A-Z

Weight change & associated health problems

Maintaining Weight Loss

Maintaining a lower weight was often a hard-won victory for those who were able to do so. Invariably, it involved long-term changes. For Maxine Mary, “it’s not a religion but it’s a definite lifestyle change where I will limit my consumption of alcohol and food”. Some of the people we spoke to found it very challenging to keep the weight off.
 

Although she knows what to do to maintain her lower weight, Maxine Mary finds it a constant battle, made harder by her arthritic problems.

Although she knows what to do to maintain her lower weight, Maxine Mary finds it a constant battle, made harder by her arthritic problems.

Age at interview: 63
Sex: Female
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I am still seeking advice all the time because I know it’s going to be an on-going thing for the rest of my life. I used to smoke years ago. And I know I’m only a one pack away even though I stopped smoking 30 years ago I know I’m only one pack away from being a smoker again. If I was ever to take it up it wold be really easy. And it’s kind of like that with weight loss. It’s going to be a battle all your life. If you’ve, if you’ve put on weight at any time in your life. I feel like I am on a huge piece of elastic, you know, and the more weight I lose the tighter and tighter the elastic is pulled and then all I’ve got to do is have one portion of fish and chips and I’m bang. And I’m right back there again. The elastic pulls me back in. And I will be 20 stone next time I look, you know. It, it’s an on-going thing. It’s an on-going battle especially as I get more and more sedentary as I get older with my arthritic problems.
 
Ok. So how do you feel about weight management now? I mean after having all this experience. So you feel that you know what to do in terms of how to maintain the weight or how to carry on losing weight?
 
Oh yeah I know what to do alright. I know what I should do but, you know, knowing what you should do and doing what you should do can be very difficult especially if you have an emotional problem that can trigger over eating as a way of comforting yourself. Whoa that is a big one to overcome. I mean I’m not uneducated. I know.  I know about overloading the system. My Batchelor’s degree was actually in agriculture so I know how to feed pigs so they get lean weight mass put on instead of just fat. You, you feed them small portions 6 or 7 times a day rather than one big portion because then it will all go to fat. And the British housewife does not like fat in her bacon. She likes lean meat in her pork and bacon. So that. I, I know what I am doing wrong. I know what I should be doing but actually having the will power, the to do it is really difficult. I think explaining that to somebody who has never had a weight problem. They say, “Well just eat carrots. Just buy a bag of carrots.” Yeah.

 

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.

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.

Age at interview: 71
Sex: Male
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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.
 

However, some said it got easier as time passed, or even that they found it easier than expected. This was the case for Heather, who said, “It’s a challenge I failed at every time previously. So to maintain a healthy weight I think has surprised me that I’ve actually managed to and made me very pleased”.
 

Heather has maintained a healthy weight for the last six years on a modified 5:2 diet.

Heather has maintained a healthy weight for the last six years on a modified 5:2 diet.

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And in six years, do you have, kind of maintained your weight?

Yes.

Okay.

Yes, yes, as I say, I don’t think I’ve ever got above 60 kilos even after a three-week holiday.

How do you feel about it?

I feel very pleased with myself because I hadn’t found any way previously to not gradually put it on. So, to me it works therefore I’m going to advocate other people using it.

What do you attribute the success of this weight management method?

I suppose because you, you can put up with feeling deprived one day if you know you’re not going to be deprived the next.

So it’s also psychological for you, isn’t it?

Oh definitely. Yes, yes you can put up with something for a short while. I think that was what I found so dispiriting with the fat-free diet was the fact that it was every day and you could never eat the other things that you wanted to eat. Whereas now, I can eat things that I like. Like, I like dark chocolate so on a non-fasting day I’ll have half, a little, little bar of chocolate, half a bar of chocolate. Just six little squares and that to me makes it all worthwhile [laughs]. I mean it’s a reward I suppose for having maintained the weight.
 

Hilary has lost 100 lbs since her diagnosis of type 2 diabetes. The advice from her diabetes nurse has given her the confidence to control her diet.

Hilary has lost 100 lbs since her diagnosis of type 2 diabetes. The advice from her diabetes nurse has given her the confidence to control her diet.

Age at interview: 62
Sex: Female
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And so, throughout the years you have lost 40…

43, about 43/44 kilos. So, it’s 2lb.4 for a kilo isn’t it? So that’s 80, oh it’s a lot isn’t it? It’s near 100 kilos something like that. Yeah, 100 pounds really.

Fourteen pounds

Fourteen pounds in stone. Oh, we’re getting into, yeah just say a lot.

