Weight change & associated health problems

Weight management groups

Weight management groups provide support to help people lose weight. This usually includes a structured diet plan and behavioural support, in groups or on an individual basis, either in person or remotely via social media or apps. The basic premise of weight management programmes is to facilitate changes in eating behaviour and activity levels by encouraging people to make healthier choices about their lifestyle and what they eat as well as suggesting practical ways to make changes.

We asked people we interviewed about their experiences of weight management groups. Among the people we spoke to there was considerable experience of both Weight Watchers and Slimming World.

What people liked about weight management groups

One of the most positive aspects of weight management groups that we heard about was the support provided by other people who were all in the same boat; according to Sue X, who felt that Slimming World had worked for her said, “nobody judges you. Everybody is there to support you and help you”. Sue X reached her target weight but continued attending the weekly classes because she valued their support and friendship.

 

The first time Myra went to Slimming World, she weighed nearly 20 stone. She felt encouraged and inspired by the success stories of other group members and the group leader.

The first time Myra went to Slimming World, she weighed nearly 20 stone. She felt encouraged and inspired by the success stories of other group members and the group leader.

Age at interview: 65
Sex: Female
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Nearly twenty stone, okay.

Which wasn’t a nice place to be. I never, the thing that really helped me, the first time I went to Slimming World, I got on the scales and I said, ‘Oh that’s absolutely awful,’ and she said, “Myra, don’t worry, you’ll never be that weight again,” and I just found that so encouraging and I haven’t been. I’ve never got anywhere near that again, you know, and I won’t, you know, I won’t.

I mean it really helps that in the, in the group I go to, there are, there are people who’ve lost seven stone and who look absolutely wonderful and that is an encouragement, you know, and I think you get as much encouragement from the other participants, participants that you do from the group leader because they’re just, it’s just such a lovely group of people, you know, mainly ladies. You get the odd brave gentleman who ventures in [laughs].

The people we spoke to said it was important to have the right kind of person leading the group. Group leaders who could draw on their own experience of weight loss to encourage and empathise were particularly appreciated. June’s teacher was young and energetic, loved cooking and had lots of positive ideas. The only down side was that her classes were often very full because she was so popular.
 

Sue X’s group leader has been through it all herself and supports the group without being at all judgmental.

Sue X’s group leader has been through it all herself and supports the group without being at all judgmental.

Age at interview: 61
Sex: Female
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But would you recommend Slimming World?
 
It’s, it’s worked for me, so I have to recommend it, you know, and I mean, I know we have, I think it makes a big difference actually who the leader is and we’re very lucky in that I mean she’s completely mad but I mean she’s, because she’s so like  the rest of us, her thoughts are very like the rest of us. Like, she’s done the, which, you know, a lot of us have done, gone shopping, bought a packet of biscuits and by the time you’ve got home, you’ve eaten the packet in the car. You know, she’s done all that sort of thing and, and, you know, so she’s, she’s very much in, in line with everybody else’s thinking. So she, she never, sort of like if somebody says, “Oh God I ate six bars of chocolate at the weekend.” She’ll come back with a story, “Oh yeah,” she said, “yeah, I’ve done that. I remember exactly when I did this.” And so she’s, she’s not kind of judging you. I don’t, I think, I think our group and I don’t know, I’ve not experienced any of the other groups round here but certainly our group, nobody judges you. Everybody is there to support you and help you. You can have as much help as you want or as little, if, you know, if you’re comfortable with doing it on your own because some ladies they just, because they’d never dieted before, they just come along and they just lose the weight. I mean it, it is phenomenal.

 

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.

Age at interview: 60
Sex: Female
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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.

Apart from the group support and a positive leader, people valued the opportunity to make friends, learn from others in the group, receive recipes and nutritional information, and have access to support via social media. Rosemary and others said that the important thing was to be weighed by somebody else; this in itself motivated her to lose weight. Realistic expectations were important though – achieving the target weight was usually a slow and steady progress.
 

Tommy learnt a lot from Slimming World but made the mistake of thinking that he did not need to keep going ‘just to get weighed’ He stopped going and his weight blossomed again.

Tommy learnt a lot from Slimming World but made the mistake of thinking that he did not need to keep going ‘just to get weighed’ He stopped going and his weight blossomed again.

