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Ellie

Age at interview: 69
Brief Outline:

Ellie put on weight after the birth of her son. Since then, there have been times she has lost weight, but she has always gained this again. Ellie was recently diagnosed with sleep apnoea and type 2 diabetes. Although she received little professional support around managing this, Ellie was motivated to change her lifestyle in order to control her condition. Through changing her diet and becoming more active, Ellie lost 4 stone over a year. However, after breaking her shoulder, Ellie put some of this weight back on. Ellie now hopes to lose weight to improve her health.

Background:

Ellie is 69, and is married with 1 adult son. Before retirement, Ellie worked as a travel agent. She is white British.

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Ellie first gained weight following the birth of her son. Although over the years Ellie has lost weight through various diets, she has put this on again when she has started eating “normally”. She also attributes her weight gain to her workaholic attitude when desk working from home. However, Ellie was recently pushed to lose weight after being diagnosed with sleep apnoea and type 2 diabetes. Ellie describes this diagnosis as a “shock”, “it makes you feel really odd about yourself because you know its self-inflicted, and ashamed and you get all the guilt”.

When she was diagnosed with diabetes, Ellie was advised by a nutritionist to reduce her fats and eat lots of carbohydrates. However, Ellie did not see an improvement in her condition, and started having side-affects from her medication, including bowel problems, sickness and nausea. She also began to worry about her health, and seeing her grandchild grow up, “I thought, ‘if I don’t do anything about this, I won’t see seventy’”. Ellie started seeking advice in online forums about managing diabetes, and changed her eating habits. She started walking every day, and following a low carbohydrate, low fat diet. Ellie lost 4 stone in around a year, which she describes as “the most wonderful feeling in the world”. er sleep patterns and energy levels improved, and her diabetes was better controlled. However, Ellie then broke her shoulder, which was “totally life changing”. Conscious of staying healthy, Ellie started to eat more dairy, and unable to exercise, put on most of the weight she had lost. Ellie is currently maintaining her weight through limiting her fats and carbohydrates, and weighing any carbohydrates she does eat.

Ellie has found that her eating patterns are dependent on her emotions. Times when she has stopped dieting often coincide with stressful events in her life, “you’ve got to be in the right frame of mind, you can’t do it if there’s something wrong in your life”. However, Ellie also wonders if genetics have contributed to her weight issues, as her sisters and aunts have also struggled with their weight. She finds people - including healthcare professionals - often do not understand the wider reasons for weight gain, and can have negative attitudes towards people who struggle with their weight, “It’s just being judged by the rest of the world. As being fat and thick”.

When she was initially diagnosed with diabetes, Ellie didn’t feel she was given much advice from healthcare professionals on how to control her condition, “you’re left totally on your own.” Ellie suggests that on diagnosis, individuals should be referred to courses to learn about diabetes and how to manage it. Indeed, she feels that the NHS is in part at fault for the diabetes “epidemic”, as it could be controlled with better support for those affected.  This could begin before diabetes is diagnosed, “they never said, ‘you’re pre-diabetic’ or ‘you’re liable to diabetes’…if the doctor had stressed that I would have done something about it”. Ellie suggests healthcare professionals should be more direct when talking to patients about weight in general, “I think that maybe the doctor should be a bit sort of more brutal and when you’re starting to put on weight say, ‘Look, this is what’s going to happen’. Nobody ever said to me, ‘Look, you’ve got to lose weight’”.

Ellie plans to go back on a low carbohydrate and low fat diet, in order to lose weight in the future. Whilst she would like to be able to wear the clothes she likes, Ellie is also motivated by health reasons. She hopes that losing weight could help improve her sleep and control her diabetes, so that she can come off her medication. Her main concern is lowering her blood pressure, which she has recently been warned is increasing her risk of a stroke. Ellie encourages others to take a long term approach to weight loss, and “to look on it as a lifestyle change”.

 

Ellie says that her diet goes ‘out the window’ every time her son has problems and that when he is fine things are fine with her too.

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You’ve got to be in the right frame of mind, you can’t do it if there’s something wrong in your life, you can’t.

What do you mean?

