A client told me today that her doctor would not refer her for counselling for depression and overeating, the doctor refused saying that it was OK to overeat to deal with depression as long as she sticks to low fat yoghurts and fruit. She even had the gall to add that they taste just as nice and would fill her up just the same. I am horrified. And it gets worse. The doctor advised her to join Slimming World or Weight Watchers, saying that they aren’t really diets. This, despite my client telling her that these clubs don’t help her as they don’t address the psychological reasons behind her overeating. And that in any case they had never worked for her and that she has in fact gained weight over the years while going to these slimming clubs. The doctor just didn’t listen. Moreover, this doctor is clearly lacking in information and effective strategies to help her. If the best she can come up with is low fat yoghurts and WW, we are indeed in big trouble. This doctor seriously thinks that telling someone to overeat fruit is a good thing. I want to cry.
I can’t tell you how many stories like this one I have heard over the years. Admittedly this is the first one where a doctor openly advises her patient to overeat fruit, but why am I so shocked and surprised? Legitimising overeating is something that diets have done for ever. In my Weight Watchers days I clearly remember being sold the number one benefit of FREE soups, namely that I could eat as much as I wanted. The message being, it’s OK, if you want to eat and you’re not hungry, eat FREE foods. I was constantly urged to abate my cravings for chocolate or crisps with as many carrot and celery sticks as I could. How does a presumably intelligent and highly educated doctor not see that promoting overeating of any food is unhelpful and downright dangerous. How can they fail to realise that they are compounding the problem, not solving or even managing it.
We always tell women not to stop overeating when they first start a course or a workshop. We invite them to overeat with awareness, to find out as much about the behaviour as they can. To take it very slowly. And this is always with a view to stopping or drastically reducing how much they overeat. We know that in order to do that, in order to stop overeating, we need to address all the psychological, behavioral and physical reasons we overeat in the first place. How can it be that Audrey and I, two ordinary women, can see that and a doctor cannot? It didn’t take me eight years of psychotherapy training to work out that if I continued to overeat free foods when I was on a diet, I’d be overeating chocolate and crisps as soon as I was off it. I didn’t need a degree in medicine to realise that the more we go on diets and sign up to slimming clubs, the fatter we become in the long run. It is blindingly obvious not just to me and to all the Chocolate Fairies; there are many, many scientists and researchers have known this since the 1940s when Ancel Keys conducted the Minnesota Starvation Experiment.
WW and SW produce wonderful glossy brochures targeted at the government and the NHS documenting just how many pounds they have helped us Brits lose over the years. Their materials fail to mention how many pounds we re-gain and how many of those pounds lost belong to same person who has lost and gained them over and over again, usually ending up a good few pounds heavier than when she started and feeling like a hopeless failure to boot. Blaming herself rather that the diets for her failure. This has got to stop. Now.
It is time the NHS woke up and admitted they are losing the so called battle against obesity. If they had the courage and the budget, they might just acknowledge that what people need is compassion, understanding and real, effective tools. This doctor would realise that my client knows best, she knows what she needs and some support in the form of counselling would be a start right now.
I’m working on a proposal for my doctors' surgery to offer them an ongoing weekly group for what they consider to be their hopeless cases, at no cost to the women or the NHS. I hope they will take up the offer.
Wednesday, 9 November 2011
What are the NHS doing?
Posted by Sophie Boss at 17:58
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that is appalling, I can't believe doctors can legitimise bingeing, as long as it's on healthy foods?! I see a psychiatrist and nurses on a regular basis (unfortunately overeating is just one of my problems). Whenever I have brought up my issues with food they just trivialise it and laugh it off! They tell me "it's very common to binge and emotionally overeat, so don't worry about it", completely ignoring how it destroys my self esteem and mental health. I think they think that just because I'm not purging, or obese, it's nothing to worry about, but they completely forget how bad it can be emotionally. Luckily for me I have found you guys at Beyond Chocolate, and have made a great turnaround, but I feel for all the other women out there who are being ignored...
I think there are many health professionals who do not understand the psychological reasons behind overeating. My doctor told me to keep a jug of water with lemon juice in for when I felt I wanted to eat a 'bad' food. That's what she had done and she had lost weight so why wouldn't it work for me?ReplyDelete
I left the surgery in tears. She had no idea, and what's more, didn't want to.
My Dr is very supportive of the psychological approach but is unable to offer me any counsellig or therapy of any kind on the NHS. He could if I were a smoker, drinker, drug user or had anger issues or depression etc etc but he said the NHS do not recognise the emotional side of over eating. Very frustrating !ReplyDelete
'free food' as legitimised by WW over 20 years ago continues to be the bain of my life. As you say, it so instills that it is ok to overeat. On Radio 4 last week I heard part of a programme talking about the NHS referring patients who 'needed to lose weight' to WW or SW, due to the success of these programmes. I was fuming whilst listening.ReplyDelete
I actually gained weigh at SW, and when I said I thought I was eating too much pasta the leader told me it was impossible to eat too much 'free food'.ReplyDelete
Screw the free foods because...... YOU CAN'T GET ENOUGH OF WHAT YOU REALLY DON'T WANT.ReplyDelete
So ditch the diets and allow yourself..........
