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Weight change & associated health problems

What has worked when trying to lose weight? Finding what works for you

There was no one way of successfully losing weight and many of the people we spoke to emphasised how important it had been to find what worked for them. Many times this involved trying out a series of diets, weight loss programmes and lifestyle approaches until they found the right way for them. As Lina commented, “there’s always many ways to skin a cat”. While some people advocated ‘everything in moderation’, others found it suited them better to cut food groups out completely. People also pointed out that it was helpful to monitor their weight to check the day-to-day effects of changes to their diet and activity of on their weight.

Below we look at the four main ways that people found helpful in losing weight:

1)    Specific diets

For some of the people we spoke to, following a prescriptive diet such as the 5:2 diet, the Keto diet or Rosemary Conley system provided a helpful way to structure their weight loss plans. Shirley had been a yo-yo dieter but said she and her husband found the 5:2 diet quite successful: “if I was going to look at a diet again at the moment, 5:2 would probably be the one I’d go back to look at because it was very interesting having those two days quite restricted, but the rest of it was quite flexible, and I think that’s the way life is these days. You’ve got to have something that’s really flexible”. When she was working full time, Meeka found the Rosemary Conley system easy to follow because all the information came in one pocket size book: “It says what 1200 calories is for me, which I need, so I found that useful”.
 

Maxine Mary loved bread but had managed to get used to low-carbohydrate diet.

Maxine Mary loved bread but had managed to get used to low-carbohydrate diet.

Age at interview: 63
Sex: Female
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No it’s not, not for me because I love bread. I could easily live off bread totally.  So I just had to change, change the things I have. For breakfast I would always have toast and for lunch I would have a sandwich [ha]. And for dinner I would have potatoes, I love potatoes. But now I don’t. I have a small amount of oats for breakfast and for lunch I will have some soup or today I made some curry that I had in the freezer, a little, small amount of curry but without rice. And you kind of get used to it. You get used to not eating the carbohydrates. And if I have dinner, a typical dinner for me would be a small amount of steak or meat like chicken or, or something and broccoli and Brussel sprouts. If I’m going to have a potato-ish product it will be a sweet potato or yam or parsnip or something like that. But yeah it’s like that old saying my dad used to say it years and years ago. If you want to lose weight ditch the bread and the spuds. Who knew he was going to be right. We’ve gone full circle.

Dieting wasn’t for everyone, however, and some of the people we spoke to said that diets had only ever been successful in the short-term and that they had gained weight again once they stopped. Meeka found out that a very low calorie diet (600 calories per day) didn’t suit her. She said she was ‘just too hungry and I find that me personally, if I get hungry I go into deprivation mode and then I start craving and the cravings are the worst things to deal with’.
 

Heather had usually re-gained weight after dieting but her modified version of the 5:2 diet worked well in preventing weight gain over the last 6 years.

Heather had usually re-gained weight after dieting but her modified version of the 5:2 diet worked well in preventing weight gain over the last 6 years.

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When I was on a diet I’ve always been very disciplined and stuck to it but as soon as I got to a target weight, the weight would gradually come back and I would never do anything about it in the early stages. That’s where I’ve found a recipe for success now in that I know how to lose the weight. I can go away on holiday and eat for two to three weeks, every day lots of lovely food, but I will come home, and I will rigorously stick to the diet plan that I’ve been following for the last I suppose it’s now getting on to six years, I’ve been following my current plan. I’ve been following what’s known as the 5:2 diet.

And then you did the 5:2 as it is advised?

That, for when I was losing weight, yes, and then I tried to go to one day a week but gradually it was coming back on again. So, I went back to two and then I had to give up running because I’ve got an arthritic knee and I was told not to, that running wasn’t really a good idea. I also had to give up dancing. We’d been doing Latin and ballroom dancing and that was even worse because of the twisting and swivelling on that leg. So, I was doing less and less exercise.

