Katie Hopkins Says It As It Is About Obesity

I'm not one for looking at reality TV shows of any kind but one late night found me meandering over Katie Hopkins and her strange quest to gain and lose weight to prove that if you have the will it can be done.


In part of the programme she ran the gauntlet of 4 large ladies for committing a hate crime by insisting that at their size they couldn't possibly be healthy, or at least not for long.


Then she made mincemeat of a psychologist claiming to specialise in eating disorders. I think that this expert was trying to change Katie's views about people's failure to lose weight. The best that this psychologist was able to do was declare Katie as lacking in compassion.

 "Would I employ you if you were obese? No I would not. You would give the wrong impression to the clients of my business. I need people to look energetic, professional and efficient. If you are obese you look lazy."

 "To call yourself ‘plus size’ is just a euphemism for being fat. Life is much easier when you’re thinner. Big is not beautiful, of course a job comes down to how you look."


This set me to thinking and I did a straw poll here at our offices. We would employ people who are overweight but the larger the person,  the more the hesitation. They say that when we make decisions about staff, the decision is made in the first 15 seconds. We have about 15 seconds to make an impression on an employer. There is a tipping point between yes, perhaps, and no. The larger a person is, the more something else has to be there, like a fabulous smile, radiant hair, and a sparkle in their eyes.


Is this right? Maybe yes and maybe no, it is how it is, the world was never fair.


I deal with this controversial issue at our trainings. Can we have an obese eating disorder therapist or an obese therapist helping someone to lose weight.  Everyone wants to say yes of course, good therapy is not about what someone weighs. But they are probably thinking NO.  This applies to therapists who are underweight just as much as it applies to therapists who are overweight. Would you want your anorexic daughter to be treated by a skinny minny who lives on mung beans and salad?


I found myself leaning toward Katie for her ability to say what she thinks. It's controversial but it should lead to honest debate. I work with people who can't lose weight and I often find that many people do what is easiest because discomfort of any kind is hard to bear.  To walk instead of sitting in front of the TV, to give up drinking alcohol which is laden with calories, to refuse to pander to children who demand their daily dose of crisps ......is just too hard so we give in to a need for comfort that is VERY, VERY deep.


The current focus of science is to try and find reasons for obesity which are not anyone's fault like genes or hormones. This demonstrates that some people have a harder job to maintain their weight than others so they look at people who are slimmer and say they're lucky. But that isn't true, many people who are normal weight work at it all the time like, learning how to cook, and it has become their habit. At the heart of it all, some people cannot tolerate discomfort.


Katie hasn't said that obesity is anyone's fault ... I think....but I think she is saying that you can run but you cannot hide.  The Health At Every Weight philosophy is one way of hiding, because if you are too thin or too fat you probably aren't very healthy. The it's in my genes approach is another way of hiding. Some parts of us must be accountable;  and if you cannot be accountable you are........ unaccountable with whatever that implies. Or you prefer to live your life with less discomfort.


Oh heavens, Katie got inside my head. Take her out someone before I lose my friends!

More About The Personalised Diet

The more I look at this programme the more worried I am becoming. There is some good stuff in it. There are strategies that benefit everyone, like eating slowly and mindfully, teaching people to eat while doing nothing else, finding out that many normal people compensate for exercising by doing less later -hoho!


But I am still absolutely flummoxed by the science behind putting constant cravers on an intermittent fasting programme.  Where is the research behind this? We learn that this group of people are always looking compulsively at food, at people eating it, at shops selling it.  I think we need to know more about it. It is like an obsession. Is it just about lacking leptin sensitivity?   Perhaps the ancestors of the constant cravers were trapped in a famine.


Perhaps the constant craver is behaving like an addict. Perhaps the constant craver has problems in the  opioid centres of the brain. Experts call it Reward Deficiency Syndrome.  Why didn't they think about that? The so called experts have PICKED OUT BITS OF THE PHYSICAL PUZZLE which suit their programme. But have they looked at the whole map?




Either way if you are a constant craver it seems to make sense that you need to eat frequently but a diet very high in protein and complex carbohydrate too. You need to wear an elastic band on your wrist and snap it whenever you NOTICE you are looking at food. You need to keep binge food out of the house.


Intermittent fasting will make the cravings even WORSE. Oh sure you will lose weight while you do the diet, but you will become even more sensitive to the sights and smells of food. I've a lot of research to prove this point.


