Latest / The Dr Louise Newson Podcast / 41 - How small lifestyle changes can transform your health

Transcript

41 - How small lifestyle changes can transform your health · The Dr Louise Newson Podcast

• 0:00
  Doctor Hussain is back on my podcast by Popular demands.
• 0:03
  You might have seen him on my Balance app.
• 0:05
  You might have listened to our podcast before.
• 0:08
  We talk about lifestyle medicine, so how we can improve
• 0:12
  all those pillars that are so important with movement, sleep,
• 0:16
  relationships, reducing addiction, nutrition, just being
• 0:20
  better versions of ourselves. But the most important thing
• 0:23
  that comes through is being honest to ourselves, being
• 0:26
  really true, what we can do to improve our future health and be
• 0:30
  happy as well. So enjoy it.
• 0:34
  So saying you're back, but you're back in real life.
• 0:37
  Last time we did a podcast it was remotely, wasn't it?
• 0:41
  It was, and it's a lot better face to face.
• 0:42
  It is. It's really nice studios.
• 0:45
  You've come down, I've kept you waiting late, but you're still
• 0:47
  smiling. So that's great.
• 0:49
  And we're still being connected. I still see you because you're
• 0:53
  part of Balance Plus. You're one of our Balance plus
• 0:55
  people. So today I, we've just refreshed
• 0:58
  it actually and we've had a great update.
• 1:00
  So it's all got different colours and everything.
• 1:03
  And you're there with your open water swimming your :) so which
• 1:08
  is, which is great. So for those people that don't
• 1:11
  know you, you are a GP extraordinaire really and just
• 1:16
  explain a bit about what you do. Yeah, so a portfolio GP that
• 1:21
  specializes in lifestyle medicine.
• 1:22
  So as well as working part time as a GP, I work at the Royal
• 1:27
  College of GPS as the Lifestyle and Physical Activity lead.
• 1:30
  Also work at Park Run which is a health and well-being charity.
• 1:33
  People may know about the event they put on on a Saturday and
• 1:35
  Sunday morning. As the health partnerships lead.
• 1:39
  Also have roles with red whales, so medical education and Swim
• 1:42
  England as a medical adviser supporting people with long term
• 1:45
  conditions to access aquatic activities.
• 1:47
  So lots of things. There's probably something I've
• 1:49
  missed, but it's a. Small sport that you are a
• 1:52
  supreme athlete as well. I try this year I haven't.
• 1:57
  Been as good. I did, yeah.
• 1:59
  I decided to fall off my bike but apart from that I'm hoping
• 2:02
  next year I can get back to form.
• 2:04
  But yeah, no representing. My country, yes.
• 2:06
  And I don't want to big you up, but you are an inspiration
• 2:09
  because you've not always been this lean, you've not always
• 2:11
  been this fit. And it's so easy I think to look
• 2:15
  at people and go, well, he's got it.
• 2:17
  He's look at him, he's really slim, look at him.
• 2:19
  But actually I was saying to Jack before you came in, but
• 2:22
  years ago when you said to your partners at work I'm going to
• 2:25
  take up running, they laughed at you, didn't they, because you
• 2:27
  were quite overweight and. Lastly, I've been diagnosed
• 2:30
  those with muscled with metabolically associated
• 2:33
  diatopic liver disease, which is essentially fat infiltration in
• 2:35
  the liver, diagnosed with high blood pressure and.
• 2:38
  And you were young, weren't you were mid 20s?
• 2:40
  And it was just. And to be honest, until I got
• 2:43
  diagnosed with the fatty liver disease, I didn't even realise
• 2:47
  that I'd gained weight. Like, I never weighed myself.
• 2:50
  I avoided taking photos, I avoided looking in the mirror.
• 2:52
  And obviously, clearly, clearly I knew on some level.
• 2:55
  But I hadn't consciously made the realisation that I'd gained
• 2:58
  weight and, and yeah, it was just that real.