My son is a real problem and every time he kicks off, that’s when the diet goes out the window and that’s when we start smoking again [sighs]. But when things are fine with him, they’re fine with me and I can do it. But you can’t do it if you’ve got some kind of emotional background and och, I can’t even, couldn’t even start to begin to tell you what he’s like, drugs and stuff. Suicidal, that kind of thing. It’s very, very difficult and that’s what knocks me, and it is not a comfort because all the time you’re eating, you’re think, ‘I shouldn’t be doing this.’ But you think you need something to, to cheer you up and that’s when you do it. But he’s okay just now, so…

Okay.

….hopefully I can get back to scratch again.
 

 

Ellie is ashamed to ask for a seatbelt extension on flights. She feels judged by other people who may assume that her weight is her fault.

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What else? It’s just being judged by the rest of the world. As being fat and thick. I think you’ve got to be thick if you’re fat.

Okay, yeah.

Plane seats. That’s just awful when you’ve got to ask for the extra belt. It’s shaming.

Okay, so shame is something that you associate with the experience of being overweight or, or the experience of obesity?

I don’t particularly think it’s my fault, right, up to a point I do. But I don’t think it’s my fault entirely. It’s something to do with genes and whatever, but everybody looks and things, ‘That’s your fault,’ and I hate that. I hate everybody thinking I did this to myself and I didn’t try to do it to myself, you know what I mean.

Hm-mm, yeah.

Everybody assumes that every fat person sits all day and eats all day. They don’t.

Yeah.

I eat a lot less than most folk.
 

 

Ellie’s workaholic lifestyle was so sedentary she got out of the habit of moving around. She remembers gradually gaining ‘maybe four stone’ during this period.

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I was a workaholic and I sat at my desk all day from eight in the morning until eleven at night, and I would come down for meals which [husband] had cooked because he worked shifts at that time and if he was going to, he’d finish at eight o’clock and I would cook for him. I would take an hour off to cook and it would always be something quick, like, pasta or something I could put in the oven, so that I could get back to work and I just got out of the habit of moving around. I just sat at the desk day in day out loving every minute.

It was two minutes to my bedroom. I would get from the bedroom to the office. I would go and get washed, but sometimes I didn’t, if the phone went, I didn’t get showered until midday. I just didn’t want to leave the desk. I just loved the work.

Okay, so that was what you, you were mostly doing…..

Yeah it wasn’t that I was eating any more. I was actually eating less because I wouldn’t leave my desk to go downstairs to make something to eat and I kept going on sort of, I used to have a can of coke and that would last me all day or the odd coffee. But that was it, and I just worked the rest of the time. I think back now, it was totally stupid. I should have made an hour at least away from my desk, definitely.

How much did you put on during this period of working from home and not doing much?

It was so gradual, I can’t remember. Maybe four stone, something like that.
 

 

For Ellie, there are lots of reasons to lose weight, ‘it makes you feel so good about yourself ‘when someone notices. She wants to see her recently found grandson ’grow older and get married and stuff like that’

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A number of reasons. I love clothes. You can’t get any nice clothes when you’re big and that’s, that’s a big part of it for me. The other part is to stop the diabetes if I can halt it, not let it progress. I’ll never lose it but if I could halt it. If I could come off the medication, that would be wonderful, and I think if I lost the weight, my blood pressure would come down as well, so it’s a sort of package thing. If you lose the weight at least other things, I might even sleep better, I don’t know, and that would be good. And it’s, it’s the sense of, I don’t know, when you’ve lost weight, it’s the most wonderful feeling in the world. If somebody says to me, “Oh you look good, you’ve lost weight.” It makes you feel so good about yourself and I don’t have issues with self-loathing or anything, I’m not, it’s just, I always think I’m fairly normal but I’m fat [laughs]. And I think if I can get away from the word, ‘fat,’ that would be nice.

I was determined. I was sort of sixty-seven, sixty-eight at that time and I thought, ‘If I don’t do anything about this, I won’t see seventy, and I’d got it into my head I wouldn’t see seventy, and we just found out, long story, he was, my son and his wife split up, she disappeared with the baby. We found him when he was seventeen or he found us and I just thought, ‘I want to see him grow older and get married and stuff,’ and it made me really take a good long look at myself.
 

 

After losing four stone Ellie was at the ‘cusp of coming off medication’ for high blood pressure and the HbA1c test results for type 2 diabetes went from 8.4 to 6.1. Her aim is to lose weight again and manage her health problems without medication.

