Hilary

Age at interview: 62

Brief Outline:

Hilary gained weight over the years, in part because of bad eating habits developed from working in a busy office environment. After being diagnosed with type 2 diabetes, she made changes to her diet, and started losing weight quite quickly. Hilary hopes to continue to lose weight for health reasons, but advocates for realistic goals in weight loss.

Background:

Hilary is 62 and before retirement, worked in data protection. Hilary is married, and is white British.

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Although Hilary did not suffer from weight problems in childhood, over time, her weight crept up to 142 kilos. After meeting her partner, they would eat out a lot, and have a drink in the evenings. Working in an office also saw Hilary pick up “really bad eating habits”. She would snack on chocolate bars and biscuits throughout the day, and have a large meal in the evening. Although Hilary wasn’t too concerned by her weight gain, or conscious about her appearance, she started to feel tired. Hilary went to her doctor for tests, and was diagnosed with type 2 diabetes. After her diagnosis, Hilary stopped snacking at work, and prepared salads or sandwiches for lunch. She became aware of the sugar contents of foods, and only ate sweet foods in moderation, including fruits. Hilary immediately began to lose weight, and has now lost over 40 kilos. Hilary’s diabetes nurse has encouraged her to be more aware of her eating habits, “when you’re diabetic, you’ve got to really look at what you’re eating…There’s a lot you’ve got to be careful of”.

When beginning her weight loss journey, Hilary wanted to “do it on my own”. Hilary has made changes to her eating habits, altering recipes so they contain less sugar and fat. She has started cooking at home, preparing wedges instead of going to the chip shop, and making vegetable crisps in the oven. Hilary also makes healthy choices, eating lean meat and fish, and lots of vegetables. Using a smaller plate has helped Hilary be more aware of her portions. Hilary has found that over time, it is easier to restrict unhealthy foods to small amounts in moderation, “I’m trained now. If I want some I’ll have a spoonful of it and that will satisfy my craving, just that little bit and then I move, move on.” Indeed, Hilary feels managing weight is about changing one’s relationship with food, “you’ve got to get yourself into a different mindset”. Hilary has found that retirement has changed her diet, as she is no longer tempted by office eating culture, and has more time to prepare healthy meals. Although Hilary enjoys walking, she feels “I probably need to do more”.

Hilary’s nurse has been “very supportive” around her diabetes, and has continued to help her manage her diabetes and her weight over the years. Hilary was also referred to a course around diabetes and weight management, which taught her foods she could eat and those she should avoid. Hilary also uses the internet for suggestions on diabetes and weight management. However, before her diabetes diagnosis, Hilary never saw a healthcare professional about her weight. When she went to the doctors, it was not mentioned, which Hilary questions could be because she had older male doctors. Hilary suggests healthcare professionals need to consider how they talk to patients about their weight, “I think you need to know how to approach people to get across to them that you’re not having a go…You need to be able to talk people through it properly and say, ‘Look, your weight is an issue. You know, at your height, you know, and your, your build, we should be looking at you being x-amount’”. Indeed, Hilary feels that there is a lack of awareness around nutrition, and people manage their diet to fit in with their lifestyles, “We’re very much geared to convenience”. She suggests that portion sizes in restaurants and fast food chains lead to poor eating habits, as does the availability of multipacks of unhealthy foods in supermarkets.

Hilary is pleased with her weight loss, but wonders if she would have developed diabetes if she had of been more conscious of her weight before, “I’m pleased with myself in the fact I said I was going to do it and I did it. I’m disappointed in myself because I should have done it earlier and I shouldn’t have let it get that far really”. Although Hilary feels “physically better” and more mobile, she hopes to lose more weight in the future for health reasons. However, Hilary advocates for healthy and realistic goals in weight loss, “I would hope one day to get it down to say a 16/18, but I wouldn’t make myself ill to try and get myself any further if my body wouldn’t accept it… But I don’t think it’s enough yet. I think there’s a little bit more to go”. Hilary encourages others to be open in facing their weight issues, “don’t be frightened about facing it…sometimes you’ve just got to be honest with yourself and to accept people’s advice”.

Being diagnosed with diabetes was a ‘wake-up call’ for Hilary to lose weight.

But as soon as I was diagnosed with the diabetes it became planned. It became, ‘you need to do something’ because I want to be around. I don’t want to be one of these people, I hope when I go they’ll be nailing down the coffin because they won’t want to let me out. It’s that sort of thing, it’s wanting to be and have a full life and I don’t, and I think that was one of the things that, that struck me as well. ‘Was I going to have a full life? Was I going to be passing away?’ My mother had a heart condition, passed away at 61.

Now it’s not inherited, thank heavens. But I’m thinking to myself at that time, ‘Do I want to be like her, passing away early? No.’ So that was another, another thing.

Wake up call is what they call it, I think really.

