Can you relate to the one in ten women who have not applied for a job because they worry they are overweight or perhaps, like a quarter of women, you shut yourself in the home refusing to go out because you are so miserable about your weight? Most of us are aware of the health implications of being overweight, but size can also affect how we feel about ourselves as almost four out of five women feel there is a direct link between how much they weigh and whether they are happy or confident.

It’s not just women that this applies to though. According to research by Slimthru, one in ten men have let concerns about their weight prevent them from going on a date and nearly a quarter have been on a diet in preparation for a holiday. With more than half the country constantly dieting, it is comforting to know we are not alone but how can we lose those extra pounds, drop a dress size and keep the weight off for good? Eating less naturally leaves us with terrible hunger pangs but how can we stop ourselves from bingeing on crisps and chocolate and putting the weight back on?

Not only is it frustrating to regain all those pounds we lost but it is also hardly healthy to be constantly losing and gaining weight. With summer here, more than a quarter of people will go on a diet ahead of their holiday but what is the best way to lose those extra pounds and keep them off?

Dr Ian Campbell and Linda Duberley joins us live online on Wednesday 20th June at 12:30 to talk about losing weight safely and keeping it off

H: Vicky Letch, Host
I: Dr. Ian Campbell
L: Linda Duberley

H: Hello and welcome to the Healthcare Show brought to you by Slimthru. I’m Vicky Letch. Now would you believe it if I told you that one in ten women have put their careers on hold because they’re ashamed of their shape? Amazingly this appears to be the case so much so that four out of five women draw a direct link between their weight and how happy they are. But it isn’t just the ladies; around ten per cent of men have admitted to putting off holidays and dates just because they thought they were too heavy. However, it is comforting to know that, with over half the country on a diet, we are not alone. Now, as frustrating as it is to regain those lost pounds, it can hardly be good for you to be constantly gaining and losing weight. With summer here, over a quarter of you will be going on a diet ahead of that summer holiday to get into a bikini, but what’s the best way to lose that weight and keep it off? Joining me to discuss the problems associated with obesity and yo-yo dieting is Dr. Ian Campbell and Linda Duberley. Hello!

I: Hi

H: Ian I want to start with you – I want to ask you, how important is it that we effectively manage our weight?

I: I think it’s extremely important to manage your weight when you consider all the health risks associated with carrying too much weight. We know that even if you’re even a few pounds overweight your risks of type 2 diabetes, heart disease and even some forms of cancer start to increase. The most important thing you can do to promote good health for the future is to keep your weight steady

H: So you’re saying that it’s not just about appearance; there are so many other underlying things going on within the body that we may not be aware of?

I: Sure. It is about appearance because that determines how you feel about yourself, how you conduct yourself. But in terms of overall health risks, there are significant medical conditions that you put yourself at increased risk from. So it’s about quality of life – it’s about quantity of life too.

H: I like that…and quantity of food which we might talk about a little bit later on. Linda, as a journalist and a woman have you ever felt pressure to look a certain way?

L: I’ve certainly noticed that people have tried to pressurise me since a very early age. I started as a newspaper journalist at nineteen and even in the print industry I think there’s tremendous pressure on women to conform to a certain stereotype if you like, because it’s all the media. Certainly when I began to work in television in my late twenties there was a huge pressure to look exactly right on television and of course on television, as you know, you look about ten pounds heavier than you actually are, so you are constantly trying hard to keep your weight steady.

H: And do you know what my friends say to me? How many cameras were on you? How cruel is that! Now of course this is an interactive show and we do have a question for you from Sarah – Sarah wants to know, with our press so obsessed with size zero queens, is it no wonder women no longer feel comfortable with themselves – Ian?

I: I think we are all responsible for promoting this image of small being beautiful. In actual fact when you analyse most of us prefer the middle ground and we like a lady with a few curves on them, so to speak. So there’s nothing wrong with that at all and I think the danger of promoting these very stick thin images is that you drive women and some men, towards a really unrealistic body image which can create all sorts of psychological and health problems in itself.

H: So it’s finding that middle ground – something you can be comfortable with. It’s all well and good saying obesity is a bad thing, and yes it is, but actually going the other way is just as risky for health reasons?

I: Well, actually if you just look in terms of health risk, your risks go up if you are underweight too – being of normal weight, right in the middle, is the best place to be.

H: So I think we’re doing alright

L: And I have to say most women in magazines they’re mostly pushing five foot ten or eleven and probably a size six or eight and there is only a very small percentage of the population that is that size so everyone is under a great deal of pressure to force themselves into that sort of shape and when you’re bombarded with those images day in day out the eye grows accustomed to seeing women look that way.

