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Weight change & associated health problems

Reasons for wanting to lose weight

Everyone has their own reason for wanting to lose weight. Among the people we spoke to, health featured high on the list of reasons to lose weight. For some, receiving a diagnosis or a conversation with their healthcare professional had been the “wake-up call” that had galvanised them into action. Kate was shocked when the doctor told her she needed to be on statins: “So I said, “Is there any other way that I don’t have to be on statins?” And it was suggested – and I grabbed this – that I lose some weight to see what would happen first. And so that was a huge incentive for me, absolutely massive because I don’t want to be taking statins every day”. David said he had felt frightened when his diabetes nurse told him what could happen if his diabetes was not controlled. He decided he would try to lose weight.
 

Being diagnosed with diabetes was a ‘wake-up call’ for Hilary to lose weight.

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Age at interview: 62
Sex: Female
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But as soon as I was diagnosed with the diabetes it became planned. It became, ‘you need to do something’ because I want to be around. I don’t want to be one of these people, I hope when I go they’ll be nailing down the coffin because they won’t want to let me out. It’s that sort of thing, it’s wanting to be and have a full life and I don’t, and I think that was one of the things that, that struck me as well. ‘Was I going to have a full life? Was I going to be passing away?’ My mother had a heart condition, passed away at 61.

Now it’s not inherited, thank heavens. But I’m thinking to myself at that time, ‘Do I want to be like her, passing away early? No.’ So that was another, another thing.

Wake up call is what they call it, I think really.

Okay. So, you were somehow forced to do it?

Yes, yes, I mean with the, it was as, I say a wake-up call. It was this business of you can’t mess about with it. You can’t say, “I’m going onto diet and I’ll lose a few pounds and then just leave it.” You have got to take this seriously and you’ve got to, you know, it’s your health. It’s, it’s not just getting into the next dress size down, looking better and feeling, you know, good about yourself. It’s about feeling good about yourself but feeling good inside with your health as well, not just that. So, it was, it, it was the trigger that made me, like, ‘you can’t mess around with this now.’

You need to do something if you want to be around.

Being overweight increases the risk of complications during surgery. Those who needed surgery had often been told they needed to lose weight before having the operation. Stuart said, “I felt I needed to lose them kilos… I didn’t want to go into the operation being obese and die on the operating theatre”. For Maxine Mary, a forthcoming knee operation was her motivation.
 

Myra was told that she needed to lose four stone, which she achieved, before having a hernia operation.

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Age at interview: 65
Sex: Female
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When I had the surgery for the hernias, the doctor then, I think because it was a very expensive operation and they really had to make sure you were totally committed to it, they, he said to me, “You need to lose four stone.” And that was about three years ago, and I joined Slimming World and did it, did, lost four stone and I’ve lost, I’ve made, and I think when you’ve got an impetus and a real goal of, you’ve got to do it otherwise, you know, this surgery wasn’t going to happen, I found I really could do it, you know. Really stuck to the diet.

Health-related reasons for wanting to lose weight included wanting to relieve existing problems or help prevent further medical intervention. For example, Meeka, who had a heart attack at fifty-five and already had a stent, did not want to end up in hospital again. John Y hoped that losing weight would reduce his back pain. Jim wanted to be a “good patient” and had been told his medication would be more effective if he weighed less. Alan, however, was doubtful whether losing weight would improve the management of his heart condition and type 2 diabetes, saying that both were already well controlled with medication.
 

Alan’s heart condition and diabetes are stable, but if his health gets worse it would probably prompt him to lose weight.

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Age at interview: 48
Sex: Male
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So, and what are your reasons now for wanting to lose weight, and maintaining weight?

Well, I think as much as anything, I'm going to have to have a new wardrobe if I continue at this rate [laughs]; it's going to be very expensive. But in other terms, I'm assuming that I will feel better again if I go... if I lose weight, but I don’t know. As I say, I go back and say I haven’t seen any evidence which says if I lose ten kilos, that'll be the effect; none of that evidence has ever been shown to me, if it exists.

What would help you to become sort of fully committed to losing and maintaining weight now?

I suspect if I had to have new medication to guard against vastly increased problems with diabetes and heart, then it would convince me I'd have to do something. But as it is it's been stable for so long that there's no incentive to do something from a medical point of view. From a social point of view, I don’t have any problem being the weight I am, it's just in family pressures to some extent. You know, they say, 'Well, oh you're looking a bit fatter than you should be,' you know.

