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BBC Good Food Eat Well Show

The BBC Good Food Eat Well Show – The Diet Consultant

Posted by | Fat loss, Fitness, Food for thought, Healthy Eating, Uncategorized | No Comments

It’s an exciting weekend ahead for foodies and health enthusiasts, with The BBC Good Food Eat Well Show being held at Kensington Olympia, London. I’m excited to be there on Friday 27th to hold a FREE drop in clinic alongside other specialist Dietitians. Here, we will get to meet with members of the public, just like you, within 20 minute appointment slots. Our aim is to help as many people as possible by providing dietary advice on how they might be able to improve their health, performance and quality of life and achieve their specific dietary goals. The Dietitians Clinic, can be found at stand no: F62, placed by the British Dietetic Association.

BBC GOOD FOOD

BDA new logo

As well as receiving dietary advice whatever your goal or health concern, you are sure to have a great weekend with many other health experts, celebrities and professional chefs there to tickle your taste buds and keep you healthily informed.

If you are keen to come along, tickets are just £15 and you can pick them up here. It would be great to see you on Friday morning, so come along and say hi! 

 

The Weight Loss Surgery Roller Coaster

The Weight Loss Surgery Roller Coaster

Posted by | Fat loss, Food for thought, Healthy Eating, Uncategorized | No Comments

In essence, weight loss surgery is one of the toughest roads you could ever choose to go down; emotionally, physically and socially.

Over the past 6 years I have been in the incredibly privileged position of working alongside hundreds of people going through the process of weight loss surgery. To be there throughout the entire process from assessment to post surgery discharge was indeed, a rollercoaster. I shared the highs and the lows, felt the frustrations and the liberation, I felt the despair and the sheer happiness, and usually all in one afternoon! Because weight loss surgery is like that; about as far from a smooth and steady journey as you can possibly imagine.

More and more individuals are being offered weight loss surgery and this, I am certain, is only going to increase.
Why?

Because it works.

But let me rephrase that slightly, because it can work and can work brilliantly. However, it can also be a complete disaster. It can be the hardest, most traumatic, heart breakingly disappointing procedure. It can shatter dreams and hope, wreaking havoc with an existing, rock bottom self-esteem.

So what have I learnt about navigating weight loss surgery to make sure it works and works brilliantly?

You can never be 100% certain that it will work. Despite high motivation levels and a good level of understanding, there will always be people for whom weight loss surgery will never work. The reasons for this are multiple and complex and I doubt even that individual will really understand what is holding them back from success.

Timing is everything. The vast majority of people will come for an assessment hoping to be put forward immediately and, in an ideal world, have their surgery within weeks. This would be a disaster. I have learnt so much about the importance of providing people with at least 6 months of  pre-surgery preparation. This time is SO important to start accepting the reality of weight loss surgery, to realize the changes that you will need to make and to reflect on the harsh reality of the hard work required to succeed. For some 6 months is enough and for others a period of 18 months works perfectly – everyone is different.

Weight loss surgery is no magic wand. Weight loss surgery or no weight loss surgery…

In order to lose weight you need to make significant, sustainable and positive changes to your diet and lifestyle.

To lose weight with weight loss surgery you need to reduce portions, cut out or reduce the empty calories, concentrate on plenty of fruit and vegetables, lean protein and complex carbs. Just as you need to do without the surgery. It is not a way of eating what you like and still losing weight. You have to work at it.

The complete team is so important. Having a multidisciplinary team with a dietitian, psychologist, pharmacist, specialist nurse, endocrinologist, surgeon, anesthetist and a radiologist is crucial. The team need to communicate effectively and have sufficient funding to offer appropriate levels of care to patients. This is a big one and fairly political at the moment but nonetheless very true.

There is no one-size-fits-all surgery option. I have seen people succeed and fail with all types of weight loss surgery and the choice of surgery needs to be a joint decision, informed, considered and chosen for the right reasons. Many people have seen friends or family fail or succeed with a certain type of surgery and then choose to avoid or select it accordingly. Be open and consider all types.

Accept that after the sunshine comes the storm. The hardest part for many is accepting that post surgery weight loss is slowing and then stopping and then worse, they start to gain weight. This is normal. It happens to everyone and is part of the process. Just as normal weight loss without surgery will come in waves; you lose, you maintain, you gain, you lose….and the cycle continues. Relapse and weight gain is a normal part of the process so expect it at some point, embrace it and use it as a valuable learning opportunity. Look at why it has happened? Which habits have crept slowly back in? (this happens to everyone!) Learn from it and decide how you plan to avoid it happening again? Your weight loss curve will look more or less like a rollercoaster – expect this and you won’t be as disappointed.

