Stay as positive and as optimistic as you can and know that it’s possible to make an improvement in your life. That is probably an absolute fact.

There’s a great deal all of us can’t change about our lives. One thing you can do is to take a few positive steps towards your own health and my experience and I’m still obviously working on it, on a daily basis, is that you can improve life and you can improve your experience of life that if you’re within a safe environment and you can become more active, absolutely do it. Get more fresh air, get more of the blood circulating round your veins. You’ll feel better and whatever positive steps you make towards your own health, you’ll feel better. You can have less indigestion. Less in the way of aches and pains and it’s worth the effort. Immensely worth the effort.

Okay and in terms of your levels of physical activity, I mean have you seen a difference when you lose weight?

Well the difference is, the difference is, the difference is doing the West Highland Way, the distance is climbing hills in the Lake District. The distance is a couple of Monros (Scottish mountains), that’s the difference.

Okay and when you have
We’re really talking all the difference in the world.

So from a physiotherapy point of view in an exercise class I can’t say that I learned so much about exercise per se, but what they were, what they were doing which I absolutely believe in and what I was reminded of which I have to remind myself or be reminded of, every time I put on a lot of weight and I begin to lose the weight, is the physical activity that you can do which is usually much more than people think that they can.

You can usually stretch further, they, one of the problems with obesity is you tend to let yourself off with a lot and believe that you are, you either can’t stretch so far or you’re going to hurt yourself if, through certain activities, and if you exercise consistently and stretch consistently in a properly safe environment, which is what the physiotherapists are doing on the programme and they are excellent and they’re what would you say, lovely girls [laughs] Yeah, they’re a bunch of really, really nice people, the whole lot of them actually, and they have a tremendous sense of humour and all the rest of it and again, it’s they have the expertise. They are, one assumes, in that capacity, it’s unusual to get more than one of them, but you do I’m sure in that environment because there are safety and health issues to do with extreme obesity therefore they want to be absolutely certain that any heart difficulties or any mobility difficulties they’re on top of instantly and they’re, they’re terrific and they’re very professional but I think that there is there are definite signs of people enjoying their time, exercising and, and beginning to get more out of it, and of course, that’s the whole, that’s the whole point because you can.

And when you start sort of putting the weight back on, on those occasions, is that, it’s gradual or it is

It starts gradually I think. Although this is the first time ever that I’ve monitored it.

Okay.

Because normally what happens is the minute I think that I’m going to get a result I don’t like from the bathrooms scales or whatever, I don’t go on the bathroom scales and if they, and that usually has a cumulative, cumulative effect because if you don’t weigh yourself one day, it’s far easier to eat far too much subsequently and then keep on not weighing yourself and then keep on not weighing yourself and before you know where you are it’s, it’s you know that it’s not going in the right direction but it’s, it’s quite some time since you’ve actually addressed it. it’s actually turning right round in the opposite direction ad just not addressing it at all
Okay.

Like some kind of child in a tantrum.

Hm-mm. It was kind of denial kind of thing isn’t it, it’s not happening.

Well no it’s not denial. I know damn fine [laughs] it’s, yeah, it’s not addressing it.

And the other thing which, which is, is interesting and it’s and I found it, and I agree with it totally this, this pattern of, of extreme behaviour and extreme expectations with people who are, who are facing sort of routinely facing extreme weight loss, is this completely unrealistic expectation of what you’re going to achieve and the time in which you’re going to achieve it. And that certainly is a pattern with me in my own life. Far, far too high an expectation of the amount of weight I’m going to lose, and the amount of time I’m going to lose it in and a consistent and constant expectation of the rate at which it’s going to go.

And that isn’t how, how you work or how the body works really, and that really you could see with it class when that was being talked about all kinds of bells ringing.

In this weight management course?

Mm. Yes

Okay.

Yes.

So, it’s something that you have been become aware or kind of worried about.

