Mon, Mar-28-22, 07:27
How following science can help you lose weight
How following science can help you lose weight
With two-thirds of Brits overweight, Dr Saira Hameed is determined to arm patients with the knowledge they need to live healthier lives
Having spent two years “following the science”, Dr Saira Hameed is hoping we can redirect that skill to another area: our weight. The endocrinologist at Imperial College London’s Weight Centre had for some time felt as though she was “leading this double life”: one in which she would read studies about “some cutting-edge breakthrough about the gut bacteria, or hormones or sleep”, which weren’t being translated into treatment for patients with weight concerns.
Standard weight-loss advice erred on the broad side of things: telling people to eat less and move more, and what and when to eat, but without rooting their guidance in new scientific findings. “I began thinking, why aren’t we telling our patients about this, because if they knew about it, I’m sure they’d fly with that knowledge,” she recalls.
So she set up the I-SatPro (Imperial Satiety Protocol) six years ago, a fortnightly programme at her clinic, convinced that “if you share the science,” being able to “understand how your body works” could lead to lasting physical change. That programme is recreated in her new book, The Full Diet, which she believes can match the 14 per cent weight loss rate at her in-patient clinic.
The programme’s approach is both full and full-on: from food to movement, sleep, gut bacteria and exercise, all bases are covered. Like everything else in the world, I-SatPro went virtual when Covid hit – which was something of a blessing, Dr Hameed says, because the 14 fortnightly sessions, previously restricted to whatever room wasn’t booked up at Imperial, had their reach expanded significantly. There is no typical patient in each 15-strong cohort, though three-quarters are women (reflective of referrals generally for weight loss): their ages run from late teens to those in their 80s, from all walks of life, with a BMI upwards of 35. Dr Hameed says she stopped reading fiction two decades ago, when she became a doctor, because “my patients’ stories are more interesting”.
The programme is stringent, I suggest – the book’s “Choose Not to Eat List” includes offenders such as bananas, mangoes and grapes, “bread of any kind”, couscous and porridge. But Dr Hameed sees the book as a science-driven sum of parts; at the end of each chapter, like I-SatPro, “you get given a series of choices” which enable readers to decide what to do for themselves. “That element of choice is so, so, so important,” Dr Hameed, 43, says. People need “agency and ownership” over their health – and a plethora of rules “is probably counterproductive... if you give people information about anything, they should be free, then, to make choices about how they implement that in their everyday life. I think that’s the only way it can work, long-term.”
Dr Hameed was on the Covid frontline until the summer of 2020 when she became pregnant with her fourth child: she believes most people “want to do the right thing” when it comes to protecting their health – particularly since the pandemic – but are often battling a tide of misinformation. One of the most common is around breakfast – which her patients routinely tell her they “know” is the most important meal of the day, and thus eat in spite of not being hungry. She tells them instead to wait until biology causes their hunger hormone to kick in, and to see each day’s food intake through the lens of an “eating window”.
Consuming anything – even the approved foods listed in the book – means sugar ending up in the blood, upping insulin levels that will convert fuel into fat storage; if we get up at 7am and are in bed by 11pm, that could mean 16 hours of food going in. Those following the programme can choose what their window looks like; either it opens or closes at a certain hour of the day, or lasts for a defined period of time. Not only does this keep insulin levels low – breaking down fat and assisting weight loss, as well as reducing the risk of insulin-driven diseases (such as type 2 diabetes) – but it will “give your body the time to carry out essential repairs and resets”.
What enters within the window makes an enormous difference too, of course. Dr Hameed believes the introduction of dietary guidelines – first produced in the UK in 1994 – has disrupted the “food culture” that existed before, where “we learnt about cooking, food and eating from our parents and grandparents”. She tries to pass on healthy habits to her four children, aged 11 years to 11 months, but admits she has been struck by looking at photos from generations past, where few if any appeared to have a weight problem. Now, in the age of semi-skimmed milk, skinless chicken breasts and margarine, British waistlines have never been bigger, with two-thirds of adults overweight or obese.
One of the reasons we have got fat, she thinks, is by cutting out fat (which is “delicious. Wouldn’t you rather eat the crispy skin as well as the roast chicken or sauté your vegetables in butter rather than eating them with a low-fat dressing?”), and “satisfying”. Eating creamy Greek yogurt, full of natural fats, both can’t be overdone and feels substantial; fullness being a key trait for stopping overeating.
Awareness of ghrelin, the hunger hormone, demonstrates the importance of the relationship between gut and brain – one modern ultra-processed foods are designed to derail even more. High sugar, high salt products with unrecognisable ingredient lists are the go-to for emotionally-driven eating – which Dr Hameed describes as “one of the biggest burdens” to all weight-loss treatments – and the fact it now makes up more than 50 per cent of our diets is a major cause for concern. Stick with one-ingredient foods, such as eggs, fish and nuts, and that issue goes away.
She prescribes Neat or non-exercise activity thermogenesis; essentially, adding bits of movement to otherwise sedentary tasks. That can be standing on the train (even if there’s a seat); walking around when on a phone call, or offering to fetch something left elsewhere in the house. These are the kinds of small additions on which you can “build until it becomes just a natural part of how you’re living”.
Dr Hameed believes that where The Full Diet has the edge is that it features her patients’ stories. “These are real people with jobs, families, commitments, or with busy, busy lives, who have made it work. And I think that should really encourage the readers that if other real-life people can do it, then I can too”.
The Full Diet by Dr Saira Hameed is published on March 31 by Penguin Michael Joseph
Dr Saira Hameed’s Full Diet toolkit
- Insulin is the fat controller. You can keep insulin levels low by eating real, unprocessed foods that do not quickly break down into sugar. Food that your body (and your grandma) would recognise as food. Limit carbohydrates that produce high insulin levels, such as cereal, bread and pasta.
- Burning it off is a myth – yes your workout might burn the calories in a biscuit, but the sugar will damage your body.
- Eating fat does not make you fat. Sugar makes you fat. Choose natural, healthy fats (dairy, meat, oily fish, nuts, seeds, natural oils such as olive oil) and avoid synthetic processed fats, such as trans fats.
- Try to tune into your body’s hunger-fullness messages, allowing you to eat when you are hungry and stop when you are full. Wait 20 minutes after eating a meal as that is how long it takes to feel full.
- An Eating Window (ideally eight hours eating, 16 hours not) allows you to harness the powerful health advantages of choosing when you eat.
- Feeding your gut bacteria with foods that are high in fibre, fermented and a rainbow of colours will help keep you lean.
- Regular daily movement will melt away insulin resistance, you will lose weight and improve your health. A short walk after eating will reduce insulin levels.
- You might have weight-gain genes, which are simply the loaded gun. You can choose not to pull the trigger by avoiding ultra-processed, sugary foods.
- Eat one-ingredient foods. Cook your own food. Don’t eat or add chemicals, no tricks.