This month’s case study is ‘Lisa’ who came to the Clinic wanting to lose weight.

Lisa’s story:

I had always been very slim and a size 10-12 throughout my twenties and thirties and since reaching my forties I had been gradually gaining weight and finding myself buying size 14-16 clothes. My lifestyle had always been very rushed – working long hours in London, commuting and not always eating the right foods because of lack of time.

What I couldn’t understand was why the excess weight was accumulating around my middle, and nowhere else. All my clothes felt tight and my waistbands very uncomfortable. I had tried several diet books and slimming programmes, none of which worked in the long term and have all been very difficult to maintain.

I was on the train coming home from work one night with the usual tight feeling around my waist and I read an article about ‘Fat Around the Middle’ by Dr Marilyn Glenville. As I was reading it, I found I could really relate to it and it just sounded like me – high stress levels, eating on the go and constantly on and off diets. This was the prompt I need to do something about it!

I called the Dr Marilyn Glenville Clinic and booked an appointment. I had read all about the link between high stress levels and gaining weight around the middle so I decided to perform the Adrenal Stress test before my initial appointment. The test kit arrived and all it involved was providing 4 saliva samples over a 12 hour period, which measured the stress hormone called cortisol.

I also had to fill in a very comprehensive questionnaire and return before my first appointment. The questionnaire enabled me to give my full medical history, symptoms I was experiencing apart from weight and importantly my current dietary habits. It was actually really valuable writing down my food intake and made me realise just how erratic my eating habits were.

My first hour appointment was broken down into sections. It started with the practitioner gathering information about me; explaining why I had been gaining weight, and then giving me dietary recommendations and a course of nutritional supplements. What I didn’t realise was that being ‘fat around the middle’ or apple shaped could actually be dangerous to my health, increasing my risk of diabetes, heart disease, stroke, high blood pressure and certain cancers. This really worried me because there is quite a strong family link with diabetes.

The practitioner explained the main reason some people gather more fat around their middle than others is specifically because of the action of the stress hormone cortisol and she explained that a fundamental reason for this weight gain is poor blood sugar control. When blood sugar increases (a result of the stress response or from what you have eaten), our body releases insulin to help move the glucose out of our blood and into the cells to actually provide them with energy. But if we don’t need that energy the body will store the glucose as fat.

If the stress continues (it usually does) cortisol levels remain high, so the body triggers the breakdown of sugar stores in the liver and muscles to provide further fuel. Out comes more insulin to deal with the extra blood glucose. It made such perfect sense as she explained that over time, the body simply can’t respond to insulin the same way it used to. We then become intolerant to insulin – or insulin resistant. It was recommended that I follow some basic dietary principles to help me lose the weight from around my middle. The main principle was to keep blood sugar stable during the day by always combining protein with carbohydrate (i.e. fish or beans with vegetables and brown rice) which I rarely did because I lived on pasta with tomato based sauces because it was low fat so I thought I was being healthy!

The second principle was to eat breakfast otherwise cortisol is produced and the whole blood sugar/insulin roller-coaster starts. Again, I rarely ate breakfast because I was always running late for the train or just not hungry. I suppose I had got so used to living like this my adrenals were just allowing me to ‘run on empty’. Something that surprised me was having to give up coffee and fruit juice. I thought I was being good by having my glass of orange juice each day and surely if my lattes were made with skimmed milk there are virtually no calories?!?

She explained that fruit juice is very concentrated which increases blood sugar and consequently more insulin needs to be produced and we’re back to the roller-coaster effect again. The same is true of caffeine – I had no idea that caffeine stimulates the same blood sugar response as sugar! So I had been doing everything wrong! I had been more concerned with counting calories and fat and eating a lot of starchy foods like bread and pasta which I then realised were not helping to keep my blood sugar levels stables and in fact were exacerbating my sugar cravings. The adrenal stress profile really helped me to understand what was happening to my body and the link between cortisol and the weight around my middle.

Each cortisol reading throughout the day was significantly higher than it should be which meant I was putting too much strain on my adrenals. In the longer term when the cortisol levels have been depleted, it can end up as to total exhaustion where symptoms of chronic fatigue can appear. I think seeing my results in black and white gave me the motivation to really make a change.

Finally, the practitioner recommended some specific vitamins and minerals and herbs to support my adrenal glands, blood sugar and cravings and weight loss. She also asked me not to weigh myself and rather judge my success by how my clothes fitted. This made so much more sense than hopping on the scales every day, which in fact was very soul destroying.

One month later I had my follow up consultation. In this time I had been keeping daily diet diaries that really kept me on track! I was definitely losing weight from around my middle as I could see some shape to my waist and my waistbands did feel more comfortable which psychologically made me feel more positive and motivated. I couldn’t believe that I was actually eating more food and losing weight!?

I was having breakfast, lunch and dinner with a mid morning and afternoon snack. My energy levels were also better and I felt less stressed and anxious, so better able to cope with the day to day work/life pressures. Three months on and I’m looking and feeling great. People have commented on the ‘new me’ and it’s given me a real boost to my confidence. I now realise that this is a way of life for me and I’ll never be tempted to follow quick fix diets!

