June
June’s weight has fluctuated since her teens. For June, weight gain is emotionally driven, and food is a source of comfort, as well as a treat or reward. June has learnt lots from the weight loss programs she has done in the past, but finds it hard to maintain these behaviors in the long-term. June hopes to lose weight in the future to improve her health as well as her confidence.
June is 60 and has 1 adult son. She is white British.
More about me...
June has been overweight “in every decade since my late teens”. She sees different reasons for her weight gain at various times in her life, although identifies “emotional eating” as a common theme. June suggests there are psychological reasons behind weight gain, and describes using food as a “treat” or “reward”, or to “cheer myself up”. For June, comfort eating has become a habit, and snacking on chocolates is “like an addiction”. Recently, June lost 1.5 stone through a weight loss support group, but put the weight back on after leaving the group for financial reasons. After this, she found it hard to get her eating back on track, “psychologically you’ve got to gear yourself up to start all over again”. She also attributes her weight gain to changes in employment, going from a physical job to a more sedentary lifestyle, eating more and exercising less.
June has tried various diets at different times in her life, and speaks of learning from these experiences. June completed an 8-week NHS weight management programme, which helped her improve her meal planning, but did not lead to long-term changes to her comfort eating behaviours, “you need prolonged support”. June has also attended several weight loss support groups. Although she has not maintained the weight loss from these diets, June feels such programmes have encouraged her to be “self-aware” about her eating behaviours, as well as giving her knowledge on nutrition, and the importance of eating “3 healthy meals a day”. Indeed, she finds this easier to do at times when she has less disposable income, as she cuts back on treats and cooks from scratch.
Even though past weight loss has shown June that she can lose weight, there is an underlying feeling of failure in being unable to maintain this, “it’s a feeling, a very deep ingrained feeling that you have no self-will and self-control when it comes to food”. Indeed, June feels there is an emotional impact to weight gain; being overweight is accompanied by a sense of feeling “judged” and “unloved” by yourself. June currently wants to lose weight for health reasons, as well as to help her confidence, and in turn her job prospects. June feels she will rejoin a weight loss support group, as it gives her motivation and a sense of “accountability” through being weighed within a group.
June has had some contact with healthcare professionals around her weight. Her doctor mentioned her weight at an appointment for a different health concern, leaving June feeling “insulted” by being offered generic and inappropriate advice for her situation. June is conscious of the pressure on GPs, and feels there should be a way to raise concerns over weight without wasting their time, “people might be really poorly and need appointments and my individual struggle with my weight shouldn’t take that time up”. June questions whether specialist services could be implemented which address deeper issues around weight, because to make suggestions on small changes is merely “scratching the surface”. Similarly, improving education around nutrition in schools is another strategy that could encourage weight management. June suggests that collaborations need to be forged between healthcare professionals, dieticians, and academics to increase understandings of the complexities around each individual’s weight issues, and work towards solutions. Dealing with weight is ‘multi-faceted’, “you can’t do a one size fits everybody type of approach to it”.
While there are many reasons why people put on weight, June thinks that “at the root of it all is emotions”.
While there are many reasons why people put on weight, June thinks that “at the root of it all is emotions”.
Yeah, because I think something I learnt from Slimming World is that, in my opinion, you can group people into why they’re there and it could be a sweet tooth, it could be comfort eating. It could be alcohol, it could be a very busy social life but at the root of it all is emotions because why can one person have exactly that same life and remain slim and another person puts weight on. There’s, there is, I think, very deeply psychological reasons underlying it.
For June, comfort eating soon turned into a habit that has lasted for decades. Her inability to change her behaviour has left her feeling a ‘failure’.
For June, comfort eating soon turned into a habit that has lasted for decades. Her inability to change her behaviour has left her feeling a ‘failure’.
I think it just starts as a small thing really. You know, my thing used to be, my son used to go to his dad’s on a Saturday when he was a toddler and I would go and do a weeks shopping and I would just buy one item that was a little treat to myself for managing all week as a single mum and then I think once you get that idea, I mean, I think they’re called neural pathways, I think your brain makes connections for good or ill so that it just creeps up. You think, ‘Oh that was hard. I did that. I’ll just have a Kit-Kat or, you know, and before you know it you’re rewarding yourself on a regular basis so eating three healthy meals a day, well balanced, five a day, all that and then I just ruin it really by treats. But it’s not just comfort eating. I, I think there’s a difference. I think comfort eating becomes habit, you know. So, your habit is to go in the kitchen and have a little look around and find something to eat perhaps while you watch a television programme or you’re reading or if you’re sat at the computer doing some work and then it just changes from being a comfort thing to, to a habit and becomes ingrained with the decades.
