Lesley

Age at interview: 60

Brief Outline:

Lesley put on weight over time, but was told to change her lifestyle after suffering a sudden cardiac arrest at 58. Lesley cut out alcohol, increased her exercise, and changed her diet, losing 10 kilos in 6 months. However, Lesley has since gained this back. Her weight is now stable by maintaining a healthy diet and exercise regime. Lesley feels her inability to lose weight may be because of her medication. Although her doctors have been reluctant to change this, she plans to raise this issue again as she feels losing weight would make her look and feel better.

Background:

Lesley is 60 and works part time in an administrative role. She is married with 2 adult children, and is white British.

More about me...

Lesley gained weight over time, from a lifestyle of eating and drinking too much, and not doing enough exercise. Although Lesley wasn’t overly concerned about her weight, but she suffered from a sudden cardiac arrest at 58, and was diagnosed with dilated cardiomyopathy. Lesley has since found out that this runs in her family, and her children have also been tested. Lesley was fitted with a defibrillator and put on beta blockers, ACE inhibitors and statins. She was told to lose weight, take more exercise, and cut out alcohol. Lesley describes the changes this had on her life, “my whole life changed from being very independent, quite sociable to being… quite frightened and trying to lose weight”.

Lesley found adapting to her new lifestyle difficult at first, “I’d had so many changes already. So for me, I wouldn’t say resentful was the word, but I thought, ‘I’m lucky to be alive. I might as well live life how I want to live it’”. However, Lesley worked through these feelings, and made changes to her diet. She started to eat lots of salad, beans, lean meats and fish, and cut down on carbohydrates. She gave up alcohol completely, and started walking every day. Through this, Lesley lost around 10 kilos in 6 months. Although Lesley has now started having a few drinks on the weekends, she approaches her diet and exercise regime as a lifestyle change, “I don’t feel I’m on a diet. I feel this is my lifestyle from now on”. However, losing weight has become “more and more difficult”, and Lesley has gained the weight she lost. Her weight has now plateaued, “I just can’t shift the weight and I find that quite depressing at times”. Indeed, Lesley feels she is “letting people down”, especially her doctors and her family, who are concerned for her health. From speaking to other cardiac rehab patients on online forums, Lesley feels that her medications could be causing this, especially as her doses have increased.

Although Lesley has been encouraged to go to a weight management group by a cardiac nurse in the past, she doesn’t feel this would suit her, “my weight problems I keep to myself, I don’t want to share them”. However, Lesley would like more individual support around her weight, and for this to be reviewed with a more “holistic” approach, taking into account her diet and medications. Indeed, Lesley has found healthcare professionals can lack empathy and understanding around peoples’ struggles with weight, offering generic advice on reducing fats and carbohydrates and eating fruit and vegetables, “There’s no alternatives… I don’t think they can really understand somebody who’s overweight. They think it was your own fault”. Lesley would like to come off statins and reduce her beta blockers in order to lose weight, but her doctors have been reluctant to change her medication as her heart condition is well controlled. Nonetheless, Lesley plans to raise this issue with her GP again, as she is confident that she can monitor her condition carefully at home, “It’s just trying to persuade the medical profession to say they’ll let me reduce that because I think if I lost the weight, I’d feel a lot happier as well”. Indeed, Lesley is aware of the impact weight can have on health, “I’m aware of the impact of getting, you know, cancer or diabetes. My parents had, my mother had both, so, but even knowing that I still can’t seem to lose the weight”.

Lesley suggests that the availability of fast food, ready meals and foods high in sugar contribute to weight problems in society, as does the shift towards more sedentary lifestyles. However, Lesley finds the focus around the ‘obesity epidemic’ to be “uncomfortable”. Whilst she accepts that certain lifestyle factors contributed to her initial weight gain, she feels the way weight problems are presented in the media is “one dimensional”, and doesn’t take into account the complex issues that can lead to weight gain, “you are made to feel that you are, you know, you’re a bit stupid actually, because you’re, you’ve allowed yourself to become obese”.

Lesley feels she is letting health professionals and her family down by being overweight, as if she was ‘abusing’ the second chance given to her following her cardiac arrest.

