June X

Age at interview: 69

Brief Outline:

June has struggled with her weight since she was 8 years old, and from an early age developed habits of fasting and overeating. Although June can lose weight, she finds it hard to maintain this, as she has a compulsion to overeat. June has tried several strategies to manage her weight, and is currently trying to change her approach to weight loss, seeing it as a “marathon not a sprint”. Whilst her weight has had an enormous impact both physically and mentally, June remains committed to losing weight in the future.

Background:

June is 69 and has 2 adult children. She is a retired estate manager, and is white Scottish.

More about me...

June has struggled with her weight since she was 8 years old. Her mother was also overweight, and June remembers watching her snack on sweets and chocolates before dinner. June became a “secret eater”, and would snack after school, where she was very unhappy. June went on her first diet at 12. “Fed up being so chubby”, June cut down her food intake, eating just once a day. Since then, June has been on a cycle of dieting and overeating. Although June can lose weight, she finds it difficult to maintain her weight loss. Indeed, June has lost and gained weight several times over the years.

June sees her relationship with food as similar to an addiction. Every time she diets, she has a compulsion to overeat, which is often linked to an emotional trigger, “I don’t even know whether it’s boredom or what it is exactly which drives all common sense and all appreciation of how well you’ve done so far, out of your mind”. However, June has tried strategies to work through this, including attending an NHS weight management program over almost 2 years, which incorporated different classes led by a range of professionals. This included meetings where participants were weighted and could discuss any issues they had, classes on mindfulness, and sessions with nutritionists and physiotherapists. June also attended psychology lectures, which encouraged participants to pre-plan their meals and eat regularly. June has also tried CBT sessions which focused on examining behaviors and creating “practical solutions” to address these. One strategy June has found useful is recording what she eats, something she previously resisted. Through this program, June has become aware of her high expectations around weight loss, which leads to negative feelings, and “extreme frustration when things don’t go as you wish”. June is now trying to change her attitude towards weight loss, seeing it as “a marathon not a sprint”, “It has to be following a different lifestyle.  I think the whole dieting thing is perhaps redundant”. She is also learning to appreciate her achievements so far.

In the past year, June has lost 75 pounds. She has tried to eat more regularly, rather than following the pattern of fasting and bingeing that she established from a young age. June has found that at times when she has lost weight, she has noticed a huge difference in her physical abilities. However, June has to push herself to be active, “one of the problems with obesity is you tend to let yourself off with a lot and believe that you are, you either can’t stretch so far or you’re going to hurt yourself.” She has been going to a local exercise scheme around weight management, where she has tried different activities.

June has found that her weight has impacted her life, leading to joint pain and making daily activities like personal care and shopping difficult. June describes her battle with her weight as “painful both physically and mentally”. She explains how it feels to lose weight and gain it again, “utter failure and utter destruction…any opinion you have of yourself, it compromises it very severely”. Having people around her feel excited at her success, only to put on weight again is particularly hard for June, “You avoid seeing people. You avoid social occasions. You avoid all kinds of things.  There are opportunities and chances that life might offer you which you don’t take up because you take up too much space”.

Whilst her weight has been an ongoing struggle, June remains committed to losing weight in the future to reduce the daily struggles she faces, and improve her health; she has been warned of her increased risk of type 2 diabetes, a condition she is “terrified” of developing after seeing firsthand how it affects others. She encourages others to take positive steps towards losing weight and improving their health, “Stay as positive and as optimistic as you can and know that it’s possible to make an improvement in your life”.

June points out the risk of injury and joint deterioration that comes with obesity.

…and the other thing that I didn’t mention as far as health issues are concerned is you constantly injure yourself. Therefore, your joints and there’s always a joint or something which is giving you real problems.

That’s part of it. If you, I don’t know how many people you’ve been interviewing who’ve had sticks and various assistances for daily life, but I would have said there’s a pretty high proportion of people who are disabled in some way or another to varying sort of sad degrees.

