Weight change & associated health problems
What hasn’t worked when trying to lose weight
People often try a variety of ways to lose weight with varying levels of success. In this section, we explore what people said had not worked for them, or had only worked in the short term. We recommend reading ‘What has worked when trying to lose weight? - Motivations and mind-sets’ and ‘What has worked when trying to lose weight? Finding what works for you’ alongside this summary. Tell me about those times that you have been trying to lose weight, other times that you have tried. And when the doctors told you, you are overweight or your body mass index is too high did they suggest anything? Did they suggest you do something to lose weight or? So for you things like Weight Watchers programme didn’t work because you didn’t like this kind of public exposure, to be weighed in public and things like that? So, you maintain, sort of you lost weight and maintained weight for how long roughly? Have you tried to find information about how to lose weight? And the other thing which, which is, is interesting and it’s and I found it, and I agree with it totally this, this pattern of, of extreme behaviour and extreme expectations with people who are, who are facing sort of routinely facing extreme weight loss, is this completely unrealistic expectation of what you’re going to achieve and the time in which you’re going to achieve it. And that certainly is a pattern with me in my own life. Far, far too high an expectation of the amount of weight I’m going to lose, and the amount of time I’m going to lose it in and a consistent and constant expectation of the rate at which it’s going to go. I had a breakdown and was sectioned, and I was started on anti-psychotics. Now that then to me was my first ever major weight gain. I must have put on about four stone due to these anti-psychotics and anti-depressants.
Dieting
The people we spoke to mentioned many different diets they had tried, from the well-known to the ‘outlandish’. Sue X had tried the Dukan diet, which she described as eating only lean meat, vegetables and oat bran. As she said, “you’re probably talking six, nine, twelve months to get, you know, to get a lot of weight off. Now I couldn’t last on just meats and vegetables for that amount of time. There’s no fruit in it”. David found he would stick to a diet for a few weeks, but then slip back into old habits. Alan had given up many of the things he had enjoyed (salt, fat, alcohol, smoking) because of his diabetes and heart condition and found it hard to stick to a restricted diet long-term.Tref had lost weight on diets, but being “a big lover of food” would become bored and give up. Rosemary said that diets didn’t only restrict what you could eat but also affected your social life: “if you’re on a liquid diet or a cabbage soup diet, you know, it is so restrictive, not just because it’s restrictive for you, but you can’t go out and you know go to somebody’s house and, “Oh, I can’t have coffee””. Being sociable in general was mentioned as a hindrance to losing weight, if eating out or with others involved rich or calorific food and drink.
Shirley found it difficult to socialise when she was trying to lose weight.
Shirley found it difficult to socialise when she was trying to lose weight.
Being sociable. I think it’s general people going, “Come out for a meal.” My first thought is, as soon as someone says, “Do you want to come out for a meal” my first thing is, “Where are we going? What’s on the menu?” I’ve never been like that really because I always like, if I’m going to going out for a meal and I’m going to pay for something, I want to have what I want to have, and I don’t want to. So I did very much, I went through a stage of saying to people, “No.” When I was being what I call really good, and in the midst of it, I wouldn’t go out. I would say, “No I’m not going out because I can’t cope with that meal.” I’m better now because I think, “Life’s for living. Yes, you have to go out and sometimes it’s only one meal and if you want to enjoy it, just enjoy it because you’re paying for it,” and that’s, that’s the way I started to look at it because my husband said, “This is ridiculous. We’re never going out because you’re always worried about what’s on the menu or can we go here because they do this.” He said, “I don’t want to do that. I want to go out and have a meal and enjoy it.” So yes, social things are the ones that get in the way.Trying new recipes may help Tref to beat boredom and stick to an eating plan but having friends to dinner does not help because they eat (and drink) more when being sociable.
Trying new recipes may help Tref to beat boredom and stick to an eating plan but having friends to dinner does not help because they eat (and drink) more when being sociable.
Well, I find that I go like, I find that the other times I’ve lost some weight a little bit and thinking, oh that’s good and then thought, oh why bother? [Laughs].
Why?
You know, I’m not I’m not enjoying this, you know. Because I’ve always been a big lover of food.
Okay.
Going to the gym, yeah. I used to enjoy going to the gym, I really did but then, unfortunately, I fell over and broke my ankle and it’s, I’ve had trouble. Still with me left foot ever since. Probably arthritis set in. And then my knee, I had a new knee, which wasn’t entirely successful. And it, I just stopped going to the gym.
Okay and the main problem to stick to a diet is because you become bored.
Yeah.
Okay.