Is there an emotional side to being overweight or to put on weight?

Yeah, I think so. I think from my point of view, I feel that being overweight is letting people down a little bit. Either whether it’s the clinical side, they’re saying, you’re letting them down because you haven’t done it. Obviously, my husband and my, the family would like me to lose weight because there’s still the slight fear that something might happen again, so you feel you’re letting them down or you’re not, you’re not trying. You know, you’ve been given another chance of living, which is what has happened to me, I’ve been given a second chance and I’m abusing it and not trying and I find that frustrating because, you know, perhaps I’m not trying as hard as I can do. But then this other bit of me says, well if the rest of my life is just eating salad leaves and water then I’m not interested. Do you know? It, it’s finding that balance and that was what, I think I keep saying, you know, I’m trying, I am eating healthily, I am eating this and I feel I need something else to come in to help me and, again, I go back to medication, I think, I don’t want people thinking, ‘Oh, she’s just blaming that because she’s eating, you know, fifteen pies a night,’ which is not the case.

So, I feel the strongest thing is letting people down about being overweight and again, the way you look. You sort of think, ‘Oh, you know, you see yourself back in the thing and you think, that’s not really what I want to see, you know, you want to see someone a bit slimmer.’
 

Lesley is worried about the popularity of high sugar energy drinks and the amount of time everyone spends sitting down or driving rather than being active.

So, I think that age, the age we’re in of the readymade meal or the instant food is probably the thing and the other thing I think for young people, luckily my two, are these energy drinks that I’ve seen young kids drink. I can’t believe that, they are just sugar basically in a, in a tin and that’s, I know, friends of mine have got teenagers who could drink six or eight of those in a day, every day and it’s those things weren’t available when I were young, when I was younger, so there are other bad things. We ate potatoes and no vegetables, but our sugar levels were quite low. But I do believe, I think that’s probably, and the fact for youngsters they’re much more sed-, we’re all more sedentary, I think. Fifty years ago, a lot of work was manual, and you’d come home, you’d done manual work, or you’d walked to work, you’d walked to school. You’ve done all this, so you could eat a larger dinner.

Nowadays, you drive to work, you drive to school. Everyone sits down all day and you still have your large dinner. But we’re not doing the same amount unless you actually go to the gym or do something to make it, but I think from fifty or forty years ago, we’d travel about on foot a lot more and say a lot more jobs. We’d go out playing or go out walking or something like that. Whereas, now it’s the computer, the Internet. I think the combination of the both is making it, that’s how I see it.
 

After a sudden cardiac arrest aged 58, Lesley followed doctors’ advice and lost weight. She is now putting weight back on again and wonders whether this is due to an increase in her medication.

Because your heart condition is caused by a genetic, a sort of faulty gene kind of thing. So, but before you had the cardiac arrest and subsequently you were diagnosed - you were overweight?

I was just overweight. Yes, not as big as I am now but I certainly was overweight.

So you have put more weight after, following the diagnosis?

Yes, I’ve put, I’d lost when I was diagnosed I think I was weighing 103/104 and I lost, got down to about 95 and now and then I went back up to 107 and then I can get myself back down to 99 and then it crept back up. I know I’ve been away this weekend and I weighed myself this morning. It was back up to 107 and I didn’t eat anything different. I know I was on holiday but, so I feel it’s just slowly creeping all the time. I keep thinking, ‘Oh, that’s going to stop now,’ and I don’t know whether it will keep going up or keep going down, so it’s frustrating thing I’ve lost, I had lost some in the first six months and even though I was still doing the same sort of things but with a bit of my old life added in shall we say, it seems to have, I think for the amount of my old life added in, the weight gain I’ve gained is, doesn’t reflect what I’ve just done, you know sort of thing. If I lived my old life straight away, then yeah, I’d expect probably, I know when you get older you can put on weight and things, everything stays down anyway but I think it’s how am I going to say this? What I’m gaining in weight doesn’t reflect the very small tweaks I’ve done to a very good lifestyle when I lost the ten kilos.

It doesn’t, the only thing that’s different is that my medication has trebled in dosage in that time.
 