OK I'm not trying to dismiss the whole programme, but I'm also something of an obesity expert and I'm asking valid questions. You people out there also need to be asking questions and wondering if these world class experts may have sold their souls to the BBC for the money they will be making out of this programme. They are telling a sort of lie, which is that a particular DIET suits different types of people while the work they do in the background suggests that many more psychological interventions are necessary for someone to lose weight and keep it off. And these other strategies are not just "CBT"

In Search of The Best Diet For You

In Search Of A Personalised Diet BBC Horizon January 2015. 

Have we finally found the Holy Grail of weight loss?  Is this the way to personalize eating plans which fit the individual and will help them lose weight? An army of world famous weight loss experts cannot surely be wrong. Can they?

Well let’s see.

We are now in the dieting months and I’m already sick and tired of all the diet plans I’m seeing.  There is the Ice Diet being promoted by Peta Bee in the Times – sorry Peta, bad science. And even a diet called EAT! Which is just another variant on the low carb diets.  These diets are one size fits all and take no account of personal genes and nutrient responses. They are designed to fail in the long run, as all fervent followers will discover. 

A few years ago, the BBC ran a diet trials experiment at the University of Surrey which compared different types of diets for success. There was a clear winner which I won’t mention now but the take- home message in the long run is that different types of diet suit different people. People who don't like detail do well with a diet like Atkins, while some types of people do really well with a group approach. But in the long run it’s pretty much all the same. Failure, that is, for most.

So here we have an all-singing-dancing world expert scientific approach that is new. Do people really divide themselves into three obesity types?  The first “cant-stoppers” who are low on gut hormones. The second “constant cravers” who probably lack a good leptin response (science here) to tell their brains they aren’t hungry.  The third, “comfort eaters” who meet the day to day stress in life by using food as a feel-good drug.

Perhaps. They have all lost weight, HURRAY  - but that proves very little; it was poor research design, and the proof of the obesity pudding must surely be in how well they are able to keep it off.  Oh well, it makes good TV but probably very little else.

Professor Susan Jebb is an expert-expert on obesity but has said that losing weight is not a matter of will, but of habits. People have to change their habits for life. I know that, and part of the therapy I do is to help change habits from very deep inside.  This is useful for everyone and flexibility training was missing from the treatment given to these subjects.

But there is a whole new science of willpower – known as self-regulation theory which is available to obesity specialists and which is helping people to use their willpower to change their lives.  This can help comfort-eaters, constant-cravers and cant-stoppers too.  Why was this ignored?   So what’s going to happen to these happy weight losers?  Will they have to stay on their diets for life, an impossible task surely, unless they learn how to exercise their WILL.

I like it when people feel they have done something valuable and positive. Who could fail to be moved when men weep real tears by having help and support. But is this real science when it ignores real psychological strategies that work, like flexibility training and self-regulation training. Is the Intermittent Fasting Regime really the right approach for constant cravers  - WHY- and is group work alone correct for people who have failed to develop better ways of managing the stress of life and living with other people?  Who said it was?

So for me the jury is out.  Some bits of this interesting programme hold out hope for people who cannot lose weight.  It's good for someone to know that they may be lacking in a gut hormone that helps them to feel full.  Its good to suggest that an emotional eater is not just weak-willed and greedy. It may be useful to know that a constant craver might not be feeling leptin in their brain.

But I’m waiting for 18 months down the line to see if you can change habits (as Susan Jebb suggests) by putting people on a diet that suits their “obesity phenotype.”

World experts should know better than to suggest that what they have done is a solution. It is just one of a number of things that must be properly explored in properly designed clinical trials before we can truly discover a personalized solution for obesity. And we experts know better than to think that any single diet can provide a quick fix even when the experts say "genes".

Sugar Addiction

Are you a sugar addict?


Can you be addicted to sugar?




There is a robust review on the subject commissioned for the National Institute of Mental Health in the USA which should settle the matter. There is only  weak association of attachment to sugar among people who diet or restrict carbs, while sugar given freely in a balanced diet may have no influence on behaviour such as escalation, tolerance and withdrawal.

Evidence for Sugar Addiction: Behavioural and neurochemical effects of intermittent excessive sugar intake. Neuroscience Bio behavioural Review 2008 32(1) 20-39 published online 2007 Avena, N., Rada, P. and Hoebel, B.

Psychologically speaking, work on the subject of sugar addiction by Terence Wilson published in Binge Eating, Nature and Treatment edited by Fairburn suggests that the so-called addiction to sugar is largely psychological. People only lose control of eating sugar when they BELIEVE they have eaten sugar, demonstrating NO evidence of intrinsic addiction to the substance at all.