Age at interview: 85
Sex: Male
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So, then I decided to, to join Slimming World. Slimming World were very good. I learnt an awful lot from Slimming World.  But what happened with Slimming World you, I forget what I paid at the time but let’s say it was something like £10 to join and £3 each visit you made and I found that after several, well several, couple of months or something like that, you were going there on a Monday night and you were paying £3 just to be weighed because you’d heard all the stuff before. Each Monday there were new people coming to join the club and the, the, the tutor said, “Well, you need to do a, b, c,d and you’d heard it all before and I was as I say, paying £3 just to be weighed and I thought, ‘No, no I’m not going to, this is ridiculous just to get weighed.’

So I stopped going and that really was a mistake because by going every week it was keeping me watching me weight. Once I stopped going then my weight blossomed again, I started putting weight on and again I tried myself to try and cut it back but I just didn’t seem to have the willpower to do it and then I developed angina, pains in the chest.

You said that you learned, what did you learn from Slimming World?

Slimming World was the fact that with the other students, you sort of learnt how they were going on, how were they combating how to sort of cut down on the wrong sorts of food and when they were tempted how they overcome this sort of temptation. That was one example going to a party and sort of doing it that way and I think generally just watching what you ate and you ate the correct food, it, it was, I wasn’t a porridge man for instance and suddenly started eating my and enjoying porridge.

Community weight management groups are open to women and men and in some areas of the country the group is quite gender balanced. Some of the men we talked to thought that the classes would be mainly women and worried they would feel uncomfortable. Jim and his wife Linda experienced a weight management programme as a couple. Jim didn’t attend the classes, because he was concerned that he might be the only man. Linda did attend and applied what she learned at home for both of them. This resulted in Jim losing two stone in six months.
 

Jim and Linda were a double act, with Linda attending Slimming World classes to help her husband Jim lose weight. He thought that attending would be ‘a girly thing’ to do.

Jim and Linda were a double act, with Linda attending Slimming World classes to help her husband Jim lose weight. He thought that attending would be ‘a girly thing’ to do.

Age at interview: 71
Sex: Male
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So why did it come about?

Linda: Right, well the doctor or the diabetic nurse actually said that it would be good if you could lose some weight, so I thought, “Well having heard from other people that Slimming World was a very easy way of doing it to be honest.’ They give you so much information and you can eat loads but you’ve got to do it in the right way and so I took myself off to the classes. I did the classes. Jim didn’t come with me because, well he wasn’t, he wasn’t really into that sort of thing and it’s mostly, well I was going to say it’s mostly women. There are men there, but you need to be quite brave if you’re going to sit with twenty women.

[Laughs]

Jim: Well you wouldn’t get a word in for a start.

Linda: Anyway, the - so I went, and I spoke to the lady and I explained why I was there and she said, well, you, you will have to obviously have a target yourself, so she gave me half a stone target, so that I could actually go and be part of the sessions. We, every week they tell you, they give you recipe for something different and you can either do them or not. There’s lots of books. You can do it in different ways.

So did you read the literature that your wife brought home from Slimming World? Did you read it? Did you talk to her?

Jim: No, no she, she generally came home and told me what had happened to her down there and she’d give me the stories and that would be quite, would be quite interesting.

Linda: You did look at it. You did look at it.

Jim: Yeah, I do understand the, sort of the, the main issues. I didn’t go myself because I thought it was a girly thing and, you know, I’d be the only man there and…

Linda: But in some places it is. But in other places, our daughter-in-law goes in [county] and it’s half and half men and women and it depends what time of the day it is, doesn’t it because the men are more likely to be at work and that sort of thing.

Jim: Yes but probably unlike quite a lot of other people, we are a double act and you, you were going to do this and we were going to do it together, so there was no point me…

Linda: No, no.

Jim: …paying, well not that we mind the money particularly.

Linda: No, you don’t pay after a while.

Jim: There isn’t an issue with that. But, you know, it was sensible that she went and got the gen and we did it, you know.

Okay.

Linda: And the other good thing of course is if you reach the - they give you these goals, once you do it, you stop paying and providing you keep three pounds either way, they still do it in pounds, pounds and stones. Providing you keep three pounds either way, you don’t pay, so that’s an incentive to people not to have to pay it.
 