Lesley used the BHF website for information and found her local cardiac rehab support group, where weight was just one topic covered, useful. The group physio wrote a letter for her to join an aqua gym.

And where does your information, where have you got information about healthy eating and sort of healthy lifestyle and things like that? What things you have now are part of your routine?

Mostly from the British Heart Foundation website. I think that was really useful. Also the, our local Trust, I was under [Name] Hospital here and the [Name], Foundation Trust. They’d run a cardiac rehab support when you’ve had a heart issue, so you have eight weeks of classes, exercise classes which are carefully monitored. They have information sessions, so every Monday you’d have an information session either on healthy eating, healthy living, exercise, your medication. They’ve just incorporated one which is also for your mindfulness and how you’re stressed and anxiety, so it was really helpful to pick up all those tips. Lots of literature and also, I think most people with a bit of common sense know how to eat healthily, you know. I think it’s, there’s so much publicity around now. There’s so much sort of push towards healthy eating that I think it’s there, but the, the cardiac rehab team were really informative, and they still are. You can go back to any of the sessions…

Okay.

…. and learn about weight management or as well as your tablets, the structure of the heart. Why did you have heart problems? What causes things?

So, you went this and these are group sessions, aren’t they?

They’re group, they’re group sessions, yeah.

And you were, you were okay with those?

I think because we, we all had a common link; we all had heart issues, you know, it wasn’t about weight management. It, one of the information sessions was about weight management, one of them was about all your pills and so all the side effects of pills and things, so then we learnt then about there could be side effects of pills, so it was very informative. They were very good.

Okay, did you have sessions about sort of kind of rehab, rehabilitation sessions, I mean in which you go to a gym or you do…?

Yeah, we had eight weeks of that.

Eight weeks of that.

Eight weeks of that and that again that was good. That sort of encouraged me to think, ‘Well, actually I can go to the gym,’ because I went to the local gym they wouldn’t touch me, they said, “No, you’re not coming in here.” [Laughs.] And then I said, “If I get a letter from the doctor, will you, can I come in?” Because I just wanted to go to the pool or do aqua gym, something that wasn’t such a strain on my heart, and again they wouldn’t because the doctor wouldn’t give me a letter. The doctor would not sign a letter saying I was, he was happy for me to go to a gym. But the physiotherapist at the cardiac rehab team said, “Oh I think you should go, so I’ll write you a letter,” in the end and they accepted that, so that’s how I joined the local gym and go to aqua gym.
 

After having a heart attack Lesley joined a local charity called Cardiac Rehab Support, for family carers as well as patients. Weight problems were discussed among members.

So you are active in the sort of kind of support group of the cardiac organisations related to heart disease?

That’s right because when I had my event, for my husband I think he had, he obviously had quite a shock. It was quite traumatic for him. He had no support whatsoever. Everything was focused on me and he was sort of left out, had no control over everything and certainly at [Name] Hospital they have a buddy system where people who have had cardiac events are volunteers and would talk to carers/partners and he found them so useful, so supportive to him because that’s what he needed because he was frightened, you know, he’s, he’d had a scare. So that’s why I wanted to become involved. I found that people who’d been through it are very good people to talk to and, you know, again, a couple of people there were talking about their weight problems in a way, “What can you do? “This sort of thing. A couple of them said, “Well I’m just giving up with it. I’m just going to live my life and come what may,” which is, which is how I felt for a few months.
 

Lesley says that she gets lots of support from both her children, who have managed to keep their weight ‘under control’ - particularly her son, who studied biochemistry.

And both my children were overweight when they were growing up as teenagers. My daughter was quite overweight. Never knew why because she was always, she always ate healthily, but as they’ve grown up they’ve both become quite keen on being slim and being healthy and eating healthy. They’ve sort of taught themselves.

My son especially is very much into all different ways of eating. Not so much a diet but understanding the effect of food in your body, so he’s, he becomes like my dietician. You don’t want to mix that with that sort of thing or have this. So that’s been quite, I think we’ve learnt a lot from here because, you know, there were times when they both got, can get quite chunky and now they sort of keep it all controlled, so that in a way is a good thing.

