home 10-15 times (without falling!).
Most people can eat healthy food, but they also eat rubbish, which lets them down.
How do I know if I'm overweight?
We use Body Mass Index BMI as a rough measure. This puts your weight and height in a formula and comes up with a normal range of 18-25. >25 is overweight, >30 is clinically obese. This measure has its limitations. One also has to take into account abdominal size (not at the belt line, but at the belly button!). Some people prefer to measure and monitor their body fat.
Why am I overweight?
If you managed to read the above without getting offended, you might now realize how you got to be heavy. It is important to know why. Because if you don't know the problem, it might be difficult to sort out. Because no one way to successful weight loss suits everyone. Everyone is unique and special.
OK, so I'm responsible for my weight, but can I get help?
Of course, the government has now realized that so many of its citizens are obese that it cannot afford to look after them in the near future. So it is investing lots of money into local schemes, advertising, funding for drugs for weight loss, and surgery too. The government is also offering you free health checks to which most are entitled.
The traditional group methods of Rosemary Conley, Slimming World, WeightWatchers work for most people, because there is group support, direction from an experienced leader and because you have to sacrifice both time and money. Self Referral
It was Freud himself who said that for a psychological treatment to work, the patient needed to be prepared to sacrifice parting with money!
But in real life one does find that help handed to patients on a platter is taken for granted. It never helps as much as that which they've shown an initiative to follow and to sacrifice time (if not money) to achieve. Schemes which involve patients showing commitment to booking their own appointments after referrals, and therefore having some 'ownership' of their treatment, are increasingly being used in the NHS to try to best use the increasingly limited resources available.
The GPs/Nurses at the surgery are always happy to help because prevention is always better than cure.
If you fill in a 1 week diet Diet Record, including every single thing that passes through your lips, including sweetened drinks and alcohol, we will gladly look at it critically. But you need to have an open mind and be ready for suggestions.
Diet recording really helps. It makes you aware of what you are actually eating, rather than just 'eat and forget!'. It also encourages you when you have had more good days than bad.
Calorie counting is not so hard as everything is marked with how many calories per 100g, and if it isn't, websites make it easy to look up foods. You may have to weigh your plate of pasta once, so you can calculate your usual portion.
Drugs or Bariatric Surgery to lose weight
The government has funded the use of Orlistat on prescription for help in reducing weight as part of a calorie-controlled diet and sufficient exercise. Cost to NHS about £30 month, which is a lot compared to a course of Penicillin which is less than £1. We have clear guidelines on how and if to prescribe these precious medicines. Both are only licensed for use BMI>30, and we can only continue to prescribe them if your weight continues to come down. No excuses. Otherwise, you and the doctor will not be insured for compensation with the manufacturing drug company if anything at all goes wrong. Of course, regardless of what the link here suggests, we recommend you do NOT buy it, but ask for an assessment with us and show an ongoing commitment to have it prescribed by us.
Xenical (Orlistat) stops you digesting any fat that is in your diet. (even the fat in a biscuit!). If you do eat anything containing fat, the undigested fat will end up as oil in your stools/diarrhoea. Accidents with clothes can occur! As well as showing proof of regular exercise class/gym membership, I expect a food diary from all my patients, if I am to continue to prescribe this expensive but very effective medicine to patients.
Boots Saxenda Injections. GP's NOT allowed to prescribe.