• 3:01
  I I went home after having that ultrasound scan and I went on
• 3:05
  the scales and I'd gained 2627 kilos from when I.
• 3:08
  Last checked, huge amounts. And I asked my wife, I was like,
• 3:13
  I've gained a lot of weight and she's like, duh, like, have you
• 3:16
  not thought about all the new clothes that I've been buying
• 3:19
  you and the fact that, you know, you're, you've got a new belt
• 3:21
  and all that. And I just, I just hadn't
• 3:23
  accepted it. I think I didn't want to because
• 3:25
  I didn't want to accept it. And I just sort of slept walked
• 3:29
  into it. I was leading a lifestyle that
• 3:31
  was actually helping me at the time.
• 3:33
  Yeah, Because I was overworking. I was overstressed.
• 3:36
  And the kind of foods that I was eating helped me feel better on
• 3:39
  the day. Yeah.
• 3:40
  Often used like a reward thing. I don't know if you've ever done
• 3:42
  that, but unless you do a duty doctor and you go, do you know
• 3:45
  what? I've worked so hard today.
• 3:47
  I deserve. Yeah, yeah, yeah, yeah.
• 3:49
  Well, I used to. I mean, as you know, I don't
• 3:50
  drink alcohol, but years ago, well 25 years ago when I just
• 3:54
  was full time GP, I would deserve that half bottom.
• 3:58
  My husband, I would open a bottle of wine and would share
• 4:00
  it not every night, but quite a few nights.
• 4:02
  But if it's been especially hard day, yeah, I deserved that.
• 4:05
  And it's, you know, it's whereas, yeah, you can get
• 4:08
  rewards in different ways, but it's that slippery slope.
• 4:10
  And, you know, I've never put on that sort of weight.
• 4:14
  But when I was pregnant three times, you know, I've put on 10
• 4:17
  kilograms. And it's very gradual.
• 4:20
  And because it's very gradual, you almost think, oh, I'm not
• 4:23
  really that big. I mean, I've had big babies, you
• 4:25
  know, 9 LB babies. And obviously I'm tall.
• 4:28
  And I look at my pregnant special, of course I had this
• 4:30
  massive bump, but you sort of get used to a different size
• 4:34
  when it's a slow thing, definitely.
• 4:36
  And I can see that how easy it is to just adjust totally
• 4:40
  yourself 100. Percent.
• 4:42
  And I think often, you know, back then when I wanted to lose
• 4:45
  the weight, like the focus was all around losing the kilos, you
• 4:48
  know, I'd want to see the numbers come off.
• 4:50
  But what I've learned now from that journey was actually the
• 4:53
  weight loss was really a tiny, tiny part of the health gained.
• 4:58
  Yeah. See, that was really important
• 4:59
  because I just like to highlight to those listeners, you lost
• 5:02
  weight without GOP ones. You did it with your lifestyle.
• 5:06
  But I'd like to, I'd like to sort of focus on lifestyle
• 5:09
  because I don't think people know what lifestyle means.
• 5:12
  It's it's one of those words that is brandished around a bit
• 5:17
  lifestyle, how style your life, what what, what does it really
• 5:20
  mean? It's a really good point and I
• 5:22
  think when I talk about lifestyle I specifically mean
• 5:25
  lifestyle medicine, which is an evidence based way of utilizing
• 5:30
  various behaviours and actions to improve health.
• 5:32
  We've got 6 pillars of lifestyle medicine.
• 5:35
  We've got physical activity, nutrition, sleep and we have
• 5:40
  mental well-being, healthy relationships and minimising
• 5:45
  harmful substances and behaviours.
• 5:47
  So when we think about also like gambling, if that's a
• 5:50
  problematic gambling use or things like social media use if
• 5:53
  it's problematic and overuse. And that's so important.
• 5:56
  And I like the way you didn't use the word exercise actually.
• 5:59
  Yes, I never used the. Word exercise.
