NICE Obesity Advice to GPs

At long last NICE are recognising the role that counselling has to play in tackling the UK’s Obesity problem and are urging GPs to refer patients to weight loss services for help and support.

Everyone is an individual, our bodies all behave in different ways, especially when it comes to food and our weight. Some rules apply to everyone; if we consume too many calories over a prolonged period of time then our body size will increase. But there are many other factors that affect our relationships with food and how our bodies react to what we eat. There are illnesses that affect how the body absorbs nutrition, both chronic and acute. Our lifestyles can also have a major affect; stress causes a release of the hormone Cortisol, which can cause weight gain. Busy work schedules result in missed meals through the day and a desire to binge eat at night, when the body retains more fat. Even drinking too little water will stimulate the body to feel hunger rather than thirst. Chronic fatigue and depression also play a role, resulting in comfort eating to overcome emotional and physical pain.

Being overweight can result in numerous problems that then exacerbate the issue. Movement becomes more difficult, and then painful, as joints lose the protection of muscles and then come under strain from burdens they have not evolved to support. This results in a more sedentary lifestyle, which weakens the body further. The constant bombardment of advertising and the media promoting slim, fit, bodies as the answer to all life’s problems makes those of us that do not match the image feel inferior and undeserving of happiness, which can trigger comfort eating. Over time our bodies override their natural systems, such as feeling full when we have eaten enough; we develop cravings for increasing amounts of sugar, fat and salt, and our organs lose the ability to deal with food in a healthy way. We steadily build up poor eating habits that become more and more ingrained, becoming psychologically difficult to break, especially on our own.

There is no quick fix, no magic bullet; unfortunately though, many diets abuse the fact that the body contains several pounds of Glycogen, a fat that acts as an emergency supply, which disappears rapidly in the first couple of weeks of a low calorie diet. They hint that this rate of weight loss will continue and while an obese individual can lose a stone in the first couple of weeks, as the glycogen is used up. After that the weight loss slows rapidly as the body starts to lose the fat reserves that are the real problem, and 2lbs a week is an average, whatever the programme. Ads that shout ‘I lost 14lbs in two weeks,’ are the ones to watch out for. If the person goes back to eating normally straight away afterwards, the the body builds up the Glycogen store as quickly as it came off, hence Yo-Yo dieting. Maintaining a steady weight loss will result in the body reducing its capacity for building up Glycogen, but this develops over a period of months.

Weight loss requires a holistic approach to be successful, understanding each person as an individual, and addressing the different components that have lead to weight gain. Some people will find this easier, others will find the process a real challenge, but it is within everyone’s ability to achieve their goal. The components to a successful reduction in weight that is sustainable are a reduction in calories, an understanding of what has lead to the increase in weight, help and support through the process,  and most importantly, building a healthy relationship with food again, one that will last a lifetime, which may now last much longer.

At Wits End Weight we treat everyone as an individual and offer a range of help and advice, including group sessions, workshops and 1:1 counselling, depending on the individual. We take people on a journey, it may be difficult at first, but we are with them every step of the way. Our goal is a new you, healthier, happier and confident in their food choices. We cannot claim to work miracles, simply to put you back in touch with the body you were born with.

Healthy Eating Tips for Nurses

Healthy Eating Tips for Nurses, by Debbie Saunders, Ideal Weight

Nurses do not always have the time to eat the healthiest of meals. Whether you’re working all night and are too tired to eat, or you’re working a busy twelve hour shift; taking care of your nutritional needs can be a real challenge. At work, you cannot always take time away from patients in need, no matter how hungry you may be. That is when quick snacks from vending machine start to look rather appetising.

Skipping meals or substituting unhealthy snacks will not provide the fuel you need to meet the demands required for nursing. Eating well can help you live better by preventing diseases and other medical conditions; and also help to relieve stress. Here are some healthy eating tips designed for busy nurses.

