DR MAX PEMBERTON: Here are my ten tricks to help you fight the battle of the bulge

Keeping trim is hard at the best of times —and this year it is particularly tough. Many people have piled on the pounds, courtesy of lockdown and the sedentary lifestyle that comes with working from home. Using food for comfort or to banish boredom has made it worse.

We’ve seen a toxic combination of having our routines and usual distractions taken away and all this upheaval is set against a background of intense anxiety caused by the virus. Who can blame us if we’ve taken solace in a packet of digestives every now and then?

Of course, there’s a bitter irony here. We know that Covid-19 affected the overweight more, with obesity one of the biggest risk factors for becoming severely unwell, yet our attempts to contain it with lockdowns has created even more people who are battling with their weight.

A survey by King’s College London found nearly half of people (48 per cent) said they had put on weight in lockdown. Dawn French, Nick Knowles, Michael McIntyre and Pamela Anderson — the list goes on —have all admitted they’ve become heavier this year.

You know what, I’ll admit it, I have too. Maintaining a healthy weight and being fit is really important to me, and I haven’t particularly changed my diet, but I usually exercise four or five times a week.

During lockdown with the gym closed, I didn’t do anywhere near this amount. As soon as I was allowed, I started working out with a trainer to beat the bulge, but then, just as I got back in the habit, the second lockdown hit. Argh!

I’m back in the gym now, but, like almost half the country, am fighting to get back to my fittest, just when the mince pies start coming out for Christmas.

So yes, I know how difficult things have been. I know that many of us aren’t quite as fit as we’d like to be. But please, don’t despair. It’s important to realise that while being active and focusing on diet is important, weight gain is predominantly a psychological issue.

Yes, of course, in some ways weight gain is simple to understand — we put on weight when we take in more calories than our body burns. The excess calories are stored as fat. But we know it’s more complicated than that because it’s our thinking that often governs what we eat.

So how to get into the right mindset and stop fretting about food? Here are my ten tricks to help you get through the festive season without feeling bad about yourself — and without piling on the pounds.

DO:

• Try to understand what’s going on. Food is often used as a coping mechanism so difficulties with weight can be the result of underlying issues such as low mood, anxiety or relationship problems. It’s vital to tackle the root cause.
• Recognise the obstacles to change. We tend to do the same old thing again and again even though it been successful. If you’ve tried to lose weight and it hasn’t worked, think about what went wrong. What stopped you achieving your goal? What can you change?
• Listen to self-talk. We tend to be our worst critics and talk to ourselves in ways we would never talk to other people. Avoid being self-critical. Try to imagine how you would speak to someone else struggling the same way you are, and speak to yourself like that. Use lots of encouragement and praise for when you make a healthy choice, and focus on the positive.
• Learn to relax and develop other coping strategies. Keeping yourself occupied and focused on other things helps tackle boredom and avoids mindless snacking or over-eating.
• Keep a journal. Understand your relationship with food and what feelings are associated with it. Do you tend to overeat when you’re sad or alone? People sometimes find a brief course of cognitive behavioural therapy with a professional therapist can help improve their relationship with food.

DON’T:

• Feel guilty if you mess up. Guilt is a corrosive emotion that can fuel weight gain as it starts a cycle where people try, fail, feel guilty, then use food for comfort. If you slip up and overindulge one day, pick yourself up, dust yourself off and think about what you can learn from this.
• Think along the lines of ‘all or nothing’. This is a common mistake. People set themselves up to fail by creating unrealistic goals, such as sticking to a very low-calorie diet. Then, when they (inevitably) fail or slip up, they think all is lost so they give up. Accept you will fail sometimes — especially at this time of year — but that this doesn’t have to mean you give up.
• Compensate when you fail. If you do slip up with your diet and over-indulge, don’t try to compensate by restricting yourself too much the next day. The drop in blood sugar levels can then trigger another binge and set up an unhelpful cycle of binge and restrict.
• Benchmark your weight against that of others. Comparison will only lead to you feeling down and self-critical. This doesn’t mean you have to do this alone — online support groups or group exercise can be rewarding — but avoid comparing your progress.
• Expect a quick fix. We all like to see instant results, but meaningful, lasting weight-loss takes time. Prepare yourself for feeling frustrated and manage your expectations about how long it will take. It’s hard to keep motivated, so focus on achieving one small goal each week.

Patients with seasonal affective disorder (SAD) are trickling back as nights grow longer. It’s not fully understood but brain chemical melatonin is thought to be involved. I advise daylight lamps to help lift mood. 

A few patients prefer winter — I’m the same. Give me a cold night over a balmy afternoon every time.

CALL TIME ON RUGBY AT SCHOOL

Sam MacIntosh, a rugby player who mistook serious concussion for a ‘black eye that swelled like an egg’ has urged others not to play on with a head injury. She was forced to retire from the game in 2017, aged 29, after a collision with a team-mate on the pitch.

Research by the University of Glasgow found former rugby and football players are six times more likely to have a form of dementia — dementia pugilistica — linked to knocks to the head, thought to only affect boxers. 

What worries me about this is young children — whose brains are still developing — are being put at risk. In 2017 academics raised this concern in the British Medical Journal and called for tackles and scrums to be banned. 

We need to change the rules of the game, to limit contact sports until the age of 18. If I had a child, I would keep them off the rugby pitch. 

A few weeks ago I wrote about the power of letter writing. I should have been prepared! I’ve been snowed under with cards and letters. 

A lovely one from a Northamptonshire lady told how she had written to a Canadian pen pal for 75 years. As I am a full-time doctor, it’s taken me a little while to reply. 

But it’s so interesting to learn of your experiences, particularly of medical care. I’m often saddened by your stories. I wish more doctors could see them as these reveal how people love the NHS, but how it sometimes fails them. Rest assured, I will keep championing your rights. 

DR MAX PRESCRIBES…. A BOOK FOR A CHILD IN CARE 

The BookTrust Christmas appeal aims to give every youngster in care a book. What a wonderful idea. 

I know from my time in child psychiatry how even the smallest act can make all the difference. 

It’s just £10 to send one book to a child. Imagine the difference a surprise present like this would make to one of them who is spending Christmas away from their family for the first time. booktrust.org.uk