If you want to lose weight EAT LESS

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Published Oct 17, 2016

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London - A few years ago, I had a patient who’d battled endlessly with her weight.

She was in her 50s and had recently developed type 2 diabetes, yet she was adamant she couldn’t lose weight despite going on diets.

She refused to listen to the dietitians who advised her to eat less, convinced instead she was simply genetically predisposed to being fat.

In my experience, it’s an all-too- common attitude.

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It was suggested this week that in one generation’s time more than three- quarters of the adult population in this country will be overweight or obese, prompting much discussion about how the crisis can be averted. What can be done, asked politicians and pundits.

Various strategies were rattled off, though we’ve heard all of these well-rehearsed arguments before.

Fattening food is too cheap; sugar — not fat — is the real demon; we should have a sugar tax on sugary drinks . . . round and round we go.

There is also much hand-wringing about the social determinants of obesity. Children from deprived backgrounds are more than twice as likely to be overweight than those children from the least deprived backgrounds.

Yet recent trends also point to rates rising among middle and upper-class men. Stress levels among men are also driving obesity, and there is a correlation between these rising levels of stress, anxiety and depression, and the rising levels of obesity.

Fast-food outlets near a work environment have a significant impact on male body mass index. Girls who live further away from green spaces are more likely to be overweight.

Feeling safe from crime is associated with lower rates of obesity. And so on (and on). Could this — any of this — in some way, hold the key to averting the crisis?

Don’t get me wrong, this is all very interesting. But in all this chatter, no one is saying what all doctors know. There is one thing that causes obesity: food.

Sorry folks, you’ve heard it before, but it’s actually that simple. Food is just energy, and people are fat because they consume more energy than they expend. Our bodies know this. Yet in our minds we’ve made it much more complicated.

An often overlooked factor in the obesity crisis is the way in which we think about our weight nowadays. When it comes to weight, we seem to believe that the basic rules don’t apply. I often have people writing to me saying they are in some way special — that, despite going on diets, they just can’t lose weight. Sorry, but that’s bunkum.

If I put someone in a room and gave them only a piece of bread a day (admittedly, not a diet to be recommended), they would lose weight because they would be in calorie deficit and their bodies would start to break down fat deposits.

There are no medical conditions that directly cause people to be fat. Even people with conditions such as hypothyroidism, which can cause a sluggish metabolism, only put on weight if they eat more calories than their bodies use. If someone is not losing weight, then it’s because their calorie intake is still too much for what they actually need.

One particular problem, I think, is that we fail to adapt our diet as we age: the energy requirement of a 20-year-old is typically very different to the energy requirement of a 50-year-old.

The key to this is, again, in the mind — humans struggle to change behaviours, we get used to eating a certain amount, or certain things, and it takes concerted mental effort, more than anything else, to change habits.

But also, I think, there’s an element of denial — we don’t want to believe our bodies have changed.

As we age, two things happen. Our metabolism — the rate we break down and utilise food — alters, as we tend not to have as much muscle (muscle burns more calories) and our activity levels tend to decrease as family life and busy jobs mean there’s less time for exercise.

Both my mum and dad were stick-thin in their teens and 20s. During their 30s, though, they both put on weight and have since struggled to lose it. Their lifestyles and metabolisms changed, but their diets didn’t.

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The answer is not to throw up our hands in horror and insist we are all victims of some malignant force determined to turn us into porkers. It is to do something about it.

There is a fascinating survey conducted by the Department of Health that compared data collected from 1967 and 2010.

It showed that while people in the Sixties were slimmer, this was despite fewer gyms being available and them eating more high-fat foods.

As you would expect, the difference in obesity rates was attributed to the fact that their lives were more active compared with our relatively sedentary modern lifestyles.

But what really stands out for me from this survey is the sharp contrast in the attitudes towards obesity between the two different eras.

The 1967 survey found nine out of ten people had attempted to slim in the past year, compared with 57 per cent of adults questioned in 2010.

A large part of the problem is that people just aren’t bothering to lose weight any more. The truth is, if you want to lose weight, then you have to eat less — and that is going to take willpower. Frankly, your mind is going to have to tell your body that it can’t have all it wants.

Last Sunday, I went to give a talk at Epsom Mental Health Week.

The aim of the gathering is to offer education, support and information to anyone interested in mental illness. There is a diverse range of events from lectures on insomnia by sleep experts to poetry readings.

There are workshops on how to make your home dementia-friendly, drama therapy and mindfulness. There are also yoga and relaxation technique classes and talks from local GPs, psychiatrists and religious leaders.

This is a real grass-roots event organised by local people who want to bring the community together to tackle the stigma attached to mental illness. There are no grants, no corporate sponsors or government incentives. What a breath of fresh air. And it shows we can all do our bit to help improve our mental health — and that starts with talking about it.

Daily Mail

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