Yes, this particular, yes this particular profile, yes much more recently actually particular profile of unrealistic expectations and far too much perfectionism and therefore the extreme frustration when things don’t go as you wish on, really on a day and daily basis. it’s, it’s this feeling of, you know, All right, I was good yesterday and I haven’t had this result that I was looking for. You know, who’s against me? Is the universe against me?’ [Laughs] it’s just, and that’s a completely obviously unrealistic expectation.

Okay. So it is more a long term kind of lifestyle?

Yes, yes. Oh very, very much so. Very much a marathon not a sprint, so and actually in a way that’s quite comforting to think about it in those terms because everything, we are sold everything on the basis of speed. Everything is Lose this in so and so a time and , you know, this will get you amazing results instantly and whatever the beauty product or the sort of weight loss product it’s, it’s going to deliver amazing results incredibly quickly. That simply is, is not the pattern of how things happen really. Not with extre-, not with a level of obesity. Not with a level of overweight. The point is that you can, you can lose your stone in a month and probably absolutely will if you’re very overweight, but nobody’s going to notice that’s the trouble [laughs].

I have been spending a great deal of time [laughs] and effort on this and I am still not convinced that I am fully aware of all the issues which come into play. It seems almost inexplicable to me, but we’ve been doing a lot of work on the weight management programme with cognitive behavioural therapy which I think is very important and it’s an absolutely excellent tool that would seem to me to deal rather less with history as something what is the experience of the individual.

It deals more I feel with practical solutions and as such, I think it works, it works pretty well, and the hope is that I, I what do I think? I think long term support is very necessary.

Can you give me some examples of what you have learned or information acquired?

Information that we’re given. The planks of it, of the programme what we’re being advised to do, is to record out own behaviour, record what we eat and I’ve resisted that for years and years and years and years and years and finally found out at this incredibly late stage of my life that actually it is very effective. That’s making yourself look at what you’re doing is interesting, [laughs] interesting to say the least, and actually if you’re in the habit of thinking about what you’re doing, you probably make slightly different choices more often.

Okay, so it’s changing the behaviour.

it’s the examination of what you’re doing
Okay.

will be apt to have that affect if you do it.

You have to do it. There is a large resistance to doing that, but I would say that it’s, yes it is and I’ve been, being told that it was for a long time now. it’s taken me a long time to move round to doing it, but it is very, very effective and I’ve actually been recording what I’ve been eating, I beg your pardon, for over a year now, I think just and that’s the first time I’ve ever had a record, black and white, long term record. it’s not without the odd blank because one goes on holidays and does different things and stuff like that. it’s not always possible, but really it is, it’s a pretty good record of the year of my life, as far as what I’ve been eating and what I’ve been in the habit of doing.

Okay, so it’s, it’s eating and also activities?

Yes, to an extent but we’re not, it’s mainly you’re asked to record perhaps if you can thoughts and feelings. We get given a record book and I don’t do it in a record book, I do it in my own diary and I would, I find that more difficult? I don’t, it probably actually now I’m sitting thinking about it would, it’s probably about time I started to have a go at doing that because I can see the way in which that might begin to make you more aware of how, of thought patterns. And it is, it’s all about patterns and patterns and behaviour and what you do regularly and what you do almost automatically and yes it’s very much, very much to do with that.

Why do you want to lose weight? What are your main reasons?

Ah, main reasons, I announced a couple of years ago and it’s, and it’s no less true right now than it was then. I just don’t want to be fat anymore. I just don’t want to be. it’s hard work in hopefully ways in which I’ve managed to illustrate, to talk about. it’s that, it’s incredibly hard work. it’s hard work going to buy a pair of shoes. it’s world shopping in terms of getting anything to fit you. Certainly, the way I was last year and the way that I’ve been at different times of my life. it’s very demoralising having to look at yourself and take into yourself what the situation is and constantly live with it. It is, it’s like good old Sisyphus pushing his boulder up the hill and never getting shot of it to the other side. Always having to push, that’s what it feels like. Always having to push the same huge boulder up the same hill. That’s what it’s, that’s what it’s felt like. Here we go again and just a feeling that I have that I just couldn’t bear to do it all again.