So I decided that I had to do something to compensate for putting the weight back on. So I went to this modified 5:2. So, it was a 4:3 mostly but not quite so stringent. I did allow myself a few more calories and generally I do Monday, Wednesday, Friday. This week because Wednesday was our anniversary of our engagement, I actually did yesterday as a fasting day and I’m going to be doing today as a fasting day.
 

Rosemary has ‘done every diet, over the years’ and feels that exclusion diets rather than limiting portion size work better for her.

Rosemary has ‘done every diet, over the years’ and feels that exclusion diets rather than limiting portion size work better for her.

Age at interview: 55
Sex: Female
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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.

Yeah.

I find an exclusion diet, for me personally, for my personality because I’m quite compliant, is much easier.

Okay.

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].

Yeah?

Yeah.

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.

 

Liz has done many diets but says that the most successful, but the least sustainable, was the 600 calories a day meal replacement diet.

Liz has done many diets but says that the most successful, but the least sustainable, was the 600 calories a day meal replacement diet.

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But I think I've probably done nearly every diet that’s out there. I've done the Heart Foundation, the Mayo Clinic, I've done all the... tried various meal replacement ones, I've done Slimmer's World, Weight Watchers, Green Goddess one. I've tried anything where anybody I've looked at and thought, 'God you, you know, you're looking really... you've lost some weight; you look great. How have you done that,' because obviously, that’s the thing you want to know. "How have you done that?" And they’ll say, "Ooh, you know, I've done it with the Atkins diet, or the Hay diet, or..." Yeh, tried that, done that, you know. But I suppose the most successful was the meal replacement, but that’s the most unstainable one, but that’s what worked because it's so strict with the calories. You know, dear god, you can't help but lose weight on six hundred calories a day, can you? But the willpower that that takes to do is.. .you know it's not willpower that I can find again. I suppose if somebody came to me and said, "Well, you know, if you don’t this you will die, and soon," then you'd probably find that willpower. But, other than that the willpower to do that is phenomenal because it just messes with your whole life; your whole life is messed with doing that. So, it's very much short-term. 
2)    Weight loss groups

Several people like Joan, June X, Hilary and Tommy were referred by their GPs to local NHS weight management services or other locally-run healthy living initiatives. These classes and programmes had been a good source of motivation and knowledge. For instance, Tommy participated in two community based health initiatives in his city and feels that he has been provided with (a) more information about food, including how to read the nutritional information on packaging (b) an ability to change what he eats, and (c) the confidence to try new methods of cooking. [see ‘Local and national NHS/charity support for weight management specifically for people with chronic conditions’]. 


Slimming World and Weight Watchers are commercially run programmes which help people lose weight by providing face-to-face support meetings, weekly weigh-ins and diet plans. Those who found them successful talked about the benefits of face-to-face and online support, being made accountable to themselves and other people, and receiving tips and information about how to lose weight [see ‘Weight Management groups’].
 

June finds slimming groups helpful for learning tips and strategies.

June finds slimming groups helpful for learning tips and strategies.

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So, I think the useful thing about slimming groups is that these days, they do explore where are these areas of -  where you might be inclined to go out of control and what sort of things you can do so trying to give little, people little tips and , you know, of how they deal with the cakes at work on a Friday or things like having a bar in their handbag so that if they suddenly find they can’t stop for lunch they’ve got something to eat instead of going for the cake or the pork pie or whatever. You know, little tips like that that you can build up over time.
 
You might already know them but sometimes I think we need to be reminded of things like that.
3)    Following a healthier lifestyle

Some people spoke of the success they had had by switching to a healthier lifestyle, rather than thinking of it as a diet. This could include cutting down on certain foods, increasing fruit and vegetable intake, decreasing portion sizes and exercising more.
 

Joan has been eating more healthily for two years and thinks of it as a lifestyle change rather than a diet.

Joan has been eating more healthily for two years and thinks of it as a lifestyle change rather than a diet.

Age at interview: 57
Sex: Female
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So what has helped for you to lose weight? Correct me…

I guess I’m not looking at it like I’m on a diet. I’m looking at it right, it’s a lifestyle change. I’m eating a lot more healthily now than what I did before.