Janet who has type 2 diabetes had gastric band surgery to improve her health. She said her weight had been piling up and she couldn’t control it.

“I decided that at the age of forty-nine that I had to something about this, not to make me look any different just to, you know, as a health precaution, I knew that I needed to do something. I’d got to that stage where this is just ridiculous. So, we decided that I would go and have this gastric band fitted which I did."
 
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Before her gastric band surgery Janet weighed 22 stone and was taking 174 units of insulin a day. She has now dropped to a dress size 12/14 and feels very much better.

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Age at interview: 62
Sex: Female
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Yeah, the reason I wanted to, the reason I had the operation in the first place, my weight ballooned up quite a lot due to the medication that I were taking. So, the Metformin and the insulin together, rather than me lose weight used to make me put weight on. So, I’d go to places like Weight Watchers or Slimming World and I’d stick to the diet and I may be on it three or four months and I never lost anything. I couldn’t lose it but then as soon as I stopped eating the healthy food I put a stone on, a stone and a half and then I’d struggle then getting that off.

So, I were on this constant programme that my weight kept going up and up and up and I really couldn’t control it but that were down to taking huge amount of insulin. I mean like 174 units a day is what I used to take, and I, I averaged 22 stone, 22, I got up to that.

Twenty-two stone?

Mm. So then came to the point where, you know, my joints were aching. I couldn’t bend down and put my shoes on and I’m talking like forty-five/forty-six. I couldn’t walk up a hill. I didn’t walk, I didn’t do any exercise. I used to swim but that’s all I ever did but that’s, that’s fine, I’ve always swam. But basically, I didn’t do anything. So, I knew I’d come to that point in my life where I had to do something.

So, you made the decision to have the gastric band for kind of…?

Just for health reasons. Not for cosmetic reasons although I feel good and now that I’m down to a size 12/14 it feels even better. I started off as size 32 and I’ve got clothes in my wardrobe of every size all the way down to a 12 [laughs]. Charity shop loves me [laughs].

I’m sure they do [laughs].

I’m there, “Do you want this?” [Laughs] So yes, yeah. So yeah, I didn’t do it for that reason. I did it solely for health reasons because I knew if I didn’t do something at that stage, you know, how were I going to carry on. Aching legs, aching bones. Not being able to walk. Can’t get your breath and the worst part, oh, we travel a lot me, and my husband. Getting on a plane and taking up two seats and the seat belt not fastening round your stomach [laughs] It’s really embarrassing. So, yeah, I’ve been there. It’s not a nice place to be. Being where I am now is a really nice place to be.

Sometimes, people were concerned with how their weight would affect their quality of life as they got older. Sue X decided to lose weight after turning sixty. She said, “I was thinking, …I don’t want to be old and creaking and having to use a stick to walk or needing assistance to get onto a bus or anything like that, and really that, that’s what kick started me into then looking to how I was going to lose weight”. Zaida saw keeping fit and healthy as she got older as crucial to keeping her independence and ability to care for herself, as well as enjoying her social life.
 

Meeka had a heart attack at age 55. Eleven years later she explains that her diet regime is focussed on getting old healthily.

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Age at interview: 66
Sex: Female
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I had a heart attack at fifty-five whilst I was working. Both my parents had heart conditions, and both died from heart-related issues. We have a family history of heart issues and I’ve yet to reach past seventy. No-one in our family actually gets past seventy, okay. So, at sixty-six, I am more than conscious that I need to do everything that I can which includes weight issues to keep myself as healthy as possible. In fact, my doctor and I have got a pact that he will get, try and get me to eighty at least, so we’re on a mission.

So I’ve accepted that this is my shape, that I need to lose the fat, so that it doesn’t accumulate around my heart and clog up the cholesterol in my, in my, in my blood and cause another blockage. I don’t want to have to go in for another stent. That, one’s enough [laughs]. I don’t like hospitals at the best of times.

Okay, so for you is your long term life project is to have a healthy weight…

Yes.

….. and to be healthy.

Absolutely, absolutely.

Okay.