A bit lost. [laughs] Yeah, I am not good at maths so.

No, not, I need a piece of paper when I’m doing maths.

Exactly, yeah, I can’t do it. Okay and what are, you’re still on sort of your way to try and lose more weight?

Oh yes, I don’t think I should stop now. As I say I lost those extra pounds when I had quite, I think it was about five kilos when I had the gall bladder operation. Then I put about two or three back on and then I took those off. So, I do try and make sure that, you know, as long as I’m not putting anything on, I try and aim to take something off.

I mean, as I say, [diabetes nurse], who I swear by, said to me at one point, “If you fancy a piece of chocolate, you can have a piece of chocolate.” “But,” she said, “don’t eat the diabetic stuff because people think you can eat more of that and if you’re having it, it’s a treat.” She said, “Have it, once a week or”, she said, “if you’re, you’re addicted to Bounty’s or Marathon’s or whatever,” she said, “get the mini, the little sort of Hero type thing,” and she said, “you can have one of those, only one but you can have one of those.”

So, if you were struggling, there is that line there to say, Yeah, if you, if you behave yourself and do as you should be, there is something at the end. If you’ve got, you know, need a little treat at some point, it’s there, so I wouldn’t be sort of, ‘I can’t have this at all.’ As I say, with people’s birthday’s, I’ll say, I’ll have a sliver of cake. Just a tiny little piece and that’s fine. Now, before, you know, you’d have a piece and then somebody say, “Oh, there’s seconds left here.” Well, I would have the seconds, you know, no problem at all. So, it is around saying to yourself, ‘I can, I can do this.’

Some of those who were maintaining their weight spoke about how healthy eating had become a habit rather than a constant preoccupation. This did not happen overnight; as David commented, “the habit takes a long time to build up”. As well as changes in thought process, maintaining a healthy weight could also involve one’s body getting used to new eating habits, such as a reduction in - or abstinence from - sugar. Hilary felt that, “your taste buds change” and things that she once liked that were sweet, were now no longer enjoyable.
 

Hilary started by using sugar substitute until her body got used to it and she could wean herself off sugar altogether.

Hilary started by using sugar substitute until her body got used to it and she could wean herself off sugar altogether.

Age at interview: 62
Sex: Female
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Do you try to get ‘x’ amount of calories per day or….?

I did initially but now I can, after a while you can sort of judge what you can, if you’re eating, the other thing is potatoes, starches, you know, it’s no good having half a loaf of bread. You’ve got to, I make sure if I have cereal in the morning, it’s, it’s always, it’s always like an All Bran. It’s never cornflakes, there’s no sugar. Initially, I had to take it with a little sugar substitute but then your body gets used to that and then you can wean it off to, to nothing like that.  Porridge I’ll have, something like that. It’s always semi-skimmed or skimmed milk.  As I say, I had a sugar substitute at one point. There’s none of that in the house now. The only time I ever get that in is if I’m making a cake for somebody else and I’ll get sugar substitute it and I’ll do that.

 

Sue X changed her eating habits to snack on fruit and vegetables instead of sweets.

Sue X changed her eating habits to snack on fruit and vegetables instead of sweets.

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So because to, to me, I mean, I use fruit like sweets now, if you like. I’ve discovered which fruits and now you can get fruit any time of the year. So, like every morning, I have strawberries, raspberries and blueberries as part of my breakfast. Every single day. I love them, you know, that’s my treat and then now it’s like all the oranges and the clementines as well. So I fill up on things like, like that now. So, yeah, so for me, plus it’s if I go out for a meal, I can usually tell which things to choose off the menu that are going to be the least high in sins.
 
Okay, and so you snack on fruit more than, yeah.
 
Fruit, yoghurts,  carrot sticks, celery, all those sorts of things, yeah. And again, it’s just become habit. I know people sort of, first of all they kind of turn up their nose think, ‘Oh I’m not going to snack on that,’ but actually after a while, you get the taste for it and it becomes habit. So yeah.
As well as dietary changes, some people had built exercise into their daily routine. Julie swims, walks and does strengthening exercises every day to keep her back muscles supple. She feels that exercise is as important as losing weight to ensure good health in old age and to manage her type 2 diabetes.
 

Paul Y started running with the help of an app on his phone and had maintained his weight through exercise for about eighteen months.

Paul Y started running with the help of an app on his phone and had maintained his weight through exercise for about eighteen months.

Age at interview: 55
Sex: Male
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So, it’s plateau?

So, it’s plateauing because I’m doing, because I’m doing more because otherwise I think as I get older a little bit less, a little bit less energy and vigour, I would be, would be, you know, you just need to put the effort in.