• 6:01
  I never used because when I started my own personal journey,
• 6:04
  I viewed exercise like many do, as a chore, as something that's
• 6:07
  good for me, but was effort and was time consuming and was
• 6:13
  painful. And that's not what real
• 6:16
  physical activity is. Physical activity should be
• 6:18
  movement that you enjoy. And often see on social media
• 6:21
  people saying, oh, you have to Sprint to and do this or you
• 6:24
  have to start running marathons to do that or you must go into
• 6:28
  the gym And look, there's lots of benefits to all those things,
• 6:31
  but the best movement is the one that you enjoy.
• 6:34
  And sometimes you don't even realise you're doing, you know,
• 6:37
  let's say if you go to a dance class and you don't even realise
• 6:40
  and you don't even love that as exercise, then that's the
• 6:43
  perfect. Yeah.
• 6:43
  Form of physical Well, you know what, Angela Riffin is sat in
• 6:46
  that chair talking about dance and, you know, you can't dance
• 6:50
  and not smile. So the two go together.
• 6:52
  And I think you're absolutely right.
• 6:55
  People's relationship with exercise can be really
• 6:58
  complicated, actually. And, you know, and I think
• 7:02
  finding some sort of movement that you enjoy means that you
• 7:06
  will do it regularly because that's part of the battle, isn't
• 7:09
  it? 100%, You know, I viewed
• 7:11
  physical activity before when I viewed it as exercise in the
• 7:14
  frame of competition. And I was always last in school.
• 7:17
  You know, my parents always focused on academia, so I never
• 7:19
  had the opportunity to really practice or get good at it.
• 7:22
  And so therefore whenever I did it in PEI was obviously rubbish.
• 7:25
  And it's funny because now I compete regularly and I enjoy it
• 7:30
  and I love it and it's such a, you know, pleasurable experience
• 7:33
  for me. But when I used to always think
• 7:35
  of exercise and always think about comparing to other people
• 7:38
  and me not being as good as other people, as soon as I broke
• 7:41
  that away and I started to just go.
• 7:43
  How can I find a way to move my body when I feel adventurous
• 7:46
  where I feel like I can spend time in nature because I always
• 7:48
  loved being outside. And suddenly these things start
• 7:52
  to develop and I can get to a point where yes, if I took up
• 7:55
  running from the get go, I don't think I'd ever have engaged with
• 7:57
  it. Never.
• 7:58
  Couch to 5K for me never worked because I do it for a few weeks
• 8:01
  and then I get bored. But when I just found a way of
• 8:04
  let's go outside, let's spend some time with friends, with
• 8:07
  family, move my body and see where this takes me.
• 8:10
  Slowly I would start to find and I, I discovered running later on
• 8:14
  and after a long time, I've spent time walking and hiking
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  and then I'd go, OK, what's it like to just run little bits?
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  And I found my own way because catch the 5K can work with lots
• 8:23
  of people. Great.
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  But if you find that those kind of programmes work and then you
• 8:26
  quit, look to discover it in your own way.
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  Do your own journey that you've designed, rather than it being
• 8:32
  three sessions a week for 9 weeks.
• 8:34
  That's not going to work for everyone.
• 8:35
  No. And I think all these pillars
• 8:38
  are so important and they are the foundation of so much.
• 8:43
  They're almost the non negotiable things, I think.
• 8:46
  And you know, I think, you know, people are quite surprised when
• 8:51
  I say I don't drink alcohol, I don't eat chocolate, I don't
• 8:54
  have caffeine, I don't eat processed foods.
• 8:56
  And I, I have to be like this because I have such bad
• 8:58
  migraines that if I didn't, it would trigger migraines.
• 9:01
  So I'm almost blessed and cursed, but I'm lucky because I
• 9:05
  can't cheat. You know?
• 9:07
  If I was hungry and I just went and bought a packet of crisps, I
• 9:10
  would get a migraine later. So I have to hunt out the nuts
• 9:13
  and the fruits, which is quite hard sometimes.