[See also ‘What has worked when trying to lose weight? - Motivations and mind-sets, ‘What has worked when trying to lose weight? Finding what works for you’ and ‘What hasn’t worked when trying to lose weight?’.] 

What people didn’t like about weight management groups

Some people did not enjoy their experiences of weight management groups. The aspect of being weighed in public and having to account for oneself in a group occasioned particularly strong feelings. Maxine Mary said she found it “degrading” and humiliating to be weighed and then clapped for losing 2 pounds, while for Liz it was “mortifying”. Carole said it made her feel more self-conscious about her weight.
 

Angela managed to get within 4 lbs of her target weight with a weight management programme but still felt like she had failed.

Angela managed to get within 4 lbs of her target weight with a weight management programme but still felt like she had failed.

Age at interview: 51
Sex: Female
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So, you maintain, sort of you lost weight and maintained weight for how long roughly?
 
After, when I did that slimming diet, not for very long. Not for very long at all. I think it gradually started going back up. I think, the key thing there was I’d got down to 8 stone 10 but my target was 8 stone 6 and I could not lose that four pounds, so they would not give me that, that certificate to say, ‘Yes well done, you’ve lost the weight.’ So just from them I went back up, up, up, up.
 
Was the certificate very important to you?
 
Yes, at that time it was my target, yeah because that’s the first time I’d ever been to a, you know, a club like that and I, I needed to have that. It was like doing your degree and if you don’t come out with your [laughs] certificate what was the whole point.
 
Okay.
 
So, it was almost like, you know, I dropped out.
 
Were they kind of places where you have to go once a week and be measured?
 
Yes, you had to go to the group. You had to be named and shamed or, you know, praised for your, you know, and it was always, [claps hands] “Oh yes, Angela’s lost three and a half pounds. Ooh” and there was always, “Oh, you’ve gained some.” Frown, frowny, frowny face at you. But it was, it was almost like your confessional there.
 
In hindsight what do you think about it?
 
I went to a few more after, after that because I joined Slimming World after that and Weight Watchers didn’t do that confession thing, I’ve noticed that. I mean my most recent club that I’ve been to is Weight Watchers and they don’t do that. They don’t name and shame you which I thought was really good but the last time I did Slimming World was three (years), when I did the Horizon documentary, I went to Slimming World there. You do go round the class and name and shame and it’s just horrible but you kind of almost apologetic to everyone in the group, “Sorry” and the teacher, “Sorry, sorry for not….” but you’re not kind of, “Well actually I was hungry that day that’s why I overate or I went to a party that day.” This sort of thing happens in life.
 
Okay, do you think that kind of way of doing things - in hindsight, how do you see that now?
 
I think it’s, I think it’s a difficult one because, you know, you’re not beholden to yourself, you’re beholden to the group. You’re not actually doing it for yourself. You’re proving to others, ‘look at me, I’ve lost this weight,’ and you, you start off going there for yourself and to lose weight for yourself, but I think it is, it gets competitive. It gets silly, you know, and you look at other people that are similar size to you and you think, ‘How come they’ve done that? How come they’ve lost weight?’ and then people will talk about what they eat and I think, ‘how can you possibly eat that, that’s so boring. How can you have a small piece of toast in the morning, you know, when a normal, you know, that’s not going to satisfy anybody.’ It just, like, you must be doing something else, there must be a secret.
 
Okay. So how did it make you feel when you were…?
 
Just like a failure. I’m never going to get this right. I’m never going to be able to do this thing, you know.

 

Liz did not like going to classes and particularly disliked the aspect of group accountability.

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Liz did not like going to classes and particularly disliked the aspect of group accountability.

Age at interview: 54
Sex: Female
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They're all doing a lot better than me. Every pound they lose I find [laughs]. So, you know it's...
 
Maybe you need another group.
 
Well yeh, maybe I do. 
 
To be honest, I don’t particularly enjoy… I don’t enjoy the classes. I don’t like going, I don’t... but then of course, if I was being successful, if I was the one sat there going, you know, "Well I've lost four pounds this week," then I would love it, wouldn’t I? But of course, because I'm not, I hate it, and I hate listening to them all talking about how great it is, and how well they're doing. And I hate... I'm sitting... I sit there every week and I'm watching them shrinking, and I'm thinking, 'Oh well, never mind.' Perhaps if I didn’t come I'd be even fatter than I am; that’s my consolation. You know, if I didn’t come here I'd be fatter than I am now – great. Yeh, not quite what I was hoping for but there you go.
 