She did a hell of a job, so, yep. But as to what, you can soak up what somebody else does to relieve their own tensions, like, litmus paper, you really can and mum used to do her day’s work. She worked hard and she would perhaps sit down about an hour before dad was coming home and she’d the evening meal prepared and all the stuff done and all the rest of it, and she would sit down for a while and she would have a pile of sweeties and she would eat her way through the pile of sweeties and chocolate and I remember, that I remember, things I remember and I suppose what we would all remember is that it was always an issue, in that mum was always trying to lose weight, always.

Okay, I mean your case, when did you started to try and lose weight? How old were you when you started?

When I decided I was fed up being so chubby when I was twelve and I decided I was going to lose weight and I did. By the usual methods, cutting down what I was eating.

Hm-mm. Were you having larger portions before?

No, I would, I would do what mum would do. I’d always been a secret eater. I can be a public eater as well, [laughs] I can, I can, yeah, more than anything I would, you know, sort of get my hands on a bag, sort of multipack bag of crisps or a big bag of crisps and eat my way through that or every day after school, I hated school, I hated it and that had a bearing certainly on, on them, how I felt about life and everything up until the time I was ten years old. I really, I really didn’t like any of that, and so when I came out of school it wouldn’t be any kind of a day unless I could go round to the sweetie shop with, you know, ten pence or something like that and buy some sweets.

So you go into a very negative mind?

Oh well, of course, if you picture yourself putting on ten stone and the faces of the people you know. That’s really all we have to do.

They would be utterly shocked and it’s seeing people’s shock because being very, very, very fat is shocking, especially if you weren’t that fat the last time they saw you [laughs]. And it’s, no, it’s very destructive just all around, it’s awful. You avoid seeing people. You avoid social occasions. You avoid all kinds of things. There are opportunities and chances that life might offer you which you don’t take up because you take up too much space. Over and over and over again.

it’s something that I hate, and I fight naturally. But I haven’t been as successful obviously as, as would have been a good idea for my health and the, it hasn’t ruined or obliterated my life, simply because I’ve been in the happy situation of perhaps not having to. But it’s been it’s everything I say, I mean it hurts, it’s painful both physically and mentally.

nd the other thing that I didn’t mention as far as health issues are concerned is you constantly injure yourself. Therefore, your joints and there’s always a joint or something which is giving you real problems.

That’s part of it. If you, I don’t know how many people you’ve been interviewing who’ve had sticks and various assistances for daily life, but I would have said there’s a pretty high proportion of people who are disabled in some way or another to varying sort of sad degrees.

Last year I had, what did I have last year? I ended up having, oh my right foot wasn’t working properly, giving me, you know, fairly tedious pain because it has to be fairly serious pain before I start. But I was having X-rays and things like that and being told severe arthritic deterioration and de, de, de, and, of course, the unspoken end of that is the same as it always is, and if you lose a significant amount of weight, it will have a significantly palliative effect on it.

I had an epiphany of sorts last summer. I hadn’t been doing very well and had been looking at various levels of despair again and because we can talk about prediabetes and diabetes in deed and lots of health conditions, heart disease, rotten circulation, all kinds of attendant health conditions. Danger of stroke, all sorts, but there are lower level practical daily considerations which impinge possibly until perhaps total health disaster hits and impinge on you possibly even more. it’s just the physical problems of living your life.

Like?

Like, you want me to be frank?

Yes.

Like, getting up off a chair, cutting your toenails, going to the loo and wiping your bottom and whatever you do, that can become almost impossible. In order to stretch your body far enough to be able to get past all the mountains of fat, you end up with interesting lumps and bumps of knotted muscle and all kinds of things. it’s very, very difficult not ever being able to get through any spaces. Being terrified if you go out, meet a friend for coffee or anything like that, when you get up you’re going to clear tables, just moving. Just the day and daily parts of living your life or attempting to live your life.

Okay, so everything is affected basically?

Oh utterly, utterly, yes of course it is.