What success looks like

 

To all those who have had surgery – ignore everyone who puts you down, thinking that you have chosen the easy option. Hold your head high, know that deep down you are mustering the same strength, determination and resilience that anyone else trying to lose weight without the surgery, has to do. Criticism is often borne out of resentment and jealousy. Try to rise above it however hard this might be. There is a growing number who realise how hard you are working – focus on these individuals.

Surgery can change the way that you eat forever. Sometimes surgery can have unpredictable effects and you might end up unable to tolerate or digest certain types of food. This can be hugely restrictive and impact on every aspect of your life. Sadly this is a risk, one of the many that those undergoing surgery will have to take. However, be mindful of the choices that you make in terms of foods. Some foods will be easier to eat, however this although tempting is not the way forwards. A good working relationship with your dietitian is the best way to avoid falling into this trap.

apple on a plate

Choosing to undergo weight loss surgery is a brave option and it is often the last option available for people. A last resort after years of struggling. Summoning up enough courage to attend an initial appointment is a huge achievement, it takes so much strength to face up to discussing food and eating and these individuals deserve a truck load of respect. I admire each and every patient with whom I have worked. I learn from them every day and I never cease to be amazed by the commitment that they show.

Losing weight might not make you as happy as you think it will. For many, weight loss surgery carries a heavy burden or responsibility – it is supposed to make you happier, improve your relationship, help you to get a job or be better at the one you do, be a better friend, have more confidence, make you do more exercise and so on. A long list of responsibilities for any one ‘thing’ to bear. Unfortunately, the harsh reality of weight loss surgery is that it often fails to deliver on one or all counts. I think this is something that everyone needs to think about. It is all too easy to live in the ‘if only’ land. ‘Life would be better if only I was thinner’, I would have a job if only I was thinner, I would have a relationship if only I was thinner….believe me when I say, that losing weight is not a guaranteed for ‘happily ever after’. In fact, it can have the opposite effect. It can be hard to adjust and you need to be aware of this, if you find yourself in this situation. You are responsible for your own happiness, and that starts from within, not from a gastric band. So reset the expectations that you may have about your slimmer self, when you go for surgery or about others who are doing so. Don’t feel entitled to a new mindset.

That’s not to say you can’t be happier, of course you can but that is down to you and the choices that you make and not a piece of silicone or a few stitches.

I hope that his article makes you think, perhaps about judgments that you have made or about choices that you might make in the future if you are thinking of weight loss surgery as an option. It can be a truly wonderful and life changing tool, but it is just that, a tool, and without the team, the personal commitment and the necessary resilience within your tool kit, the surgery alone is a very small part of a large and complex jigsaw.

Faith Toogood

Faith Toogood

 About the Author 

Faith Toogood is an experienced Dietitian, specialising in weight management and weight loss  surgery.  She has a breadth of experience spanning the NHS and the private sector.  In addition to  running a busy private practice, she is a regular on our TV screens, appearing on ITV’s ‘The Biggest  Loser’ and other weight loss shows. Faith is passionate about helping everyone to feel empowered  around food and cooking, and is well  known for her practical, no-nonsense and warm approach in  helping others to drastically improve  their diets through simple, sustainable and affordable  changes.
Connect with Faith here: FaithToogood.com, on Twitter and on Pinterest 

 

Faith is a fantastic dietitian and one of the nicest people I have had the pleasure of working with so check her out, on her website and social media links above. A huge thank you for writing this guest blog post Faith, it really highlights the highs and lows of the weight loss surgery journey for the patient and that its not the plain sailing procedure, as its often perceived.

Have you or anyone you know embarked on weight loss surgery?

We would love to hear about your experiences?

Do you have any advice for others considering weight loss surgery?

Optimized-top-10-tips-to-avoid-weight-gain-in-the-USA

How to avoid (too much) weight gain on ‘vacation’ in the USA

Posted by | Dining, Fat loss, Fitness, Healthy Eating, Uncategorized | 2 Comments

Having just returned from a well-deserved and thoroughly enjoyable break in the USA, I was pleased to find out that I’d only gained 1.5 lbs in weight.  I normally assess my weight by how my clothes fit and since they were a little tight, I was curious to know.  Now, one of the reasons I wanted to do this trip was because of the amazing and authentic food on offer; from deep pan pizza in Chicago, Buffalo wings in Buffalo, cheesecake in New York to Cheesesteaks in Philly, this trip was a foodies dream!  Therefore, I absolutely expected to gain some weight, and having been to the US before I knew exactly what I was in for when it came to; portion sizes, hidden calories and the not so hidden calories in the form of ranch dressing and cheese drenching a perfectly healthy balanced salad!

Icecream

So how can you reduce the weight gained while away in the US?  Here are my top 10 tips for minimizing weight gain whilst holidaying in America.

