have never been on a diet, but that is about to change – thanks
to an argument with the waistband of my favourite shorts and new
research suggesting that middle-aged spread increases the risk of
frailty in old age – along with myriad other degenerative complaints.
At just over
14st (89kg) and 6ft 3in (1.9m) I don’t have a serious weight
issue – more an unsightly spare tyre – but that is not
why I have never dieted. My main objection is that more than 20
years in the job have taught me that diets do not work. They may
briefly help you to squeeze into your shorts or bikini, but you
are almost certain to return to, or even exceed, your pre-diet weight.
the research in this area and you are likely to come to the same
conclusion – the only weight-management programmes that work
in the long term involve lifelong change to diet and lifestyle,
or stomach surgery. Anything else is doomed to long-term failure,
explaining why so many of my overweight patients have shelves of
diet books. If they worked they would need only one.
long-term change is not going to get me into my shorts in time for
our trip to Menorca – and gastric banding is going a tad too
far – so I am going to follow the advice I give my patients.
Physician heal thyself.
Step 1 is to
work out where you are going wrong. The first thing I do when advising
an overweight patient is to request a seven-day diary of everything
he eats or drinks. This often reveals the problem, and patients
can be surprised at how much they eat when they see it totted up.
If it’s not a quantity problem it’s invariably quality.They
eat the wrong types of food, typically high-fat or high-sugar, full
of calories. NHS dieticians can provide more expert assessment and
with teenagers and older children include “hidden” calories
in soft drinks, including juices – orange juice contains as
much sugar as cola – which can account for 20 per cent of some