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Weight change & associated health problems

Regaining weight after weight loss

“I don’t think an overweight person who loses the weight ever can afford to drop their guard.” (June)

Maintaining weight loss can be difficult to achieve and many people who lose weight then regain it. This can take place multiple times in a pattern known as “weight cycling”, often through a process of “yo-yo dieting”. We talked with people who described their own experiences of regaining weight, which we explore below.

Changes to routine
 

Shirley describes what she calls her “rollercoaster” of ups and downs with her weight.

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When you have lost weight and then you said you have put some back, was it gradual or was it, kind of….?

No, gradual.

Gradual?

Yeah, little things when you put a pair of jeans on that you know are getting tight and so you’ve already putting them on and little things like that. Quite gradual, not a massive…

Okay, okay, so and that, okay and you were sort of introducing food that you were not supposed to eat?

Okay. It’s a bit like, a couple of things it’s happened. It’s been things like, the things that get in my way are being school holidays because I’m not in my routine and I’m a very routine person. I like to know every day what I’m sort of doing and when you’re off, I roughly know when I’m seeing people, but I try and avoid things that I’m not going to do.

So that was a long time in the six weeks’ holiday and then Christmas, and it’s all things like that that I know are my triggers that at some point something’s going to go wrong in those times and then a friend of mine last Christmas, you get so far up to Christmas and then it’s, well we know we’re going to eat over Christmas so let’s join, go back in January and that’s what we were doing. So, it’s like a bit of a, that’s what I call my rollercoaster.

Okay.

So you go through the year doing this and then you have a really good bit and then it dips and then Christmas comes, and you think, “I want to enjoy Christmas. Everybody else is enjoying Christmas.” So we used to stop and then join again after Christmas, which is a big mistake. If you’re going to do it, you’ve got to stick with it. You’ve got to keep at it, I think, that’s the main thing.
Changes to routine were a common thread in people’s accounts of how they had regained weight. Holidays and Christmas – as Shirley mentions – were key moments at which it could be hard to stay on track with diet and exercise. Before she adopted a 5:2 way of eating, Heather found she would regain weight every time she went on holiday. She said, “We’d go on holiday and I’d eat and drink lots more food than I would do at home but I wouldn’t do anything about it when I came home. So it would stay a bit high and then the next holiday it would go up a bit more and a bit more”. Weddings were similarly difficult, Stuart found, because of the huge amounts of food given to guests.
 

As she has gotten older, Meeka finds she gains weight faster, with Christmas and holidays key times she puts on the pounds.

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Age at interview: 66
Sex: Female
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When you start gaining on weight on those occasions that you have gained weight…

Yes.

…is it gradual? What…?

Yes, I think it is, but as I’ve got older the weight’s gone on quicker. So, whereas in the past it would take me maybe six months to put half a stone on. I can now put, well I did over Christmas, I can put a stone and a half, two stone on in two months. Boom. Just like that and then it will take six months to a year to lose it. I’ve got records of my weight going back to about 2008 and I can chart up and down and it’s taken me so long. It can take me a year to lose a stone because it goes off, comes on. Goes off, goes off, comes on. So, I’ve always got to watch, and I weigh myself every week. Sometimes it will be every two weeks. If I go away on holiday, I won’t weigh myself and I, one of my faults is we go away all inclusive and that’s another issue. I always come back with putting on at least half a stone in a fortnight. Okay.

Okay.

My husband, he’s very good, even on holiday. He will just more or less try and eat very healthy. Me, if it’s there and there’s a cake stand, and a dessert stand and that’s my holiday, I paid for it, I’m eating that dessert [laughs].

[Laughs]

And I’ll deal with the consequences when I get back [laughs].

You’re not the only one, yeah [laughs].

Because I’m going away on holiday and a holiday is just that. It’s a break from routine.

Following participation in a local NHS weight management services for people with chronic conditions, people like Tommy, June X, Joan and Sue Y learned to think differently about occasions like Christmas and holidays. For example, Tommy said that he now realises that there is no reason why he should expect to put on weight just because he is on holiday.

A new job, shift work, changes in access to food (at work and home), retirement, an operation, or an accident could all affect diet and exercise. Tommy had been able to manage his weight through exercise, which was mostly based around his place of work. When he retired at the age of sixty, he lost access to the facilities he had been using and his weight crept up. After being diagnosed with type 2 diabetes and sleep apnoea, Paul Y was motivated to lose weight and lost 15 kilos through exercise. However, he then took another job which was more office-based and “It just caused me irregular eating, weight crept up, less exercise”. After a stressful period of time, including relationship changes, Paul Y had to give up his job and developed high blood pressure and high cholesterol. He found it harder to exercise, and put on some of the weight he had lost.
 