What do you think would help you to break that pattern?
I think, one of the main, one of the main things I think I have to say is that you feel a failure because, you know, I’m an intelligent person, I know what I should do so you feel a failure so and if you’ve got decades of evidence to prove you’re a failure that does sort of reinforces it really.
June reflects on how the pace of life contributes to people being overweight.
June reflects on how the pace of life contributes to people being overweight.
I think just, just one thing I would like to mention really is the busyness of today’s world is a big factor that I haven’t mentioned. I do think society is changed and speeded up an awful lot and people have jobs that have, you know, perhaps not as physically demanding obviously but mentally very demanding and a lot more stress in life and I think all of that is another major contributor to overweight. People not having the time to cook, to think about the shopping before they do it. To be supervising the children, to be sat down at a family meal table. I think time is a massive other factor that needs to be thought about in any initiatives. It’s no good thinking we, we live in this ideal world of the fifties because no, nobody does anymore.
June has overweight and diabetes in her family; cheap multi-buy offers for bars of chocolate and too many everyday temptations make it hard to make the best choices about food.
June has overweight and diabetes in her family; cheap multi-buy offers for bars of chocolate and too many everyday temptations make it hard to make the best choices about food.
I can only say for myself I don’t think it’s one thing at all. I think that would be most people’s experience that yes my father was overweight, but he got diabetes and his mother was overweight and the same thing so, there is like a possible genetic thing there. But I do think everyday life comes now with so many sort of, you know, ways that encourage you to be overweight and I think a lot of people, it’s like having a selection of a hundred things and people chose some of them. So, for example, my local mini-supermarket a bar of chocolate is 80p, but you can have three bars of chocolate for £1.20 and as a chocoholic that’s terrible temptation because you think, ‘Well that’s ridiculous. I’ll buy three and I’ll put two in the glove compartment. One can be for tomorrow. One can be for the day after,’ but no you see I’ve been eating. I’d creep out to the car at midnight and get one out of the glove compartment. I, I just think there are so many every day temptations and if you’re already over weight and you think to yourself that you think a slimmer person has either got more self-control or doesn’t need to exercise for some reason their brain is wired differently, you know, that you’re presented with say thirty choices in a day to do with calories or exercise and you just pick some of them wrongly every single day.
June kept attending because she liked the positive and enthusiastic teacher at Slimming World.
June kept attending because she liked the positive and enthusiastic teacher at Slimming World.
Well I suppose it’s like any educational experience really. You, you want a good teacher at the front of the classroom and the one that I went to last year, she, she was a lot younger than me, but she, she loved cooking, so she was full of ideas, full of recipes and very positive about everything and she wouldn’t entertain too much negativity. She moved the things on quickly and you’ve got to feel that that person is I think really on your side. The only downside to it I would say is because she was a good leader, her group was massive. So, for her to go round every person, every week and ask us in a group how we’d done etc., you know, it was getting really late when we were finishing. I think there should be a maximum size of group really for it, of course it’s a commercial enterprise so…
Okay, so, how, how big was your group?
I would say between 30 and 50 people. Yes, yeah it was that good.
Okay and she was running just one group or within that area?
She, she ran three groups. One in the morning, one in the early evening and then the evening one that I went to after work.
Okay. So, if you would like to, I think this is, this is very important so if you based on your experience, if you need, if they ask for your advice kind of what group, what group size would be good, the qualities of a leader. What would be, if you had to recommend something?
Well I would say definitely no more than thirty people. I mean, probably twenty’s ideal but commercially that’s probably not viable because of all the cost involved but they only, I think they mainly recruit from people who have lost weight with them. So in theory, the people have got that knowledge and enthusiasm but she’s gone on to be, she’s dropped two of her classes now and she’s like an area manager. So clearly, she did stand out, just enthusiastic and interested in cooking because at the basis of Slimming World and Weight Watchers really is healthy eating and just, just a good healthy diet and that involves putting time and effort into cooking and lots of people don’t cook. Lots of people don’t cook. I have always enjoyed cooking but lots of people don’t know the first thing about cooking and they need some help to and they need it from people who are doing it and are, you know. She was very good at identifying new products that had come onto the market, not, not Slimming World ones, just new things like squash being used as lasagne sheets and things like that. So, she was really on the ball all the time every week.