They weighed you when you go?
 
Yeh, yeh
 
How do you feel about that? I mean obviously, you don’t feel sort of kind of...
 
You're not going to feel very enthusiastic are you when you look and say, "Oh great, I've stayed the same," or, "Ooh, look I've put weight on, great. OK, I'll just slink off." And then they...then you sit down, and they go round the room and go, "Well, you know..." and that...I mean that is just mortifying isn’t it you know. When they go round and saying, you know, "OK, well you know you’ve put weight on this week, and why is that?" You know, it's just like that bloody...was it the Peter Kay sketch, you know, with Margery Dawes – 'Bit of a dust, I ate a bit of dust and I've put on a pound,' you know. And I can't bear that going round the room clapping. I mean I'm really pleased for the people who have lost weight, but do you have to go round every single person and clap? Can you not just go, "Right, who lost weight, put your hands up. Great, yay." One clap. No, we have to go round it, ooh. So, I sit there cringing inside wanting to just a) punch the people who have lost weight, b) go home because I don’t want to be there, and it's just all horrifically cringe-worthy; it's horrific. It is just like that bloody Margery Dawes thing. That comedy sketch sums it up; just sums it all up.
 
What I can't work out is why, if I'm being pretty good, not perfect, but pretty good, why I can't lose weight. Why on those six hundred calorie meal replacement diets I still struggled to lose two pound a week. Why, at a roughly a thousand calories a day, I should be losing two or three pound a week, but I'm not. That’s what I can't deal with. That’s what I can't find the answer to.
 
So, that’s what I need the answer to. That’s why… I need to know... yes, if there was somebody I could speak to who would say to me, "Well, the reason that you're not losing weight on a thousand calories a day is because of..." or, "You could do this and that would mean you would," that’s the person I need to talk to. 

Moreover, the calorie counting element of some weight management programmes wasn’t for everyone, with some preferring a more flexible approach to weight loss.
 

Carole found calorie counting ‘too muddling’ and switched to a ‘less regimented’ programme. Being weighed in class made her more self-conscious of her weight and of the task ahead.

Carole found calorie counting ‘too muddling’ and switched to a ‘less regimented’ programme. Being weighed in class made her more self-conscious of her weight and of the task ahead.

Age at interview: 59
Sex: Female
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Yeah. I’ve done, I did Weight Watchers years ago. For me, it didn’t work. I just found it, it was counting calories and things and I found it too muddling for me, too hard. The Slimming World was better and I just went for a short while and that was when I was a lot better.
 
Why was the Slimming World better?
 
I think because it was more, it wasn’t so regimented. It wasn’t like a portion of this, it was much more easy to follow. And you could eat more of what you wanted but just smaller amounts of it all, if you had, then you don’t have that, and, it sounds silly saying it because in my head I know this, but it’s so why don’t I do it. I don’t know. It’s.
 
Is it the one that you are weighed in front of other people. In a group?
 
Yeah and I found that very hard so, yeah, yeah.
 
What, hard in which in which sense?
 
Because, because it showed me how big I was, how much I did weigh so it was like, well, there’s no way I can lose all that. It’s too, it was too big an amount too big a mountain to climb for me. And other people were saying, “Oh, I’ve got to lose five pounds.” And there’s me thinking, I’ve got to lose, you know, however many stones and it’s just like, [sighs] I’ll never manage to do that. So.
 
Okay. So it was it was, you found that the task was too much.
 
It was too much, yeah. It was too overwhelming for me.

At one point, June stopped going to Slimming World because “it was all about what had gone wrong for people who hadn’t had a weight loss and I found that, you know, I was already negative in me self, I didn’t need to hear everybody else’s reasons and excuses”. Angela felt it could get competitive “it gets silly, you know, and you look at other people that are similar size to you and you think, ‘How come they’ve done that? How come they have lost weight?”
 

After feeling depressed listening to other people, Shirley decided only to stay to be weighed and not for the discussion part of meetings.

After feeling depressed listening to other people, Shirley decided only to stay to be weighed and not for the discussion part of meetings.