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I was on medication by this time and the medication is horrendous and it gives you all sorts of bowel problems and sickness and nausea, so I thought, ‘I’m going to get off this. What can I do?’ So, I started going right through these forums and found that if you go on a low carb, high fat and start exercising, you can actually, maybe reverse or reverse the symptoms. You’ll never reverse it, but you would have to keep this up for the rest of your life, so I find that quite successfully. I lost four stone in maybe a year and I sort of tootling along at that and I was, I was on the cusp of coming off the medication when I had this accident.

So, hopefully I can get back onto that and try and get some of this weight off because I found it when the weight’s off, you can do more. You’ve got more energy and plus I can sleep better. If I can get, if I can get a full night’s sleep, test myself in the morning, my numbers are down drastically, and I think there’s a definite link between the, the amount of sleep you get, good sleep and what your blood sugars going to be.

So that was my aim was to get my blood sugars down and get off the medication and that way I felt like my life would be going somewhere rather than just waiting to die.[laughs]

Okay, so your diabetes control improved?

Oh hugely. I was never really that bad. You know how they do the numbers, I was always around about 8.4 and then they got it down to 6.1 and the one that they say when you’re, you’re not diabetic anymore is 5.9 and I couldn’t get there. I got stuck at 6.1 but it became an obsession to get down, so I was trying to walk more and more and more and then this happened and it just went.
 

 

Ellie felt “elated” to find that the diet plan and walking routine were helping her lose weight and control her diabetes.

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And tell me a little bit about when you started it, this diet and you were losing weight, how did you feel physically and emotionally?

Oh elated, absolutely elated and the walking thing, the further I got, I kind of did the first, I used to do sort of fifteen minutes and I’d think, ‘I’m good. I’ve done fifteen minutes.’ Then it got to half and hour and then it got to an hour and then it would become slightly obsessive [laughs]. Trying to beat yourself every day and I think maybe I’ve got a compulsive personality, I don’t know, but once I start, I really go for it. And by the end of it, my sort of best one was eight miles in a day that I’d walked, and most of it was about five every day. So, and as the weight was falling off you feel just absolutely wonderful.

Okay.

Hungry but wonderful.

Okay, so your diabetes control improved?

Oh hugely. I was never really that bad. You know how they do the numbers, I was always around about 8.4 and then they got it down to 6.1 and the one that they say when you’re, you’re not diabetic anymore is 5.9 and I couldn’t get there. I got stuck at 6.1 but it became an obsession to get down, so I was trying to walk more and more and more and then this happened and it just went.
 

 
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Ellie’s relationship with her mother was made worse by her mother’s “cruel” remarks about her weight. Her two sisters are trying to lose weight after Ellie was diagnosed with diabetes.

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My mother was quite cruel. She never missed an opportunity to say, “You’re fat.” And that was awful and like she’s come at Christmas and she’d say, “I’ve brought you some chocolates but by the look of you, I shouldn’t have bothered.” She’d say it really scathing things like that or horrible things, like, once she was in, she was having a bypass vein in her leg and she said to me, “It’s just as well you don’t need an operation, they’d never get through.” I thought, ‘That’s really cruel and that made me feel really, really sort of childish and defeated and it caused a lot of problems for me in my relationship with her.

She got worse as she got older, much worse. She was all right when my dad was alive, but once he died she fought him all her life, she started to fight with me and she’d pick real fights in public, it was horrible. But her favourite one was to say, “You’re needing to,…” what was it, “you’re needing to starve yourself for a week,” or something and she’s sitting there with her bacon roll [laughs] and that was hard. But my son has never said anything to me, but he hates me being fat, I know he does. It doesn’t bother me with him and my two sisters are like me so, we just laugh at each other…

Okay.

...but me being diagnosed has had a good effect for them because they’re both trying now not to get diabetes. Like [sister’s] started first, she’s the youngest and she’s fifty-five. She started about five years ago and she’s got all her weight off and she looks like somebody of thirty. She looks great. Whereas, [sister’s] five years younger than me and she only started last year, and she’s lost about a stone, so she’s, she’s doing all right. But I’m sure that was the trigger was me being diagnosed.

Okay.

Absolutely positive it was.
 

 

Ellie reads the information others post in an online forum for people with diabetes but does not offer advice because she thinks there are always people who are more knowledgeable than she.

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So you are part of this forums in which you exchange information with other people. Is that your main kind of support?

Yep.

Yep.