TO GET ENOUGH OF WHAT YOU REALLY DO WANT!
This came up on the forum recently. I was - and am - truly shocked and do not where this GP is coming from. The government has invested heavily in Improving Access to Psychological Therapies (IAPT) and there should be no diffculty in accessing therapy. People can self refer if necessary and details should be available in GP surgeries. Depending on the area of the country quite a few do offer both 1-1 and group work for such issues. The local primary care trust should be able to helpReplyDelete
ha! so true! i've recently (the last few months) stopped SW i did it for about 18mth & initially lost wt (1 1/2 st)however this year i have had so much stress that eating for comfort has been a big part of my life so even tho i continued to go to SW i was gaining wt. i've now put almost all of the 1 1/2 st back on :( & am trying intuitive eating, in early stages & haven't lost yet but don't feel guilty if i want something other than "free" food! & i haven't touched low fat yogurt or quorn (you'll understand if you've ever done SW!) since :).. what i will say as well is that on SW the focus is pretty much "eat as much as you like as long as it's free" as far as i'm now concerned bingeing is bingeing regardless of whether it's carrots or chocolate!so i'm not surprised that many health professionals will fall for this too! also SW (as well as WW i'm sure) tell people & convince (brainwash) people that it's NOT a diet, it's a way of eating for life! no it isn't!!! i don't need syns or healthy extras! that is NOT proper eating!! all that did was made me feel so bad when i wanted something tasty!ReplyDelete
After decades of nothing better than "I thought I told you to lose weight, young lady" finger-wagging, I was recently shaping up to argue the toss with the brand new practice nurse who was determined to weigh me. I sighed deeply and said, "What can you do to help?" To my surprise she said, "Well I could refer you for three months' free gym membership." At last! A good idea! And it's really cheered me up. Don't know if it's affecting my weight but hey! Don't converse with doctors.ReplyDelete
I am a doctor myself (training in psychiatry) so am well aware of what NICE suggests for obesity. Yet when I asked my own GP for a referral to address the psychological issues she looked blank and told me to eat more brown bread! This is the same GP who has told me for years that I'm overweight without suggesting anything sensible.ReplyDelete
Good luck with your initiative with your GP surgery, Sophie - let us know how it goes.ReplyDelete
Hi I agree, things need to change. In Coventry the NHS run a Well Now programme based on the Health at Every Size Approach which is being promoted by a dietician called Lucy Aphramor. I feel that this is definately the way forward. She runs workshops on Obesity ethics and the Health at Every Size approach.ReplyDelete
Lucy Aphramor guardian.co.uk, Saturday 9 May 2009 12.00 BST Article historyReplyDelete
Following on from above, this article is well worth a read - she talks so much sense
Thanks Jules - always good to be pointed in the direction if interesting journalism. Will take a look.ReplyDelete
I hear the sentiment in your writing Sophie but the flavour of persecuting the medical profession isn't a nice taste for me.ReplyDelete
I don't think that I am persecuting the medical profession, that sounds rather strong. I am reporting an incident described to me factually and I am also expressing my frustration and shock that the medical profession remain either ignorant or unwilling or hands-tied or that they are not looking beyond what they have unsuccessfully been doing for decades.... in the face of the problems that so many people face with their weight. I would not say that I am powerful enough to persecute an entire profession. Sophie
With you all the way on this one Sophie. I went to SW as a member first and then trained as a consultant for them and ran groups for over two years but have since seen the light. My weight rollercoastered while with them as I soon got used to the unlimited free food when following the plan but happily ate just as much chocolate, biscuits, whatever, when I wasn't following it. It definitely teaches you to overeat. I remember analysing members' food diaries and telling them that they hadn't eaten enough on weeks when they didn't lose weight - as that is what you are trained to do as a consultant, actively encourage more free food whether the member wants to eat it or not!ReplyDelete
I have since discovered Beyond Chocolate this March and have followed the 12 week ecourse handbook and the 12 week Overeating course. I am not actually losing weight yet as I haven't quite mastered the "stop when you feel satisfied" part - not helped by a flare-up of my ME and being signed off work for a month so far because of that - but I have learnt to accept myself at the weight I currently am and am maintaining that weight with no problem at all. This was unheard of in my dieting days.
It has taken a long time to rid myself of the whole overeating mentality but it has been so worth it. Telling people who are struggling with overeating to just continue to do it but change what they are actually overeating is definitely not a solution!
I wish the NHS would find the budget and sense to find a way of helping those of us who can't diet, especially those of us with eating disorders. All they can offer is paying for diet clubs or weight loss surgery. Even the psychologist at the surgeons clinic thinks the system is madness!ReplyDelete