Wednesday, 28 May 2014

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.

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