Yes to give my heart and my cardiovascular system the best possible chance of getting old healthily. So that’s, my diet centres around my heart and, and the fat and things. Not so much the diabetes, although what I’m doing is good for reducing the chances of getting diabetes. But that’s an aside. It’s, my regime is aimed at keeping my heart and cardiovascular system healthy and also, I have osteoporosis in my thighs, so calcium take on and exercise and it’s centred around that and to some extent, the brain, you know, I am my brain. I’ve always been a brain type person and disciplined brain person so, I have to eat and try and keep that healthy. So, I’ll eat my salmon and my oily fish. I have two lots of fish a week and build that into my calories.

People like Meeka, Sue X, Rosemary, Joan and others have lost weight and have seen an improvement of their chronic conditions. The thought of ‘slipping back’ and putting on weight scares them. As Meeka says, ‘we are on a mission’.
 

Joan’s health ‘isn’t brilliant’ and she knows it could be much worse if she gains weight again. She fears she might end up unable to walk.

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Age at interview: 57
Sex: Female
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I can see myself, if I put on the weight that I’ve lost, ending up in a wheelchair not being able to walk and that scares me more than wanting to eat does [laughs].

Okay, that’s a big motivation.

That’s a huge motivation for me. My health isn’t brilliant, but it could be a lot worse and I know if I put on weight then I guess my biggest fear would be, ‘Would I be able to lose it again?’ and it’s taken a year and a half for me for lost what I’ve done. I think that would be insurmountable if I put on all the weight that I’d lost, you know specifically for me and the health problems that I have.

You cannot afford to put weight on.

Can’t afford it, no. I mean, yeah, I can put on a couple of pounds and that’s manageable, if you’re really good you can lose that. I would even say up to half a stone but over that you’re on the, you’re on the right slippery slope.
 

 

Carole has MS and ‘overwhelming fatigue’ She hopes that carrying less weight would improve her energy levels.

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Age at interview: 59
Sex: Female
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If you if you have to give me one reason why you want to lose weight, what would that be?
 
Energy. I want to be able to do things again. I know I can’t do very, as much because of the MS but at least if I had some more energy to be able to, not to get, it’s not so, it’s not out of breath.
It’s the fact that I oh such, such absolutely overwhelming fatigue, absolutely shatterness and so, if I didn’t have so much to carry around, that would still be there with the MS, the fatigue, but at least I wouldn’t have this to carry around as well. It’s it would help with that I think.
 
Okay. So that’s your main reason.
 
That’s my main reason. I mean there’s loads of reasons like feeling better about myself and my health, obviously, but that the, to have a bit more energy would be fantastic for me. It’s yeah.

Some people were motivated to lose weight when they approached the age at which a parent had died – heart disease runs in Meeka’s family and none of her relatives have lived beyond 70 years. Paul Y said he didn’t want to die at sixty-four, like his dad, and that was a good motivation to lose weight. Hilary, whose mother had a heart condition and passed away aged 61, said she wanted to be around to have a full life.
 

Wanting to see her children give her a grandchild was a reason for Lina to lose weight.

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Age at interview: 49
Sex: Female
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But just remember you’ve, you know, you’re on a path and it might not be a path you choose but you’re on one anyway and for the sake of your family, your friends, you know, you want to be here to see lots of things. I want to see my kids give me a grandchild, as an example. That’s an example or see them get married. You know, I’d like to be around for those things and if they’re saying for me to be able to attain a life so that I can see those things, why would I not want to do it?

Okay, that’s your main reason for…?

Yeah.

Yeah.

I’ve got to be here. I’ve got to.
 

Health was not always the only reason why people wanted to lose weight. Keeping fit, having more energy and being able to do more things was another motivating force. For example, Zaida wanted to lose weight to be able to play tennis better, an activity she greatly enjoyed. Shirley said her daughter was getting married and she wanted to look good in the photos, while Rosemary was keen to lose weight so that she could look good on holiday in her bikini. Although the holiday was the immediate prompt, she said she also had underlying health motivations, such as avoiding diabetes and looking after her joints. On reflection, Shirley questioned the wisdom of short-term goals to motivate weight loss and said, “Am I just going to lose weight for that and then what happens after that? But really the foremost should be health”.