H: I find that petrifying – size 6 and that tall. I think I was probably a size six when I was six! OK, from Jo – having constantly dieting on and off for the last 15 years, I am worried about the effect I’ve had on my metabolism rate – I would like to know about this – is there any way to repair any damage?

I: This is a complex issue really. If you lose weight, regain it, lose it, regain it – as most of us do when we try and diet – we call that yo-yo dieting. And the risks in the long term are that you end up being a greater weight that you started out. And the reasons for this are not fully understood, but it might be that the body becomes accustomed to that higher weight and it’s what we call the ‘set point’. So as you try and lose weight your body fights back to try and get you up there – it thinks it’s being starved or exercised to death and all those physiological forces are working against you. You can counter it, but the sooner you try and control your weight at a less level of overweight, the better because it will be easier. You will get a better response if you’re a few pounds overweight than if you're grossly obese.

L: Is it true you can get osteoporosis more easily once you’re yo-yo dieting?

I: Yo-yo dieting creates some concerns about osteoporosis, it also raises concerns about increased risk of heart disease so it’s certainly very unhealthy way to approach the problem

H: That’s petrifying because you don’t consider those things when you do it. Because certainly I wouldn’t say all teenagers are the same but when I was a teenager many moons ago I went through a good year when I probably ate an apple and a bowl of cereal maybe a chocolate bar a day and that was it. And I'm sure that’s why I have problems now later on in life maintaining a weight – I struggle with it.

L: Do you diet?

H: I'm going to be completely honest I'm really naughty with food. I'm the type of person that if I want something then I will have it and then maybe the next day I’ll try and be good – I need to learn to have more of a balanced attitude to wards food. I’m a bit of a party girl and if there's a burger there I think why not!

L: Absolutely, me too. But at least you try and make up for it the next day – that’s a fairly moderate approach. The danger is some people will gorge and think they might as well carry on

I: I don’t think there's anything wrong with this as long as it’s in moderation. The worst thing you can do is really punish yourself by eating things you don’t like, you don’t enjoy and miss out on all your favourites. And I've found the most successful people who lose weight and keep it off are those who still enjoy normal foods. It’s about controlling portions, controlling snacking, not going without – I think that’s quite harmful

H: It’s about making the diet work for you – it’s got to be bespoke to your lifestyle. If I tell myself I can’t have something it’s all I can think about all day long

L: I’ll tell you what's quite handy as well with any kind of weight maintenance supplement or product – at least you don’t get hungry. The danger point when you're hungry is that you just go to the nearest vending machine or fast food outlet and cram it in because you're tired and hungry.

I: Strict diets make you feel hungry, you’re sweaty, you're tired, you're hungry, you get headaches…it’s an extremely unpleasant experience that doesn’t last for long. Why are you going to do something that hurts – you're not. So people go on a crash diet, they quickly become uncomfortable and fed up with it, they stop and their weights starts to creep up again.

H: And the weight piles on. A friend of mine went on the ‘no carbs’ diet – terrible breath. Lovely girl, but I really didn’t see her for a fair few months. And she shrunk – she did shrink – but then of course her body was craving the carbs, she went straight back on the carbs and the weight just piled straight back on. We've got one from David – my wife always cooks me hot evening meals, but I get home so late that I tend to sleep soon after eating. Is this going to contribute to my excess ‘baggage’.

I: Yes, is the quick answer for a lot of reasons. If you tend to eat late in the evening there are two issues. One is you tend to go to sleep afterwards and not burning off that energy that you’ve just consumed. The second thing is because your stomach was full before you went to bed, you wake up in the morning, you're not hungry so the temptation is to skip breakfast and the whole day gets off to a bad start, which is really very unhelpful

L: Is it true that you should have breakfast like a king, lunch like a prince and dinner like a pauper?

I: It’s very true, but who does it? It’s not realistic is it?

H: It’s all king king king for me! It’s funny how you remember certainly back in the day it would be the norm for children to have meals at four thirty when they came home from school or five thirty. Because of our busy lifestyles I think it’s quite difficult to have that type of time restrictions with our meals. Your partners may not be getting in until nine or ten at night and you want that time – that’s the problem – that’s usually when you sit down and chat about your day.