June attended a “very good” NHS programme where she learnt new ways to tackle her eating and exercise habits over an 8 week course. She would have liked longer-term support.
June attended a “very good” NHS programme where she learnt new ways to tackle her eating and exercise habits over an 8 week course. She would have liked longer-term support.
I went on a very good NHS programme in [City] called ‘Keep it off for good’ and that was fantastic. But it was eight sessions and if you’ve spent thirty or forty years getting bad habits and being overweight, you need prolonged support. You need it to go on and on, whether it’s a group or whatever it’s, it, you can’t undo in eight good sessions no matter how excellent they were, you can’t undo all the habits. So I think it’s a reason to keep going back and the availability of something that you can keep going back to.
Can you tell me a little bit more about that programme, the NHS programme?
Yes, so it was, it was self-referring, so you had to be overweight. It was self, you had to have a BMI over a certain amount and it was a small group which was excellent. There were only eight or ten of us and the, the leader of it, [name], she was she never said what her qualifications were, but she worked in a gym and I think she had qualifications of some kind in nutrition and it’s the first time really that somebody had put all information together. Every week we had a, a strong topic and I learnt some new things because I think overweight people are quite experts in things and you think, ‘I’ve not got much, much I can learn.’ But actually, she, you know, she used a, a wide range of references and excellent handouts and she emphasised exercise. But I think it would have been improved if it would have been far longer than eight weeks and if it would have been a two-parts thing so that those sessions were one part and actual exercise was another part.
Okay.
Joining the two together.
Okay, so, yeah, sort of, kind of to keep…
No, a token amount within the session but a separate session for exercise, I think that would have been great.
Okay, and what about in those sessions that she did, [21:32] she talk about sort of how to change behaviours so what would help to change behaviours?
Yes, so she talked about keeping a food diary, looking at what we were currently doing. Making small changes which, you know, she emphasised all the medical side of things, what it could lead to. She had a week on exercise. She had a week on all the temptations and downfalls and how you could get around those things. So things like, something that’s become prominent like cakes at work on a Friday and eating out and coffee shops and all the things that really contribute to people potentially putting weight on. And, but I just think then she gave us a little bit of homework, so we had to go away and think about whatever the topic was. But I just think it should have been far, far longer course.
Okay, so would have been, for you more, more, a longer term to keep you …
Yes, because I think to take a new idea on board and turn it into a new and better habit, they say it takes three weeks minimum and to be doing that every week, obviously you’ve not got enough weeks to, you’ve not even ingrained one good habit before you’re having to try and start another one.
What has stayed with you from that course in terms of habit changing?
I suppose really it’s just that it combined elements of other things that I’ve done all in one place and with a bit more thought and knowledge and it, it’s sort of, you know, it’s, I’ve never really believed in silly crash diets but there was a week where it was all about, you know, debunking the myth of crash diets and why they don’t work and things. But she did sort of really say, you know, at the end of the day the responsibility is with me, nobody, you know, “nobody could wave the magic wand for us. It was down to each individual,” which you know that but if you, if you have this negative feeling that I’ve spent a long time failing and that I’ve got no will power. Self-blame plays a very strong part I think in weight problems or my weight problems.
June had mixed feelings about exercise on prescription. For her, it is important to link exercise and food and have a long-term programme of support.
June had mixed feelings about exercise on prescription. For her, it is important to link exercise and food and have a long-term programme of support.
I just think people need to look at every, every single strand. It’s a very, very complicated problem and I think it does need to be more joined up. I mean I have done like an exercise on prescription. We have like an, an arm’s length organisation in city that does sort of weight loss for the terrified, exercise for the terrified and that was good, but I felt that, the training, he was a gym trainer and he was very fit, and I don’t think he under, I think he underestimated how reluctant people feel, frightened even of doing exercise. Some of them a lot more frightened than I was about doing things. Especially the more over weight they are and also, I think they narrow it to just being gym activities and for lots of people, overweight or not, a gym is not the thing that switches them on and keeps them motivated. I like classes, I like groups, I like making a commitment to going to something. So I think it needs to be more joined up thinking between the exercise and, and the food really.