June has gone from having two jobs to one, which means a more sedentary lifestyle and being closer to the kitchen when she is at home.

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Why do you think you put it back?
 
Well I think once you sort of come off the path of, of giving it one hundred per cent attention,  you know, if you, if you sort of  fail on it for a day or two, a day or two becomes a week and then a week becomes a month  and also I had two jobs last year and I’ve only got one job now which means I’m at home more which means the kitchen’s nearer  and I’m less, far less active because I’m sat at a computer more often and looking for jobs and definitely more sedentary  and I am thinking about going back to Slimming World again.
Managing weight alongside health problems

Sometimes people with co-morbidities find it hard to balance advice for the different health conditions. Jim, has regained some weight since his stroke, and would like to cut out carbohydrates to see if that helps him lose more weight. However, his wife Linda, a pharmacist, suggests that, because of his type 2 diabetes, he should have some carbohydrate with every meal. He also has atrial fibrillation and worries about how to find the right balance of exercise because walking up hill makes him “quite puffy”.
 

Jim and Linda discuss weight gain, diet and exercise and what to do about it in the context of Jim’s co-morbidities.

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Age at interview: 71
Sex: Male
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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.

Okay.

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.
 

Stressful life events and emotional eating

Sometimes, stressful events, such as a family member’s illness, or changes at work, could contribute to people regaining weight. In 2006/2007, Angela‘s Dad was really ill. She stopped attending Weight Watchers and says, “I just continued to stuff my face”. As she describes below, she was also negotiating a stressful time at work.
 

Angela started comfort eating to cope with the stress of her Dad’s illness and the threat of redundancy at work. She regained the weight she had previously lost.

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Yeah, so it was a very stressful time then because it was a lot of toing and froing and I again ended up again doing the comfort eating. I think I’d gone, I’d gone up to thirteen and a half stone. So, I had lost some but then gone back up again, you know, and then in between those times, I was trying my own little diets and whatever, promising that I’d cut back, cut back but I just was convenient, convenient eating, eating at meals. Also, I was having a really stressful time at work. I didn’t get on with one of the managers and then I was going to, I was being faced with redundancy, you know, it was just my role that was being made redundant.
Emotional eating was a key factor in regaining weight for some of the people we spoke to (see also ‘Emotions, emotional eating and self-esteem issues’). As well as taking less and less exercise, June said, “there’s like a pattern really which is emotional eating, I think, to cheer myself up or as a treat… So every decade I would say I’ve gained a stone… which is a lot, but when it’s very, very gradual over ten years, it’s not that you don’t notice it. It becomes your new way of life”. Boredom, depression, and the winter months were other triggers which people mentioned led them to regain weight.
 

Meeka finds she puts on most of her weight in the winter months, when it is harder to get out and exercise and her mood starts to drop.

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Age at interview: 66
Sex: Female
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Holidays. But also, it’s bad weather here.

Without a shadow of a doubt. Without a shadow of a doubt. That’s when I put most of my weight on. Starts in November. It’s the winter time and it’s harder to exercise because you can’t even get out sometimes. I can’t go out if the temperature drops below I think -2 or 3, because of my heart. Okay, so I have my cross trainer upstairs and sit and watch QVC, stand and watch QVC, sorry when I’m doing that. But because I, my mood starts to go down, I get fed up of doing that as well. So I then put on some more weight and it just by the end of time Winter comes, I think, ‘Eight that’s as low as I go.’ There’s a point that I reach, and I say, “That is as low as I’m going,” because I won’t go into depression. I know when I’m getting low and know what’s wrong. It’s lack of sunshine and I take the multivitamins and do all that. Take the extra Vitamin D, but as soon as I’ve reached that point, [husband] and I say to each other, “Right, we need some sun.”

Physical changes

A change in medication or an operation were other things which people said had caused them to put on weight they had previously lost.
 

After a sudden cardiac arrest aged 58, Lesley followed doctors’ advice and lost weight. She is now putting weight back on again and wonders whether this is due to an increase in her medication.

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Age at interview: 60
Sex: Female
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Because your heart condition is caused by a genetic, a sort of faulty gene kind of thing. So, but before you had the cardiac arrest and subsequently you were diagnosed - you were overweight?

I was just overweight. Yes, not as big as I am now but I certainly was overweight.

So you have put more weight after, following the diagnosis?