Okay.

Whereas before I used to be, sometimes if I hadn’t had anything to eat up at my mums, I would stop and have fish and chips and bring them home or I would get a carry out. I don’t do that now. I will still have a curry, but I make it myself. I use the spray fat instead of like oils. Haven’t had anything out of fish shop in maybe two year, yeah.
 

 

Colin used to have chips with everything but is now increasing the amount of fruit and veg he eats.

Colin used to have chips with everything but is now increasing the amount of fruit and veg he eats.

Age at interview: 72
Sex: Male
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Since I came out of hospital this last time, I’ve been eating a lot more fruit and veg. I don’t get the recommended five a day every day, but I usually manage four. Sometimes more  and over, over a week, I would say I probably average four a day  either through bits and pieces  like yesterday when I was out shopping, and I was starving hungry I bought a sandwich in the local sandwich shop which contained a bit of salad which all goes as part and parcel of course even though it’s got to add up with other things.

I had a few pieces of dried fruit yesterday, again counts towards your five a day. I’ve been eating bananas like they were going out of fashion. I’ve been eating apples like they’ve been going out of fashion and I don’t know why but I’ve suddenly, well I do know why actually, I suddenly acquired a taste for satsumas. When I was in hospital they, they restricted my fluid intake to one and a half litres because of fluid retention and the nurse there advised me if I felt thirsty the best thing to do would be to eat an orange or a lemon.

Okay and what are you eating less of, or trying to eat less of?

Just about, just about everything to be honest. I suppose chips was my big downfall. My son will tell you it was chips with everything. It was almost getting to the stage where if I had cereal for breakfast, I’d have chips with it. But I’ve stopped those not completely but I’ll maybe only have chips now once a week where, whereas it would be three, four or even five times a week. I try not to eat potato unless it’s new potato and I tend, I tend to bulk up on fruit and veg because I found it’s not that that upset my stomach at all even though something in the old grey matter told me it would do, and it didn’t.

Tommy has changed the way he cooks and switched to healthier culinary techniques: “the frying pan has gone out through the window. I don’t use the frying pan”. Eating more slowly and drinking more water were other things that had worked for some of the people we spoke with.
 

Hilary enjoys the challenge of finding healthier ways to cook.

Hilary enjoys the challenge of finding healthier ways to cook.

Age at interview: 62
Sex: Female
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But even things like oven chips, roast potatoes, you, you brush them with oil and put them in the oven. You don’t sit them in it and goose fat and let them fry. Yeah, so it’s, it is things like that sometimes around you don’t actually need some of the cooking techniques that you imagine you have, you know, you built up over the years and think, ‘Oh, I must have a roast potato that’s in goose fat or, you know, that you can at least just bobs above the fat as it’s cooking away in the oven.’ You can brush it with oil and just put it in. I think it’s around looking at those. In fact, I enjoyed the challenge in one way.

Health experts advise that the best way to lose weight is through a combination of diet and exercise. People emphasised that if exercise was enjoyable it wasn’t a chore to do. A whole variety of activities were mentioned, from traditional sports such as rugby, cycling and swimming to activities such as gardening, litter picking and even sex! Age was no barrier, although some chronic health conditions made it difficult to be active in the ways that people had enjoyed before [see ‘The vicious circles of chronic health conditions and being overweight’].
 

On Christmas Day Tommy decided to swim a length for every year of his age. He swam 85 lengths.

On Christmas Day Tommy decided to swim a length for every year of his age. He swam 85 lengths.

Age at interview: 85
Sex: Male
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I couldn’t swim much at first, couple of lengths and that sort of thing but like the jogging, it develops, and it develops, and it develops. Now that swimming started round about 60, early ‘60s. I’m now 86 so I’m going back twenty-five years.

And now I swim every day. Every lunchtime, not today. Every lunchtime I go for the swimming in the local baths and from that, beginning where I said I did the length and maybe two lengths. At Christmas that had just gone, the bath, normally the baths aren’t open now for adult swimming so you can’t do an awful lot but at Christmas they were open all the time.