Okay and also to have an exercise programme that is tailor made…
Yes.
…for people if they haven’t done exercise for a while or ever.
I mean, in fairness this was a very gentle set off and yet I think again, it’s about six or eight weeks and then after that period, you had an induction to the main gym and then you were on your own and it wasn’t so much the being on your own it was the fact that you could go any time then so you didn’t have to be committed and if you felt under the weather you didn’t bother going and if you didn’t particularly like the gym, you didn’t have quite enough motivation to, to carry on with it really.
A brief interaction with the GP about her weight was “one of the most unsatisfactory experiences” June had ever had.
A brief interaction with the GP about her weight was “one of the most unsatisfactory experiences” June had ever had.
Have you talked to your GP, your doctor about it?
Well I’ve only had one, one sort of discussion with a GP. I went with a different problem totally and while I was there, she mentioned my weight and actually it was one of the most unsatisfactory experiences I’ve ever had because she had somebody, a trainee doctor in the room and I felt she’d just put that question into our consultation just as a, an example of good practice or something and she, she asked me a couple of quick questions and I explained to her that I did eat well but time was a factor when it came sometimes, time could be my undoing as well and she just said to me, “Well, you know, if you make a small change like take a salad to work.” And I felt quite insulted really because she, I’d only ever seen her a couple of times before. I didn’t feel she knew anything about me and I know it’s a doctor’s duty to point out overweight, but I just felt it was like a tokenistic really. You know, because I’d just explained to her that where at that point I had fallen down on my lunch meals and it was because each day I was driving from one side of town to the other teaching in community settings and I was eating as I was driving and I thought if she’d have listened to that she’d hear what I was saying that a) it wasn’t generally my lunches that were a problem b) to eat a salad while you’re driving is, you know, not, not at all sensible and c) she totally ignored the bit about, you know, the chocolate and the snacks which is, was the key. So, it, it felt like, you know, I’ve read a little bit since about how doctors should intervene with patients.
And how should they?
Well they say it’s all about the language you use but I honestly believe that most GPs nowadays do not have the time. I think full stop they don’t have the time so if, if they feel it’s important then it’s up to their surgery or their health area to organise something where people can go to people who have got the time to spend. I just think it’s, you know, we’re, we’re told as patients, don’t bring a second symptom, a second problem into a five or ten minute appointment and then the doctor brings something in like that which is huge in an older person, weight person’s life. Huge thing and to think that anything a doctor might say like that, you know, about small changes or habits it’s scratching the surface.
June suggests that the NHS should have more control of weight management interventions outsourced to private companies.
June suggests that the NHS should have more control of weight management interventions outsourced to private companies.
Well, I think if the NHS is putting public money into subsidising big companies like Slimming World, I think then maybe they should have a bit more say and control over it really. So, the point I mentioned about the classes being too big, you know, maybe they commission some classes specifically or said, “Well if, if we’d got people that were paid to be in that class, we’d like that class to have no bigger, no more than so many people because that gives people more of a chance of success. More of a chance of asking questions and being listened to and so possibly better outcomes.” Don’t, don’t just throw the money at it and hope it’s going to get the right results, you know, use the public money to do it sensibly.
June recommends trying things and if they don’t work out, don’t be put off trying other things.
June recommends trying things and if they don’t work out, don’t be put off trying other things.
I think I would mainly say, try, try things, if you haven’t tried something I don’t mean in a diet. I would say in a group or some sort of local offering of like the, ‘Keep it off for good’, try something and if it doesn’t work for you or you don’t like it, don’t be put off trying something else because I think in lots of other areas of life, if we don’t like something, we don’t blame ourselves, if we went to the cinema and it wasn’t a good film, we didn’t enjoy the film we wouldn’t say, ‘Oh, it’s my fault I didn’t enjoy the film.” So don’t say that about, you know, it could be that the group’s not got a great leader or it could be it’s too late in the day for you to be alert and taking in all the messages or but the only other thing I think is that I do think that cost is a big factor, you know, and one thing I try to say to myself is I tell myself, I can’t,’ at times, I’ve said, ‘I can’t afford to go to a group because it’s five pounds a week,’ and you have to be honest with yourself and say, ‘Am I spending five pounds a week on food that’s doing me harm?’ And if the answer to that is, ‘yes’ then you should go to the slimming group really.