Last year I had, what did I have last year? I ended up having, oh my right foot wasn’t working properly, giving me, you know, fairly tedious pain because it has to be fairly serious pain before I start. But I was having X-rays and things like that and being told severe arthritic deterioration and de, de, de, and, of course, the unspoken end of that is the same as it always is, ‘and if you lose a significant amount of weight, it will have a significantly palliative effect on it.’
 

June talks frankly about the multiple ways in which obesity affects her daily life: everything is more difficult.

I had an epiphany of sorts last summer. I hadn’t been doing very well and had been looking at various levels of despair again and because we can talk about prediabetes and diabetes in deed and lots of health conditions, heart disease, rotten circulation, all kinds of attendant health conditions. Danger of stroke, all sorts, but there are lower level practical daily considerations which impinge possibly until perhaps total health disaster hits and impinge on you possibly even more. It’s just the physical problems of living your life.

Like?

Like, you want me to be frank?

Yes.

Like, getting up off a chair, cutting your toenails, going to the loo and wiping your bottom and whatever you do, that can become almost impossible. In order to stretch your body far enough to be able to get past all the mountains of fat, you end up with interesting lumps and bumps of knotted muscle and all kinds of things. It’s very, very difficult not ever being able to get through any spaces. Being terrified if you go out, meet a friend for coffee or anything like that, when you get up you’re going to clear tables, just moving. Just the day and daily parts of living your life or attempting to live your life.

Okay, so everything is affected basically?

Oh utterly, utterly, yes of course it is.
 

June avoids social occasions because of being ‘fat’. She explains that being overweight hurts both physically and mentally.

So you go into a very negative mind….?

Oh well, of course, if you picture yourself putting on ten stone and the faces of the people you know. That’s really all we have to do.

They would be utterly shocked and it’s seeing people’s shock because being very, very, very fat is shocking, especially if you weren’t that fat the last time they saw you [laughs]. And it’s, no, it’s very destructive just all around, it’s awful. You avoid seeing people. You avoid social occasions. You avoid all kinds of things. There are opportunities and chances that life might offer you which you don’t take up because you take up too much space. Over and over and over again.

It’s something that I hate, and I fight naturally. But I haven’t been as successful obviously as, as would have been a good idea for my health and the, it hasn’t ruined or obliterated my life, simply because I’ve been in the happy situation of perhaps not having to. But it’s been it’s everything I say, I mean it hurts, it’s painful both physically and mentally.
 

June’s mother used sweets and chocolates to relieve tensions – June also became a ‘secret eater’.

She did a hell of a job, so, yep. But as to what, you can soak up what somebody else does to relieve their own tensions, like, litmus paper, you really can and mum used to do her day’s work. She worked hard and she would perhaps sit down about an hour before dad was coming home and she’d the evening meal prepared and all the stuff done and all the rest of it, and she would sit down for a while and she would have a pile of sweeties and she would eat her way through the pile of sweeties and chocolate and I remember, that I remember, things I remember and I suppose what we would all remember is that it was always an issue, in that mum was always trying to lose weight, always.

Okay, I mean your case, when did you started to try and lose weight? How old were you when you started?

When I decided I was fed up being so chubby when I was twelve and I decided I was going to lose weight and I did. By the usual methods, cutting down what I was eating.

Hm-mm. Were you having larger portions before?

No, I would, I would do what mum would do. I’d always been a secret eater. I can be a public eater as well, [laughs] I can, I can, yeah, more than anything I would, you know, sort of get my hands on a bag, sort of multipack bag of crisps or a big bag of crisps and eat my way through that or every day after school, I hated school, I hated it and that had a bearing certainly on, on them, how I felt about life and everything up until the time I was ten years old. I really, I really didn’t like any of that, and so when I came out of school it wouldn’t be any kind of a day unless I could go round to the sweetie shop with, you know, ten pence or something like that and buy some sweets.
 

June: “I just don’t want to be fat anymore”.

Why do you want to lose weight? What are your main reasons?

