Wednesday, March 22, 2006

The Diet

She: I want to go back on them slimmin' pills I had last year. While I was takin' them I could loose the weight. When Dr X stopped them I put it all back on again.

Me: O.K. so what are you doing to loose weight now?

She: Well I'm still on me diet, an' I go to the gym three times a week.

Me: I see, what is your diet at the moment?

She: 'ealthy eatin'.

*continues in response to the Dr J Inquisitorial eyebrow raise (TM)*

Tha's muesli wiv' skimmed milk in the mornin', sallad an' that for lunch, and a proper cooked dinner.

Me: O.K. (see I'm being really good today, oozing empathy and Royal-College-of-GP-ness) and how many Calories does that work out to?

She: *blank look*

(In a tone that suggests I just asked her to drown baby kittens) Oh, I don't count Calories.

Me: *lightbulb clicking on overhead* I think we've hit on the real problem here.....

And so the consultation went on. You get the picture. So here's the (as our cousins across the pond so serendipitously call it) skinny. Loosing weight is all about a ridiculously simple equation.

Calories out > Calories in = weight loss.

So be it "cabbage soup", "F Plan", "Atkins", "GI", "Mars Bar" ( a personal favourite), "That bird off the telly", "Hi Fibre", "Lo Cholesterol", "Very small stones" (o.k. I made that one up) or "what ever the hell else you like" diet, the key to the whole exercise is to reduce the enegy value of the intake below what your metabolism is currently burning.

Now I'm not for one minute pretending that makes the process of dieting easy, but I remain convinced that anyone who tells you it can be done without at least some attention to Calorie intake is conning you.

The consult ended with me agreeing to supply the Xenical she had last year to kick start the process, and with her (I hope) going away to really look at her intake afresh. Personally I'm not a great fan of slimming pills, especially not the ones derived from amphetamines or thyroid hormones, but Xenical I can just about live with.

Oh and for information the Mars Bar diet-- three normal sized Mars Bars equate to around 1200 Calories. So eat three a day- and nothing else- and with effort weight loss should be entirely possible.

Just don't tell your dentist I said so.


Moof said...

Very nice blog! :o)

Found you through a comment left on Dr. Crippen's blog a few days ago ... and glad I did.

Blogrolling you.

Doctor Jest said...

Thank you for those kind words. Glad you like the ramblings, and duly honoured.

pink said...

i want slimming pills too... amphetamine based ones please ;)

Doctor Jest said...

In the words of Faye Dunnaway (in Little Big Man) "That way lies madness" pinkie.

The line always sounds better with a southern drawl somehow.I know she wasn't talking about speed, but the message is the same. Just say No!

Trust me.... (you know the rest) :-(

Happystance said...

Hmm - what are you going to do with the recent NICE approval for weight-loss surgery for teenagers and diet-pills for the under-12s where appropriate?

I realise that diet pills (for want of a better term that encompasses something that blocks fat absorption or reduces appetite) as supposed to be part of a strategy, rather than the whole solution. What is it about the drugs or the way patients use them that makes it difficult to support a change in eating habits?

In Italy, 'balloon surgery' is so popular and believed to be so safe that it is being offered to people who are overweight rather than obese. Some doctors reportedly support this extension of use as prophylactic against obesity and the development of co-morbid conditions.

So, in the future you may have consultations where people ask for a balloon rather than a calorie counter or diet pills. Will you tell them to go fly a kite or give up the struggle to re-iterate the fundamental equation of calories in v. calories out?

Struggling with the image of Dr. Jest, saying, "Sure, hop on the couch. I'll insert the balloon and fill it from the sink tap myself...".

Doctor Jest said...

happystance-- We live in an age of plenty, where instant gratification has never been easier, hence the rise in obesity a nd the increased demand for artificial "fixes" for the same. Baloon gastroplasty has a lot going for it on the surface. It's minimally invasive, and "retrains" the patient to eat less by making them feel fuller quicker.

Still, once the balloon is out I remain unconvinced that, without further attention to diet old habits are likely to reassert themselves.

After all, we have spent milennia of evolution seeking High energy foods and regading fatness as good/desirable (cf Reubens nudes), so the odds are rather stacked against us in the "war on weight".

weight loss said...
This comment has been removed by a blog administrator.
Doctor Jest said...

Two "advertorial" posts removed. This is NOT that sort of blog peaople. Please don't do it again. k thx.

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