You do realise that BMI is a statistical tool and not a diagnostic one right?
According to the NHS report, Statistics on Obesity Physical Activity and Diet 2018, 26% of adults are classified as obese. When you look at the split between men and women that numbers get even more interesting, a higher percentage of women than men are obese (26% for men, 27% for women) but a higher percentage of men are classified as overweight than women (40% for men versus 30% for women).
So what does this tell us?
Considering the UK is sixth in the world obesity rankings (with the United States topping the charts) the situation has given rise to some controversial headlines, with national newspapers such as The Independent and The Guardian dedicating significant space for the discussion, but could it be that we've got the question of obesity completely wrong, or at least looking at it from a skewed perspective?
The 2018 NHS report holds the key, and on further examination (rather than just sound bites from news reels and click bait headlines) could it be the very way in which the conversation around obesity, and creating strategies to deal with it, be a part of the problem?
Consider the opening statistic I gave you from the NHS report, 26% of adults are now classified as obese, when you take into account that is a 15% increase since 1993 it sounds like a lot.
If that continues exponentially then we are certainly heading for an obesity epidemic, just like the experts predict. Yet you'd be missing one important fact also stated in that report, obesity levels in adults have been similar since 2010. No drastic increase, in fact it's stabilising.
Now lets look at admissions to hospital. For admissions into hospital where obesity is the primary diagnosis there is an 8% increase since the 2015/16 report, with 3 out of 4 admissions being women. When it comes to hospital admissions where obesity is a secondary admission there was again another increase, this time of 18% (women accounted for 2 out of 3 admissions). Here's where it gets fascinating.
Barbiatric surgery is often used to facilitate weight loss (though it is often used for other health conditions) It includes stomach stapling, gastric bypass, gastric band maintenance and sleeve gastrectomy ( ). Barbiatric surgery is used for for people with a BMI of over 40, or those with a BMI of 30 - 40 and secondary diagnosis such as type 2 diabetes, or heart conditions.
There NHS has seen an increase in this type of surgery too, in fact a 5% increase than in 2015/2016. Yet the report clearly states that this is still a 23% decrease when at it's peak in 2010/2011.
So now lets talk about medication for a moment.
"401 thousand items were prescribed for the treatment of obesity in primary care in 2017. That is 10% less than in 2016 and continues a downward trend since a peak of 1.45 million in 2009.
In real terms, the Net Ingredient Cost (NIC) to the NHS in 2017 the cost was 6.9m GBP, which has fallen from 9.9m GBP in 2009 and 51.6 million in 2007.
That's a 87% decrease in cost - so either the NHS was paying
an exorbitant amount for prescriptions or all of a sudden a lot of obese people suddenly
Now consider that since 2001, death rates from heart disease and stroke have halved for both men and women in the UK, yet the rate of obesity in adults have remained at similar levels since 2010, you can see that something doesn't quite add up.
Are we turning now to less radical non-clinical interventions?
That could very well be. But what does the report tell us? 39% of adults were actively using a weight management aid - with the second highest being gym and exercise. Diet clubs, NHS services and local weight management programmes were at the bottom of the list. There is clearly room for improvement here.
Obesity is now "disease of the poor" and experts warn it's because healthy food is too expensive
That was an actual headline from the UK tabloid newspaper, The Daily Mirror. This belief was also propagated by celebrity chefs such as Jamie Oliver, who was quoted as saying that,
"Obese poor think in a different gear.
No, for real. That's apparently a legit quote. If you want to continue to feed the stereotype of fat people being, stupid, lazy, ignorant, poor and incapable of helping themselves, this would be a great way to do it.
Lets dehumanise obese people, and slap them in one big box so that that we don't have to deal with the complex reality of the situation. Here's the thing, the NHS report doesn't exactly support this view of obesity being related to class - not when it comes to adults anyway.
The report highlighted that with adults obesity and area deprivation varied between women, but not so with men.
What does this look like? 38% of women were obese in deprived areas compared to 20% in less deprived and affluent areas. But when it came to the men, regardless of deprived area or class status the prevalence of obesity levels remained pretty consistent at around 25 - 29%.
So what does this potentially tell us about obesity in adults? That income level is not defining, and other factors such as gender come in to play.
Poor people being fat, lazy and incapable and "wired differently" is an easy narrative trap to fall in to. But that doesn't make it right, and doesn't make it ok.
So how did we get to this? Well, when the NHS report looked at the levels of childhood obesity is noted that childhood obesity had fallen in reception year, but increased in for Year 6 since 2009/10. They then mapped this across to deprived and less deprived areas and found that the higher prevalence was in deprived areas.