Age at interview: 56
Sex: Female
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So 9 out of 10 times I go but I don’t stay. So I just go in, weigh in and come out. So I’m not getting the whole what they call image therapy where you talk about things. But I just find it, and again my friend we just found it so, a bit depressing because you’re just listening, you know, you’re listening to people that have said, “I’ve eaten chocolate this week and I’ve lost three pounds.” You know, you’ve stuck to the plan and put on a pound and you’re thinking, ‘You don’t need to hear...’ because in your head you’re thinking, ‘Well why’s that happened?’ It’s just the negativity and how, I think how a person works, their mind is, ‘you want a result,’ because my husband can never understand why I get so upset about results on the scales every week. He says, “but it doesn’t matter.” I said, “No, it doesn’t matter to you, but I’ve worked hard.”

Not managing to lose weight in spite of following a weight management programme could be a dispiriting experience, particularly as the reasons were not always clear. For example, Joan was disheartened by her lack of progress at Weight Watchers and only later discovered her thyroid may have played a part. While such groups are designed to provide a supportive community, this was not always the experience of the people we spoke with.
 

Shirley describes what it felt like not to lose weight in spite of sticking to the rules.

Shirley describes what it felt like not to lose weight in spite of sticking to the rules.

Age at interview: 56
Sex: Female
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Okay and when, how do you feel on those occasions that you are kind of dieting or doing things that Weight Watchers or Slimming World is telling you to do and you are not losing the weight, the weight, how do you feel, sort of from week to week?

Quite disillusioned actually because you sort of think, and I think that’s the trouble with some, some of the classes because you think, ‘I’ve done it. I’ve been on it a hundred per cent.’ I know I’ve been good and I’m the first to admit when I’ve done something wrong but when you know you’ve been good and then you get on the scales and they tell you and if, I’ve printed my story off for you actually, it will tell you in there how I have felt. Like I think there was one week I went to a different class because of circumstances and I’d put on two pound and that was over an Easter period. I’d had no Easter eggs, no hot cross buns or anything nice and I came out of there feeling so disillusioned because you think, “Why?” There’s nobody can answer and your consultant, like you say hasn’t got the time or the time, but you feel really down.

Whereas I stuck with it and then the next week I lost three pound and it was just sort of balanced it out but if you don’t get that it can send you in to complete despair because I think, ‘What, what shall I do?’ And even with this [name group] that I went to, I was losing half a pound. I went for a whole month where I only lost half a pound a week but because I was losing I kept going with it and then every now and again, I’d get a big weight loss and I think that’s how my body is. But again, you don’t get told that, you don’t get told, “Some weeks you could stay the same for three or four weeks and then get a big weight loss. Some weeks you could, you know, do the right thing and gain.” You don’t really get any of that explained to you because they don’t want that negativity. I think that’s the thing. They don’t want to say, “Some weeks this is going to happen.”

Whereas I think if they were honest from the beginning you’re prepared for it. But you’re not, when you think, ‘I’ve done it for hundred, I’ve been on it a hundred per cent and I’ve managed to lose two, I’ve gained two pound. Why?’ And that’s when you can get on a real and there’s girls on there, there was a girl this week who’s lost six stone and she gained this week and she was ready to give up just after that even though she’d lost six stone because she’s got no rhyme or reason or why because our bodies are weird. Because my husband did a thing. He weighed him every day for a week and he said the difference in what you’ve eaten the day before to what your scales weigh the next morning. But he said, “but nobody tells you that at Slimming club do they?” So he said, “That particular morning you’ve got on those scales and weighed two pound could be because of something you did the day before,” and I went, “Yeah, but nobody explains that to you.” You don’t, and you don’t want to hear that at the time but, yeah. Yeah, it is, it is hard, very hard.

 

Julie did not find the group very supportive when she was struggling to lose weight

Julie did not find the group very supportive when she was struggling to lose weight

Age at interview: 73
Sex: Female
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I’ve never sought any support and I’ve never got any support. I’m not sure, I mean apart from going to slimming groups which they’re not always that supportive when you say that you’ve really gone at everything you should have done and you haven’t lost any weight or you’ve only lost half a pound, they lose interest. They’d rather talk to the person who’s lost four pounds that week than the person who’s tried really hard and not lost anything because there’s nothing they can do and there’s nothing they can suggest.

