John X

Age at interview: 67

Brief Outline:

John X gained weight in middle age, but only became aware he needed to lose weight because of medical problems. After being diagnosed with prostate cancer, he searched for information about diet and cancer, and made several changes to his diet. Although John has lost some weight, he hopes to continue his weight loss in retirement. He believes that GPs could be more direct in talking to patients about weight.

Background:

John X is 67, and is married with 2 adult children. He works as a university professor and is in the process of retiring.

More about me...

John X has always been active, and never considered himself to be very overweight. He started to put on weight in middle age, but only became aware that he needed to lose weight because of medical problems. Around 5 years ago, he was diagnosed with sleep apnoea. John was aware that this condition may be affected by his weight, but he didn’t try to change his diet until he was diagnosed with prostate cancer 2 years ago. John was surprised that there may be a connection between his weight and the cancer, because it runs in his family. However, the diagnosis made his weight issues “hit home more strongly”.

Although John feels that weight gain is common in middle age, he also believes that his lifestyle has added to his weight gain. Working in academia, he often goes to events which encourage social drinking. He also drinks alcohol at home and doesn’t get as much sleep as he should.

After he was told by his doctor that he needed to lose weight, John searched for more information. He wasn’t given support from his doctors or nurses but found advice about managing his weight from his cancer support groups. Since then, he has made changes to what food he eats, eating smaller portions and cutting down on certain foods like sugar and bread. After talking to other members of his support group, he has also started eating alternative foods that might help his condition, such as turmeric and green tea.

John has found that since he has made changes to his diet, he has lost some weight and his sleep apnoea has improved. However, he is aiming to lose a little more weight. As he continues his retirement, John looks forward to facing less pressure and having more free time. He also hopes he will be able to cut down on alcohol and do more exercise. Doing exercise helps him feel better physically and mentally.

John feels that there should be more public information on the connection between weight and other illnesses. He believes that GPs should “be more vocal” in talking with patients about weight. He feels that this would be useful as they may be able to offer people advice on weight management, “it might be nice to know what the latest recommendation is from the National Health Service”.

John X talks about the dietary advice he has received from a national and a local cancer support centre.

As I say it’s just through the cancer issue. The support group and the support group helped to organise. This may have been happening any way but we were told about a very good dietary seminar at [name’s] Centre which I attended. And that was excellent and we got encouragement about what things to cook and what kinds of foods to avoid and that sort of thing.

So was there anything that they said about food that sort of was new to you, surprised you or?

Well I mean I was pretty naïve about tumours, for example. And of course, the connection with sugar I should have realised before. But I mean this was brought home to me that sugar is not good for tumours because it tends to, it tends to increase growth. And also these other issues like turmeric, green tea, and pomegranate that kind of thing. I don’t know how well established this is but there certainly was encouragement and particularly from other members of the support group.

And I didn’t. I never really considered myself to be sort of hugely overweight but it was obvious to them I needed to lose weight. And then I started to get more information about what is good to eat, what is not good to eat for, for cancer sufferers. And I went to. I had some very, very good information coming for example from the [City] Support Group for Prostate Cancer which, I attend their meetings. And we, we had very good advice from the nurses for example about what we should eat.

But again I got very good advice concerning the right kinds of food for cancer sufferers. And, of course, one of the things that is absolutely top of the list is to cut down on sugar and chocolate and that kind of thing.
 

John X was diagnosed with sleep apnoea, which he knew was related to his overweight. Neither the hospital nor the GP discussed the benefits of weight loss.

But coming back to the issue of sleep apnoea there was no, nothing came. There were no suggestions about diets or how I might lose weight.

From, coming from your GP?

Or well the GP I barely see. Certainly not from the GP.

And not from the hospital you went to?

No.

No?

No not that I remember.

Ok so nobody at that stage mentioned?

Well I think it

Your weight or

No I don’t remember specifically any kind of dietary discussion. Of course I was aware sleep apnoea applies frequently to men who are overweight. I mean I was aware of that but I don’t remember I mean I hope I am not doing them an injustice but don’t honestly remember any kind of. The GP didn’t follow it up. There was no follow up about this.

Ok

And as I say once I used that, that piece of apparatus in my mouth to sleep with that made a huge difference and I used it for years.

Ok.

I used it for years.
 

John X did not receive information on how to lose weight when he was diagnosed with sleep apnoea, but it was one of the first things the consultant mentioned when he was diagnosed with prostate cancer.

Well I guess I should start with the episode of sleep apnoea that I had I think it must be about five years ago, 5 or 6 years ago. I can’t be absolutely sure of the date.

Ok, ok. So I was, I had one of these sleep-overs in a hospital here in [City] in which my breathing was recorded and it was clear that there was a mild to moderate case of sleep apnoea and there was an issue, of course, of losing weight. But the main suggestion that I got, professional suggestion, was to buy an apparatus for my mouth which I eventually bought. Which is a thing that basically holds your jaw, lower jaw forward. And I started using that and that made a huge difference. I used that for several years.

I wasn’t given any information about or any suggestions about a change of diet but I realised that weight was an issue but I have to confess I didn’t do a lot about it. I mean once I had this, this apparatus in my mouth at night it made a huge difference in it. So I just continued with that. But I suppose what really made a difference in terms of my weight or my attitude towards weight was two years ago when I was diagnosed with prostate cancer. And again the doctor said to me, they took one look at me and they said, “Well you are going to have to lose some weight.”

Ok. When the oncologist said to you, “I think you need to lose some weight.” What was your reaction? What were your first thoughts? Were you surprised?

Slightly surprised, slightly surprised but I could see that I was, that my girth was increasing. I could see that. So it didn’t come to me as a huge surprise, no. But I was surprised more by the context. And what does this has to do with prostate cancer, I thought. What does this have to do with prostate cancer and my chances of, of keeping fit and well? But that was one of the first things that, the first rather arrogant oncologist told me was, “It would be good for you to lose some weight.”