This is something that needs to be addressed. But I strongly believe educating on food that is readily accessible and how to make better food choices that are within your budget, without having to resort to snorting wheatgrass and pissing prana energy is key.
Not only that, but we need to take a 360 degree approach. I wonder ow many people have had a traumatic life event, such as a death, abuse, fleeing from war or relationship breakdown and felt their life fall apart at the seems, with their self care spiralling out of control.
Simply telling them that,
"You need to eat less calories. That's why you are fat - and get more active ya lazy bastard"
Isn't going to be the most effective strategy, nor the smartest one.
Plus, what experts not working in the trenches often fail to realise is that there is a false belief that your diet needs to be perfect. Not so.
Most people already know that they aren't going to be perfect - so why try? Or if they do, it is an "all or nothing" approach, and when they fall off the wagon, they resort to eating habits that impair their health.
Your diet doesn't need to be perfect. You just need to remember that your nutrition exists on a continuum
Worst option ---------->Better Option-------------> Best Option
Do what you can, with what you have, and start where you are. If it's not simple it's not sustainable.
So what's my point? I'm not one hundred percent sure. I'm just here to clear up some myths and provide perspective.
" I love sleep. My life has a tendency to fall apart when I am awake, you know?
Your mind is foggy
Lack of sleep (sleep deprivation) or prolonged wakefulness (sleep restriction) can result in reduced alertness and concentration, impaired judgement, and forgetfulness.
(Sleep Deprivation: Impact on Cognitive Performance: Alhola et al: 2007)
Heightened stress, impaired regulation of emotions, low mood, and possible increase in risk of depression are signs that your sleep hygiene may need a check up.
(Cumulative Sleepiness, Mood Disturbance: Dinges D. et al: 1997)
You get ill a lot
Sleep and the circadian rhythm wield a strong regulatory effect on the immune system through various mechanisms within your body. When you don't get enough sleep you have an increased risk of vulnerability to viruses and bacteria, increased illness, increased risk of heart disease and other inflammatory diseases.
(Sleep and Immune Function: Besedovsky et al: 2012)
You are struggling with your weight
If you want to lose weight, addressing your sleep hygiene is key. Lack of quality sleep has been shown to decrease glucose tolerance, disrupt your hormones and metabolism, including insulin sensitivity, hunger signalling, and your body's fullness cues.
This can all result in your consuming too much food, and also not being able to utilise it for energy effectively.
(Sleep and Obestiy: Becutti et al: 2013)
Your sex drive has dropped
While research is inconclusive, sleep deprivation has shown to impact sex drive in men through various mechanisms, with little or no impact on women. So if you find that your sex drive has dropped and you are just not in the mood for sex anymore, or that you are experiencing erectile dysfunction, this could be a contributing factor.
Your workouts feel way too hard
While research shown mixed results on how sleep restriction impacts your performance, a slower reaction time, low energy, reduced desire to exercise, and faster onset of fatigue are common with reduced sleep.
(Sleep and Athletic Performance: Fullagar et al: 2015)
But you can turn it around...
Get It In!
The recommended amount of sleep is 7 - 9 hours. While there are some who can function with slightly less. Research has show that for many less than 7 hours sleep can result in impaired health, mental and physical performance.
If you are not there yet, not to worry. Simply adding a further 30 minutes to your sleep and gradually building up until you get 7 - 9 hours sleep can help greatly.
Clear Your Mind
When your mind is busy with thoughts from the days activities or challenges you are currently facing, your brain is in the beta brain wave state. This can prevent our brain from slowing down and falling into a Theta brain wave state (common in deep meditation and sleep) or delta brain waves which are what we experience in deep, dreamless sleep.
Did you know that healing and regeneration are stimulated when we are in this state?
Having a "brain dump" before we go to bed, by writing (on paper or a journal) or recording voice notes so that we clear, or at least unburden our mind, can be a very powerful tool to promote healthy sleep.
Get To Bed
Going to sleep at a regular time before midnight can help to train your body when it's time for bed, and signal to release hormones that help to promote sleep.
Eat A Small or Medium Dinner
Have you ever noticed that when you have eaten a big meal and gone to bed, that while you may feel sleepy you struggle to fall to sleep?
Well, for one, now that your stomach is full with food it will be difficult to actually find a comfortable position, and second your stomach is actively digesting your food.
By having a small or medium sized dinner at least 1 -2 hours before you go to bed you can avoid feelings of discomfort and bloating.