I was losing half a pound, where everybody else was losing two or three and still, you know, they’d come to the class and say, “Oh, I was so naughty this week. I ate this, and I ate that, and I went out to eat and the thing, and I’ve lost four pounds.’ And I would say, “Well, I haven’t eaten all that. I’ve just had proper food. I haven’t had any potato. I haven’t had this. I haven’t had sweets. I’ve lost half a pound.” And, you know, they’d lose interest in you because, well, that’s not so exciting is it. So I don’t find them especially helpful. They’re only helpful in what I can get out of them not what they give me. It’s what I take from it.  They don’t give me anything  except, you know, for me it’s, it’s it helps my discipline but I haven’t had any support really, no.
 

Weight management programmes were not usually able to provide a personalised approach taking into account a person’s health condition, living circumstances, history or preference. Class sizes were sometimes too large for personal attention, but also group leaders did not have always specialist knowledge about nutrition. Julie commented that it would have been more useful if the group lead knew about health problems, including her own diabetes.
 

Julie would have liked a more personalised and specialist approach than the weight management programme could provide.

Julie would have liked a more personalised and specialist approach than the weight management programme could provide.

Age at interview: 73
Sex: Female
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I think having sort of someone to talk to about what I’ve eaten and how I’ve felt or whatever would be perhaps a way forward. I don’t always, I don’t always find the group help, it only goes so far because I mean my problems are different from the next persons and, which are different from the other persons, so there’s not time to go into, into depth about what you’re eating and why you’re eating it or, or whether I would be better to eat something else because, but you’ve also got to take into account what you like and enjoy. I’m not one for eating things because they’re, because they’re healthy and I don’t like them. You know, I like to, I enjoy my food so I like…..

But, you see, I’ve cut out things like gravy’s and I look on ingredients all the time to see what’s in food.

Okay, so you would like sort of a one to one with someone who can give you, tailor more,…

Yes, yes, yes…...

...tailor made advice.

…..and perhaps be somebody who knows about nutrition, knows about health. Knows about my conditions, my diabetes and recognises my need for low carbohydrate and, you see, when I went to Slimming World,  the advice they gave to diabetics as well, just eat the, the non carbohydrate foods, but there was nothing to show you how to make something different or nice with, without carbohydrate. You know, there was no, I didn’t find any recipes that were specifically without carbohydrate.
 

 

For Angela, it would be better if the programmes “treated people as individual not as the group” and listened to their history to understand why losing weight hadn’t worked for them in the past.

For Angela, it would be better if the programmes “treated people as individual not as the group” and listened to their history to understand why losing weight hadn’t worked for them in the past.

Age at interview: 51
Sex: Female
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Okay so any other kind of downs from this or things that these programmes should improve. You don’t need to mention any programme in particular but I mean ideally what would be a good programme, a good diet?
 
I don’t think, what a good, the best diet I think if you treated people as individual not as the group, you know, that is just the thing because I will compare myself with other people. I mean the last time I went to Weight Watchers nearly coming up to a year ago, I remember talking to somebody and they were saying, “Okay, well you’ve done that now. So you draw a line under it and you just carry on, yeah, because that’s what I would do.” I think, ‘Well, I’m not you. I’m not you.’ And, you know, a lot of the time I think, ‘Okay, because I’m from an Asian background, I will go home and make curries and okay they’ll be fat free and whatever, but they are tasty. Now what a native English person might eat won’t be spicy or garlicky. They will, they’re happy with steak and jacket potato and whatever. I wouldn’t find that satisfying, you know, we’re all different people. So I’d say a bit more personalised approach but that’s not going to be possible for these commercial programmes.
 
Why?
 
Because it’s just so much investment. Imagine the amount the client would have to pay to get that service. Actually, may be that would work [laughs] that would work, you know.
 
What would they need to have in order to provide that individual kind of service if you want?
 
I think exactly what you’re doing today, asking me my history, you know, they want, you need to know what, what’s gone on before and why they haven’t worked, why the programmes haven’t worked and what are the things that trigger me off, you know. It could be the slightest thing, it could be the biggest thing, you know, if for example, my son moved out a year ago but when, you know, if you’re living in a family, you’re catering for everybody else, it is not practical to make different meals for different people.
 
So, yeah, and the social aspect as well. If you’ve got a good social life, you know, you’re going out a couple of times a week, you know, how do you manage that?