Yeah, so you’re quite happy to do the exercise bit?

Yeah, yeah, I mean for, for quite a, for a year or so, up till, up till about eight, I’m trying to think when I, when I stopped running. But I put an app on the phone and, you know, started running round the block and, you know, started running thinking, right I’ll do it once, do two laps, do the three laps, do four laps, you know. Was just about up to 5k.

Okay and how does it make you feel when you look at this app and…?

Yeah, great, good, encourage, encouraging, you know.  I think I just  as I got busier with the B&B and trying to fit that in around, around visitors and around the dogs needs and then, you know, picking up some shin splints and you just think, ‘Oh,,’ and once I stop, I’m a good trainer once I’m going but once you stop you stop. Difficult to get motivated to start again.

Okay but now you are sort of within the walking routine?

Yes, yeah, yeah. But that’s not to say, not to say, you know, I’ve reaches, I may have reached a plateau but it’s not, it’s not bringing my weight down, so I’m kind of thinking, ‘Okay, well that’s good but what can, you know, I……

Yeah.

…I need to do something else right now.’

Okay, so for how long have you maintained this  this same weight?

Probably, probably a good eighteen months.
 

Self-monitoring through counting calories, tracking activity and weighing oneself regularly helped people stick to their goals. Meeka said she always kept an eye on   their diet, because both of her parents had died of heart disease: “I always count my calories. I can pretty much tell you, you know, what 120 grams of turkey is in calories and I know how much protein I should have. So, I’m very careful”. Angela said that on the occasions when she had lost and maintained weight, this was due to having set meals consisting of the same thing every day.
 

David used a NHS Choices diet, he monitors his calorie intake and weighs himself every day.

David used a NHS Choices diet, he monitors his calorie intake and weighs himself every day.

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NHS Choices diet was the one that helped me to lose weight.

Okay.

I, that’s when I started monitoring my weight regularly and I noticed, when I started monitoring it, that, yes, it would come down and then it would gradually creep up again and then I would have to keep at it. It’s something that the habit takes a long time to build up.

Yes.

I think the, initially, I needed a shock to start me off and to pull me back, occasionally, and I think, as time has passed, I’ve got more used to eating smaller quantities, eating more vegetables. I, I still I still, occasionally, yearn for and eat a bacon sandwich and - but, because I monitor things regularly, I can see the effect that it’s having on me. So it’s, yes, it was, it was it was difficult to start. As time has passed, I’ve got more into the habit of dieting. I’ve got more into the habit of exercising regularly. I stopped smoking about what, four years ago, which made quite a difference.

I was I was very pleased that, when I stopped smoking, my weight did not go up. It stayed down.

Okay.

I just, I’m more I’m more conscious of the effect of diet and exercise on my health, put it that way, than I used to be.  But, and I’ve got into the habit of eating less and exercising regularly  but it’s been a long a long, hard struggle.  

What I would, what I am interested is you have used the word the word diet, dieting - do you think you now, you are sort of continue dieting or it is has been a kind of a lifestyle change?

I mean it’s got to the stage where it has been a lifestyle change. I still I still monitor my calorie intake and I’m quite rigorous about that.  

How do you do that? You weigh yourself or?

I weigh myself every day. I record what I eat and  I convert that to calories again, using the NHS calorie counter so, and I record how many calories I, so I record my weight and I record my calorie intake.

Okay.

I’ve noticed that I can lose weight if I reduce my calorific intake to around about well, less than a thousand to about eight hundred, eight hundred and fifty, I’ll lose weight. I’ve found that it’s difficult for me to maintain that for a long time. I can hold about a thousand calories, which keeps my weight more or less as it is.

But it’s difficult for me to go much lower, why is it difficult? Because my wife is too good a cook [laughs] and we still eat out. I, eating out is difficult. It’s again, some places are more difficult than others but I found it, I’ve changed my lifestyle to a round about a thousand calories. I was eating more than that, certainly when I was young and fit, I ate a hell of a lot more than that but I need less calories these days than I used to. And so it is a continuing battle to keep one’s weight…
Yeah.

… sensibly down.
The people we spoke to had adopted a range of strategies from portion control and cooking from scratch to making food plans and cooking tasty meals. Maxine Mary keeps high protein foods, like sliced chicken, available in the fridge so that she can snack on them to stem her hunger.
 

Kate describes the strategies she uses to maintain her weight, including food plans and distraction. She understands now that she mustn’t have sugar and describes it as her ‘nemesis’.