Ah, main reasons, I announced a couple of years ago and it’s, and it’s no less true right now than it was then. I just don’t want to be fat anymore. I just don’t want to be. It’s hard work in hopefully ways in which I’ve managed to illustrate, to talk about. It’s that, it’s incredibly hard work. It’s hard work going to buy a pair of shoes. It’s world shopping in terms of getting anything to fit you. Certainly, the way I was last year and the way that I’ve been at different times of my life. It’s very demoralising having to look at yourself and take into yourself what the situation is and constantly live with it. It is, it’s like good old Sisyphus pushing his boulder up the hill and never getting shot of it to the other side. Always having to push, that’s what it feels like. Always having to push the same huge boulder up the same hill. That’s what it’s, that’s what it’s felt like. Here we go again and just a feeling that I have that I just couldn’t bear to do it all again.
 

Psychological support and recording what she eats as well as her thoughts and feelings has helped June to understand her eating behaviours.

I have been spending a great deal of time [laughs] and effort on this and I am still not convinced that I am fully aware of all the issues which come into play. It seems almost inexplicable to me, but we’ve been doing a lot of work on the weight management programme with cognitive behavioural therapy which I think is very important and it’s an absolutely excellent tool that would seem to me to deal rather less with history as something what is the experience of the individual.

It deals more I feel with practical solutions and as such, I think it works, it works pretty well, and the hope is that I, I what do I think? I think long term support is very necessary.

Can you give me some examples of what you have learned or information acquired?

Information that we’re given. The planks of it, of the programme what we’re being advised to do, is to record out own behaviour, record what we eat and I’ve resisted that for years and years and years and years and years and finally found out at this incredibly late stage of my life that actually it is very effective. That’s making yourself look at what you’re doing is interesting, [laughs] interesting to say the least, and actually if you’re in the habit of thinking about what you’re doing, you probably make slightly different choices more often.

Okay, so it’s changing the behaviour.

It’s the examination of what you’re doing…

Okay.

… will be apt to have that affect if you do it.

You have to do it. There is a large resistance to doing that, but I would say that it’s, yes it is and I’ve been, being told that it was for a long time now. It’s taken me a long time to move round to doing it, but it is very, very effective and I’ve actually been recording what I’ve been eating, I beg your pardon, for over a year now, I think just and that’s the first time I’ve ever had a record, black and white, long term record. It’s not without the odd blank because one goes on holidays and does different things and stuff like that. It’s not always possible, but really it is, it’s a pretty good record of the year of my life, as far as what I’ve been eating and what I’ve been in the habit of doing.

Okay, so it’s, it’s eating and also activities?

Yes, to an extent but we’re not, it’s mainly you’re asked to record perhaps if you can thoughts and feelings. We get given a record book and I don’t do it in a record book, I do it in my own diary and I would, I find that more difficult? I don’t, it probably actually now I’m sitting thinking about it would, it’s probably about time I started to have a go at doing that because I can see the way in which that might begin to make you more aware of how, of thought patterns. And it is, it’s all about patterns and patterns and behaviour and what you do regularly and what you do almost automatically and yes it’s very much, very much to do with that.
 

June feels she has had unrealistic expectations about weight loss and the time is going to take.

And the other thing which, which is, is interesting and it’s and I found it, and I agree with it totally this, this pattern of, of extreme behaviour and extreme expectations with people who are, who are facing sort of routinely facing extreme weight loss, is this completely unrealistic expectation of what you’re going to achieve and the time in which you’re going to achieve it. And that certainly is a pattern with me in my own life. Far, far too high an expectation of the amount of weight I’m going to lose, and the amount of time I’m going to lose it in and a consistent and constant expectation of the rate at which it’s going to go.

And that isn’t how, how you work or how the body works really, and that really you could see with it class when that was being talked about all kinds of bells ringing.

In this weight management course?

Mm. Yes

Okay.

Yes.

So, it’s something that you have been become aware or kind of worried about.