There’s an awful lot of people who come on it, just and usually quite young people saying that they’ve just been diagnosed, they’ve no idea what to do. Now, so that’s still happening and the people, I never give an opinion because I feel that my opinion might not be right and so I just, I read it and I take the information in, but I don’t give any out because there’s always other people who are more experienced than me who can tell them better things to do than I could.

I mean, I would say to anybody, “Cut your carbs, start exercising.” End of. But that might not be right. It might work for me. It might not work for anybody else…

Okay.

….so I’m more a reader than a, I don’t given opinions.

Okay so you read other people’s post.

Yeah.

Okay rather than you.

I can have my own opinion, ‘I’ll say, “What an idiot or whatever,” or “that’s good. But some of them come on are completely lost, especially the young ones, like the twenties, they haven’t got a clue and they feel very, very lost and they don’t know that you can sort of go to your doctor and demand this and demand that.
 

 

Ellie faulted her doctor for being “too nice” because he didn’t impress upon her the consequences of not losing weight.

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It’s so sad and I think that maybe the doctor should be a bit sort of more brutal and when you’re starting to put on weight say, “Look, this is what’s going to happen.” Nobody ever said to me, “Look, you’ve got to lose weight.”

No?

No, they’d say, “Well, you’re a wee bit chubby,” and I was at that time.

Oh yeah. In fact, I used to get tested every six months and every time I, I was tested I would think, ‘Phew, made it. I’m okay.’ And the time that he said, “You’re definitely diabetic. They never said, “You’re pre-diabetic or you’re liable to diabetes.” I just kind of knew that myself but if the doctor had stressed that I would have done something about it. I think.

So, they tested you for diabetes?

Oh, for the last maybe, before I was diagnosed, about five years. Twice a year.

Were they telling you that you have to lose weight at the same time?

It was never a big deal. It was never, “Look you’ve got to lose weight.” It wasn’t, it was just, “Maybe you could do with losing a little bit of weight.” And I would say, “Oh, I’ll try.” But if they’d been more firm and explained what could happen, maybe people would pay attention. I just felt maybe it’s my doctor, he’s too nice. I don’t know but I think they have to be a bit more brutal…

Okay, that’s the….

...and make you aware of what can actually happen.
 

 

Ellie thinks that GPs find it hard to make connections between different health issues when they don’t have time to listen to more than one issue per appointment.

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I don’t think, I don’t think GPs make connections. I think they treat you for the thing you go in with and they’re not really interested, [sighs] not because they don’t want to be interested, because they don’t have the time. I once went in with a list and it wasn’t a big list, it was maybe three or four things and she says, “Now, what can I do for you today.” “I went, “I’ve got this list.” She went, “I don’t want a list. Tell me one thing, make another appointment.” And it was things like, I’ve got a freckle there which I thought, ‘Does that need to be looked at?’ Nothing huge but she wouldn’t deal with anything other than one thing and I thought you could have, it would have taken, I don’t go to the doctors unless I have to and she could have spent the time just saying, “Okay, right.” So, one of the things was my blood pressure, not my blood pressure, the blood sugars, but I can’t remember, oh I had polyps removed, she only wanted to speak about that and I just felt that you can never go into the doctor again with a list. You had to go with one specific complaint, so I don’t think they have time to connect things, like you do research, they don’t. They just process people, don’t they? And if somebody would make the connections maybe it would be better for everybody all the way round.

 

In Ellie’s experience, you need to look at weight management as a lifelong thing, not a short-term goal.

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Based on your own experience, is there anything you would like to say or no?

To look on it as a lifestyle, lifestyle change, not just a few months change. It has to be lifestyle. It has to be a lifelong because I don’t think you’ll ever get, if you’re the type of person who is prone to putting on weight, there is nothing you can do to change it. So, it’s your lifestyle that’s got to change. I mean, we’ve got friends, she’s eighty something and she still diets because she’s had to do it all her life and she can’t, you think when you get to eighty you think, you can have a wee treat now and again. But, no, she is rigid, and I just think, ‘What a life you’ve had. None.’ [Laughs].

No, I think you’ve got to accept it as your whole life, not for a few weeks. If you’ve got whatever it is that makes us fat. I’m not talking about there’s just two pounds for you to go to a do or something. I’m talking about real fat. If you, if you treat it as a short-term thing, it’s not going to work, which is what I’ve done.

Until now?

From now on, I’m going to be good.
 

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