Jim was encouraged to lose weight by a nurse after being diagnosed with several health conditions, including type 2 diabetes and atrial fibrillation. Jim joined a weight management group and made changes to his diet, losing 2 stone over 6 months. However, Jim found this affected his mood, and stopped following the program. Jim has since put on some of this weight, in spite of maintaining a good diet and exercise regime. Jim is now maintaining weight at around 79 kilos and would like to reduce this to 77 kilos in the next two months.
Jim is 71, and is married. He is now retired, but previously worked in the military, before starting his own education business. Jim is white British.
More about me...
Jim has led a “reasonably healthy and active life”. He was in the military, and had to keep fit for his job. After leaving this position, Jim set up a teaching business. This put a lot of pressure on Jim mentally, and he suffered a stroke. Although Jim recovered fully, he was diagnosed with several other conditions soon after this, including atrial fibrillation, high blood pressure, sleep apnoea, and type 2 diabetes. Although his health is largely controlled with medication, Jim’s nurse suggested that he would benefit from losing weight. Jim lost 2 stone, but has since put some of this on again.
To lose weight, Jim and his wife Linda joined a weight management program, although Jim didn’t attend the classes, as he was concerned about being the only man there. Jim found this diet effective, and liked how he was able to fill up on “free foods”. However, Jim found having to plan meals and avoid certain foods was a “right faff”, especially when eating out. Nonetheless, Jim lost 2 stone in around 6 months. Although he felt physically better after losing weight, it affected his mood, “I don’t want to be miserable for weeks and weeks and weeks because I’m denying myself… you feel down”. Jim has since stopped this diet, and has gradually put on some of the weight he lost.
Although he is no longer following the weight management program, Jim continues to make healthy choices. In this, he has been much supported and encourage by his wife Linda. He eats white meat and plenty of vegetables, and reduces his carbohydrate intake through swapping white potatoes for sweet potatoes and swede. When he does have meals like fish and chips, this is made at home to reduce the fat content. Jim also avoids puddings in the week, opting for fruit or yogurts, yet he often has a cake or a pie on Sundays. Jim now weighs himself daily, which encourages him to maintain this diet. Indeed, since finding out he is diabetic, Jim’s diet revolves around his health, and not what he “likes”, “there were lots of things that would be a great pleasure to eat, but I don’t do it”. Although his heart condition makes exercise difficult, Jim also tries to spend time on his feet, and walk for an hour each day. However, Jim’s weight has continued to rise gradually, and he wonders if this could be affected by his medications, “there’s always a very irritating inevitable rise no matter how careful you are”.
Jim feels his care around his conditions has been “magnificent”. Jim has a good relationship with the nurses at his practice. Although they have suggested he lose weight, they do not force the issue, “they’re always gentle and they’re always encouraging”. They have offered him advice on his diet, and told him he can still have “treats”, although Jim would like to be clearer on how often he should do this. Jim feels education around diet at the diabetes clinic he attends twice a year could be improved, as this is not covered in sessions. Although Jim tries “not to bother the doctor” where possible, he would also like more advice on exercising with his conditions, as he isn’t sure how much exercise he can do without putting strain on his body.
Jim feels weight problems generally result from pressures in society, where people are “bombarded” by food adverts, by businesses whose goal it is to make money. People eat out more than they did in the past, partly because they have more disposable income. However, Jim feels the ‘obesity epidemic’ is about more than food, “there’s far more going on than just what people eat. It is much deeper seated than that”. He suggests that researchers need to look at wider factors that are contributing to weight gain.
In the future, Jim hopes to lose weight for health reasons, and to make his medication more effective. He is considering returning to the weight management program where he previously lost weight, as well as taking up swimming. Jim encourages others to “be active” in managing their weight and their health, “it doesn’t matter how old you are, what your disabilities are, you must do physically the most that you can each day”. He also suggests that diet should focus less on taste and more on nutrition, “get rid of the ‘like’ word and don’t eat what you like, eat what you should”.
Jim is now maintaining weight at around 79 kilos and would like to reduce this to 77 kilos in the next two months.
Jim has discussed with the nurse at the clinic that his medicines will work better if he loses weight; he doesn’t want to be “miserable for weeks and weeks” due to denying himself normal meals.
Well physically, I feel better and as I’ve discussed with the nurse in the clinic then, then the less weight and sort of volume I have in my body then the more powerful will be the action of all the medication, presumably, and, you know, we’ve discussed that. So physically I’m fine, but you have to, I think we need to bear in mind your mental health as well and I don’t want to be miserable for weeks and weeks and weeks because I’m denying myself, it’s a fundamental loss in your life, you know, there’s something, you may not put it into words, but you feel, you feel down. Well, I don’t get depressed, I’m not a sort of depressed sort of person. I’m pretty good at keeping myself buoyant and happy and interested in all sorts of things.
So however you do feel there’s a bit of a loss because you’re not eating normal regular, well we haven’t always had regular meals but normal meals.
Jim and Linda discuss weight gain, diet and exercise and what to do about it in the context of Jim’s co-morbidities.
Jim: I would cut down on the breads. See, we’ve got this, we’ve got this carb, we’ve got the carbs issue here now coming through [laughs]. But I would lose, but the end result is I would lose the weight. But it’s better that she does the Slimming World here because that would be controlled and, and that would work as well. I would also increase exercise and I would probably go swimming every day.