Yes, this particular, yes this particular profile, yes much more recently actually particular profile of unrealistic expectations and far too much perfectionism and therefore the extreme frustration when things don’t go as you wish on, really on a day and daily basis. It’s, it’s this feeling of, you know, ‘All right, I was good yesterday and I haven’t had this result that I was looking for.’ You know, who’s against me? Is the universe against me?’ [Laughs] It’s just, and that’s a completely obviously unrealistic expectation.

Okay. So it is more a long term kind of lifestyle?

Yes, yes. Oh very, very much so. Very much a marathon not a sprint, so and actually in a way that’s quite comforting to think about it in those terms because everything, we are sold everything on the basis of speed. Everything is ‘Lose this in so and so a time and , you know, this will get you amazing results instantly and whatever the beauty product or the sort of weight loss product it’s, it’s going to deliver amazing results incredibly quickly. That simply is, is not the pattern of how things happen really. Not with extre-, not with a level of obesity. Not with a level of overweight. The point is that you can, you can lose your stone in a month and probably absolutely will if you’re very overweight, but nobody’s going to notice that’s the trouble [laughs].
 

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

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.
 

Since losing weight, June has been climbing hills in the Lake District and has walked the West Highland Way. A physiotherapist-led class taught her that she can do much more physical activity than she thought she could.

Okay and in terms of your levels of physical activity, I mean have you seen a difference when you lose weight?

Well the difference is, the difference is, the difference is doing the West Highland Way, the distance is climbing hills in the Lake District. The distance is a couple of Monros (Scottish mountains), that’s the difference.

Okay and when you have…

We’re really talking all the difference in the world.

So from a physiotherapy point of view in an exercise class I can’t say that I learned so much about exercise per se, but what they were, what they were doing which I absolutely believe in and what I was reminded of which I have to remind myself or be reminded of, every time I put on a lot of weight and I begin to lose the weight, is the physical activity that you can do which is usually much more than people think that they can.

You can usually stretch further, they, one of the problems with obesity is you tend to let yourself off with a lot and believe that you are, you either can’t stretch so far or you’re going to hurt yourself if, through certain activities, and if you exercise consistently and stretch consistently in a properly safe environment, which is what the physiotherapists are doing on the programme and they are excellent and they’re what would you say, lovely girls [laughs] Yeah, they’re a bunch of really, really nice people, the whole lot of them actually, and they have a tremendous sense of humour and all the rest of it and again, it’s they have the expertise. They are, one assumes, in that capacity, it’s unusual to get more than one of them, but you do I’m sure in that environment because there are safety and health issues to do with extreme obesity therefore they want to be absolutely certain that any heart difficulties or any mobility difficulties they’re on top of instantly and they’re, they’re terrific and they’re very professional but I think that there is there are definite signs of people enjoying their time, exercising and, and beginning to get more out of it, and of course, that’s the whole, that’s the whole point because you can.
 

June is ‘beyond impressed’ with the combination of psychological support and exercise, with physiotherapists in attendance, at the group she attends.

And for how long has the programme lasted?

Oh, for me?

Yeah.

I think it’s up to as much as a couple of years.

Okay,

Not at the same level obviously. There’s an initially more intensive groups, it’s once every two weeks the group sessions and then it’s one a month I think for another period of time and then it’s even more spaced out, but they keep your eye on you for an extended period of time which is great, you know, sort of and I would imagine if you were in particular trouble you felt or they could help or something like that or, you know, I’m sure that they would.

Okay, okay, so they don’t leave you just when you finish the course.

No, no, no, don’t, don’t appear to.

Okay.

But on the very long term I mean I really, I really don’t know. But certainly I was very impressed at how long it did last anyway.

Okay because I mean the fortnight, the every two weeks sessions, they involve what? A talk… ?

You come, you are seen individually and that you’re weighed and a brief word and with the emphasis on brief, obviously, can’t spend too much time or there wouldn’t be too much time or there wouldn’t be a session. And yes, there is an agenda for each session and so yes, you will have your talk and a group discussion and yes, you can, you can contribute as and when with questions and things like that, as you wish.