• 9:15
  We always have to have something in my bag, but it's so easy to
• 9:18
  do it wrong and it has such an impact.
• 9:21
  And all these pillars work very closely together, but you have
• 9:25
  to work at it. But then it becomes part of
• 9:28
  routine and I think getting to that stage can be quite hard for
• 9:32
  a lot of people. Content for.
• 9:34
  Sure. And I love what you've done
• 9:36
  there because it's something I try to encourage patients to do,
• 9:38
  which is, you know, you have a barrier, for example, migraine
• 9:41
  or a condition, you could see that negatively or you can see
• 9:44
  it as that drive. Like for me, it was the muscled,
• 9:47
  it was the liver disease that because I got that with ABMI of
• 9:49
  28. And there's lots of reasons why
• 9:51
  that happened. And we know that there's ethnic
• 9:53
  and genetic variations, which means that your complications
• 9:56
  from increased weight varies. It's not equal across society.
• 10:00
  And instead of thinking, Oh my God, I'm so unlucky that I got
• 10:03
  high blood pressure and metabolically associated liver
• 10:05
  disease at only BMI of 28, I said, think of it.
• 10:09
  Oh, that's a blessing. That means that I'm going to
• 10:12
  target lower. You know, I'm going to, I'm
• 10:14
  going to really focus on making sure that I don't get to that
• 10:16
  because I don't want those implications.
• 10:18
  So no, you're right. Like if we can switch that
• 10:20
  narrative can help. But the interconnection of those
• 10:23
  pillars are so important. You know, let's just take for
• 10:27
  example, going to Park run, OK, whatever form that may be.
• 10:31
  Let's say you want to walk at Park Run.
• 10:32
  Yes, you get the physical activity, but you also get the
• 10:35
  healthy relationships in building a community.
• 10:37
  When you go regularly, you go to your local 1, you get to know
• 10:40
  people. You also get the green social
• 10:43
  prescribing of being around natural spaces.
• 10:45
  You also get that regularity of seeing light in the morning and
• 10:49
  waking at 9:00, starting your weekend, right?
• 10:52
  So these things, they rarely just have one benefit.
• 10:55
  You see compound benefits when we talk about lifestyle.
• 10:57
  Yeah, and that's so important. And the other thing is, I know
• 11:00
  it sounds a bit weird as us as doctors, but I don't actually
• 11:03
  like prescribing drugs other than hormones, which I think are
• 11:06
  probably the 7th pillar actually for men and women.
• 11:08
  Hormones are so important because they're natural, but we
• 11:12
  don't want to be prescribed. Every medication has side
• 11:14
  effects and risks and you know, they can interact with each
• 11:18
  other as well. And you know, if I didn't
• 11:20
  exercise, if I didn't eat health today, I mean, I'm 55 now.
• 11:25
  I probably would have hypertension.
• 11:27
  I know that my, I've, I'm sure I've got ADHD.
• 11:30
  It's not me formally diagnosed, but it's just the way I am.
• 11:33
  And I know if I didn't do yoga most mornings ending in a
• 11:36
  headstand, that would really affect my mental health because
• 11:40
  I would be so fragmented. I just know the way that I am, I
• 11:43
  would probably be lowering my mood.
• 11:45
  I wouldn't sleep well. I probably would be overweight,
• 11:48
  you know? And so it catches up with us all
• 11:52
  these things and any ways that we can demedicalize and de
• 11:57
  prescribe, but actually not even start those prescriptions.
• 12:01
  It's actually really important, isn't it, 100?
• 12:03
  Percent because people are suffering, you know when when
• 12:06
  it's not just a label of getting a long term condition, it's all
• 12:09
  the symptoms and the impact on people's quality of life that
• 12:12
  those things bring. And we know from sort of
• 12:15
  estimates that The Who has done in terms of long term condition
• 12:18
  rates that 60 to 70% would be eradicated if people were
• 12:22
  supported to live a lifestyle which included healthy food and
• 12:26
  regular movement. You know, that is astonishing.