Think Whole Foods, Not Deprivation

Luckily, it’s not difficult to give your body the nutrition it needs to run efficiently and then you will have more energy and generally feel better. Good nutrition does not mean depriving yourself of all your favorite foods. It is about adding more whole foods into your everyday diet and enjoying the less healthy options, such as doughnuts, chips and caffeine drinks, as occasional treats. The less you consume these treats, the less you’ll crave them.

Keep Blood Sugar within Normal Limits

As a nurse, you know that missing meals can cause a drop in your blood sugar level, which can make you even more hungry, irritable and fatigued. When that happens you are more likely to eat anything that is easily available for a quick energy boost. In extreme conditions, if you don’t eat, you could become light headed and disoriented, which is obviously not the best condition for a nurse.

Try to keep blood sugar levels stable throughout your workday by planning ahead for your nutritional needs. Stock up on apples, low-fat cheese, dried fruit and raw nuts, such as almonds and walnuts. Pack moderate portions to snack on before you get too hungry. Remember that fruits, especially dried fruits, have a sugar content of their own, so do not overdo it or your glucose level could rise again. Balance fruits with protein from cheese or nuts. Focus on high-fiber snacks, too, such as rice cakes, oranges or berries.

Don’t Eat One Big Meal a Day

Saving the bulk of your calories for one large meal is not the best eating strategy. Your body can’t handle too much food at a time, so it’s better to divide your food intake into regular intervals throughout the day. For many nurses, eating six small meals a day would make them feel better than one or two large meals and snacks.

Add Colour

Colourful foods are generally higher in nutrition. For variety and optimum health, aim for three colours in every meal. Aim for two servings of fruit and three vegetable servings each day. Pack a big salad for your lunch or dinner at work, for an easy way to add colorful veggies to your diet. Prepare a large bowlful of salad on your day off and you’ll be ready for quick meals throughout the week.

Avoid Processed Foods

Processed foods are easy to prepare, but usually high in sodium and fat. They often contain preservatives and hidden sugars, as well. Skip the aisles of packaged and canned foods and make your own basics from scratch. Brown rice, prepared dry beans and whole-grain pasta can fill you up and prevent you from overeating. The fibre is good for your digestion and blood sugar, too.

Create a Healthy Food Zone

Encourage nutritious eating with co-workers by establishing a “healthy food zone,” where only healthy food is allowed. It is too easy to overdo it on biscuits, cakes and other treats brought from home, and given by grateful patients, so make a pact that only healthy foods will be brought into the workplace.

Take Small Steps

Changing eating habits takes some planning and effort, but it’s not difficult. Every small step you take adds up to new, healthy, lifelong behaviors.

Start with bringing salads and healthy snacks to work.

Is Fat Necessary?

Fat is often thought of negatively in a diet, but your body could not survive without it. For one thing, it’s a valuable source of energy, but more importantly, we also need fat to absorb certain vitamins that are important for your health – such as A, D, E and K.

Fat is made up of individual ‘building blocks’ which are the fatty acids. Some of these are essential, in that they have vital functions in your body, and you can only get them from your diet, as your body cannot synthesise them. These essential fatty acids include omega-3 and omega-6, which are vitally important as they are used to make the outer layer (membrane) of the cells in your body, and are also involved in the production of substances that control the chemical reactions inside these cells.

Although it is undeniable that you need some fat in your diet, it is all too obvious what happens if we eat too much. Fat is the richest form of energy that we consume, which means it is very easy to eat more than we can burn off through activity, leading inevitably to weight gain. The rise in obesity levels is often blamed solely on eating too much fatty food, but it is a bit more complicated than that. The average intake of fat in the UK is not far off the recommended level, and as a population, people are eating less fat today than 20 years ago; so why is the population getting fatter, why are we not at our ideal weight? Fat is obviously not the main culprit.

The problem in our diets is not the total amount of fat we eat, but the types of fat. Naturally occurring fats can be classified as either saturated, monounsaturated or polyunsaturated, depending on the chemical structure of the fatty acids they contain. There are also trans-fats – which are produced artificially, turning a source of fat, such as vegetable oil, that is liquid at room temperature, into one that solidifies. Unfortunately, these trans-fats make excellent ingredients and greatly enhance the taste and texture of processed foods, but are disastrous for our bodies.