Probably having that support as a family round you is, is it makes it so much easier than perhaps trying to do it on your own or if you’re living with someone who says, “This is what I’m going to have, my pie and chips.” I don’t have that at all. I just have nothing but support. I think that makes it a lot easier.
 

Lesley finds the GP’s mantra “you’ve got to lose weight” too simplistic and would like more detailed advice. She feels there is a lack of empathy, which sometimes makes her feel bad in herself.

I think the thing is every time you see a health professional if you are overweight, they’ll always tell you, “You’ve got to lose weight,” and, and that’s it and then they will say, “The….” It’s, it’s like a mantra of, “You’ve got to lose weight. Eat more veg and more fruit. Less carbs, less fat,” which is what I do and if I say, “Well, I do that already,” and they say, “Well, you’re not doing it enough.” There’s no alternatives. I think there’s a, they’re given a script to read in a way or script to say, “This is what you must do. You must lose weight and then you do this, this and this,” But if you say to them, “Well, I’m doing that. Can you suggest anything else or what can you…?” There is no further of advanced level of giving advice, you know, and because most, a lot of people find it very easy to keep their weight down and lose weight, I don’t think they can really understand somebody who’s overweight. They think it was your own fault. Whatever you’re doing is wrong. You are made to feel sometimes that it is your fault and there’s, there’s lack of empathy or understanding. I find, I find that and then you feel bad in yourself, think ‘Well, actually, I’ve got to try harder,’ and I can understand, you know, people can have, you know, eating disorders because, you know, you don’t eat all day and then you binge because you haven’t eaten all day and it’s not the health eating, not the three, three good meals a day or healthy meals a day rather than that, so I feel that that the, the sort of general GP level of it has good knowledge but not a specialised knowledge and they don’t look at the whole picture, you know, whether, is there stress? Is there medication? Is there …?

And you would like sort of a more advanced kind of level?

I think if you’ve, if you’ve had prolonged, you know, because of, you know, an incident, you know, and it’s been two years and you feel you’ve been living healthily and nothing’s changing then I think it should be looked at in, in the same way that you would look at my heart if my ejection faction was, was getting worse, they’d look at my heart. ‘Well can we look and see what’s happening with my weight if I tell you, keep my food diary and I show you what I eat? Where am I going wrong?’ Because from that more but I know that’s a bit of a luxury, you know, in this day and age in the NHS, I’m lucky to be here. I’ve good treatment. I’ve my medicine, so is that something that’s a bit….?
 

Lack of detailed information about how her heart medication might affect her weight has frustrated Lesley, who would like more control over her doses.

So it seems to me that what you would like is to have a kind of review of both of your condition, the medications and the healthy eating or healthy lifestyle.

Yeah, the more, I think holistic, I think holistic…

Holistic, yeah.

…..approach. It’s not, that’s there, that’s there. It’s bring them both together and saying well, “You’re doing that, you’re doing this.” It, it’s fine for anybody to say, “Oh, you’ve got to lose weight,” and you think yeah I know but, “you’re giving me this, if I reduce that will that help or if, what is the thing that’s making counteracting with each other? Is there something?” you know, I’d love to have more knowledge if there a certain food type that disagrees with beta blockers, so if you’re on beta blockers don’t, try to avoid. Not, not just standard carbs and fat, because we all know that, but is there something that perhaps is linked. Is there some enzyme or something that is, is created? I know it looks like you’re trying to find an excuse but it’s, I really feel there’s, there’s something there because the biggest change for my life has been all this medication that I’m now suddenly on and nothing else.

You need intervention to find what is interfering with what?

Yes, it would be lovely to have the research or to find out especially when so many people take this medication now. You know, I know, I know people have said, “They’ve lost a bit of weight here, they’ve lost a bit of weight,” but in general most people that I’ve spoken to on the groups of social media have said, you know, “It’s a huge effort, you know, and a lot of people are a lot more ill than what I am and they still said, “It’s so difficult,” you know.

Have you asked this type of question to health professionals?

To the cardiac nurse the last conversation I had, and she said, “Go to the Slimming Club.” And it is difficult because they have, they only have so much information that they can give you, but that was her, that was her advice.