That’s what I would say.
And what do you think it will help?
I don’t think anything would help really.
I don’t know, trying new recipes or.
Maybe try new recipes, I don’t know.
Or inviting friends to eat with you, I.
Maybe, yeah.
Okay. Yeah.
But again, it’s difficult when you’re seventy seven years old because I haven’t got too many friends of your, of the same age range, you know, would you.
Occasionally, the friends down the road will eat with me. We’ll have a meal up here together or I’ll go down there but I, when you sort of have a bit of a party, if you like, you tend to go a bit mad.
Okay, so.
You know, I’ve, if they come up here, I’ll cook a Chinese curry or roast lamb or lamb shank or.
Okay.
And we’ll drink a couple of bottles of wine.
Okay.
So that’s not really, that doesn’t really help or.
So-called ‘diet pills’ can refer to prescription medications to treat obesity, such as orlistat (Xenical) as well as non-prescription products which are available over the counter or advertised on the internet, or herbal and other supplements. Shirley said she had resorted to buying tablets which “did nothing. I didn’t even understand what they were meant to do, but they didn’t do anything”. Maxine Mary found that even though orlistat ‘shifted the fat’ she did not like the smell of her skin when she was taking it.
Maxine Mary describes the many ways she tried to lose weight, including orlistat (Xenical). The diets worked but only in the short term.
Maxine Mary describes the many ways she tried to lose weight, including orlistat (Xenical). The diets worked but only in the short term.
Yes I’ve been prescribed things in the past. I’ve been prescribed diet replacement, food replacement thing that you bought every week. And they’d come back and see if you’d gone into ketosis. That didn’t work, just made me very ill. So and then I had a drug that I think it was called Xenical that shifted the fat or something but that just made me smell so bad I couldn’t stand myself. It just, I could smell it in my skin and everything and it was horrible. What else did I have? Oh I had diet pills when I lived in the States. I was prescribed amphetamines to lose weight. Very effective in the short term but, you know, you just put it straight back on again as soon as you stop taking them. It’s like whoosh there it goes and more. I’ve been to Weight Watchers. I’ve been to Slimming World. Just about every diet going. The Cambridge Diet, The Atkins Diet, the Grapefruit Diet, The Cabbage Diet.
Why do you think? I suppose these diets in the short term made you lose some weight or no? Some of them have worked?
Yes some of them work. What all of them work actually in the short term.
Why do you think they didn’t work in the long term? What was missing or what was happening in your life?
I think because I approached it as a diet. And, you know, I’m going on a diet until I lose this much weight. Then I’m going to stop being on a diet and eat normally.Angela’s GP would not prescribe orlistat (Xenical) for her so she bought it online.
Angela’s GP would not prescribe orlistat (Xenical) for her so she bought it online.
I tried Xenical one time. I bought it off the Internet because a friend of mine, my doctor wouldn’t prescribe it for me, so I bought it. They said, she said, “It was absolutely useless and it won’t help you at all. What you need to do is follow a proper diet,” and she’d given me like an NHS one and I just remember breaking down in tears thinking, ‘Nothing’s going to work. Nothing’s going to work. It’s so unfair, whatever.’ So that’s the only time I’ve tried diet pills.
Weight management groups
Slimming World and Weight Watchers are programmes which help people lose weight by providing face-to-face support meetings, weigh-ins and diet plans.
“You can’t do it on your own… most people I think would find going to some sort of group helpful because you get a huge amount of support and, not only from the leaders but from other people who are going through the same thing as you”. Myra
“I personally am more compliant if there’s somebody weighing me”. Rosemary
While some people find the weekly weigh in motivating, others do not like this approach. Maxine Mary found it humiliating to be weighed in public. She and Angela described ways to “trick the scales”. Liz had never managed to achieve a target weight and felt that “slimming clubs just want to take your money”. Tommy said he had learned a lot from Slimming World but had stopped going because the sessions became repetitive. Once he stopped going, he put the weight back on again. [See ‘Weight management groups’.]
Maxine Mary did not like being weighed in public as part of weight management programmes.
Maxine Mary did not like being weighed in public as part of weight management programmes.
Absolutely, absolutely [ha ha]. Yeah no the getting weighed in public. What’s that all about? I just
How long were you doing this programme?