The role of sugar in the hedonic systems of the brain are not equivalent in effect or severity, as drugs like cocaine and nicotine, even though there is an effect on endogenous dopamine.

Sugar is present in many foods such as vegetables, potatoes, tomatoes, lentils and other pulses so eliminating sugar from the diet seems impractical. Sugar is not equivalent in its physical effects as fructose including high fructose corn syrup further confounding the evidence.

Sugar-fat combinations are as potent in promoting the surges of endogenous dopamine as sugar alone if not more so. Thus there is danger in focusing solely on the so-called addictive properties of sugar. Based on a macronutrient analysis of binges by Susan Yanovski in 1998, it seems that it is fat which binge eaters really crave when fat is made palatable by sugar.

Thus while clients talk in the language of addiction to sugar,  the evidence-based success of cognitive and cognitive-emotional / behavioural treatments for compulsive eating warn us of the dangers of focusing on sugar as an addictive substance. Addiction approaches to treatment which ask you to remove sugar and white flour from the diet might be unhelpful. It keeps people well only when they continue to restrict their diet. This approach merely fosters the all or nothing thinking that pervades eating disorder work.

 I used to get sugar cravings long ago, but I know now that it was just too much dieting.  I now eat a broad diet which contains all nutrients including a reasonable amount of refined sugar. And I'm fine.


But if you think you are a sugar addict and need help, call us on 0845 838 2040 OR  visit www.eating-disorders.org.uk

Intermittent Fasting: Our Professional Opinion

Hello everyone.


For an in depth overview of our latest opinion of Intermittent Fasting, follow this link.


http://eating-disorders.org.uk/intermittent-fasting-if-our-version/


We can tell its summer here, the phones have gone quieter. Does this mean that people aren't worrying about their weight and their eating?  I don't think so, this is the time of the dreaded swimming costume; this is the month of ice cream and holiday splurging.


What have I been doing? I've been reading two separate accounts of anorexia which the writers wish to publish. I have been immersed in their private and intense suffering. What a terrible illness anorexia is, I'm so ANGRY with it and so SAD about it.


What is clear to me that Anorexia is the tip of the iceberg. The ONLY reason anorexia comes in to someone's life is that there is a fundamental weakness in someone's ability to manage life and other people. Life is stressful. Relationships are the source of joy and also pain. We need a web of confidence and inner strength to be able to cope with it all. Anorexia is a story of holes in this web. We all have some holes but if there are too many holes the web caves in.


Different stories, but the same symptoms, the same presentation, the same pain. Do we need more accounts of anorexia to help us KNOW what to do about it? Your thoughts appreciated.


Happy holidays...

Anorexia Recovery Guest Blog

Hannah Brown has posted a guest blog about anorexia recovery which she equates to restoring a stately home. What a beautiful metaphor.


You can read it here at  http://eating-disorders.org.uk/weight-restoration-guest-blog/


If you can read this and share it with someone you know, you might save their life, or save your own.


Love to all

Obesity And NICE or, One Gramme Of Gold

Lots in the press this week about NICE guidelines for Obesity and  sleeping in the light makes you fat. And, British girls are the fattest in Europe and they wear less clothes than any other Europeans as well which it is obvious to anyone going to Benidorm.


Sorry about that, but I think it's true. And as for the boys (but that's another story).


Then the Times today publishes findings that low fat foods full of sugar have more calories than normal foods, as if some of us didn't already know. Because some of us do read the labels.


But many people don't. (Read the labels, not wear less clothes). So the advice to visit the slimming clubs on the taxpayer's account to lose 3% of body weight might make sense if you are delivering information and wisdom  to the ignorant and the cheated.


But I genuinely (based on real sound evidence) do not believe that people will sustain 3% weight loss, much of which will not be fat at all. People won't look better and they won't feel better which is why they want to lose weight in the first place. And, many people who are prescribed the slimming club at the cost to taxpayers don't really want to control their eating in the long term. They just want to lose weight so that they can start eating and drinking their favourite foods again.


They must be another way, which has been ignored. I'm training 70 obesity professionals this week about ways to help people lose weight and keep it off. There is, sadly, no quick fix.  We will all be fatter until society begins to change. Or, like the Qataris, give each weight loser one gramme of gold for every kilo they can keep off ....in one year.


I've written a bit more on our website blog  at http://eating-disorders.org.uk/obesity-and-nice/