 

Sue Y attended a local commercial weight loss programme but “was not impressed” by it, describing the young leader as “the wrong person to give advice on weight loss”.

Sue Y attended a local commercial weight loss programme but “was not impressed” by it, describing the young leader as “the wrong person to give advice on weight loss”.

Age at interview: 69
Sex: Female
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But you went to an introduction by…?

Yeah, I thought they were just out to get my money and I wasn’t impressed and then you have to kind of keep waiting around and, you know, you could be doing other things with your time that’s more industrious and product-, you know, more interesting things. I wasn’t, it didn’t impress me at all. Maybe it wasn’t as professionally done as it could have been. I suppose it’s different in different places but I wasn’t impressed.

So, I’d like to think that there’s some kind of system where people can get information on losing weight and, and one thing that I will say is that I did go to something, I’ve forgotten what it’s called. It was run by, it was given by a young guy who was a trainer, who’d been a gym trainer and completely the wrong type of person to give advice on weight, loss of weight.

Why?

Because he didn’t angle it towards being 1) a female; 2) older and 3) it was all very patronisingly put.

What do you mean? Talking down?

It was the way that it came over expecting us to do this and people to understand that and so on and being dismissive of some people’s questions and so on and I didn’t like it. I didn’t like it at all. So, I didn’t continue and he particularly kind of talked to, mainly focused on the young people in the group because he was a young person and that was wrong. Do you understand what I mean?

Yeah, yeah, yeah. Very clearly, yeah.

He didn’t have empathy. He didn’t have the right empathy. It was almost as though he was just doing the job and anyway…

This was run by, by, which programme was this?

It was a private company and I can’t remember what the name of it was.

For a number of reasons including life events, social life and health problems some people found it difficult to attain their target weight. Angela described her target weight as an ‘unattainable goal’. She got down to 8 stone 10 but because her target was 8 stone 6, she couldn’t lose the four pounds she needed to get her achievement certificate. The certificate was important to her because “it was like doing your degree and if you don’t come out with your certificate what was the whole point”. She dropped out of the programme.

While many of the factors people didn’t like concerned the format and style of the support groups, for some, it was the advice itself which was problematic. Liz was frustrated at the seemingly illogical way some foods were promoted over others, and how this could change from one week to the next. Ria felt that “some of the advice is very iffy” and was sceptical of the bars that were sold which contain the artificial sweetener aspartame. There have been many scare stories about aspartame, but a comprehensive review of the scientific evidence by the European Food Safety Authority in 2013 concluded that it was safe for human consumption (EFSA 2013). Nonetheless, some people continued to wonder whether diet products promoted by weight management programmes, which contain aspartame, really were safe.
 

The promotion of aspartame-containing products put Christine off going to Slimming World.

The promotion of aspartame-containing products put Christine off going to Slimming World.

Age at interview: 53
Sex: Female
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But what I’ve started doing and it’s a really important point this about food and intakes, I’m drinking that now which is full Coca-Cola and the reason I’m doing it is because I know it has high sugar, but that diet coke has aspartame and I have real issues with aspartame because it’s a carcinogenic and I think it’s all right saying, “You’re all on Slimming World, you’re all dieting because you’re overweight.” But if you’re pumping your body’s full of chemicals, like aspartame, I’d rather have the sugar, you know, on the occasions when I drink that which is not every day. We don’t have a bottle in every day. On the occasion we drink it, we’re now drinking full sugar.

Because it’s like Vimto, we have normal Vimto. We don’t have reduced because it’s all got aspartame and you can taste it. It’s a carcinogenic and I refuse to just pump the body full of chemicals. I’m very funny about having tablets and things. I don’t like taking tablets, you know, so, because I’ve never smoked, never taken drugs or anything, so I’m a bit particular and aspartame is a big issue and I think that if people are trying to push everyone to lose weight and do it by having low fat yoghurt, Muller yoghurts, drinks, diet drinks etc, they need to look at it because all you’re doing is you’re killing people with cancer because you’re filling them with that stuff. You’re better saying to them, “Have reduced sugar or less sugar or even natural sugar in fruit than having all these chemicals.” You know, I think that’s a very important thing to look into because people think they’re doing right by having diet coke, but they’re not, they’re not. It’s all false and I won’t go to Slimming World to start filling up with you know, with aspartame. I’m not doing it, so.
 