There was a fair bit of work on mindfulness, relaxation and that type of thing, which varying views on that, but I think it’s very helpful. I think just from anything that I’ve experienced in the past encouraging people to be more thoughtful, to perhaps interrupt behaviours and to be able to relax and, and make relaxation or bringing yourself down from anxieties is, is very, very useful and techniques such as slowly down your eating are tremendously helpful. If you eat more slowly, you really do eat half as much [laughs]. It’s really that simple….

[Laughs] Yeah.

…and that’s, that’s one thing is, is remembering to do that and remembering to adopt these techniques is very, very important and they’re very helpful.

Okay, so it’s relaxation, techniques to, to help you.

Hm-mm. Hm-mm.

Okay.

And, also, to think about what you’re doing in a more positive light. I think to have a more positive attitude period. Not to be so scared of negative thoughts and negative events. To be able to be mindful and relax more and to slow down.

And at what point do you have the physiotherapy sessions?

They are, generally speaking, the ones that I attended were on a Thursday afternoon/ and those are straightforward getting back into movement classes with two physiotherapists in attendance and movement to music and good classes actually…

Okay.

….good classes. They, they give you stations. You have the floor exercises and then you have the stations round the room of, of sort of wall presses and work in a trampoline and work in an arm press and various sort of things, and a step, getting on and off a step, things like that type of thing.

Yes you kind of can do, you can, you can come to your, absolutely, to your group session and you can come to the psychology lecture and you can attend the physio and you can also attend the Live Active programme and get the benefit of, of people, people who are expert in, in various types of exercise and getting you going in that regard. I would say it’s pretty widely supported.

… as I say, I’m beyond impressed. There’s a tremendous willingness to help in any way that they actually can.

What have been the most positive aspects of it for you?

I think that the recording and eating regularly and not perhaps stressing too much, getting, not getting too rigid. This rigidity or your feeling profile that I was speaking about. This unrealistic expert, expectation. This over perfectionist attitude really is going to get thoroughly in the way. We’ve had a bit of an exploration of how negative thinking is what happens to the human organism first. That it’s far more part of our evolutionary cycle to think in, in negative terms than it is to think in positive terms and therefore it’s not that strange but challenge it. Wait, wait a while [laughs]. It won’t necessarily stay that way and perhaps challenge it. If, as and when possible

And the number of times since beginning this that I’ve thought, ‘Oh no, no, wait a minute, you know, this isn’t a disaster. This isn’t the universe versus me this is just temporary, this will pass,’ and it’s very true. Everything passes, and I think probably that to, [Name] who’s one of our, our group leaders who’s, who’s psychologist and very good one saying, “This is a marathon not a sprint. This is a marathon not a sprint,” has been probably the most useful thing that has been said to me that makes sense. However, you think this is going to happen whatever, it’s not and the last thing actually he said to me was, “Remember to enjoy the benefits of what you’ve achieved so far,” because since last year I’ve lost 75 pounds, so that again is tremendously, tremendously important.

Exactly, yeah.

You know, and to, to let it slip your mind, to, you can’t become blasé about that.

Yeah.

That’s a big difference from where you were, you know. It may not be where you want to go but it’s a big difference, oh I’ve done it now.
 

June says that losing weight is a positive step towards your own health. Stay optimistic because “It’s worth the effort.”

Stay as positive and as optimistic as you can and know that it’s possible to make an improvement in your life. That is probably an absolute fact.

There’s a great deal all of us can’t change about our lives. One thing you can do is to take a few positive steps towards your own health and my experience and I’m still obviously working on it, on a daily basis, is that you can improve life and you can improve your experience of life that if you’re within a safe environment and you can become more active, absolutely do it. Get more fresh air, get more of the blood circulating round your veins. You’ll feel better and whatever positive steps you make towards your own health, you’ll feel better. You can have less indigestion. Less in the way of aches and pains and it’s worth the effort. Immensely worth the effort.