And I, and I just went in and I thought, ‘I’ll see how many lengths I can do.’ I was by that time, by last Christmas, in the habit of doing about thirty or forty lengths in an hour. About a minute a length, you know, that, that sort of thing, which quite pleased with it. But on this particular day at Christmas of last year, I’ll see how far they can go and believe me or believe me not, I swam a length for every year of my age. In other words, I swam 85 lengths….

Wow.

….and I was so proud of that.

4)     Medical intervention

Some of those we spoke to had experience of losing weight following a medical intervention. Having been unsuccessful in her attempts to lose weight through other means, at the age of 49, Janet had a gastric band fitted. Now aged 62, she has lost about 10 stone.
 

Janet’s gastric band has been a success.

Janet’s gastric band has been a success.

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So the reason why, sort of, kind of, all your attempts to lose weight before was not working because it’s linked to your medication isn’t it, the amount of the insulin?

Yeah linked to the medication, you know, I didn’t have any self-control. You’ve got to be able to say, ‘Right, okay. I’m in that zone and I’ve never had that.’ I’ve never had to worry about that without, with this band. It’s just, if it’s something you want to do, just let it get on with it. I have not had that worry. I have not had to think, ‘I can’t have any chocolate.’ Yeah, I can go and have some chocolate if I want chocolate, but I can’t have what I used to eat. So that’s the difference and it still satisfies that crave. If I want a biscuit, yeah I just go in the kitchen. If I want a bag of crisps, well right I might not be able to eat a full bag of crisps, but I can go in and I can have them to whatever control measures that the gastric band takes, right you’ve had enough now.

So, before you could eat a whole chocolate or…?

Exactly. I could eat two, [laughs] three if you wanted but, you know, I probably didn’t. But I could eat what I wanted and that’s where I didn’t have the control to say, ‘No.’ I haven’t got it. I haven’t got it, that in life. I just, if, if I want something then just don’t seem to have that, you know, that grit to say, ‘Hang on a minute, step back you can’t have them, you can’t do that.’

Okay, okay, so you needed that, those boundaries?

Yeah, yeah. I’ve not, I haven’t had to worry since I had that, I had the band fitted. The worry’s been taken away. Something else is doing that for me.
Surgery was not the only intervention that helped people lose weight. Interventions to improve sleep could also help break the vicious circles that occur when people are exhausted.
 

Carole found she no longer craved carbohydrates and lost a stone and a half after she started using a sleep apnoea mask at night.

Carole found she no longer craved carbohydrates and lost a stone and a half after she started using a sleep apnoea mask at night.

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Yeah, I’ve lost a stone and a half since I started a sleep apnoea mask and it just was magic. It was it was [sighs] I don’t know how it works but I wasn’t starving all the time, when I started wearing this mask. So it’s, I got a really good night’s sleep. I slept sort of at least eight hours a night but concentrated. I wasn’t so tired during the day so I could do more.  The, I mean the MS fatigue was still there but it wasn’t the complete dragging, [sighs] you know, the complete every day, every bit of the day. It was  it really helped a lot  and I managed to lose a stone and a half. I just wasn’t hungry at night times. I wasn’t hungry. I ate less during the day. I ate a lot less at night. I didn’t crave the carbohydrates. I didn’t crave bread. I didn’t buy bread. I was fine. It was so encouraging it was brilliant.
A change in medication could sometimes have a desired effect on weight. David, who has type 2 diabetes, uses a daily release exenatide to manage his condition rather than insulin. One of the reasons for giving people exenatide is that it helps with weight reduction. Steroids are among the medications that Lina needs to take to manage her co-morbidities and they led to a dramatic increase in weight. After she was put on anti-psychotic drugs she gained 4 stone. Her medication was eventually changed and she noticed a positive effect on her weight (see also ‘Ideas about why some long term health problems are associated with being overweight’).
 