Okay. So, you were somehow forced to do it?

Yes, yes, I mean with the, it was as, I say a wake-up call. It was this business of you can’t mess about with it. You can’t say, “I’m going onto diet and I’ll lose a few pounds and then just leave it.” You have got to take this seriously and you’ve got to, you know, it’s your health. It’s, it’s not just getting into the next dress size down, looking better and feeling, you know, good about yourself. It’s about feeling good about yourself but feeling good inside with your health as well, not just that. So, it was, it, it was the trigger that made me, like, ‘you can’t mess around with this now.’

You need to do something if you want to be around.

Hilary enjoys the challenge of finding healthier ways to cook.

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.

Hilary has lost 100 lbs since her diagnosis of type 2 diabetes. The advice from her diabetes nurse has given her the confidence to control her diet.

And so, throughout the years you have lost 40…

43, about 43/44 kilos. So, it’s 2lb.4 for a kilo isn’t it? So that’s 80, oh it’s a lot isn’t it? It’s near 100 kilos something like that. Yeah, 100 pounds really.

Fourteen pounds

Fourteen pounds in stone. Oh, we’re getting into, yeah just say a lot.

A bit lost. [laughs] Yeah, I am not good at maths so.

No, not, I need a piece of paper when I’m doing maths.

Exactly, yeah, I can’t do it. Okay and what are, you’re still on sort of your way to try and lose more weight?

Oh yes, I don’t think I should stop now. As I say I lost those extra pounds when I had quite, I think it was about five kilos when I had the gall bladder operation. Then I put about two or three back on and then I took those off. So, I do try and make sure that, you know, as long as I’m not putting anything on, I try and aim to take something off.

I mean, as I say, [diabetes nurse], who I swear by, said to me at one point, “If you fancy a piece of chocolate, you can have a piece of chocolate.” “But,” she said, “don’t eat the diabetic stuff because people think you can eat more of that and if you’re having it, it’s a treat.” She said, “Have it, once a week or”, she said, “if you’re, you’re addicted to Bounty’s or Marathon’s or whatever,” she said, “get the mini, the little sort of Hero type thing,” and she said, “you can have one of those, only one but you can have one of those.”

So, if you were struggling, there is that line there to say, Yeah, if you, if you behave yourself and do as you should be, there is something at the end. If you’ve got, you know, need a little treat at some point, it’s there, so I wouldn’t be sort of, ‘I can’t have this at all.’ As I say, with people’s birthday’s, I’ll say, I’ll have a sliver of cake. Just a tiny little piece and that’s fine. Now, before, you know, you’d have a piece and then somebody say, “Oh, there’s seconds left here.” Well, I would have the seconds, you know, no problem at all. So, it is around saying to yourself, ‘I can, I can do this.’

Hilary started by using sugar substitute until her body got used to it and she could wean herself off sugar altogether.

Do you try to get ‘x’ amount of calories per day or….?

I did initially but now I can, after a while you can sort of judge what you can, if you’re eating, the other thing is potatoes, starches, you know, it’s no good having half a loaf of bread. You’ve got to, I make sure if I have cereal in the morning, it’s, it’s always, it’s always like an All Bran. It’s never cornflakes, there’s no sugar. Initially, I had to take it with a little sugar substitute but then your body gets used to that and then you can wean it off to, to nothing like that.  Porridge I’ll have, something like that. It’s always semi-skimmed or skimmed milk.  As I say, I had a sugar substitute at one point. There’s none of that in the house now. The only time I ever get that in is if I’m making a cake for somebody else and I’ll get sugar substitute it and I’ll do that.

Everyday movements like climbing the stairs and getting in and out of the bath were easier for Hilary after losing weight. She wishes she had lost weight earlier.

And how does it make you feel to have lost all this weight?

I’m pleased with myself. I’m pleased with myself in the fact I said I was going to do it and I did it. I’m disappointed in myself because I should have done it earlier and I shouldn’t have let it get that far really. I should have been more concerned as the weight was going on but I feel much better for it. I feel much better physically. I know that I was wheezing when I was walking because of the extra weight. That doesn’t happen anymore.

It’s, I mean, we moved to this house because it’s, it’s easier to manage but also the stairs when you’ve lost a lot of weight, you realise how difficult the stairs were. But now that doesn’t bother me. It does with, with me knee, but that’s not something you can’t manage but when you look back at the way sort of I was and the things I couldn’t do. Getting in and out the bath was difficult because of coming up from so low and having knee damage anyway, it was difficult. But we had a walk-in shower put in, so okay, that’s great in the long term but it shouldn’t be the answer in the short term. Yeah.

After being diagnosed with type 2 diabetes, Hilary was referred to a course which helped reinforce information about diabetes and weight management. She attended with a friend from work who was also recently diagnosed.

