Sugar, sugar…

When you reach the age of 60, the UK NHS offers you some exciting experiences – or at least that was the case before the pandemic. There’s a one-off general health check, which wasn’t very encouraging about my body weight, but at that point I didn’t feel I had the mental energy to do anything about it; and a regular poo check, which thank goodness has improved between the two occasions on which the jolly little test kit has plopped through my letterbox. None of this is compulsory, but I tend to support health screening (while being aware of the risk of false positives etc), so I cooperated.

A month ago, however, I had a blood check for something and my GP added in a request for a diabetes check ‘because of your age’. It’s so much fun being older… And, as seems to be the case for a lot of people of my age, it came back as ‘pre-diabetic’. Not very pre – nearer the safe zone than the panic zone – but not great. My GP – who hasn’t seen me in person for a long time due to Covid, and is working from phone calls and test results – advised me to ‘lose a bit of weight’ and to return for another blood test in six months’ time. A visit to the Healthcare Assistant, who can more easily be seen in person, gave me the numbers, and she was very positive about how reversible my pre-diabetic condition should be.

My previous experiences with weight have been at the other extreme. As a young person, I was always underweight, despite eating very enthusiastically. There were questions from adults about whether I was anorexic, to which my mother would respond, ‘She doesn’t stop eating!’ I obsessively measured not just my bust, weight and hips, but my thighs, my upper arms… At around the age of 14, I even invested in a calorie counter so I could work out how to gain more weight. As a friend commented after the recent diagnosis: ‘You clearly did well!!’

So, with no prior experience of weight loss methods, I went online to get some ideas. I’m reasonably active and I don’t eat a lot of dodgy sugary/processed foods so the obvious culprits can’t be blamed and I am concerned as to how I can make the right changes to improve my scores. It turns out that there’s a site where you can assess your risk of diabetes, here. If you score at the high end – and, with a close family member who developed type 2 diabetes, I had those bonus points to add in – then you can Go On A Programme. This programme is extensive, and free of charge. This has to be one of the glories of the NHS who, in their Long-Term Plan published in 2019, rightly identified type 2 diabetes as a major threat to the nation’s health. This means that various providers have the contracts to offer courses across the country, and these courses are online, not just because of the pandemic but because the plan was always to deliver them in this way because ‘face to face interventions do not always work for everyone’. They certainly don’t. Would I trek to one of the nearby towns for a couple of hours in a church hall in order to learn more about diabetes? Even as a person supporting health screening and education, probably not.

The programme to which I’ve signed up goes on for nine months, starting with fortnightly Teams meetings, the first of which – 90 minutes – was last week. Before that first meeting, I had various online questionnaires to fill in about my lifestyle, and a one-to-one 40-minute interview by phone. It was all pretty intensive, with lots of emails and texts in advance, because the provider really wants you all to turn up and engage so that they can prove their programme is effective. At the meeting, there were 20 people and a trainer, and a standard PowerPoint which the trainer worked through. Our questions, plus answers to questions posed by the trainer, and any discussion, were through the Chat function.

The information was helpful and I’m glad I am doing the programme, but I was unexpectedly entertained by the way the Teams format panned out. Most people quickly turned off their video, although the trainer said it was fine to leave it on (if the sessions on exercise involve us doing any – which I think may be the case – I anticipate a mass video switch-off). There was the usual plea for everyone to mute, and the usual pause while this happened (I was impressed that there was a slide showing newcomers just where to find the important controls). We had a lot of questions on the lines of ‘I didn’t receive the email about …’ which were met with requests to check your spam filter. We had a bit of trouble with the slides not coming up or being blank where they shouldn’t have been, and with animations that didn’t animate. Evidence of attendance is apparently by giving one’s weight to the trainer, and those he hadn’t been able to reach by phone (in the 45 pre-meeting minutes he is allotted) were asked to type it in the chat box, say it to him at the end of the meeting, or email it to a central mailbox. One person shared hers by chat and it was a lot lower than mine, so I glanced at her screen, where she looked to be more overweight than I am, so maybe she is just shorter than me. And weight on its own, as the trainer made very clear, isn’t a guide to glucose scores. However, on the Facebook page for everyone who is following this provider’s programmes, people are quite cross about having to share their weight. We’ve been told that the weight-sharing is in any case non-judgemental; just a way of showing you were present. I’m not quite sure that all this adds up; how does the trainer provide evidence that you really did submit your weight rather than just entering a convincing figure on their spreadsheet?

But I haven’t just been sitting around waiting for the programme to start. On a friend’s suggestion, I’m doing the 5:2 diet, where you eat normally for five days and ‘fast’ (500 calories per day) for two. I have always been terrified of hunger, so my first fasting day was traumatic as I expected to faint at any moment and was sure that going to bed hungry would mean I wouldn’t sleep. But it was all fine, and it was effective; not just in losing some weight but also in making me want less on the following days. Cake has always been my downfall, and in the various lockdowns a trip to buy cake has been a life-saver: or not, as I now discover. No more cake. I also hate waste, so if there are seconds of a meal and it’s not something which can easily be kept for next day’s lunch, then I tend to eat it all. No longer!

My use of this diet is relevant because at some point in the Teams meeting, the various intermittent fasting/5:2 programmes were mentioned in the PowerPoint. I shared something in the chat about how I was finding this useful, and received a response from another participant to the effect that this surely wasn’t sustainable. I found myself becoming quite an evangelist for 5:2; a real surprise, as ‘not eating’ has never been part of my experience before. And I realised that those on my programme are already showing how people work in groups. There are the pushy ones, the compliant ones, the good boys and girls, the resistors, the silent ones – and the evangelists. I’m currently showing elements of all of those styles, other than ‘silence’. I confess, when I get an answer right, the trainer’s ‘That’s right, Helen!’ makes me feel all warm and glowing. It’s even more extreme on the Facebook page, but there my default setting is going to be ‘silent’. The evangelists are particularly pushy on Facebook. People tell their success stories in detail and at great length, with a typical final sentence being ‘This is some of my story, sorry to go on’. Others respond with gratitude for the sharing, and say that this inspires them. Others tell the group how many steps they walked or how much gardening they managed yesterday. I can see that some people need the group to motivate them. But I wonder: when they can’t do as well as other people say they are doing, are they more likely to feel disheartened, and give up? I would rather measure myself against… myself.