I think I would mainly say, try, try things, if you haven’t tried something I don’t mean in a diet. I would say in a group or some sort of local offering of like the, Keep it off for good’, try something and if it doesn’t work for you or you don’t like it, don’t be put off trying something else because I think in lots of other areas of life, if we don’t like something, we don’t blame ourselves, if we went to the cinema and it wasn’t a good film, we didn’t enjoy the film we wouldn’t say, Oh, it’s my fault I didn’t enjoy the film So don’t say that about, you know, it could be that the group’s not got a great leader or it could be it’s too late in the day for you to be alert and taking in all the messages or but the only other thing I think is that I do think that cost is a big factor, you know, and one thing I try to say to myself is I tell myself, I can’t,’ at times, I’ve said, I can’t afford to go to a group because it’s five pounds a week,’ and you have to be honest with yourself and say, Am I spending five pounds a week on food that’s doing me harm?’ And if the answer to that is, yes’ then you should go to the slimming group really.

Well, I think if the NHS is putting public money into subsidising big companies like Slimming World, I think then maybe they should have a bit more say and control over it really. So, the point I mentioned about the classes being too big, you know, maybe they commission some classes specifically or said, Well if, if we’d got people that were paid to be in that class, we’d like that class to have no bigger, no more than so many people because that gives people more of a chance of success. More of a chance of asking questions and being listened to and so possibly better outcomes don’t, don’t just throw the money at it and hope it’s going to get the right results, you know, use the public money to do it sensibly.

Have you talked to your GP, your doctor about it?

Well I’ve only had one, one sort of discussion with a GP. I went with a different problem totally and while I was there, she mentioned my weight and actually it was one of the most unsatisfactory experiences I’ve ever had because she had somebody, a trainee doctor in the room and I felt she’d just put that question into our consultation just as a, an example of good practice or something and she, she asked me a couple of quick questions and I explained to her that I did eat well but time was a factor when it came sometimes, time could be my undoing as well and she just said to me, Well, you know, if you make a small change like take a salad to work And I felt quite insulted really because she, I’d only ever seen her a couple of times before. I didn’t feel she knew anything about me and I know it’s a doctor’s duty to point out overweight, but I just felt it was like a tokenistic really. You know, because I’d just explained to her that where at that point I had fallen down on my lunch meals and it was because each day I was driving from one side of town to the other teaching in community settings and I was eating as I was driving and I thought if she’d have listened to that she’d hear what I was saying that a) it wasn’t generally my lunches that were a problem b) to eat a salad while you’re driving is, you know, not, not at all sensible and c) she totally ignored the bit about, you know, the chocolate and the snacks which is, was the key. So, it, it felt like, you know, I’ve read a little bit since about how doctors should intervene with patients.

And how should they?

Well they say it’s all about the language you use but I honestly believe that most GPs nowadays do not have the time. I think full stop they don’t have the time so if, if they feel it’s important then it’s up to their surgery or their health area to organise something where people can go to people who have got the time to spend. I just think it’s, you know, we’re, we’re told as patients, don’t bring a second symptom, a second problem into a five or ten minute appointment and then the doctor brings something in like that which is huge in an older person, weight person’s life. Huge thing and to think that anything a doctor might say like that, you know, about small changes or habits it’s scratching the surface.

I just think people need to look at every, every single strand. it’s a very, very complicated problem and I think it does need to be more joined up. I mean I have done like an exercise on prescription. We have like an, an arm’s length organisation in city that does sort of weight loss for the terrified, exercise for the terrified and that was good, but I felt that, the training, he was a gym trainer and he was very fit, and I don’t think he under, I think he underestimated how reluctant people feel, frightened even of doing exercise. Some of them a lot more frightened than I was about doing things. Especially the more over weight they are and also, I think they narrow it to just being gym activities and for lots of people, overweight or not, a gym is not the thing that switches them on and keeps them motivated. I like classes, I like groups, I like making a commitment to going to something. So I think it needs to be more joined up thinking between the exercise and, and the food really.

Okay and also to have an exercise programme that is tailor made
Yes.

or people if they haven’t done exercise for a while or ever.