• 12:29
  Imagine. Massive, isn't it?
• 12:31
  I mean, if you could prescribe a pill of exercise it I mean, it
• 12:34
  must really frustrate you, but I feel as healthcare
• 12:38
  professionals, we have a responsibility.
• 12:40
  And I know like you and me were on at the public more than a lot
• 12:44
  of doctors, but I've always tried really hard as a doctor to
• 12:49
  be an example for my patients. And I I'm not perfect.
• 12:53
  I could always do more exercise. I could do a lot, you know,
• 12:55
  better and all sorts of things. But I do think it's important.
• 12:58
  And I think it's a shame when I see doctors like you were many
• 13:02
  years ago, you know, because it's it's not good example, is
• 13:06
  it? But it's so easy in medicine,
• 13:08
  especially in hospitals, because you can't access good food.
• 13:10
  Often you're working long hours. It's very stressful.
• 13:14
  So I'm not criticizing medical professionals here, but I do
• 13:18
  feel you have we have to have a bit more maybe responsibility
• 13:22
  for our patients. Definitely.
• 13:24
  And The thing is, the challenge is we're just living within an
• 13:28
  environment where there's various social determinants,
• 13:30
  which means it's really challenging.
• 13:32
  It's challenging for everyone, but it's even more challenging
• 13:35
  for certain groups, often underserved in lots of other
• 13:38
  areas. And it makes gaining weight
• 13:41
  actually kind of the default. Like you have to do so much and
• 13:45
  as you just said, you know, so many elements in our own
• 13:47
  lifestyles to do it. So I kind of think of it as, do
• 13:50
  you know what? It's it's not your fault, but it
• 13:53
  is your problem. Yeah.
• 13:54
  So until we can look for real policy change to support more
• 13:58
  people, to access healthy lifestyles that are affordable,
• 14:02
  that are achievable, an environment that promotes
• 14:04
  health, brilliant. But until that point, we do need
• 14:07
  to take some personal responsibility because no one
• 14:10
  else is coming, unfortunately, to help us out.
• 14:12
  I wish it could. And, and clinicians, yes, we
• 14:15
  need to lead by example because we are better placed often,
• 14:18
  let's say if we think about our other fellow doctors, like we
• 14:21
  are well placed to understand the information and to not just
• 14:25
  communicate to our patients, but communicate it by living it.
• 14:28
  Active healthcare professionals are more likely to encourage
• 14:32
  patients to be physically active.
• 14:34
  So it's really important that we make sure that as a workforce we
• 14:38
  are enabled to support that because for many, as you know,
• 14:42
  it can be really challenging even to get a toilet break, let
• 14:45
  alone have time to stretch and to to keep our bodies moving and
• 14:49
  to eat well. Yeah, and sometimes when someone
• 14:51
  who works in our practice teaches yoga, so we've got her
• 14:54
  to just teach some of our and it's very basic, 15 minutes,
• 14:57
  that's all. People come away from their
• 14:59
  desk, they're moving and they're laughing because they're
• 15:02
  watching everyone else. And it's just a really lovely
• 15:04
  uniting thing. And it doesn't cost me much
• 15:07
  money, only the company. It doesn't take much time away
• 15:11
  from people's duties or work and little things can make a there's
• 15:15
  a really big difference coming in.
• 15:17
  Exactly. And if you guys are doing it,
• 15:18
  you know you're private and you're doing that for your
• 15:20
  staff, it shows that there's a good reason to do it.
• 15:23
  So you know, the argument often is that we have no funding
• 15:26
  etcetera. But I think the reason we have
• 15:28
  limited funding is why we should be doing these things.
• 15:30
  So we need to get the most out of our staff and our staff will
• 15:33
  only deliver the best if they're if they're healthiest.