Linda: One of the things, one of the things that I keep telling him when he says he’d cut out potatoes and all this lot, is that actually you can’t do that as a diabetic. You have to have some carbohydrate with every meal because it’s all part of, because otherwise you will go into hypo or whatever.
Jim: Yeah, but I’d kick start losing the weight, it would drop off.
Linda: Yeah but you’d drop off all together and that is, that is, that is where you’ve got to make the adjustment and the balance to make sure that for one thing you’re not causing something else. Everybody has that problem.
I also think that you should give yourself a achievable goal because that’s one of the things they tell you when you go, because you were saying you want to be 70 whatever it was, but you’re now 83.
Jim: Well I’ll come down, obviously I’ll come down to 81 and then 79, so.
Linda: But your goal, I think your goal should be 82 and then down to…
Jim: Oh yes.
Linda: ….gradually, a gradual thing.
Jim: I agree, and I do that.
Linda: Otherwise you never achieve and the whole point of anything is to be able to achieve it otherwise it, it knocks you out of you doesn’t it. You don’t want to be bothered because it’s just, you’re not achieving anything. Mm.
Linda: After his stroke they put him on a course at the gym and that came to an end.
Linda: And so, you decided then that walking and stuff would be…
Jim: But the main thing you see I, I don’t know because, because there’s nobody telling me this and this is a really key thing I think is where is the balance between putting my life at risk by over exercising? That’s one side of the, of the question. The other side is, am I fit or unfit and how fit can I get without getting into the area of risk and danger? Now no, that’s that critical question. I didn’t explain that terribly well but…
No, no, no you did.
Jim: Did you understand where I’m coming from?
So too much exercise could result in death and I don’t know where that line is. I don’t know where I’m safe and where I’m not safe and nobody is telling me that.
Jim and Linda were a double act, with Linda attending Slimming World classes to help her husband Jim lose weight. He thought that attending would be ‘a girly thing’ to do.
So why did it come about?
Linda: Right, well the doctor or the diabetic nurse actually said that it would be good if you could lose some weight, so I thought, “Well having heard from other people that Slimming World was a very easy way of doing it to be honest.’ They give you so much information and you can eat loads but you’ve got to do it in the right way and so I took myself off to the classes. I did the classes. Jim didn’t come with me because, well he wasn’t, he wasn’t really into that sort of thing and it’s mostly, well I was going to say it’s mostly women. There are men there, but you need to be quite brave if you’re going to sit with twenty women.
Jim: Well you wouldn’t get a word in for a start.
Linda: Anyway, the - so I went, and I spoke to the lady and I explained why I was there and she said, well, you, you will have to obviously have a target yourself, so she gave me half a stone target, so that I could actually go and be part of the sessions. We, every week they tell you, they give you recipe for something different and you can either do them or not. There’s lots of books. You can do it in different ways.
So did you read the literature that your wife brought home from Slimming World? Did you read it? Did you talk to her?
Jim: No, no she, she generally came home and told me what had happened to her down there and she’d give me the stories and that would be quite, would be quite interesting.
Linda: You did look at it. You did look at it.
Jim: Yeah, I do understand the, sort of the, the main issues. I didn’t go myself because I thought it was a girly thing and, you know, I’d be the only man there and…
Linda: But in some places it is. But in other places, our daughter-in-law goes in [county] and it’s half and half men and women and it depends what time of the day it is, doesn’t it because the men are more likely to be at work and that sort of thing.
Jim: Yes but probably unlike quite a lot of other people, we are a double act and you, you were going to do this and we were going to do it together, so there was no point me…
Linda: No, no.
Jim: …paying, well not that we mind the money particularly.
Linda: No, you don’t pay after a while.
Jim: There isn’t an issue with that. But, you know, it was sensible that she went and got the gen and we did it, you know.
Linda: And the other good thing of course is if you reach the - they give you these goals, once you do it, you stop paying and providing you keep three pounds either way, they still do it in pounds, pounds and stones. Providing you keep three pounds either way, you don’t pay, so that’s an incentive to people not to have to pay it.
Jim and Linda have been married for 47 years. She actively encourages him with his weight management.
Jim: Well this is Linda, my wonderful wife, and I must say that I’m incredibly lucky with the way this is all panned out for me. A lot of the things I’ve, I have I’m sort of only just in frame for anyway and I don’t think my weight is, is a great big issue. Literally it’s not and as I say I’m 83k today, so Linda’s been a great help and a very supportive wife. We’ve been married for 47 years and she instigated us taking a really positive interest in Slimming World, so you’re probably the best one to explain.
See, I just take this medical knowledge that I get from my wife who’s got such a good background in, wide experience in all this stuff. It’s wonderful for me to have a partner and I’m very conscious that I’m probably statistically one of the few that have got such a wonderful set up and I’m very, very, I mean I would do my best for her as well, but I don’t have the background and she does it all the time.
Jim: So I’m very, very fortunate and I do realise that and I’m also very sensitive that a lot of people don’t have anybody to help with this which is, which is…
Linda: It’s natural instinct for me…
Linda:…..and I used to do cholesterol testing and everything and I used to have to advise the patients, so I’ve got all that as well which is quite interesting and I say to him, “Your dark chocolate, it was, it was a couple of pieces a day, not the whole bar.”
Jim: Oh, I don’t have that. Not the whole bar [laughs]. That is extreme.
Linda: It does vanish from the cupboard [laughs].