Marilyn’s comments:

Lisa’s story is such a classic example of the women we see at the clinic where they have lead busy lives during their twenties and thirties, holding down stressful careers or bringing up their children and not really looking after themselves and really ‘living’ on their adrenals.

When they reach their mid to late forties the weight suddenly creeps up because they have pushed their adrenal glands to the limit. Of course it is not just purely down to lifestyle, because with age we lose more muscle mass which is essential to help us burn fat.

Although the diet is the most important area we focus on, we do recommend nutritional supplements and exercise to support and enhance how successful your outcome is. Successful weight loss is about looking at all aspects of your life, i.e. diet, lifestyle and stress and activity levels and making changes for the best outcome. So if you are caught up in the yo-yo dieting trap and you want to take control of your weight and life, then please do contact the Dr Marilyn Glenville Clinic. If you are interested in having the Adrenal Stress Test mentioned please click here.

The Christmas/New Year celebrations are here once again. The pressure to indulge in family feasts, cooked breakfasts and festive drinking is immense. If you’re not sure how you are going to make it through the festive season without stuffing yourself silly read through the following steps to help you survive the Christmas calorie attack.

You’ll see that you can still enjoy all the goodies of the season, interleaved with some sensible eating, and not put on a stone and spend the next three months regretting everything. So start your celebrations here, with 12 healthy eating tips for the Christmas season.