Saturated and trans-fats are the ‘baddies’ – the ones that are harmful to our health, by increasing cholesterol levels, which can lead to heart disease. Trans-fats are thought to be particularly unhealthy as they raise the levels of bad cholesterol (low-density lipoprotein) while lowering the good variety (high-density lipoprotein). Since their harmful effects have been exposed, the food industry in the UK has been pro-active towards cutting these fats out of processed foods; so fortunately, most of us are not consuming large quantities anymore, just dealing with the after affects. Nowadays it is saturated fats that are the main cause of problems because we are eat far too much, about 13 percent of people’s energy intake currently comes from saturated fats, with the recommended level being 11.

Monounsaturated and polyunsaturated fats meanwhile, are actually good for you, and most people don’t eat enough of them. Unsaturated fats help to lower cholesterol and also provide you with the essential fatty acids that your body needs. Omega-3 fatty acids that come from fish are thought to have specific benefits in helping to protect against coronary heart disease; and there is evidence to suggest numerous other health benefits as well.

So, what should we avoid?

Foods high in saturated fats include:

• fatty meat and meat products
• dairy products – such as butter, cheese and cream
• pastries
• cakes and biscuits
• chocolate
• coconut oil and palm oil

The average man should have no more than 30g of saturated fat a day, and the average woman no more than 20g.

Foods to look for:

Good sources of unsaturated fats include:

• Sunflower, rapeseed, olive and vegetable oils, and spreads made from these oils (so long as they have not been hydrogenated (trans-fats), not to be confused with emulsified, combined with water.)
• avocados
• nuts and seeds
• oily fish, such as mackerel, salmon or trout – these are a particularly good source of omega-3

So, yes, too much fat in a diet where it is not being burned off will lead to an increase in weight, but it is in fact sugar, in its numerous guises, that is really responsible for high levels of obesity. For a healthy diet, all most of us need to do is reduce our saturated fat intake, while some of us would actually benefit from an increase in unsaturated fats. As with most things, moderation is essential to maintain your ideal weight.

For more information on weight loss in South Wales contact Debbie Saunders, weight loss counsellor.

Find Your Ideal Weight

South East Wales is a good place to live, but especially so if you would like to lose some weight because that is where Debbie Saunders works. Debbie is a qualified, trained counsellor and coach, who uses the highly regarded techniques of cognitive behavioural therapy and transactional analysis to help people who have serious weight issues, or want to lose a little and maintain.  Our modern day relationship with food is very complicated; we have the same urges as our hunter gatherer ancestors, but have access to as much food as we could possibly want and more. Over time, our bodies are affected by this constant feast without famine and we lose the sensations that tell us to stop eating when we are full.

With a structured diet plan, group counselling sessions and lots of support, it is possible to get your body back on track.  Debbie has done this for hundreds of clients over the past six years and is an expert on the whole diet journey.  For example, even on a steady diet containing exactly the same calories each week, weight loss is not constant. There are times when the weight loss plateaus, and despite the diet, nothing happens for a week or two which is when people are tempted to give in, but Debbie helps clients understand what their body is doing and see this in a different way.  Sure enough, the body relents and the weight drops again, with a sudden big jump. It is this kind of insight that enables Debbie to help her clients reach their goals. An unexpected weight gain could be down to a stressful week, as high levels of cortisol released into your system will encourage water retention.  Talking through why your body is reacting the way it is can help you to stay focused.

There are a number of reasons why group counselling is so effective; firstly there is the support that comes from the other members. Everyone has good and bad weeks, so it is great to be able to pool experiences and strategies to cope with the down times but also to celebrate successes together.  There is nothing as motivating as a group member hitting an 11 stone weight loss target!  Groups also mean that costs are kept down, although Debbie is happy to provide 1:1 sessions if that is what you would prefer. So if you are lucky enough to live around the Abergavenny, Monmouth areas and need some help to reach your ideal weight, why not give Debbie a call and find out how she can help.