Lina takes steroids for her asthma which have given her a noticeable ‘moon face’. Reducing the dosage is enabling her to control her hunger pangs and reduce her weight.

Lina takes steroids for her asthma which have given her a noticeable ‘moon face’. Reducing the dosage is enabling her to control her hunger pangs and reduce her weight.

Age at interview: 49
Sex: Female
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Absolutely, there’s no hundred per cent but everybody who knows me, family, friends, they said to me, ‘Oh wow, what’s happened?” and I’ve said, “Well since I’ve started taking steroids and medication I’m just, this is what I look like,” and anybody that takes steroids it happens to us all, we get this face, this moon face effect. And I said to them, “What it is, is your body tries to store fat in other places so it will shoot to your face, or the back bit of your neck or round your midriff area,” and unless I’m you know, killing it in the gym, it’s unfortunately is going to, that’s how I have, I have to get used to looking like this because at the moment there’s isn’t going to be a way of me, to be able to burn off that amount, that much amount of fat and that much amount of calories in my, my current physical state, so I’m just noticed I was getting bigger and bigger and when I got to thirteen stone, I was like, ‘I can’t, I’ve got to try and do something.’ So hopefully, well not hopefully, it has, I have been losing weight. I’m, from 88 kilograms, I’m now 84.2.

Okay.

So, I have lost, I’m quite happy with it because it means that I’m losing. So long as I’m not gaining, I don’t care, I don’t mind. I didn’t want to get any further than 88 kilograms.

And this is just by controlling what you eat…

Yeah.

…because you can’t…?

Because I can’t exercise, so that just shows you, just simple changes in your diet can actually, can actually help because I’m, I’m no way going to be able to run on a treadmill [laughs]. I know, I know this until they come up with a plan that can get me off these medications, the most I’m going to be able to do is swim and I’ve have to be an Olympic swimmer to be able to shift all this weight in a set amount of time.

Do you have those, do you still have those hunger pangs or…?

No luckily, I fought damn hard with the consultants to bring my steroids down.

We’re trying to get it down to five milligrams. We’re at seven, so I feel that I’m heading in the right direction, so long as I, you see the problem is they get frightened because they’re like, “Oh, you know, we don’t want you to have another bad asthma attack,” You know, this one could be the fatal one because that’s what you think, that’s what you know. You don’t know that particular asthma attack could be the one that puts you in hospital so you’re wary of taking your medicines down but I found that since I’ve gone down in my medication, my appetite is starting to kind of normalise itself now.

I have normal hunger pangs [laughs]. I still, I’m managing with protein shakes for breakfast, but I know that I’ve got to eat breakfast, lunch and dinner, that’s it and I maybe I’m allowed a snack and that’s it.
 

Having strategies

People who had successfully lost weight had usually developed strategies to help. Distraction techniques to cope with cravings worked well for Kate who said she could distract herself on her phone or computer until the craving passed.
 

Lina found snacking difficult but now drinks carbonated water, eats fruit or drinks tea so that she can hang on until mealtimes.

Lina found snacking difficult but now drinks carbonated water, eats fruit or drinks tea so that she can hang on until mealtimes.

Age at interview: 49
Sex: Female
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I found snacking difficult. That’s the one, that’s the in-between meals. The meals were not a problem. It was, you know, behind you I have a box of snacks and to be able to just walk past the box every day was never, I could never do it, ooh, ooh and now I can actually have the box there and not. I’m just learning what I can snack on and what I can’t snack on and finding extra things. For me, I found even the people say, “That’s still bad, there’s a lot of salt in it,” carbonated water.

So, when I feel a little bit hungry I have some bubbly water for squirty, I put lemon juice in it, lemon it and that tricks my stomach into thinking it’s full, it fills me up, so I can hang on until mealtimes. So, I do little things like that. Maybe have a piece of fruit or even a cup of tea, it’s fine. Cutting out the desserts and that. I order things, so I know, I know Haagan Dazs, so that comes off my shopping list, you know, that sort of thing. I’m mindful now of not ordering things that I know are going tip me over the edge and I’ve suddenly had a likening now for dark chocolate and I used to hate dark chocolate [laughs]. But no, if it’s all I can have, then I’ll have that. At least, it means I’m still not being a naughty girl. I’m allowed that.
 