If you consume a lot of fluid before you go to sleep you will wake up during the night for frequent bathroom breaks. This disruption to your sleep patterns can effect the quality of your sleep and how much you get.
Turn of Electronics
Remove your eyes from electronic devices at least 30 minutes to 1 hour before you go to sleep. The artificial light can interfere with your production of melatonin which ensures deep sleep. Using a blue screen filter on laptops and computers and mobile phones is also recommended.
Make Your Room Dark As Possible
Light pollution can impact your quality of deep sleep. To optimise deep sleep make your room dark as possible by switching off electronics that have lights, turn phones face down if left on, use black-out blinds or curtains where you can.
Never underestimate the power of a good nights sleep to boost your health, your relationships, mood, fitness, sex drive and weight.
Step 1: Identify and correct nutritional deficiencies
Nutritional deficiencies are more common than you think.
Whether it's a case of not getting the right amount of vitamins and minerals (known as micronutrients) or the right blend and amount of fats, proteins and carbohydrates from our food (known as macronutrients).
In the UK the Department of Health has established DRV's (Dietary Reference Values) via the Committee on Medical Aspects of Food and Nutrition. These set of guidelines of what are required to maintain health, but remember your requirements can change according to your physical activity level, whether you are ill or not, and what stage you are in life (certain nutrients are required more in different stages of life).
Blood, saliva and urine tests can uncover potential deficiencies.
As a Nutritional Therapist, here are some of the more group of deficiencies that I come across with my Nutrition Coaching clients
Put simply, when we don't get the right nutrients that we need in the correct amount then we suffer, but when we do , that's when we set ourselves up for a win and thrive.
If you are not ready (or able) to get testing done, then I have some suggestions for you which are a great place to start. Choose which one's works for you.
Drink More Hydrating Fluids - water intake is key.
Nutrient Density And Diversity - eat a variety of wholefoods, get those vegetables and fruit in.
Eat More Foods Rich In Protein - if you do not eat animal products then it's particularly important that you understand what are good sources of plant based protein. While all plants contain protein, for higher sources, think beans, pulses, tofu, tempeh, hemp foods, peanuts, meat replacements, and plant protein powders are great to add to smoothies too.
Get Your Healthy Fats In - again, for those who follow plant based nutrition betting your essential fats in is important. You can get healthy fats from avocado, algae oil, chia seeds, flax seeds, and hemp are just a few places, nuts are also a good source, just you want to limit the amount of those you take in (you need a good balance of what's called Omega 6 and Omega 3 fats).
Step 2: Adjust your food amount and food type
So now you've corrected your food deficiencies best you can and you are ready for the next step. That involves adjusting your food amount and food type. First, lets clear up a few things
1) Food Amount
Now you may have read that when it comes to weight loss, your macronutrient break down (the mix of protein, carbs and fats) doesn't really matter, as long as you are in a negative energy balance.
Strictly speaking this is true. But please keep in mind just because you are tracking calories that doesn't always mean that you are in a negative energy balance. Calculations and food labelling is are not always accurate (there is an estimate of error). Then due to genetic factors and how efficient your digestive system is, the way each person absorbs nutrients from food will differ from the amount of calories that are consume.
Put simply, the way my body absorbs 2,000Kcal will be very different to how you absorb calories.
Plus food type matters. Your body cannot always absorb 100% of energy from food ( to be frank, it's one of the reasons you defecate in the first place).
2) Food Type
So just because you are in a negative energy balance (if you wish to lose weight) or a positive energy balance (if you wish you gain weight) that doesn't mean you are healthy (or even eating correctly for your goals).
Remember earlier when I talked about nutrient deficiencies? Even if you eat enough in terms of calories, that doesn't mean you are getting all the nutrients that your body needs. Two key phrases that you'll want to remember are....
Make sense? Great!
I bet you're thinking, "Ok, so how much should I eat?"
As I said, unless you have a specific medical condition or compete in a sport that requires it, I actively encourage people not to count calories as this can back fire for many reasons (some of which I have already highlighted). Plus I find that what really matters when it comes to sustaining healthy nutrition is the ability to tune into your body's hunger and fullness cues.
Outside of that, Precision Nutrition have put together a good starting point based on your body type. It's useful information and I share it with everyone who is on my nutrition program to give them a head start. I've included it below for you to take a look.
Now this is not an exact science, but it is certainly a good reference point for you to start from. Treat it as an experiment. Test it, then adjust your macronutrients base on whether what you are currently doing is bringing you closer, or further away from your goals.