Fitting into clothes and being able to wear nice clothes was part of the reason why some people wanted to lose weight. For Christine, not having well-fitting clothes was eroding her self-confidence. She wanted to lose weight so that her clothes would fit better and she would then feel better in herself. Myra said that since having a hip operation, she had been living in tracksuit bottoms. Her short-term goal was to lose weight so that she could get back into her summer trousers and feel better about herself. Alan said he was keen not to have to buy a new wardrobe, which would be expensive, if he continued to gain weight. June X explained what hard work shopping for shoes and clothes could be when overweight.
 

June: “I just don’t want to be fat anymore”.

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Age at interview: 60
Sex: Female
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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.
 

Not wanting to appear fat, to be described as fat or to be judged for being fat were other motivations for people to lose weight. June wanted to lose weight because she was looking for a job: “I do think presentation is important and I do think people make value judgements about people that are overweight, so that inhibits my confidence then in job seeking”. Finding social acceptance mattered, for example Lesley wanted people to think she was looking after herself rather than seeing her as an overweight person who wasn’t trying. Angela said she had dieted at various points in her life “for people to like me” and to “get acceptance from everybody”.
 

When Angela looks back, she realises she lost weight to win other people over. Her main reason now is to please herself by fitting into nice clothes.

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Age at interview: 51
Sex: Female
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But when I look back and think, I was doing a lot of the dieting and this, that and the other, trying to better myself for you. Not for me, you know, but then I started liking somebody else but I, I felt I was doing the same for him as well. Trying to be thin for him so he would like me and he’d already told me that actually I’ll only just be friends with you. But I thought, ‘Maybe I can win him over. Maybe I can win him over.’ It was just silly little things and I’ve had that throughout my life, of this winning over. ‘If I’m thin, I can win them over,’ you know and it’s mainly down, it’s not if I’m the best writer in the world or if I’m, you know, the happiest person in the world, I’ll win them over. It’s if I’m thin, I’ll win them over.
 
And what are the reasons for wanting to lose now?
 
To fit into my, at this stage in my life, I’d say to fit into my clothes that I’ve got. I’ve got, you know, I love buying nice clothes and I’ve got some 12, size 12 and 14s that are absolutely lovely and I want to wear those that I’ve never worn. They are my main reason. It’s not to sashay past people to say, ‘Look at me,’ or to attract anybody, I would say it’s mainly to fit into nice clothes.

While health, and improved appearance, both clearly mattered to the people we talked to, there was rarely a single reason for wanting to lose weight. People felt more accepted in society when they were in control of their weight.. Several commented that when they lost weight people noticed and told them they were looking ’good’. No-one said that they were losing weight for someone else’s sake, but families and relationships were clearly a factor. For example, Ellie said that she wanted to be around to see her grandson grow up and hoped that losing weight would improve her long term health. Being in control of weight, looking and feeling good came to be closely linked in some people’s minds.
 

Liz says losing four or five stone would help improve her arthritis and fibromyalgia symptoms. The other reason she wants to lose weight is out of “vanity”.

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Age at interview: 54
Sex: Female
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And it's so depressing; it really is depressing. I mean, you know, for me it's more about my health. I struggle with my joints. I've got arthritis in my ankles and my feet. I've got fibromyalgia as well, which I don’t let it affect me; I don’t let it stop me doing anything, but it does make life a little bit difficult. And I know very well if I could lose four or five stone I could help my joints, fibromyalgia would be helped, you know the stress incontinence would be helped; everything would be so much better. My mental health would be better as well because, you know.
 
At the beginning you mentioned that your main reason for wanting to lose weight is for health reasons?
 
It is, yeh.
 
Would you like to add something else?
 
Oh, it's vanity as well. It's vanity, I'm sorry. But it's so vanity as well [laughs]. Yeah, I'd love to say...you know I'd love to say, "Oh yeh, you know, it's for my health." It's because I'm vain as well. I don’t want to be the fat one; I don’t want to...I don’t want to not go to things and do things and not be able to wear things. You know, the question, does my bum look big in this is completely irrelevant – of course it looks big in this. One day I would like it not to look big; I would like to just wear what everybody else wears. I'd like to shop where everyone else shops. Yeh, health wise it would improve my life a lot, but I'm vain as well; I'm vain.
 
We all are.
 
We all are. Anybody who says they're not is lying.

 

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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Age at interview: 69
Sex: Female
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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.
 

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