GPs can refer patients who are overweight or obese to a commercial weight management programme (groups) for a free course. However, not everyone we spoke to was aware of this and some felt that the programmes were expensive or even unaffordable.
 

Carole could not afford the fees of one weight management programme and was not aware she could be referred by her GP to some programmes.

Carole could not afford the fees of one weight management programme and was not aware she could be referred by her GP to some programmes.

Age at interview: 59
Sex: Female
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Have you tried to find if there is any specific like, I don’t know, weight management  programme within sort of your local area?
 
Yeah, yeah, again I’ve looked on the internet and there’s, for, so I’ve looked and, you know, but you have to pay for it.
 
Okay.
 
And I can’t afford. It’s, you know, yes, you can, you know, I read this thing and it was just like, yes, that’s what I need, that’s what I need and then it’s like, you know, hundreds of pounds and when you’re on benefits because you can’t work because of everything then you just can’t.
 
Can you be referred by your GP to?
 
No.
 
To them?
 
No, they wouldn’t, it’s, no, you’d have to be, you have to pay, it’s a private sort of thing. It’s.
 
But I mean some of these programmes sometimes they have an agreement in which NHS patients could be referred to them.
 
Oh okay.
 
Have you asked?
 
So what.
 
Your GP for it?
 
No.
 
If there is any programme they could refer you to?
 
No, I’ll do that when I go next.
 
Okay.
 
I’ll make I’ll make an appointment, when you’ve gone, and do that [laughs].

Weight management groups are not for everyone

Some of the people we spoke to had not tried a weight management programme because they did not like the idea of joining a group. Heather said she was “not a joining sort of person” while David said he was “not a great group person”. Hilary said she felt losing weight was something she needed to do on her own, and Lesley didn’t want to share her weight problems with other people. Ellie had tried a group and hated it because “I’m quite private and I don’t really like the thought of talking about things that really matter in public”.
 

Alan said he would consider going to a weight management programme for the recipes but did not feel he needed the element of group support.

Alan said he would consider going to a weight management programme for the recipes but did not feel he needed the element of group support.

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I'm not the sort of person who needs support from other people. I mean the thought of going to a weight management group doesn’t fill me with hope because I don’t like being told by other people, you know, 'Oh, you’ve got to lose two pounds,' or if you... no, I'm not into that; I'm not into group things like that.

OK. And do you know what happens in these groups?

I've heard from my sister-in-law what happens.

OK

That appals me [laughs], but I might have to go there to get the recipes and then come back out.

Is this the one in which they weigh you, or no?

I assume so

In front of everybody else?

Yes, I would assume so; I don’t know.

And how would you feel about that?

Not impressed [laughs]. I mean if it gets you in, fine, but I'm not a... I'm not a person who joins groups, so the thought of going to a group and then everybody having an opinion, you know, about how you’ve performed about weight gain or weight loss – no, not interested in that.

OK

But I would take what I wanted from the group and then...

OK

Not necessarily go in for the full package as it were.
 

Paul lives in a rural area and would have to “drive for miles” to attend weight management classes. He would prefer to join a sports team rather than a weight management group.

Paul lives in a rural area and would have to “drive for miles” to attend weight management classes. He would prefer to join a sports team rather than a weight management group.

Age at interview: 55
Sex: Male
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And what about taking part in kind of a management, weight management programme, like, I don’t know, Slimming World or…?

Well, I’d be driving miles, I don’t know, you know. I really, yeah

Yeah.

I live where I do and, you know, you’ve, you’ve just driven here, it’s, you know, a good twenty minutes to the nearest very small town…

Yeah.

...so, no, a) no it doesn’t appeal but b) I wouldn’t have access anyway.

Why doesn’t appeal?

It’s part of a, it would, it would appeal if somebody said to me, you want to be part of our sports team, our cycle team or our rowing team, come and train with us.” That would appeal. Going along to Sliming World, no.

Okay, so a activity.

Activity.

Okay.

Yeah, that sort of team effort I get. You know, I don’t think I would draw a lot from a group meetings of that kind.
 

For more see:
'Mental and emotional benefits of losing weight
Local and National NHS/Charity support for weight management
Online and other sources of information and support for weight loss
Messages to others interested in controlling their weight

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