Pretty simple to follow right? There are a couple of things I want you to keep in mind though.
Step 3: Fine tune the details
Managed to sort your nutrient deficiencies? Eating the right types of food in the right amount for you? Look at you, you badass you! (give yourself a pat on the back - you got this).
Now, it's just a matter of dialling in your nutrition and making minor adjustments. Here's somethings that you might want to consider.
Carb Cycling and Calorie Cycling
It's a complex topic and beyond the scope of this article. It can work really well for some and not so for others.
In a nutshell, on the days that you are lifting weights, add starchy carbs to your baseline diet (or your evening meal the night before if you are lifting in the morning).
While on the days you are not lifting, eat mainly protein, vegetables and healthy fats with minimal carbs.
1 - 2 hours before your workout have a meal as outline above if your schedule permits. If not, some form simple cabrohydrate shortly before your workout (roughly 30 mins).
Sometimes a carbohydrate supplement may be useful.
Coffee/ Caffeine prior to your workout can also be beneficial for some. Caffeine not only acts as a stimulant, it can also acts on the beta receptors in the cells, releasing fat so that it can be utilised for energy.
Creatine can also be great for those wishing to improve lean muscle mass and improve performance. If you are vegan, plant based or vegetarian this can be a complete game changer for you.
Post Workout Nutrition
While for some, the default workout nutrition is a protein shake (which can be a life saver if you are unable to get a meal in after your workout). Your body will need a variety of macronutrients and micronutrients to help the repair process. Ideally consume a meal from whole food sources much like outlined above.
Get the basics right first, before moving onto more advanced techniques. Steps 1 and steps 2 cover the fundamental basics. If you only do these two steps, I promise you that within the space of six weeks you will being to notice a difference, not only in how you look, but how you feel.
If you stick with it for just six months then you'll be surprised by what you can achieve. But don't just take my word for it.
Test it. See what happens.
(Thank me later).
If you would like to learn more about my Project 12 Transformation Program and discover how I use simple nutrition strategies, effective workouts and mindset tools to transform more than just your body, check out the links below.
It was a clear Wednesday evening, as I entered the gates to the business park in Clapham North, London. I was about to train with Animal Flow Royalty. Someone who is arguably the best Animal Flow Coach in the UK.
This wouldn't be my first time either.
I first discovered Rachel Thompson on instagram. I had recently been suffering with a condition known as FIGF (Fitness Industry Gimmick Fatigue).
Now I'm not going to lie, I had been one of those lifters who was quick to dismiss Animal Flow as powder puff nonsense, and just a weak imitation of dynamic yoga and gymastica natural.
But I was wrong.
After studying her clips on instagram, I was impressed not only by her ridiculous movement quality (she is a trained contemporary dancer), but her versatility in training (she lifts too, and is far from a powder puff) and her depth of understanding completely sold me.
I began training with Rachel Thompson sometime in 2017 and have attended various workshops and classes. Each one slightly different. Learning something new, while still returning to fundamental principles.
This master class at Reach Fitness was no different.
An intimate affair, with a mixed blend of female and male participants of various levels. From complete newbies to coaches, and seasoned movement enthusiasts - Rachel catered for us all.
What first strikes you about her coaching style is her passion and enthusiasm for what she is actually teaching. You can literally see her light up as she gets into the flow of what she is doing...
"Seeing people really [connect] with their bodies is awesome, with animal flow there is no time to think about anything else. It's rare in life that we really find or make the time to find the mind body connection
I had worked out earlier in the day - upper body pressing. I was soon to discover that was a mistake.
Within five minutes of the warm up I instantly regretted it. The muscles at the back of my arm began to lock up. Have you ever had cramp in your triceps? It's bloody uncomfortable to say the least - and I still had another ninety minutes to go.
I grabbed some electrolytes and cracked on. Rachel took a part - part - whole approach to the session. This is where you teach one movement, highlighting the finer details. Then build on to the next one before putting it all together. Never once easing back on her enthusiasm as a coach.
The culmination of these movements would evolve into what would be our final flow.
From beast to scorpion to crab, and a whole host of animals my body would soon rather forget (I had some serious muscle soreness the day after!), we were taken through various transient postures which utilised our body's full range of movement, highlighting strengths and areas that I need to develop. It was great fun.
Then for the grand finale we flowed together with superb synchronicity and precision that would leave Cirque du Soliel in the unemployment line - ok maybe not, but we certainly gave it a good try.
"I love feeling the flow unfold. Learning a move, building a flow. It's like watching magic happen.