I: It’s an interesting think you said – our busy lifestyles – in actual fact one of the problems is in the evening we’re not that busy. We get home from work and we crash out – we lie on the couch and we watch tv and we eat and we get bored so we eat a little bit more and the problem I have with most of the people I’m helping to lose weight is that they’re eating when they’re not hungry. And what they have difficulty doing is both controlling the portion sizes of their main evening meal and the snacking that takes place afterwards. And they find that very difficult because they feel hungry, it’s there and they have it.

H: When you say that we eat when we’re not hungry – I agree that I certainly do that, but there is something that I work through – I say ‘oh I’m a little bored’, ‘oh I think I'm hungry’ and I know I'm not but I work on it yes I'm hungry Im hungry and before I know it I'm in the fridge.

L: I'm peckish – food is entertainment. I think it’s one of the great distractions in life at the moment and it starts when they're very young. My kids – I've got three kids – they're at it the whole time and its got absolutely nothing to do with hunger.

H: How old are they, because they may be growing

L: Well, that’s what they tell me – they're seven, nine and fourteen – the seven year old is the work. She said mummy I eat cheese its healthy I eat quavers. They are empty calories – there’s no nutritional value, or very little.

H: It’s finding that good thing that can be in place for the naughty things and still give you that lovely feeling. Darren wants to know – I feel so ashamed about my shape that I never approach women, my mum says it’s what's on the inside that counts, but I need advice on how to lose a few pound please help

L: That’s sad when you're bringing up children and they feel that way, that’s tragic, and mothers do say that – they say it matters what's on the inside, but that’s no help to a growing teenage boy is it. You’ve got two teenage lads…

I: Yeah I do , and I think weight and image is very important to them. But I work with people of all shapes and sizes in my medical practice and some extremely heavy people – many of them have got very happy marriages and relationships. I know it’s a cliché, but there is someone for everyone out there and I think the most important thing you can do is to learn to live himself as he is and to go out there and find someone who accepts for who he is and what he is. If he then wants to move on to do something about his weight at the same time then great – do it – but don’t let it stop you going out and enjoying life

L: And maybe find a way of building his confidence. That could be anything – learning to sail or something like that – then you kill two birds with one stone, something building your confidence and you're getting some physical exercise.

I: There's another feature here which I find extremely common is when people start to take control of their diet and exercise, their mood starts to lift, their confidence improves even if they’ve only lost one or tow pounds, they feel so much better – the whole process of taking care of your health can improve your self confidence and make you feel better. And in effect because you feel better, you will look better.

H: I agree – exercise is the way forward if you can be bothered. Lee Kisley wants to know, I've been dieting on and off for about three years but I can’t seem to get down to my desired weight of around fifteen stone. What do you suggest other than starving myself.

I: Quite simply, don’t aim for a specific weight if it’s too much to lose. Most people will struggle to lose five per cent of their body weight, so five kilograms of an average obese man or just under a stone. Set yourself a reasonable target over three to six months – maybe five, at most ten per cent of your body weight. If you achieve that you’re hugely successful, stick there – allow your body to settle down for a period of time and then if you want to start pushing it again. But whatever you do be moderate in your expectations, because if you expect too much it will only lead to disappointment.

L: Increase your exercise weight as well, because that will have its effect on your metabolism.

I: It has a huge effect. Exercise helps people to lose weight, but it’s more important to help them maintain it thereafter – a much greater effect in terms of weight maintenance

H: And it’s not about rushing the whole process. I always think if I’m going to lose weight we all want to see results in the first two or three weeks or we can be very disheartened about the whole thing. But actually is it true that we should be aiming for one or two pounds a week?

I: On average one or two pounds a week is sufficient on any good weight loss programme and people tend to lose four or five pounds in the first week – it’s mainly water from around the live, it’s not fat at all and it’s very quickly regained. If you’re aiming for one or two pounds a week, that’s fast enough.

H: Linda this one's for you – Mary wants to know – my sixteen year old daughter is dieting at the moment, but I am worried for her. Do you think this is too young to diet?

L: Well, I would rather see young girls not diet at all – I would like to see young girls eating moderately and getting exercise and not be obsessed by how they look. But I feel that’s probably an unrealistic attitude. I’ve got a seven year old daughter and I know that we’re heading in this direction even now she's paying attention to fashion magazines. I would say what is a diet, it’s an eating plan – it doesn’t have to be a faddy diet – it could just be a healthy eating plan, and that's the way to go.

I: But the word ‘diet’ has connotations of going without and causing yourself discomfort doesn’t it – it’s a punishment almost. When I work with children we never talk about dieting, we talk about health, we talk about well being, and the point I push with them is that eating healthy now makes you feel better, perform better at sport etc and actually makes you more likely to live a longer happier life as well so it’s about health not dieting.