Oh I’ve done Weight Watchers many times. I learnt, I actually learnt how to cheat at Weight Watchers as well. I, [laugh] I learnt pretty early on that if you, if you reach a target weight you don’t have to pay anymore. So on the first weigh in because I’ve joined Weight Watchers many times and, and left again. But on the first weigh in you just put a load of rocks in your pocket. And then the next week [chuckle] and then you soon learn, you soon reach your target weight and you don’t have to pay anymore. Because it’s expensive, you know, just to be weighed and to be humiliated or clapped even if you’ve lost 2 pounds, even that’s humiliating. It’s degrading. So yeah that didn’t work for me, Weight Watchers didn’t work. And also Slimming World that didn’t work for me either. Couldn’t get my head around it how you just eat red one day or green the next day or something. So yeah just smaller portions and leave out the bad stuff like alcohol and…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.
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.Angela ate a lot before her first weigh in at Rosemary Conley so that she could ‘trick the scales’ on week two. She then tried Slimming World and lost two stone but then ‘the novelty wore off’.
Angela ate a lot before her first weigh in at Rosemary Conley so that she could ‘trick the scales’ on week two. She then tried Slimming World and lost two stone but then ‘the novelty wore off’.
But again, I remember on that first, that first weigh-in people coming up to me and saying, “Well done, well done.” I was like a hero. It was like I knew the secret to weight loss but, you know, it was just a trick of the scales. You can trick the scales that way, it’s easy to do and then I lost, I remember losing a stone in total and I remember one week, I didn’t go to the class because I had something on and a week later I carried on the diet as it was meant to be, I lost four pounds and the lady said, “Well, I’m not going to make you slimmer of the week because you weren’t here last week and you didn’t do that with me.” I thought, ‘Well, actually it’s my weight loss, not yours.’ And she was a cow and I dropped out of her class because I thought, ‘You’re such a cow. You’re not encouraging at all.’ And then I joined Slimming World, which again was a lot like the diet I’d done back in the ‘80s with the high protein because you could chose red days or green days. You could have all carbohydrates or all proteins and I notice when I eat all carbohydrates I don’t lose weight, in fact I gain it. So, I was doing this protein thing. Again, that worked, and I made some really good friends who to this day are still really good friends from there. But after losing two stone nothing seemed to happen, nothing moved and the novelty wore off.
Lesley has a heart condition which is managed with beta blockers, ACE inhibitors and statins. She wonders whether her inability to lose weight may be because of her medications: “you think, ‘I work, I go to the gym, I eat as healthy as anybody. I think that shows because the nurse said to me I’ve actually got no sign of pre-diabetes. I’ve got no blood pressure. Got very good glucose levels. Everything was sort of in line with perfect. But I just can’t seem to, to shift this weight which I think I’ve put another, the ten, the ten kilos back as my medications has got, had increased over the last year, up to last year increased steadily.”
Janet found it impossible to lose weight with Slimming World and wondered if this was because of the high dose of insulin she was taking.
Janet found it impossible to lose weight with Slimming World and wondered if this was because of the high dose of insulin she was taking.
So, I went, and I got weighed and I went back the week after and I’d done the diet for the full week and I’d put four and a half pound on when I got on the scales and she said, “You’re doing the diet wrong. You’re obviously doing something wrong. It’s impossible to put weight on.” “Right okay.” “Go home,” she said, “and right everything down.”
So, I went home, stuck to the diet again. Wrote everything down. Took it back. Got back on the scales and I’d lost half a pound. So, she said to me, “Let me look at the chart.” So, I showed her the chart and she said, “Well, I don’t know what that’s about,” she said, “because you’re doing everything right.” “Okay but I seem to be eating a lot on this diet, healthy diet but, you know.” On your carbs day, your reds day, it’s just unbelievable and I thought, ‘these are huge portions. You can eat what you want kind of thing from what I ate normally.’ All right, I’m eating healthy. So, at the end of three months sticking to this diet, I’d lost five pounds bearing in mind I’d put four and a half pound on when I first went. She said, “It’s not working for you is it?” I said, “No,” I said, “I think it’s the medication.” So, I came home and decided I’m not doing this, carried on for a week and you start eating normal because you’re not dieting and no self-control and three week after, I put two stone on.
Okay, so the weight was going up and up?
All the time, all the time.
Okay.
And that, I generally think that were just down to the insulin bearing in mind how much I were taking at the time.Paul X explains that losing weight is ‘hard bloody work’ when you live with heart disease, asthma and other co-morbidities.
Paul X explains that losing weight is ‘hard bloody work’ when you live with heart disease, asthma and other co-morbidities.