Okay, but you would like more kind of targeted information?

I think targeted information, and also, again being able to sort of control things from the medication front myself a bit more. Having a bit more input with that and I know that, that cardiologist could listen to me and think, ‘Well, what does she know.’ And I could be doing, and I could, you know, do it for a week and think, ‘Actually, I feel really unwell by doing this. They were right all the way along.’ I’m quite happy to take that chance for a few days. It’s, it’s being able to, I feel certainly for cardiac patients there’s, the, the big three medications you’re given are the statins, ACE Inhibiters, beta blockers and it’s like a, “That’s what we give you. That’s what we give you...” and there’s no because the evidence has shown they are good, they bring good results which is fine, but I feel that I’m not, I can’t, I haven’t got the chance to say, “Can I change it a little bit?” Can I, can I lower it? Can I do it?” And them saying, “No you can’t,” sort of thing.

That’s where I feel a bit frustrated and I could be totally wrong, and I know that. I could try it for a week, as I said, and have palpitations or have whatever and then I think, “Actually they’re right. It’s not that then. I’ve got to try and find another solution or, or live with it.’

But just being able to try, not just eating well, which is what I’m doing, but let’s, let’s try tweaking this one, see if that helps as well.
 

Lesley describes how people with heart conditions can be scared to exercise. She suggests having specialised exercise and peer support classes for cardiac patients.

In term of intervention and services, what do you think would be a good idea? What do you think it would help you?

Oh, that’s difficult. I think, I, I do believe it’s, sort of, more exercise classes for people who, you know, aren’t completely mad at the gym but aren’t, just don’t want to do a little bit of, like, light walking or anything. It’s, I think having someone who understands that you’re slightly worried about doing anything too thing because if your heart rate goes up you will think, ‘Is this going to fire up or am I going to have..?’ But I want to push myself. It’s knowing how much to push yourself. I think that’s…

Okay.

That’s the for me, for probably a lot of people I spoken with cardiac conditions, you know, you’re frightened to push yourself but if you don’t push yourself, what’s the point in doing it in a way. You know, it’s like going for a walk. But I, I know that they’re, they’re basis, the cardiac rehab team, ‘Go ‘till your pink and puffy.’ That’s, you know, you’re pushing, but which I, which I probably do every day, nearly, walking to work because I’m always late. But it’s not enough, but I think if you had more specialised exercise classes. Again, talking to people from the cardiac thing, they just need, I suppose in a way, I’m talking around about having a slimming group and I’m talking about having cardiac group. It’s exactly the same thing, yet I’m reluctant to go to one because I don’t feel a part of it yet but I’m happy to go to another. So perhaps in a way, I’m, I’m talking myself round to say that peer support and that group work is probably, you know, the most beneficial thing you can have.

Hm-mm. But you would like it to be more focused on people with heart conditions?

I think if, yes, I think so…..

Okay.

...because it is different, you know, it is, you know, and to talk about the whole, the whole picture the medication, the reluctance to exercise. Not reluctance, but hesitancy to exercise because you’re just a bit frightened…

You’re scared, yeah.

….. of doing that. So, it’s just being able to talk about that and have a professional say, “Oh, you can do that. Don’t worry about that.” you know.
 

Lesley says she will keep on trying and not give up and if something isn’t working she will try something different.

Do you have any messages for other people who are interested in losing weight or people who might have gone through or might be going through a similar situation that you, that you are in?

I think just keep, keep trying. It’s not giving up. It’s keep trying to find the solution, you know, again it, it’s, it is just keep trying, I’m not going to give up. I had my little six months of rebellion that I’m not going to be like this, but I realised that was no good to anybody. I was, but I think I probably needed it to sort of do that and I will keep trying and it is frustrating. And then you get on the scales and think, ‘Oh.’ But, you know, even if I can get one kilo down then I’ll feel that’s great. I don’t want to put that back on and I just can keep trying with the doctor, keep trying different things, you know, slimming world online is, is something that will work but I’ll try that. If not, I’ll try something else. I, I will just keep trying.