I mean, in fairness this was a very gentle set off and yet I think again, it’s about six or eight weeks and then after that period, you had an induction to the main gym and then you were on your own and it wasn’t so much the being on your own it was the fact that you could go any time then so you didn’t have to be committed and if you felt under the weather you didn’t bother going and if you didn’t particularly like the gym, you didn’t have quite enough motivation to, to carry on with it really.

I went on a very good NHS programme in [City] called Keep it off for good’ and that was fantastic. But it was eight sessions and if you’ve spent thirty or forty years getting bad habits and being overweight, you need prolonged support. You need it to go on and on, whether it’s a group or whatever it’s, it, you can’t undo in eight good sessions no matter how excellent they were, you can’t undo all the habits. So I think it’s a reason to keep going back and the availability of something that you can keep going back to.

Can you tell me a little bit more about that programme, the NHS programme?

Yes, so it was, it was self-referring, so you had to be overweight. It was self, you had to have a BMI over a certain amount and it was a small group which was excellent. There were only eight or ten of us and the, the leader of it, [name], she was she never said what her qualifications were, but she worked in a gym and I think she had qualifications of some kind in nutrition and it’s the first time really that somebody had put all information together. Every week we had a, a strong topic and I learnt some new things because I think overweight people are quite experts in things and you think, I’ve not got much, much I can learn. But actually, she, you know, she used a, a wide range of references and excellent handouts and she emphasised exercise. But I think it would have been improved if it would have been far longer than eight weeks and if it would have been a two-parts thing so that those sessions were one part and actual exercise was another part.

Okay.

Joining the two together.

Okay, so, yeah, sort of, kind of to keep
No, a token amount within the session but a separate session for exercise, I think that would have been great.

Okay, and what about in those sessions that she did, [21:32] she talk about sort of how to change behaviours so what would help to change behaviours?

Yes, so she talked about keeping a food diary, looking at what we were currently doing. Making small changes which, you know, she emphasised all the medical side of things, what it could lead to. She had a week on exercise. She had a week on all the temptations and downfalls and how you could get around those things. So things like, something that’s become prominent like cakes at work on a Friday and eating out and coffee shops and all the things that really contribute to people potentially putting weight on. And, but I just think then she gave us a little bit of homework, so we had to go away and think about whatever the topic was. But I just think it should have been far, far longer course.

Okay, so would have been, for you more, more, a longer term to keep you
Yes, because I think to take a new idea on board and turn it into a new and better habit, they say it takes three weeks minimum and to be doing that every week, obviously you’ve not got enough weeks to, you’ve not even ingrained one good habit before you’re having to try and start another one.

What has stayed with you from that course in terms of habit changing?

I suppose really it’s just that it combined elements of other things that I’ve done all in one place and with a bit more thought and knowledge and it, it’s sort of, you know, it’s, I’ve never really believed in silly crash diets but there was a week where it was all about, you know, debunking the myth of crash diets and why they don’t work and things. But she did sort of really say, you know, at the end of the day the responsibility is with me, nobody, you know, nobody could wave the magic wand for us. It was down to each individual which you know that but if you, if you have this negative feeling that I’ve spent a long time failing and that I’ve got no will power. Self-blame plays a very strong part I think in weight problems or my weight problems.

Well I suppose it’s like any educational experience really. You, you want a good teacher at the front of the classroom and the one that I went to last year, she, she was a lot younger than me, but she, she loved cooking, so she was full of ideas, full of recipes and very positive about everything and she wouldn’t entertain too much negativity. She moved the things on quickly and you’ve got to feel that that person is I think really on your side. The only downside to it I would say is because she was a good leader, her group was massive. So, for her to go round every person, every week and ask us in a group how we’d done etc., you know, it was getting really late when we were finishing. I think there should be a maximum size of group really for it, of course it’s a commercial enterprise so
Okay, so, how, how big was your group?

I would say between 30 and 50 people. Yes, yeah it was that good.

Okay and she was running just one group or within that area?

She, she ran three groups. One in the morning, one in the early evening and then the evening one that I went to after work.

Okay. So, if you would like to, I think this is, this is very important so if you based on your experience, if you need, if they ask for your advice kind of what group, what group size would be good, the qualities of a leader. What would be, if you had to recommend something?