Kate describes the strategies she uses to maintain her weight, including food plans and distraction. She understands now that she mustn’t have sugar and describes it as her ‘nemesis’.

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Ok any other kind of tips or strategies to, that you can think of, that have helped you to maintain your weight apart from, because you said you think carefully and
 
Yes so I have a food plan
 
You still plan everything in your head?
 
I do, at the beginning of the day I do food plan. I leave. Another strategy is every now and then I leave out a meal. So for example last night I didn’t feel hungry so didn’t have supper. And then there was, later on in the evening there was a feeling of hunger so I just rode that. So I used to be frightened of feeling hunger and think I had to deal with it. But I, I knew it would be fine. So I distracted myself by going to bed early after a very hot bath and watching Alias Grace on Netflix. So that was distraction wasn’t it?
 
I believe the difference this time and, you know, every reformed anything says this but I believe the difference this time is I have understood at a fundamental level that I mustn’t have sugar or that, that if I eat sugar it’s really bad for me. It’s my, it’s my nemesis.
 

Cooking from scratch, avoiding bland meals and portion control are all strategies Shirley has learned and applied to maintain a healthy weight.

Cooking from scratch, avoiding bland meals and portion control are all strategies Shirley has learned and applied to maintain a healthy weight.

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Yeah, I cook everything from scratch now.  Used to buy a lot of processed, especially jars for sauces and that but it’s just so easy to make stuff and I enjoy cooking so it’s quite a good. It’s, it’s nice to have a good result at the end of the meal. It’s nice to have that result. But yeah, I very rarely do I, unless I’m in a real hurry for something do I buy a jar. My cupboard used to be full of Domino sauces for this that and the other and now I just make it all for scratch and it tastes better.

Okay and are there ingredients that you have added now to your diet that you didn’t use before?

Yeah, I’ve got  I used to have a spice rack that was about probably this big. I’ve now got a whole cupboard. I think I’ve got every spice you can have and that is the key. It’s making it tasty. It’s not having bland, like even just cooking some chips or whatever and making your own ones, I’ll put something on the top of them now just to spice it up. It’s just using the little tricks to make everything that much nicer tasting and not bland. I think if you’ve got too much bland food then you’re not going to stick to it. But I can honestly say that recipes, there’s not, my husband was surprised how tasty they were because he said, “For something that’s meant to be slimming,” he said, “I’m surprised how tasty they are.” But, yeah….

So it is something that is sustainable?

Yeah, yeah.

This way of eating.

Yeah, totally. I just think the sizes, as you said earlier we discussed about portion, that would be my only concern the whole time that I’ve done it. My husband said, when I first started it, he said, “There’s no way you can lose weight on that much food.” I said, “No it’s balancing your plate.” But now I’ve cut down on the pasta side of things and that because I don’t cook because you could ridiculously have the most massive size and I can’t see that you would, that doesn’t make you feel good either because you can feel bloated after too much of that. So no, I think we’ve got the portion size right now. So, yeah.
Some people mentioned that it was important to find a balance between eating healthily and enjoying treats. Being comfortable doing this represented a newfound confidence and sense of control. For example, Heather who uses the 5:2 approach: “I still feel confident that I can maintain it now as a lifestyle which I never have done before. I think it’s because… you can eat normally one day and then the next day you can compensate”. Eating normally for Heather meant being able to enjoy cheese, which she was particularly fond of, and having bread rolls and butter on holiday.
 

Shirley is much happier now that she is slimmer. She has learned to accept that it’s OK to slip up every now and again.

Shirley is much happier now that she is slimmer. She has learned to accept that it’s OK to slip up every now and again.

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Okay, so do you think you have made this long-term change commitment in terms of changes to what you eat?

Yeah, I think so. I think I’ve really, I’ve begun to realise you’ve got to stick with it and you can have the odd blip and yes, if you go on holiday enjoy it, it’s not, it’s just not worth beating yourself up about. I think that’s the trick is not to get so annoyed with yourself when you do slip, and you do have something bad. Just forget it and just carry on and I think that’s my friend’s attitude who does, who’s never dieted. She said, “I don’t worry that I’ve had chips twice in a row,” but she said, “I don’t beat myself up about it,” and I think, yeah sometimes life gets in the way and you’ve just got to, just got to deal with it.

Yeah, you tell me that maintaining or achieving a healthy weight for you is now a lifetime project through healthy eating.  How do you feel about the, the prospect of kind of committing yourself to a lifestyle?