L: I remember starting dieting when I was about thirteen or fourteen, Crispbreads, wafers, cheese and raisins, believe me if it was out there I tried it. And my weight fluctuated a lot until I was about 19 and I just decided to stop paying attention to it – I just got fed up with it – and I stopped and the weight dropped off and I’ve been roughly the same weight ever since

H: And happy

L: And happy, because I love my food

H: Me too! Stay behind and we’ll talk about all the naughty foods later. A lot of the attitudes do you think these come from the parents, when it comes to imprinting ideas about diet or lifestyle on the children – do you think it should be coming form the parents from a very early age?

I: I think parents have a responsibility to lead by example – to live a healthy lifestyle themselves which their children will copy and adapt to. I think that it’s fine to put responsibility on to teachers, on to doctors, tv programmes, but actually, health starts at home and every parent should be showing the children the best way to live their lives I think.

L: Or just learn to cook and teach your child to cook. I taught my daughter how to make pancakes the other day and she knows more about nutrition, she knows more about food and we’ve had some fun in the kitchen

H: Absolutely. We have a question here form Michael Tudor, he wants to know – I’ve experienced consistent weight gain over the last couple of years – not a great deal, but I've put on about two stone so I'm now just over 15 and a half stone. I’ve been an active sportsman competing weekly for the last 16 – 17 years but have been injured for the last year when the bulk of the weight went on. I'm now injury free and want to go on a diet before I seriously hit the fitness trail again. But working late and eating the wrong type of food has been a problem. What is a quick, easy and cheap solution to my dietary plans.

I: There is none. Losing weight is not easy – it’s hard. So what you need to do is not expect to do it quickly, but to do it over a prolonged period of time. But you can get results quickly just by moderating your food, stopping snacking, and someone who has been a really active, athletic type of sportsman might have been consuming 6000 calories a day. And once you become inactive, that piles on pounds every week, so you can become obese in a very short period of time. I think it’s about increasing exercise at the same time as controlling your portion size, your snacking between meals

H: That’s interesting that you went back to portion size, because I think that's very difficult thing to judge. Certainly in a past relationship, he would eat a huge amount of food, so I would have just a little bit less on my plate, losing all perspective about what was a good size portion.

L: And I think we see that in America in particular, where their weight issues are slightly more advanced than ours – particularly in middle America – their portions are huge. I was filming in Chicago a year ago and we went to a very famous steak restaurant and they brought all the raw meat to the table so we could have a look at it that would have fed a family of five – it was like a joint and I thought my god people were actually ordering it and consuming it and the trouble is you get used to it and cant go back to a normal size.

I: You get used to the volumes of food. Even the plates that we use around the dinner table have increased in size from an average of 9 inches in diameter to eleven inches and our whole concept of what a normal portion is has become distorted.

L: And wine glasses

I: As have wine glasses too

L: Someone told me – I drank a bottle of wine the other night – they said that’s the same as eating 6 jam doughnuts – I haven’t done it again

H: I close my ears to that because I do like my wine. That’s one thing that I'm afraid…I won’t be giving that up. Simon from Cambridge asks- is there a case where some people’s natural body weight is slightly overweight?

I: Well weight is quite a complex issues, because it depends on your bone structure, your height of course, your muscle mass – so if you're very athletic, very muscular, you will have a higher weight, but less body fat, therefore less health risk. So you can appear to be overweight, a professional rugby player would be clinically obese but would have a body mass of about 10 which is about half of an average adult.

L: What we hear a lot about – the BMI – is that what all the fuss was about with the size zero models who weren't allowed to participate in the London fashion week once their BMI was too low

I: Below eighteen or something like that

L: And what does eighteen look like- average?

I: Size zero – if you want to picture that – it’s very skinny. You would perceive it as someone who looked unhealthily thin.

L: So 18 is skinny?

I: Yes

L: So girls of 16 or 17

I: Very unhealthily skinny

H: Very unhealthy. Thanks you so much – this has been really informative. Just to surmise, we are saying that we’re looking for lifestyle change rather than a diet. We want to avoid the diet word because it scares us

I: The most important thing you can do is find ways that you can eat healthily and be more active for a long period of time – think long term

H: Lovely thank you so much and thank you all for your questions and for getting involved, that’s what it’s all about. If you would like further information please feel free to go onto the website www.slimthru.co.uk we’ll see you next time thank you very much.

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