The words that are bound to irritate when used by a HCP as a simple (for them) answer to shift responsibility to you.
Reminds me of being told, when reporting that there was more work to be done than time available, to "work smarter not harder". The implication being, of course, that it was my fault that I wasn't bright enough to fit all the work in.
The correct response of course, in both cases, is to take joint responsibility for solving the problem.
However I can report that eating less and exercising more can result in weight loss, as long as you go to uncomfortable lengths and have the time, physical ability, location and determination to go on a prolonged campaign.
I have been a bad person, and prior to the year end I have spent quite a bit of time away from home being tempted by the food normal people eat. My particular downfall was seriously good roast potatoes which lit up pleasure centres I'd forgotten that I had. My alcohol consumption was routine and fairly major (by NHS standards) of a beer or two during the day plus half a bottle of wine with my evening meal and perhaps a brandy as a digestif before bed. More on social occasions, obviously.
My HbA1c was 7.7 just before Christmas and my cholesterol 8.39; both way higher than recent tests.
[Noted to check further about cholesterol sometimes tracking HbA1c.]
Anyway I decided that I was probably drifting into a danger area and decided to have a campaign to improve stuff. Doing several things at once means that I cannot track which were effective and which weren't but I have another blood test scheduled 3 months after the last one to see if I really (in the opinion of the surgery) need to try statins again.
I am not a fan of statins, which is another reason to improve my overall numbers.
Anyway:
(1) Increase Metformin from (2 * 500 mg) to (3 * 500 mg). Two in the morning and one at night.
(2) Try to briskly walk at least 4 miles every day, or at least every other day. I am lucky to live by the sea, and a return trip along the promenade is 4.4 miles which makes for an easy exercise regime with minimum organisation overheads and cost.
(3) Cut out the booze - which has drifted to one smallish drink per day with the main meal. Psychological weakness on my part but a small glass of red or white wine sipped slowly removes the illogical cravings without hopefully doing too much damage. This hopefully will let my liver get on with its main functions to do with glucose and cholesterol without being derailed to handle metabolic poisons.
(4) Eat very little. Current regime is:
- Strong coffee with butter and double cream around 8-9 in the morning. Take 2 Metformin with this.
- Apple or similar around 2 if I am feeling desperate.
- Lidle roll with protein filling around 4-5. Salad sometimes but not always. Metformin with this.
- Small drink with meal (sometimes, not always)
- Drink plenty of fizzy water (big green bottles from Lidl) with a squirt of lemon juice (yep, Lidl again) in each.
I have noted that moving my main (only?) meal to between 4 and 5 ties in with a recent theory about this being better for you because of the longer fasting period between last meal of the day and first meal of the next. For me this could be around 16 hours.
It is (unsurprisingly) working at the moment, in that I am losing something like a pound every other day. Some days I lose a pound a day. So far the very dense meal of a Lidl roll and protein seems to fill me up for a few hours, and then it is just a battle of willpower not to snack on anything before bed. Keeping extra busy helps.
So far I am more alert. However a constant nagging hunger can do that to you.
I seem to be sleeping better, but then again not drinking alcohol later in the evening probably reduces bladder pressure and I suspect that when the liver has finished processing alcohol somewhere in the middle of the night and switches back to more normal functions this can disturb sleep. Hot flushes and the like. So lack of that will help.
If I can hold the line and lose even 4 lbs per week then my long term target weight may be achievable.
I have always wanted to get down to 11 stone 7 lbs.
The nearest I ever got was 11 stone 10 lbs.
My starting weight this time was 12 stone 10 lbs, and I am now down to 12 stone 5 lbs.
Of course, the first few pounds are generally the easiest and then it gets progressively harder.
Am I happy?
I am struggling against being totally miserable.
I feel good after my brisk walk, but that wears off.
The rest of the time I am constantly aware of denial.
Food has been a traditional reward and celebration in our society, especially sweet things.
Birthday? Cake!!
Alcohol has always been built into society as well.
Bad day mate? I'll buy you a beer to drown your sorrows.
Promotion? Champagne!!
Wedding/birth? (Hopefully not on the same day). More champagne!!
So I am in the traditional mode of "Give up smoking, drinking and sex and you may not live to be 100 but it will bl**dy well feel like it!".
It feels as though if this campaign really improves my numbers then I will be faced with the choice of health or pleasure/comfort and I'm not convinced that I can countenance a regime of constant denial for the rest of my life.
So "eat less exercise more" may be (when you really push it) a way to lose weight but is it sustainable? It certainly isn't the easy solution that non-combatants sometime present it as.
Anyway, this rant has distracted me for a while which can only be a good thing.
