Rosemary’s weight has fluctuated since her teenage years, and she has tried many different diets to manage her weight. Rosemary has found that weight loss support groups are most effective, as she is more compliant about reducing her portions and cutting out certain foods when she knows she will be weighed every week. Rosemary finds maintaining a diet difficult, but hopes to lose weight in the future due to “vanity”, as well as to maintain her health as she gets older.
Rosemary is 55 and is a retired research nurse. She is married, and is white British.
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Although Rosemary was an average weight as a child, she started to put on “puppy fat”, and went on her first diet at 16. Rosemary dieted again 3 years later before her wedding, when she reached her slimmest. Since then, Rosemary’s weight has fluctuated, especially motivated by occasions like weddings or holidays. Although she has never been very overweight, Rosemary would like to lose weight as she feels “sluggish” and not as attractive when she is heavier. Whilst losing weight is “a vanity thing”, Rosemary is also aware of the impact of weight on health. She is conscious of developing type 2 diabetes, as other members of her family have, as well as other weight-related conditions. Maintaining mobility is another concern for Rosemary as she gets older, “I have a long-standing back problem and I know that weight is, exacerbates degenerative disease of your joints”.
Although Rosemary is well educated on nutrition, big portions, particularly of carbohydrates, are her “downfall”, “I know what to eat and what not to eat and I do lots of exercise, but I really enjoy food…I like big volumes of food...I don’t mind if it’s not a varied diet, as long as I get that full feeling”. Rosemary found working long shifts in a hospital encouraged bad eating habits, as she would come home tired and snack before preparing a proper meal. Rosemary also keeps cakes and biscuits in the house as she regularly has guests around, and finds herself snacking, particularly at night.
Rosemary has tried many diets over the years, from the cabbage soup diet, to liquid diets, to the alphabet diet. However, Rosemary has found weight management clubs to be the most effective diet for her, “I personally am more compliant if there’s somebody weighing me”. Indeed, Rosemary has lost weight successfully in the past through these groups, as she is “much more vigilant” over what she eats, reducing her portions and weighing her food. Rosemary also finds cutting out certain foods completely works for her, “I don’t want to eat one biscuit, I want to eat the whole packet of biscuits… I find it easier if people were to give me a list and say, ‘Right, you can’t eat any biscuits, you can’t eat any crisps…’”. Rosemary also avoids situations like parties and eating out when dieting. However, Rosemary finds maintaining weight loss difficult, as she loses motivation once she has reached her goals; throughout much of her adulthood, Rosemary has followed a cycle of losing and gaining around 1.5 stone. Rosemary has found that since menopause, it is harder to lose weight.
Working as a research nurse, Rosemary was on her feet all day. Since retiring, Rosemary has been aware to remain active, and tracks her exercise on a Fitbit. Rosemary aims to walk at least 15,000 steps a day, which she does through going to the gym most days, and litter-picking each morning, “it’s good for the community and it’s good for me”. She also gardens, and cleans for her mother-in-law and her nephew.
Healthcare professionals have never raised the subject of weight with Rosemary, possibly because of her clinical background. Rosemary suggests that health professionals can be reluctant to discuss this with patients, “we feel like we’re dictating to people what they should and shouldn’t do”. However, she encourages them to bring weight into discussions wherever possible, something she used to do when working clinically. Indeed, doing this in the context of wider health conditions may be easier for doctors, and understanding the health implications of being overweight can in turn push individuals to manage their weight. Rosemary suggests that those with lower income should be encouraged to lose weight through free membership to weight loss support groups, “I think people know that they need to lose weight but sometimes they just don’t know where to start”.
Rosemary grew up in a single parent household and recalls big portions of a ‘typical English family meal’. She still likes to have ‘big volumes of food’ even when she is poorly.
I don’t think I’ve ever lost my appetite once, even when I’ve been poorly, and I like big volumes of food. I don’t mind if it’s all, I don’t, I don’t mind if it’s not a varied diet, as long as I get that full feeling.
So you, you like big portions?
Big portions, and I think that’s my downfall. So, and so particularly when I was working, I would be working like twelve hours, come in really tired, think I’ve got to make tea and eat a packet of crisps and then have another four packets of crisps because, you know, and then I would have my tea [laughs].
So, I’m a volume person. It isn’t that I, I get bored with diet. It, it’s just that I like big volumes. Carbohydrates, I like carbohydrates, like that full feeling.
[Laughs] Was, that’s how it was in your family when you were growing up? I mean were you brought up with good size portions?
Yeah, we, we were quite poor. Mum was a single parent family. I was the youngest, so we never had very much money. We never went out for meals, but we always had meat and two vegetables. Typical English family, and always had a dessert, yeah.
Rosemary has ‘done every diet, over the years’ and feels that exclusion diets rather than limiting portion size work better for her.
I personally find it easier if somebody says to me, “Don’t eat any sweet things. Cut it out all altogether.” I will comply with that much easier than if somebody says, “Well you can have a little bit of chocolate, but only a bit every day.” Because I like volumes, I don’t want to eat one biscuit, I want to eat the whole packet of biscuits. So if I’m, for me personally I find it easier if people were to give me a list and say, “Right, you can’t eat any biscuits, you can’t eat any crisps. You can’t eat any,”…. you know.
I find an exclusion diet, for me personally, for my personality because I’m quite compliant, is much easier.
So, have you ever heard of the alphabet diet? So, you cut out all foods beginning with A and then the next week, all foods beginning with ‘B.’
You have done that diet?
I have done every diet, yeah over the years. So I found those quite easy [laughs].
Okay, and has it worked for you that diet?
I only did it for a short period of time, but yeah, exclusion diets for me work much better than, than portion size really.
Rosemary, a retired research nurse, thinks it’s important to bring weight up at every opportunity and not “be shy of bringing it into the conversation”.
Do you have any messages for health professionals, who are overweight - , who want to help people with weight control?
I think it’s really important to incorporate it into, at every opportunity. I think having, having been a health professional, I think we’re very loathe to sometimes bring it up because people, we feel like we’re dictating to people what they should and shouldn’t do. But the, the ramifications of being overweight are so large I think, you know, if we have contact with people we can, I used to bring it in to every -, I was obviously only dealing with breast [cancer] but if a lady came in and she was overweight, I would bring it in to the conversation and say, you know, “I know you’ve got a genetic predisposition, but you do realise that obviously that carrying extra weight does increase your risk.” There’s a nice way of putting it but I think it’s really important, we mustn’t be shy of bringing it in to the conversation.