I know how to lose weight. Go and, eat healthily and exercise. There you go, that’s it. That’s how you lose weight. It’s as simple as that. This is not rocket science, it’s as simple as that. But my argument then is, ‘Okay, yeah, I’ll go for a walk.’ Ten-minute walk we’re told by the NHS. Do that. It hurts. I’ve got me ankles and me toes and then I’ve got to carry this around [touches tummy ]and I’ve got this thing [touches heart area] banging away. It’s hard bloody work and then I’ve got to take all this bloody lot and then I’m going, I think I’m going bloody daft. Now all these things, you know, the straw that breaks the camel’s back, there’s a lot of straw on this old camel’s back.
So it is difficult?
It is, yeah, exactly, it is so difficult. It sounds so easy and you’re right. “Go for a ten- minute walk. Just go for it, go for one now.” It’s not as simple as that with me or I perceive it as not as simple with me. Maybe I’ve got myself stuck in such a rut I can’t climb out.
Unrealistic expectations
Some of the people we spoke with said they had had unrealistic expectations about how much weight they needed to lose and the speed with which they could lose it. Angela successfully lost weight at a weight management programme but could not lose the final 4lbs to meet her target, which left her feeling she had failed. As part of her participation in a weight management intervention, June X has become more aware that she had unrealistic expectations about the speed of weight loss, followed by ‘extreme frustration’.
June feels she has had unrealistic expectations about weight loss and the time is going to take.
June feels she has had unrealistic expectations about weight loss and the time is going to take.
And that isn’t how, how you work or how the body works really, and that really you could see with it class when that was being talked about all kinds of bells ringing.
In this weight management course?
Mm. Yes
Okay.
Yes.
So, it’s something that you have been become aware or kind of worried about.
Yes, this particular, yes this particular profile, yes much more recently actually particular profile of unrealistic expectations and far too much perfectionism and therefore the extreme frustration when things don’t go as you wish on, really on a day and daily basis. It’s, it’s this feeling of, you know, ‘All right, I was good yesterday and I haven’t had this result that I was looking for.’ You know, who’s against me? Is the universe against me?’ [Laughs] It’s just, and that’s a completely obviously unrealistic expectation.
Okay. So it is more a long term kind of lifestyle?
Yes, yes. Oh very, very much so. Very much a marathon not a sprint, so and actually in a way that’s quite comforting to think about it in those terms because everything, we are sold everything on the basis of speed. Everything is ‘Lose this in so and so a time and , you know, this will get you amazing results instantly and whatever the beauty product or the sort of weight loss product it’s, it’s going to deliver amazing results incredibly quickly. That simply is, is not the pattern of how things happen really. Not with extre-, not with a level of obesity. Not with a level of overweight. The point is that you can, you can lose your stone in a month and probably absolutely will if you’re very overweight, but nobody’s going to notice that’s the trouble [laughs].
Heidi’s weight has been affected by taking anti-psychotics and anti-depressants and steroids.
Heidi’s weight has been affected by taking anti-psychotics and anti-depressants and steroids.
And then because of, I’d gained so much weight, I was becoming almost a Type II diabetes candidate and the doctor actually recommended, the doctor, not the psychiatrist that I was seeing, actually recommended me to change my medication, my anti-psychotics and I did so. I went on a different anti-psychotic and then I gradually lost weight. I think it was probably like two stone in a matter of six weeks. I was very, I got down to basically my more natural weight.
I stayed the same weight and then I was gradually over the next few years I was diagnosed with a lung fibrosis condition.
As soon as they noticed I had like a web feature in my lungs, they put me on 40mgs of steroids. Over the last, I think it was over a matter of Christmas and over a matter of into the January, I was left on 40 milligrams without being seen by any GP, any doctor and I ballooned up to an absolute big weight and I was gaining so much fluid, it was unbelievable. And the doctor started then to, my GP, when I went to her and just say, “Help,” because I didn’t know what to do. She just said, “Right, we’ve got to lower, start lowering your steroids.” So, this started and with steroids it’s a gradual lowering, otherwise it can have disastrous effects. Then I’d started ballooning less but my weight was still big but looked even worse because of the fluid that I was full of fluid on my chest, my arms, my legs were swollen. My face especially and then they saw me at the lung function clinic and the lung place, specialist, specialist lung place and they said, “that they were still wanting to lower the steroids,” but I was, I was still big.
I’m trying to think what happened next. I gradually started losing the, a tiny, tiny bit of weight but because I was on pain meds as well as the steroids, they gradually made me put, have an appetite, so it just, it’s only just recently that I’ve lost my appetite completely and I just haven’t been wanting to eat food. I suppose I’ve been in a very low mood because of the weight and the pain I’m in. It’s been very severe in my legs and my hands and my arms. As I can’t, because I can’t walk without a stick, so…
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