• 15:38
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• 15:40
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• 15:43
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• 15:47
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• 15:51
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• 15:54
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• 16:00
  pharmaceutical companies. So information is down in the
• 16:04
  show notes. So have a look and subscribe and
• 16:07
  enjoy. Because of migraines, I'm always
• 16:12
  taking my food to work and it's a bit of a constant.
• 16:15
  You know, if I have a lunchtime meeting, I will eat in front of
• 16:17
  people because if I don't, I just don't want the
• 16:19
  consequences. And having fridges at work is
• 16:22
  really interesting. So when people first start, they
• 16:25
  are bringing in their ready made sandwiches, their low fat
• 16:28
  yoghurt, thinking they're doing really well.
• 16:30
  And over time it's don't actually say anything, but you
• 16:33
  can see how people change. They don't, we have fruit
• 16:36
  delivered at work as well on a Monday.
• 16:38
  We just have a local supermarket delivers some fruit.
• 16:42
  Brilliant. So there's less crisps around.
• 16:44
  And when P when I'm walking around and people have a kind of
• 16:47
  whatever on, on their desk, they're hiding it from me and
• 16:52
  it's just quite funny. But I, what I have noticed also
• 16:55
  is a lot of my work colleagues have lost weight, they're
• 16:57
  exercising more. And now I've been talking more
• 17:01
  about Vivo Bear effort, which I know you're an ambassador for as
• 17:04
  well. We've both got our Vivo
• 17:06
  barefoot. Oh, yeah.
• 17:08
  And people initially, because I've won them for quite a few
• 17:10
  years, they're like, what? Those Louise, you know.
• 17:13
  And, but now, like, in fact, one of my colleagues has just gone
• 17:16
  and bought 1 and he's like, oh, feels a bit weird, but I could
• 17:19
  get into this. And I, I love that sort of
• 17:22
  passive influence. I'm not going around lecturing
• 17:24
  people. Yes, but they're sort of
• 17:27
  watching and they're like. 0 minute consultation I call it
• 17:31
  and like I do it less. Yeah, with the footwear I've got
• 17:33
  or with I leave my cycling helmet on the back of the door
• 17:38
  or I leave my trainers that cause I can do a run after work.
• 17:41
  I'll leave the trainers just visible in the corner of the
• 17:44
  room and I don't mention it, but patients will often mention it.
• 17:47
  But oh, you, you like to run or oh, you've cycled into work, you
• 17:51
  know, things like that. Helps to open the conversation.
• 17:54
  I. Never want to just be telling
• 17:56
  people what to do. No, because it's also, you know,
• 17:59
  I've got three children. If you tell them what to do,
• 18:01
  they'll do the opposite. So it's, it is funny and, and I
• 18:05
  think I told you a story before, but before I left general
• 18:07
  practice, one of my, well, I've got quite a few favorite
• 18:09
  patients, but one of my real favorite patients was in her 70s
• 18:12
  and she'd recently lost her husband, who again was, she was
• 18:16
  a lovely patient of mine. But about 10 years before I
• 18:19
  left, I had pancreatitis and was really ill.
• 18:22
  And she used to come in morbidly overweight and she'd say, hi,
• 18:26
  Doctor Newson, all these seeds that you eat, look at you, it
• 18:28
  hasn't done you any favours. You've been really ill.
• 18:30
  Because I was off work, obviously trying to and it was a
• 18:33
  bit harsh and I was like, hang on a minute, you know, because I
• 18:36
  spent a long time trying to help her to lose weight, really
• 18:39
  talking about her lifestyle and everything else.
• 18:42
  And then obviously when her husband died, things went and
• 18:44
  she was comfort eating a lot. But then the last two years she
• 18:48
  quietly, she didn't tell me she was doing it.
• 18:50
  She just changed her. Her eating and all the little
• 18:54
  things I'd said to her over the years before had sort of just
• 18:57
  fallen into place and she lost about 5 stone.
• 19:00
  And this was just with her lifestyle.
• 19:02
  It wasn't with any medication. And she was so happy and so
• 19:06
  proud to show me what she had done.