Well I would say definitely no more than thirty people. I mean, probably twenty’s ideal but commercially that’s probably not viable because of all the cost involved but they only, I think they mainly recruit from people who have lost weight with them. So in theory, the people have got that knowledge and enthusiasm but she’s gone on to be, she’s dropped two of her classes now and she’s like an area manager. So clearly, she did stand out, just enthusiastic and interested in cooking because at the basis of Slimming World and Weight Watchers really is healthy eating and just, just a good healthy diet and that involves putting time and effort into cooking and lots of people don’t cook. Lots of people don’t cook. I have always enjoyed cooking but lots of people don’t know the first thing about cooking and they need some help to and they need it from people who are doing it and are, you know. She was very good at identifying new products that had come onto the market, not, not Slimming World ones, just new things like squash being used as lasagne sheets and things like that. So, she was really on the ball all the time every week.

I can only say for myself I don’t think it’s one thing at all. I think that would be most people’s experience that yes my father was overweight, but he got diabetes and his mother was overweight and the same thing so, there is like a possible genetic thing there. But I do think everyday life comes now with so many sort of, you know, ways that encourage you to be overweight and I think a lot of people, it’s like having a selection of a hundred things and people chose some of them. So, for example, my local mini-supermarket a bar of chocolate is 80p, but you can have three bars of chocolate for £1.20 and as a chocoholic that’s terrible temptation because you think, Well that’s ridiculous. I’ll buy three and I’ll put two in the glove compartment. One can be for tomorrow. One can be for the day after,’ but no you see I’ve been eating. I’d creep out to the car at midnight and get one out of the glove compartment. I, I just think there are so many every day temptations and if you’re already over weight and you think to yourself that you think a slimmer person has either got more self-control or doesn’t need to exercise for some reason their brain is wired differently, you know, that you’re presented with say thirty choices in a day to do with calories or exercise and you just pick some of them wrongly every single day.

I think just, just one thing I would like to mention really is the busyness of today’s world is a big factor that I haven’t mentioned. I do think society is changed and speeded up an awful lot and people have jobs that have, you know, perhaps not as physically demanding obviously but mentally very demanding and a lot more stress in life and I think all of that is another major contributor to overweight. People not having the time to cook, to think about the shopping before they do it. To be supervising the children, to be sat down at a family meal table. I think time is a massive other factor that needs to be thought about in any initiatives. it’s no good thinking we, we live in this ideal world of the fifties because no, nobody does anymore.

Yeah, because I think something I learnt from Slimming World is that, in my opinion, you can group people into why they’re there and it could be a sweet tooth, it could be comfort eating. It could be alcohol, it could be a very busy social life but at the root of it all is emotions because why can one person have exactly that same life and remain slim and another person puts weight on. There’s, there is, I think, very deeply psychological reasons underlying it.

I think it just starts as a small thing really. You know, my thing used to be, my son used to go to his dad’s on a Saturday when he was a toddler and I would go and do a weeks shopping and I would just buy one item that was a little treat to myself for managing all week as a single mum and then I think once you get that idea, I mean, I think they’re called neural pathways, I think your brain makes connections for good or ill so that it just creeps up. You think, Oh that was hard. I did that. I’ll just have a Kit-Kat or, you know, and before you know it you’re rewarding yourself on a regular basis so eating three healthy meals a day, well balanced, five a day, all that and then I just ruin it really by treats. But it’s not just comfort eating. I, I think there’s a difference. I think comfort eating becomes habit, you know. So, your habit is to go in the kitchen and have a little look around and find something to eat perhaps while you watch a television programme or you’re reading or if you’re sat at the computer doing some work and then it just changes from being a comfort thing to, to a habit and becomes ingrained with the decades.

What do you think would help you to break that pattern?

I think, one of the main, one of the main things I think I have to say is that you feel a failure because, you know, I’m an intelligent person, I know what I should do so you feel a failure so and if you’ve got decades of evidence to prove you’re a failure that does sort of reinforces it really.