1. Sharing is Caring

Portions in the US of A are just huge, in many places I feel ‘quantity’ takes precedence over quality.  Luckily, I had some equally health conscious friends (one being another dietitian @perryncarrol) with me who were happy to share the load.  So one meal became 2 or sometimes even 3, there was no need to worry about whether there would be enough, we were always left feeling full to the brim!

Deep pan Pizza

2. Think Small

Starters and sides are often as big as a main course meal here in Britain, we were always so surprised when they arrived that we couldn’t hide our shock even after 2 weeks! Ordering a starter as your meal will help to reduce the total amount of food you eat, plus tips one and two undoubtedly helps you to save the dollars too!

3. Be Specific

The USA are a service-centric nation and so making requests at the start of your meal, no matter how much bother it seems to you, really isn’t to them.  Us Brits, don’t like to make a fuss I know, but if you ask for grilled instead of fried, and cheese/dressing on the side it really won’t be too much trouble.  In fact, I suggest this is one of the main ways slim Americans stay that way.  If I had eaten the food given to me in the way it’s normally served, I’m sure I’d be sat here writing this an extra 3 lbs heavier!

4. Eat In

We travelled around the North East and stayed in hostels, hotels and Air B&B apartments.  This was great as all but the one hostel had a refrigerator, plates and cutlery for us to make some of our own meals.  I personally feel that eating out all of the time can get a bit much, its a financial drain but most of all it’s pretty time consuming! Having the fridge was perfect, because we could buy fresh milk, yoghurt, fruit and cereal to whip up a nice healthy (and familiar) brekkie.

5. Drink Well

I mean water, of course.  As expected, it was pretty hot and humid over there.  This, combined with the continuous flow of the AC conditioned air is enough to dehydrate a cactus!  Its common to feel hungry when in fact you are thirsty.  Therefore, I would suggest drinking more than you would normally and especially at meals to help fill you up, replenish salts lost through sweat and restore hydration.

6. Drink Light!

By this I DON’T mean ‘light’ beers; these are often reduced in alcohol but not in calories – so don’t be fooled!  I mean, go for light drinks nothing to thick, heavy or creamy. I realise that this tip is extremely generalised, but when you fancy a boozy beverage you don’t really want to think too long and hard about calories.  So simply think; ‘drink light’; prosecco over white wine and white wine over red.  Lager over ale, stout or Guinness and vodka/gin instead of whisky, brandy or liqueurs.  Always try to mix with a low/zero calorie mixer and add plenty of ice, and while it’s tempting to indulge on the way home – remember that what you eat at the end of boozy night will more than likely be stored as fat (if you are in a calorie surplus), since your body is already working hard to metabolise each unit of alcohol you have effortlessly sunk and not the calories from the burger and fries.

7. Joyful Jogging

I take my trainers with me everytime I go away!  I find running through exciting locations the best way to get your bearings and explore new holiday hot spots. I tend to head out first thing to avoid the midday heat.  From Central Park to Saugatuck (on Lake Michigan) I pounded the pavements and felt great for it!  I know many of my clients don’t like to exercise when they’re away, but there were so many people doing the same thing.  Why wouldn’t you? It wakes you up, snaps you out of your heat induced coma and burns calories, plus it was the first time I felt like a local – which is pretty cool!

Running

Training like Rocky!

8. Cultural Ride

Everywhere we went, there were bikes available to hire, again its a pleasant (calorie burning) and cooling way to explore.  We took the bikes out in Chicago and Saugatuck and on both occasions got to see way more than we could on foot.  Just remember to ride on the ‘wrong’ side of the road when you aren’t on cycle paths but don’t cycle in NYC (unless you are only in Central Park) its far too dangerous on the roads and this is coming from a London based cyclist!!

The Cloud Chicago

9. Count your Steps

We walked sooo much, from the Freedom trail in Boston, the Constitutional walk in Philadelphia to the Brooklyn Bridge and just about the whole of Manhattan in NYC.  I didn’t realise that my comfiest Havaianas could give me blisters, but they did!  Our friend had bought a pedometer at the start of our trip and it was quite rewarding as well as encouraging to find out how many steps we had clocked by the end of the day.

10. Enjoy it!

We had an amazing trip and while I followed all of these tips to minimise weight gain, I didn’t feel restricted.  I still ate what I wanted to eat and enjoyed every mouthful! So what if I gained a lb or 2, now I’m home and back to eating my normal healthy diet and exercising regularly, I’ll return to my previous weight in a few weeks, which is absolutely

Genos            Buffalo wings Optimized-4th July cake

In short, life and all it contains is here to be enjoyed.  So, do just that, eat a New York Cheesecake but just make sure you’ve packed your trainers to run it off in Central Park afterwards!

 

Fat-exercise

Eat less, move more! Is it really that easy?