I think I’ve got to because I hated how big I’d become. I don’t want to go back to that because I was unhappy and I’m one of these that can put on a happy front even when I am big, but I know it wasn’t true, it wasn’t me. I am a lot happier and I think, ‘yeah, I know I’ve just got to stick with it,’ and also now I’ve also learnt, not like I said just now, don’t beat yourself up, it is a lifestyle change and you are going to slip, every now and again, you’re going to come off the road and just have a little blip. It’s not the end of the world.
As well as feeling confident about managing slip-ups, some of those we spoke to described the importance of having rewards or positive feedback. For Angela, this was feeling comfortable in her clothes and being “rewarded by how good a dress felt on”; for Kate and Sue X, it was feeling good about not being overweight.
 

Sue X works hard to maintain her weight but is motivated by “the prize at the end” She is committed to maintaining her current weight.

Sue X works hard to maintain her weight but is motivated by “the prize at the end” She is committed to maintaining her current weight.

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And what keeps you motivated now is to maintain that weight that you have now?
 
Because, because it feels so good. It feels so good not, not to be heavy and, you know, I like being able to do my Zumba. I like being able to  go and pick up a size 12 item of clothing knowing it’s going to fit me. I’m not going back up again. Not.
 
You work hard for it.
 
I do, and, you know, that’s the thing you do have to work hard for it, you know, it doesn’t, it doesn’t just happen and I think that’s the other thing looking back now, you know, you do have to work for it  but, but, you know, the prize at the end is so worth it.
 
Okay. So it is a kind of full on commitment?
 
Oh, it definitely, I mean, absolutely, when I joined, as I say when I joined this last time, I, I was absolutely going to commit to it because for me I thought this is the last not like the last chance, but I didn’t want to be doing this again. I’ve done it too often and I thought I don’t want to do it again.
Stuart eats smaller portions to keep his weight about the same as before his heart surgery and drinks a pint of water every morning and again after his evening meal. Hilary wants to manage her condition well to avoid the complications associated with poor management of Type 2 diabetes. Heather wants to be able to ski and to slow down the progression of her knee arthritis. At the age of eighty-five, Tommy works to maintain a healthier life style.
 

Four years ago Stuart made the decision to cut down on portion sizes to try to maintain the weight he achieved before his heart surgery.

Four years ago Stuart made the decision to cut down on portion sizes to try to maintain the weight he achieved before his heart surgery.

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How long did it take you to get into it and to maintain it?

I think properly, apart from this weight loss before my operation which was sort of a starvation diet but I, I felt I needed to lose them kilos, you know what I mean, I didn’t want to go into the operation being obese  and die on the operating theatre. Although I knew it was highly unlikely it was going to be one in a million that something, but never-the-less, losing weight had to be in my favour.

Probably six months after, probably 2014, sort of middle to end of year, made a decisive, well made a decision to actively cut down on portion sizes.  If we’re having pasta for instance, I, my portion is smaller than me grandchildren’s portion.

But you, you haven’t got to your kind of original weight pre-?

I’ve managed to keep, I, I have spiked up at about eighty-three, eight-four kilos at the beginning of last year. But I managed to sort of shake it off and come down to about eighty. One of the other things I do, every day I drink a litre, well not a litre, I have a pint glass which I thinks about seven hundred and fifty millilitres in it. I drink a glass in the morning and I drink a glass after my evening meal and I do that every day.
 

Tommy has lost three and a half stone. Aged 85, his goal is to have a healthy lifestyle rather than to worry about the Body Mass Index (BMI) chart.

Tommy has lost three and a half stone. Aged 85, his goal is to have a healthy lifestyle rather than to worry about the Body Mass Index (BMI) chart.

Age at interview: 85
Sex: Male
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No, you have lost three and a half.

Is it three and a half?

Three and a half stone.

Yeah, yeah, right, right. Yeah, yeah. I mean people have noticed. People tell you and that’s always, that’s nice too when people say, “Are you losing weight?” and, you know, it’s nice when they say that really, you know.

Okay. So for you the aim is not to lose X amount of weight. For you is to change and to adopt a more healthy lifestyle?

Yes, yeah because going back to what, I keep repeating myself on this, there’s no way I’m going to get down to, well I don’t know, I shouldn’t say this but in the past there’s no way I’m going to get down to sixteen stone which is the, you know, that, that graph thing. So it, it’s important going back to the GP, to keep battling at it, to come down, come down, come down at a nice gradual level because you’re not going to do it, such a large amount.

Okay.

And I haven’t, I haven’t got the years to go, I’m 85, I don’t know how long I’ve got, you know, but I’ve got no long term plans put it that way, you know.

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