Yes, I’ve put, I’d lost when I was diagnosed I think I was weighing 103/104 and I lost, got down to about 95 and now and then I went back up to 107 and then I can get myself back down to 99 and then it crept back up. I know I’ve been away this weekend and I weighed myself this morning. It was back up to 107 and I didn’t eat anything different. I know I was on holiday but, so I feel it’s just slowly creeping all the time. I keep thinking, ‘Oh, that’s going to stop now,’ and I don’t know whether it will keep going up or keep going down, so it’s frustrating thing I’ve lost, I had lost some in the first six months and even though I was still doing the same sort of things but with a bit of my old life added in shall we say, it seems to have, I think for the amount of my old life added in, the weight gain I’ve gained is, doesn’t reflect what I’ve just done, you know sort of thing. If I lived my old life straight away, then yeah, I’d expect probably, I know when you get older you can put on weight and things, everything stays down anyway but I think it’s how am I going to say this? What I’m gaining in weight doesn’t reflect the very small tweaks I’ve done to a very good lifestyle when I lost the ten kilos.

It doesn’t, the only thing that’s different is that my medication has trebled in dosage in that time.
 

Stuart, Myra and Heather all said they had regained weight after an operation. Before her hernia operation, Myra was told by her doctor that she needed to lose weight and managed to lose 4 stone. After the operation, she put a stone back on.
 

Heather lost weight on a rigorous non-fat diet for her gall stones. After an operation to remove her gall bladder, she started eating fat again and gradually put the weight back on.

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I did manage to control my weight but simultaneously to that I developed problems with my gall bladder. I had gall stones. I couldn’t eat any fat so I went on a very, very rigorous non-fat diet and that must have lasted two to three years and I did get to a very healthy weight at that stage because the alternative was considerable pain so that, that was a good way of making me lose weight.

When I had the gall bladder removed, they said to me that the side effect was that I would put on weight again, which I did. I should at that stage have continued on a low-fat diet but one of the things the consultant said to me at the time was, “You’re forty, you’ve a life expectancy to eighty-four or something,” he said at that stage, and he said, “Do you want to live on a fat free diet for the next forty-four years?” and I thought, ‘Well probably not.’  So that meant I gradually put weight on again.
 

Janet put on three and a half stone in six weeks after her gastric band broke.

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Like I said, then the gastric band broke and within three months I put all this weight back on and..

How much did you..?

About three and a half stone in like six week. Not over time, it just went on. So, it must be the way my body is because I weren’t eating excess food. I just ate normal food but I think because it hadn’t, my body hadn’t had it for so long, it kind of said, “Oh, I’ll keep it while she’s feeding me.” [Laughs]. And I was going through the process of having it, you know, I’d looked into having it redone because I knew I couldn’t live without it. I can’t, no matter how old I get, I honestly do not think I can ever now live without this gastric band.
Reaching goals and losing motivation

For some people, reaching their weight loss goal meant that their commitment to a healthy lifestyle dropped off and they started to put weight on again.

“My problem has been over the years, and this is the ongoing problem is the fact that in common with a lot of people who are severely overweight, I have a difficulty, I don’t have so much of a difficulty taking off a pretty significant amount of weight, but I have a terrible difficulty keeping it off and sustaining that lifestyle.” (June X)

Sometimes this coincided with stopping their membership of a weight management group, such as Weight Watchers or Slimming World. In the past, before she discovered the 5:2 plan, Heather had found that she would stick to a strict diet until she reached her target weight, but then the weight would gradually come back on. Rosemary said, “It’s usually because either the occasion has gone past, so I might have dieted for a wedding or for a holiday or the occasion will have, the motivation will have gone”. The same was true for Ellie: “I would do a diet for such and such. I would lose that and think, “I’m now good” and then I would think that’s it, I don’t need to bother anymore and then I didn’t go out and binge or anything, but I would gradually just get back”. Trevor found that each time he tried to lose weight after regaining it, the task was harder.
 

June could not afford the £5 a week so took a break from Slimming World. She regained a stone and a half in 6 months and says it’s hard to go back and start all over again.

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So you said that you have lost a bit of weight now or….?
 
Well I lost a stone and a half last year by May and from May, I’ve not been on the scales, but I can tell by the fit of me clothes, I stopped going to Slimming World in June and from June to January, I’ve put all that stone and a half back on.
 
And what was the reason you stopped?
 
It was financial because my job, one of my jobs came to an end. So, it was five pounds a week that I just, you know, couldn’t afford really. I went on holiday and just before that and that was another reason and then the person, name who I went with, she was ill, and as I say, once you’ve had a little break from it and, you know, things are going in the wrong direction it’s the hardest thing in the world to, to start back because, you know, you’ve got to, you know, it does take effort and you’ve got to focus so, you know, you’ve got to get that all back together. It’s not that the leader won’t make you welcome and every week she was good at reassuring people that, you know, if you sort of stepped off it you could  don’t let it worry you, come back anytime.
 
But psychologically you’ve got to gear yourself up to start all over again.
 

June has started to monitor her weight – before she would have avoided the bathroom scales when she thought she wouldn’t like the result.

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Age at interview: 60
Sex: Female
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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.
 

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