Posted by | Fat loss, Food for thought, Uncategorized | 2 Comments
Throwing comments around, about other peoples appearance, (specifically their weight) seems to be commonplace in today’s society. Typically, I’ll hear somebody (of a healthy weight) say something like “how can ‘they’ let themselves get like that!”, “‘they’ must eat junk food every day” or “why don’t ‘they’ just join the gym and exercise more!”. The advice to ‘eat less, move more’ may well be overly simplistic, but in essence, it’s what leads to the desired weight loss and target body shape. While this simplistic slogan and approach is aimed at the overweight/obese population, it’s also given the ‘Judgemental Judy”s among us, a superiority complex!  THEY find it so easy to be a healthy weight,to meet their health and fitness goals, so why can’t everybody else do the same.. Hmmm?
Well, here to explain some of the considerations and complexities associated with weight loss is guest blogger; Perryn Carroll.  She is a Specialist Obesity Dietitian based in London, an ex-colleague of mine and a dear friend.  As you can imagine, her role can at times, be extremely challenging.  She has kindly written this blog, to explain why it’s not as easy as ‘eat less, move more’ for many of her overweight/obese patients.
Thank you Perryn x. 
 
 

Don’t be patronising. Weight loss is hard and it takes a lot of physical and emotional effort. In a society that is booming in the waist and media coverage around weight loss, a perception has developed that it is down to personal control (that is, one who is overweight/ obese has no control or is ‘lazy’).  A large review published in Obesity (a research journal) in 2012 highlighted the extent of weight stigmatisation, which appears in the work place, media and sadly, in health care.

Recent statistics have reported that 1 in 4 of us is classed as obese in the UK. Putting this into context, 1 in 4 of your family or friends may be stereotyped by others as being lazy, lacking discipline, sloppy and unattractive.

Why do some people have better control over their weight whilst others struggle?

If you have a good eye for mazes and puzzles have a look at the ‘Shift Obesity Influence Diagram’ below, which highlights the complexity of barriers to weight loss which include:

  • Biological (genes)
  • Social influence
  • Finances
  • Medical health and associated treatments (e.g. medications which may stimulate appetite)
  • Emotional health
  • Environment (associated to physical activity and food availability) and
  • Food consumption.
Obesity System Influence Diagram

Obesity System Influence Diagram
Source: www.shiftn.com

 

Needless to say, it’s a bit patronising to say ‘eat less, move more’.   As an obesity Dietitian, the above influences are always in the back of mind when I first meet a client. Why? Unless the people I see have lived under a rock for the last 50 years, they know the key nutritional messages to benefit their weight, and have been trying to implement them.

eat less exercise more

 

Weight loss client journey considerations

  • ‘Don’t judge a book by its cover’. This best sums up supporting anyone with weight loss. In my career, I have yet to witness a stereotypical weight loss client. Come to think of it, if there was a common weight loser, would there be an obesity epidemic?
  • Exercise does not always create weight loss. If you’re doing high volumes of exercise and weight is not shifting, then energy intake may be compromising efforts.
  • No food is a silver bullet. Unfortunately research has yet to uncover a food that creates lengthy increases in basal metabolic rates (fat burning). For weight management, consider food portion sizes.
  • The answers are not obvious. In regards to diet, people always look for the obvious and provide advice around this. e.g. reduce fats and sugars. If it were obvious, clients would not be seeing a professional, as a simple Google search would have answered all their questions.

What are the diet considerations for overweight/ obese:

Everyone is different and everyone has his or her barriers to weight loss. From a diet perspective, I might support clients with:

  • Re-education of diet advice for weight loss and discuss the research
  • Learning what is hunger (when to eat)
  • Learning what is fullness (when to stop eating)
  • Learning what is not hunger (triggered eating as response to environment, emotion, thoughts)
  • Tailoring diet advice into their busy lifestyle (e.g. If they are time limited at breakfast time, they’re not going to sit down for cereal and milk. They need something convenient and enjoyable so they don’t skip).
  • Cooking ability (if they don’t know how to cook their favourite meal, it makes sense they will go out and be at the mercy of chefs and takeaway cooks rich meals)
  • Shopping (how to read a label, what is high fat or sugar, what is too big or too small)

The above are a drop in the ocean in what I do in sessions and direction of support differs amongst client. In other words, everyone is different, and everyone has his or her challenges.  Weight loss is hard and if you have a good understanding of your client’s personal barriers and struggles you will both make a great team for weight loss.

What do you think is the hardest barrier to weight loss? What do you think more people need support with when they are planning to lose weight?
Perryn Dietitian
Perryn Carroll is a weight-loss dietitian who actively contributes and comments on obesity management issues.  A self-confessed diet geek, Perryn writes for her website, Diet Duchess. She also regularly guest blogs and is a media spokesperson for the British Dietetic Association.  If she’s not tackling weight-loss issues, she’s tracking down the world’s best coffee.

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