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We never repent of having eaten too little

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“We never repent of having eaten too little”– Thomas Jefferson

Health promotion is an important aspect of any GP’s job, be it advice on smoking cessation, weight loss or dietary advice.

When it comes to dietary changes, ‘eat less, do more exercise’ is the advice I’ve given most people. But despite recommending this to my patients, I have struggled to shift the weight I’ve gained over the past year.  I have never considered doing a diet, mainly because most of them involve eliminating a major food group, and often cause ‘yo-yo’ weight changes.

Many diets are promoted, such as: Atkins, Beverly Hills, Dukan, Grapefruit, Low Glycaemic Index, Weight Watchers and the Zone to name a few.  In the US, the diet industry is a multi-billion dollar business – profiteering on the fact that only 5% of diets actually work.1 This failure allows the diet industry to profit from this ‘globesity’, because a familiar cycle usually develops. People start a diet, lose weight, gain it again and then look for a new diet.

Recently, I watched an interesting episode of Horizon fronted by Dr Michael Mosley, a diet sceptic, who introduced and appraised the 5:2 diet. It is based on the idea that intermittent fasting can lead to weight loss, reduction of blood pressure, cholesterol and glucose levels, reduced levels of IGF-1 (which leads to accelerated ageing) and switching on DNA repair genes. 2

For five days normal feeding occurs, but for two non-consecutive days, between 500-600 calories only must be consumed.  After six weeks of dieting, Dr Mosley lost well over a stone in weight and significantly lowered his cholesterol levels. Despite his initial scepticism, he seemed encouraged by the results he saw personally, as well as the clinical outcomes from animal model trials in the US, and as such I felt swayed enough to try the 5:2 diet for myself.

My initial aim was to try the diet for six weeks. My start weight was 101.1kg with a BMI of 31.2 (class 1 obesity). If I want to aim for a BMI of 24.9 to be normal weight, I would have to lose approximately 20kg, so I feel that aiming to be just ‘overweight’ may be sufficient for now.

In fact, I have done one week of the 5:2 diet without any significant problems so far, but it’s early days.  I don't feel too bad at the moment – after all, it's not like I'm starving myself, I’m just eating less calories. When I checked my weight this morning I found I had lost 1.8kg already, although I'm sceptical as to whether that is just ‘water weight’. The six-week point will be the best value to look at – I will let you know how I’ve done at that point.

Dr Avradeep Chakrabarti is a GPST3 from Swindon

References

1         Marianne Kirby. Investors in obesity industry are sure to make a profit. The Guardian 2012. http://www.guardian.co.uk/commentisfree/2012/jul/18/business-obesity-big-fat-profit

2         Dr Michael Mosley. The 5:2 diet: can it help you to lose weight and live longer? The Daily Telegraph 2012. http://www.telegraph.co.uk/lifestyle/9480451/The-52-diet-can-it-help-you-lose-weight-and-live-longer.html

Readers' comments (8)

  • Although I think "intermittent" fasting is a misnomer - it is (or should be) a proper 24 h fast, the benefits has stood the test of time like no other "diet": Cancer; Metabolic Syndrome; Ageing, all benefit. I also recommend patients to exclude supplements on the fasting days as it seems that the underlying mechanism is in putting the body under mild stress.

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  • I very much doubt I could stomach (pun intended) a 24 hr fast, especially whilst working in a busy practice!

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  • Following Michael Moseleys programme my husband tried this regime( which does allow 600 calories on a fasting day) and has successfuly lost 8kg. Awaiting blood test results!

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  • I personally swear by the Butterfield Diet. http://www.youtube.com/watch?v=wtF3_ybJJ50

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  • It is important when 'dieting' to do weight bearing exercise to at least maintain muscle mass. Failure to do so means muscle mass is lost as well as fat. Also, when fat (not weight!) is lost, the calories needed to maintain the new weight are lower than before the diet. Failure to take both these factors into account is the explanation for rapid rebound when the diet is stopped.

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  • I have lost 42 lbs (3 stone/19 kg) by using my fitness pal. It is an app which calculates how many net calories you need and then you make a food diary. I am more mindful of what I put in my mouth, enjoy adding my exercise as I am then allowed more calories, I haven't cut anything out and feel fabulous. I will be recommending this method of weight loss to my patients when I return from mat leave in the new year. It is just about sensible quantities and eating properly.

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  • Good luck with your plan! Could I point out though that as you are a GP who may be referring patients to weight loss programmes, you are wrong to say that the Weight Watchers plan involves missing out on a major food group. Neither does Slimming World, Rosemary Conley or other mainstream slimming clubs, which have referral systems in place with the NHS in many areas.

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  • I agree, we have some excellent NHS programmes which I do use such as FAB and LEAP (education and exercise) I was more referring to things such as the Atkins and others that the author mentions. Weight watchers etc are very good as they work in a very similar way to calories ie point system and you have the added benefit of group support and motivation which cannot be under estimated. I have watched some very helpful programmes such as the Hairy Dieters and 'Men Who Made Us Fat' over the past few months.

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