What are the NHS doing?

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.