Now the nurse was very supportive. They sent me on one of these courses where they talk about diabetes and weight management and what you can do at our local hospital and that was very helpful as well because that came round with some of the things which I already knew but reinforced things like ‘don’t assume diabetic chocolate is good for you’. It’s not because something, it’s got sorbitol in it and, you know, if you have too much of that you’ll spend the rest of the day on the toilet because it’s just a laxative basically. Those sort of things, and certain things that you could have, you assume sugar free sweets, again there’s no sugar in them. There’s no sugar as such but again there are things like sucrose. Another form of sugar but a different name, so it’s all those sorts of things. So, they were very helpful in that respect and told me the sort of things. I thought, “Well, I’m not sure about those?” and they were able to say, “Well, no you can’t.”

They’re all trained in the diabetes side, so they can help and support. They were able to refer me on to [NHS courses], our local health people our local NHS who had courses that people could go on. They could show you how to cook as well. In fact, I went on one of those initially as well because there was a lady at work that was diagnosed the same time and she came through and said, “Look there’s something here.” So, we went and had a look. Again, it gives you just a reminder of the things you can and can’t do and some alternatives if you say. I suppose it’s like going to Weight Watchers where somebody’s going to say, “I can’t do without gravy. I’ve got to have gravy on the mashed potato,” or whatever, and they’ll come up with a calorie friendly solution. Perhaps not ideal but it will, you know, it will see you over that need to have something like that.

Hilary describes the importance of going to trusted websites such as the Mayo clinic and Diabetes UK.

But do you think that they have given you the information in, let’s say, plain English, in a way that you can absorb and is easy?

Yes, yeah, I think so and as I say, with the, the Internet sites as well, you, you begin to pick up very quickly, the NHS, Mayo clinic, as I said before, they’re very good with their information. Diabetes UK, all, there’s always something you can pick up proper information from. You do have to be careful you’re not going on to these sites that are going to frighten the living daylights out of you because they don’t know what they’re talking about. You need to go on a proper, you know, recommended site, I think.

Hilary describes her diabetes nurse as “very much a people person”. She values the encouragement she has been given to lose weight.

And the advice came after you were diagnosed?

Yes, yes.

Okay and how do you feel about what was offered at that point?

It was fine from that point. I think because [nurse] specialised in diabetes and she’s very much a people person. I think that’s another thing as well, I think you need to know how to approach people to get across to them that you’re not having a go and saying, you know, “You’re just fat. You need to do something about it.” That’s not going to work. You need to be able to talk people through it properly and say, “Look, your weight is an issue. You know, at your height, you know, and your, your build, we should be looking at you being x-amount,” and a realistic sort of thing and saying, “Well look we need to start….” which [nurse] did. But up to that point, no.

Okay.

But after that, it was fine, there was support there and there was encouragement and there was, [nurse] would be like, “Yes. That’s great. We’ve lost another four pounds.” And, and sometimes I’d say, “Oh, it’s only four pounds.” “You’ve lost. You’ve not put on. So, let’s be positive, you know. Let’s try more for the next month or the next quarter, or the next six months, but you’re not putting it on. It’s still going down.” So, I think that’s it.

It’s a lot of encouragement.

Yes, yeah and I think you’ve got to have some of that to, because you need, you need the, the stick and you need the praise. But you need the stick in a way that you’re going to respond, and not just say, “Well I don’t care what you say because I like food.”

So, you have a good rapport with her?

Yes.

That helps.

and the other nurses there and the receptionist and as I say, Dr [name of Dr.] as well. 

Hilary says it’s important to face up to weight issues and be honest with yourself.

I would say, don’t be frightened about facing it. I think people put off and perhaps I did, in that respect. I put off, although I knew there was an issue. I put it off that there was an issue because I was fine. ‘I’m fine. I don’t feel ill. I don’t, I don’t look awful. I don’t.’ So, it’s something that you can do another time perhaps, if you do at all. So, I think sometimes you’ve just got to be honest with yourself and to accept people’s advice, you know, when you go to somebody like your GP, you’ve got, if they’re, if they man up to telling you that there is an issue, then they’re not doing it to be horrible. They’re not sitting there saying, “Oh gosh, aren’t you fat?” they’re saying, “You’re overweight and it’s going to affect your health.”

But I think if you look round, you’ve only got to turn the news on and I look at people and I actually said to my husband, “Do I look like that?” and he went, “No, but you did.” So, I think sometimes that can come as a shock because I thought, ‘Gosh, that woman looks really overweight. Really overweight.’ And that’s when I said, “I don’t look like that, do I?” and he said, “No, not now,” but he said, “but you did.” And I think sometimes you’ve got to come up front, you’ve got to face it really ad I think sometimes that’s a difficult thing is actually facing you’ve got to do something about it. That does mean stopping doing the things you like, or eating the things you like and requires you to do a little bit more….