First person by Oxford GP Dr Joe McManners
“I’ve put on a few pounds during lockdown Doc.”
My patient had popped in for a check of his painful knees, and he gave me a rueful smile as he admitted what I could see- his extra girth.
He then explained why it had happened, I nodded as he spoke as what he said is familiar at the moment: not being able to go on his long walks with friends, reaching for the comfort biscuit to cheer himself up, and working at home not in an office.
Not to mention the extra booze.
He is not alone; self-reported statistics suggest nearly a third of people gained weight during lockdown.
Weight problems are known to be a serious threat to the long-term health of the nation, with experts predicting that obesity could cause the first known drop in life expectancy in modern times.
Covid-19, or at least the response to it, has probably accelerated this.
It has also probably accelerated some of the inequalities in obesity that we already know about, that it is more of a problem for those with other medical problems; those disabled, and those on lower incomes.
The reasons for so many of us piling on the pounds are similar to the reasons for the long-term trend in weight gain: reducing activity to burn up the calories, and excessive consuming of the wrong sort of calories.
The diet side is probably the most important, it takes roughly 20 minutes of running to burn off a Mars bar.
The health problems of being overweight are numerous. The extra weight worsens muscle and joint pains, osteoarthritis, and back pain.
Being obese can cause Type 2 diabetes, raised cholesterol, blood pressure and increase risk for heart disease and stroke.
Higher weight has even been shown to increase the chances of getting cancers such as bowel and breast cancer.
Dr Joe McManners
It is easy to feel a bit defeated by this. But there are reasons to be hopeful.
I meet patients all the time who have managed to lose weight, they may not all now look like super models, but they have lost enough weight to feel better and the good news is that we see health benefits of even small amounts of weight loss – blood pressure can quickly improve and diabetes can even be ‘cured’.
Well then, what can we do? Again, good news is that there is support out there, the NHS and local groups can help.
It is especially important that we understand why someone is overdoing the calories and not exercising.
There are usually reasons why someone struggles to lose weight; there may be an underlying depression; they may struggle with time; there may be medical problems that restrict them.
Often people aren’t aware of what they shouldn’t be eating; have got into bad habits; or are following what their family and friends do.
It doesn’t help that a lot of food now is packed with cheap calories and almost becomes addictive.
Therefore, the solutions to poor diet and exercise also need to tackle the causes of this. This means helping improve mental health, reducing stress, making exercise easier, improving education and linking together groups who are improving their diets and exercising.
A few practical tips I’ve observed work from people I know who have managed to lose weight:
Avoid fads: some diets work more than others but go with whatever works for you and make sure it is sustainable.
Work out what is behind the overeating and try to work on fixing that.
Reducing carbs is useful, especially ‘quick release’ carbohydrates containing sugar, but also less obvious sources like bread, pasta and potatoes.
Try to avoid processed food as there is often a lot of hidden sugar and calories, fill up on vegetables and drink lots of water.
Find people to support you, and maybe ‘buddy’ with someone.
The NHS has a scheme to refer patients to weight loss schemes and classes, ask for help.
Take your time, it takes a long time to lose weight and if you’re going in the right direction it will happen.
Try to combine diets and exercise but try to make the exercise fun and to achieve a goal. If you exercise, don’t eat more afterwards.
And above all, try not to feel bad about the whole thing. Stigma and shame make the problem worse.
For the rest of us, including those in charge, obesity is not a moral failing or a choice.
Life is tough, but there is a lot that can be done, as long as we work with people to understand what solutions are going to work for their particular problems.
To hear more listen to the podcast, ‘A Doctors Appointment’, where I chat informally to a friend about weight issues visit podbean.com/ew/pb-9q9wy-ed1194.