Not having unhealthy foods in the house was another way to cope with temptation, and avoiding the supermarket - particularly at certain times of the year like Christmas and Easter, when there would be more temptations on the aisles – was also mentioned. Sue X said she would always make a list before she went shopping and have a plan of what she would be eating during the week, including lunches to take to work: “if I didn’t take my lunch in for work tomorrow it’s very easy to just nip to Subway or KFC”. Julie found it important not to run out of proper food in the house to avoid turning to unhealthy fixes. Shirley emphasised that it helped to tell the people she spends time with, who have been supportive.
 

Shirley is open with friends and family that she is dieting and this helps her stick to her plan. As she has grown older she has grown in confidence and is less embarrassed.

Shirley is open with friends and family that she is dieting and this helps her stick to her plan. As she has grown older she has grown in confidence and is less embarrassed.

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So when you are trying to lose weight do you still have those rules that you limit your social life or, or you have changed?

No, no, not my social life now because I’ve got to a point with I think you hit an age where you think, ‘I want to go out. I want to meet people. I want to have fun because we don’t know how long we’re on this earth for, and if I keep saying no to everything I’m never going to, [laughs] never going to enjoy my life,’ So no, I don’t do that anymore. I’ve absolutely stopped that.

Okay, but what do you, what rules do you still have when it comes to…?

I will limit what I’m doing like, I’ll go for coffee with friends, but they know I won’t have cake. It is just a coffee.” And so I think what I’ve done is, I’ve told more people what I’m doing rather than, so you’ve got hopefully that support. You’ve got the odd people that will try and entice you to have that extra drink or, so I know when I’m going out, I’ll say to somebody, “Yes, I will have a bottle of wine with you but I’m only going to have two glasses of it. So you’re going to end up with the rest of it.” So I’m pre-empting what I’m doing. So then I know I can go and enjoy my evening without worrying rather than thinking, ‘I’ve got to get there now, what am I going to do, I’ve got to tell these, I’ve got to pretend that I’m not doing it.’ So now I’m more open with people that I am dieting and I think that is a key to be honest with people that you’re following a plan rather than trying to cope round it, like my family they come over and see me in the school holidays or I go and see them. If they know I’m on Plan, I tell them and then I take my own dinner over. So, whereas, they might go to fish and chip shop, I’ll have my own food and enjoy it and that seems to work. I think it’s telling as many people as you can rather than trying to hide it.

I think as you get older you do get more confident. I think you’re, when you’re younger you’re embarrassed that you’ve got to do this plan. You’re embarrassed that you’ve got to tell people and then you hit an age where you think, ‘Who cares. It’s my life.’

Why, why were you embarrassed?

I think just sort of admitting that I was big. I think it was just admitting and if I had to tell people it was taking, but when I did start telling people I got the support. So it’s like a bit how your mindset works. I was embarrassed to tell people and I didn’t want people to know but when I did, and people could see me losing weight I got more encouragement so it’s finding that time when you’re ready to tell people and you’ve got to be ready. It’s no good you trying to force it, you’ve got, it’s like doing the plan. You’ve got to be ready to do it. If you’re not in the right mindset it won’t work.
Losing weight, as we said at the beginning, is not always easy and some people we spoke to said that one thing that has helped them to ‘stick to the rules’ is to ‘cheat a little’ and allow themselves to have the occasional treat like a small piece of chocolate or a more substantial one like a bacon sandwich. The commercial weight management programmes Weight Watchers and Slimming World both allow a limited number of these ‘treats’. David said that his ‘little treats’ helped him to stick to his healthy living plan and prevent him from binging. Sue Y said she has a treat ‘once in a while, like an ice cream’.

Also see ‘What hasn’t worked when trying to lose weight?
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