1. Increase your protein and fibre: One of the easiest and best ways to curb cravings and boost your mood and energy levels is to increase your protein and fibre intake. Make sure every meal and snack contains a little protein in the form of nuts, seeds, eggs, fish and legumes. And increase the amount of fibre in your diet to between 25 and 30 grams per day. More fibre means more whole grains, fruits and vegetables. Why? Because fibre delays the return of hunger and a meal with protein sustains blood-sugar levels; balanced blood sugar levels not only boost mood but are also the key to weight control.
2. Portion size: Instead of a dinner plate, choose a side plate. Remember to use the size of your clenched fist as a measurement for carbohydrates (rice, potato and pasta). For protein (fish, eggs etc.), use the size of your palm as a measurement, and from the knuckle to the top of your thumb for fats.
3. Eat regular meals: If you think skipping meals will help ward off winter weight gain, think again. Starving yourself during the day inevitably leads to ‘feasting’ or overeating at night. Anytime you allow yourself to get too hungry, it’s easy to over indulge. How many times have you eaten half a packet of biscuits while trying to decide what to have for dinner? So start the day with a good healthy breakfast and make sure you eat every three to four hours. Not only will you be less tempted by unhealthy snacks – mince pies, sausage rolls and so on you’ll be less tempted to over indulge at the big Christmas meal.
4. Get physical: Hibernating may be a natural impulse during the gloomy grey winter months, whether you live in a sub-zero climate or a winter-rainy one. Trouble is pumping the remote instead of weights and succumbing to the allure of comfort food when shorter days and longer nights induce feelings of depression, fatigue and cravings for sweets and starches which increases your chances of gaining weight. In fact many of us gain a pound per winter. And while this may not sound like a lot, those who gain during the coldest months typically keep the extra weight on and add more over time. Over the long run, this helps explain why our weight tends to creep up as we age, despite an active lifestyle. So try a different tactic this winter: Exercise for at least 30 minutes a day and resist the urge to hibernate. Take stock, and ward off winter weight gain and the blues. Switch off the PC and television and go for a brisk walk or Christmas shopping! Walking around in a large mall or shopping centre makes for great activity and great fun. Throw a Christmas Party. As host or hostess, you’ll certainly be getting in more than your share of activity for the day or night. Grab some friends and go carolling. Have a snow ball fight with your kids or if it isn’t snowing take them for a run around. Do any of the following, depending on where you may live: ice skating, sledding, skiing, power walking, swimming, bowling, dancing, rebounding, hula-hoop or disco dancing to Jingle Bell Rock.
5. Raise a glass: If everybody else is drinking make sure you have a glass of water (could be sparkling water with a slice of lemon) and drink that instead. Nobody will notice that you haven’t drunk much wine or that most of it is left at the end. Alcohol is full of empty calories but if you can’t resist the following tips may prove helpful. Try to stick to dilute fruit juices (can add sparkling water) or at least dilute a dry white wine with sparkling mineral water. During festive meals, especially on Christmas Day, accept a glass of wine but sip it just for toasts. Red wine is the drink of choice this season, but any benefits of red wine diminish after a couple of glasses, so don’t overdo it. Choose organic drinks when possible, as they have less additives/chemicals, which can cause headaches for some people. Remember that while vodka is the purest alcohol, it’s still a toxin. Choose pure fruit juice, mineral water as mixers, keeping away from the sugary, sweetened options. Don’t let others constantly top up your glass. Refill it only when you’ve emptied your glass, so you can keep a check on how much you drink. Alternate alcoholic drinks with water to help prevent dehydration and a hangover the following day. Don’t feel pressured into drinking if you really don’t want to. Avoid it altogether when driving, as bad weather and other drivers are more of a danger during the holidays. Sparkling water with ice and a slice of lemon or a Virgin Mary are good substitutes for an alcoholic drink, especially if you don’t want to be seen as a party-pooper. Avoid alcopops; they’re heavy on sugar, sweeteners and additives and are easy to guzzle in large volumes.
6. Clever party tricks: If you’re at a buffet stand as far away from the party food table as possible so you’re less likely to eat without thinking. If you can’t help stockpiling your plate with food then ask a friend or your partner to get the food for you. Remember you’re not at school any more so you don’t have to eat everything on your plate. Make your loved ones – not the food -the main focus of the party.
7. Keep reading the labels: But don’t be fooled. Are ‘lite’ potato chips or crisps really a great health option? You could save a worthwhile 20 calories on a packet – but they’re still a high-fat food, so go easy. At the supermarket, avoid huge ‘bargain’ packs of special biscuits etc. Buy smaller sizes and cut the temptation.
8. Out of sight is out of mouth: Hide away indulgent puddings, cream and other temptations in the salad drawer, so they don’t beckon every time you open the fridge door.
9. Keep your vegetable intake high: Serve two vegetables with each meal (try not to smother them in cream sauce), and put salad greens in every sandwich.
10. Stay fresh: Late nights, alcohol, smoky atmospheres and rich foods can take their toll on the way we look and feel. If you’ve had a particularly heavy night, try to take it easier the next day. Have lighter foods, increase your water and fresh vegetable intake and stick to whole grains, nuts, seeds, legumes and oily fish. Don’t keep celery just as an accompaniment for rich cheeses. Cut up a box of mini-sticks of celery, and nibble on them when you need a snack. Celery keeps blood pressure low, and helps lower cholesterol too. You should also try to have juices containing carrot, apple, beetroot, parsley and ginger to aid detoxification and provide the body with nutrients, especially vitamin C. And include herbs teas that can help settle the stomach: camomile, peppermint, ginger, fennel or green tea.
11. Christmas Day survival tips: Have bowls of nuts with dried fruit for snacking instead of the bottomless tins of foil-wrapped sweets. Raw vegetables with dips (hummus, guacamole or salsa) are a good alternative to pastry-based canapés. Don’t drink large volumes of fluid with your meal; this doesn’t help to ‘wash it down’; it dilutes your digestive secretions thus reducing their effectiveness. Remember to chew your food slowly and thoroughly. Chewing is essential for the digestive process and can help prevent bloating, wind and indigestion. Chewing thoroughly also reduces the likelihood of overeating as it allows the brain the register when you are full. If you want to stockpile your plate, do it with vegetables. Aim for a variety of colours and flavours. Vegetables are a great source of fibre, antioxidants, vitamins and minerals and you would have to eat vast amounts to get fat on them. Vegetables can be steamed and tossed in extra virgin olive oil or unsalted butter with fresh or dried herbs and sea salt and pepper. Steaming is quick and helps to preserve the nutrients. Use garlic and/or fresh or dried herbs for added flavour. If you must eat chicken and turkey, remove the skin, it is one of the fattiest things you can eat. Better still opt for salmon steak or nut roast on Christmas day. Use more vegetable-based stuffing as opposed to sausage meat or breadcrumbs. Use low-fat Greek or live bio yoghurt instead of brandy butter or custard in desserts.
12. Get some light: Too little sunlight can trigger cravings for high calorie foods and fatty carbohydrates such as cakes, biscuits and even ice cream. Most people find they eat and sleep slightly more in winter and dislike the dark mornings and short days. This is because diminished sunlight in winter reduces the brain’s production of serotonin, the mood-boosting brain chemical that helps suppress food cravings and overeating. Reduced levels of serotonin are involved in depression. Being exposed to an hour of outdoor light daily can help ward off the winter blues. Don’t forget that exercise can be an effective treatment for mild to moderate depression. People who experience winter depression can try combining exercise and light therapy by exercising outdoors when time and weather permit.

Enjoy yourself And whether it is the first or the twelfth day of Christmas remember the healthy eating golden rule: everything in moderation. A healthy diet for weight loss is a nutritious and varied diet.

Remember the 80/20 rule. You don’t have to cut out all the tasty treats from your diet that are around this time of the year – it’s just a matter of “everything in moderation.” Eat healthily 80 per cent of the time and you can afford to indulge now and again.

If you’re still hungry after dinner, go back for a second round of veggies. And, if you want a couple of chocolates, have a few. Just don’t end up sitting in front of the TV watching holiday repeats and finishing off a whole box on your own. Remember, this is the festive season. It is okay to indulge on the odd treat now and then, but if it becomes a daily trend then it is no longer a treat. You have worked hard all year and you deserve a break. Set yourself limits and work within these, but also have fun and set goals for the New Year.

It’s festive to use sweets, candied fruits, nuts, cheese balls and other condiments to decorate the house but do something different this year.

Instead use scented sachets, pine cones and primitive crafts that are inedible. The same goes for gift giving. Instead of sweets and chocolate give your friends an arrangement of dried flowers, a simple pine cone wreath or a framed picture and encourage them to do the same for you.