• 19:09
  And I thought, wow, because it's so easy to think when I'm too
• 19:12
  old now. I, you know, my metabolism
• 19:14
  change. I'm not going to be able to lose
• 19:16
  weight. And but the whole thing really
• 19:18
  for her was she had to admit to herself.
• 19:21
  And I think honesty to yourself is quite a hard thing to do
• 19:25
  often. Yeah, it is.
• 19:26
  It's so important to do and it is the biggest barrier that
• 19:30
  often people aren't even visualizing because they're
• 19:33
  focusing on all the other, yes, important barriers, whether it
• 19:35
  be various long term conditions, symptoms, financial barriers,
• 19:39
  time barriers, yes, they are all genuine.
• 19:41
  But it is so important. Like for me, I had to realise
• 19:44
  that I was addicted to certain types of food.
• 19:47
  Do you know what I mean? Like I used.
• 19:49
  To have a crisp, you used to have a low.
• 19:50
  Man, don't get me started on those Louise.
• 19:52
  I could on days easily of consume more than 1314 packets
• 19:57
  of crisps. I can't even imagine you.
• 19:59
  I think a packet of crisps and. The thing is like, Oh yeah, I
• 20:02
  haven't had a crisp for I don't know how long, like maybe 3-4
• 20:05
  years, you know, and, and before like even just looking at them,
• 20:09
  like I would just be driven to just consume them.
• 20:11
  And I would always go with the intention of having one packet.
• 20:14
  Don't get me wrong. Yeah, I never used to start a
• 20:16
  day going. I'm going to have like 13 packs
• 20:18
  and one go. I used to have to hide it
• 20:19
  Louise, because if I put it in the bin, my wife would see and
• 20:22
  she'd get upset with me. So I used to take it to the
• 20:24
  outside wheelie bin and like lift up a bag and put the
• 20:27
  packets there because because otherwise she'd see and then
• 20:30
  she. Isn't it?
• 20:31
  It's crazy. You weren't honest with
• 20:33
  yourself, You see, I. Wasn't honest.
• 20:35
  I used to I used to say that I had no time.
• 20:37
  That was distressful and reality.
• 20:39
  I was using food as a way to make me feel better, and it did,
• 20:44
  and it did a great job at that, but it was having unwanted side
• 20:48
  effects. And so until I realized that I
• 20:50
  needed to work on my relationship with food and what
• 20:53
  I was actually using it for, what were the wounds that I was
• 20:58
  trying to heal with it. Only then did I start to
• 21:01
  actually see some benefits and to start to make shifts towards
• 21:04
  a healthier lifestyle. It's so important.
• 21:06
  And the the one of the other pillars if you like you were
• 21:09
  talking about was addictions. And I've recently done a survey
• 21:13
  looking how addictions change in perimenopause and menopause and
• 21:17
  with any hormonal change, because a lot of people, as you
• 21:20
  know, these hormones, progesterone, estradiol,
• 21:23
  testosterone have effects on dopamine especially.
• 21:26
  So if your levels are low or fluctuate, you don't get that
• 21:28
  dopamine hit. So a lot of people are trying to
• 21:31
  get pleasure elsewhere. And I see it a lot in patients.
• 21:34
  They drink more to numb their symptoms, trying to help them
• 21:36
  sleep. But I also see patients who take
• 21:39
  harder drugs. And one lady who's very posh
• 21:41
  told me recently how she'd been using a local dealer to get some
• 21:44
  cocaine. And I thought, Oh my gosh, what
• 21:46
  about hormones? Well, her GP refused to
• 21:48
  prescribe them. She wanted to feel better.
• 21:51
  And a lot of people actually said in our survey that we did
• 21:55
  in the free text comments, they were taken to try and improve
• 21:57
  their confidence because they felt been perimenopausal,
• 22:01
  menopausal. Their confidence had gone, their
• 22:03
  self esteem had gone. They wanted confidence or they
• 22:06
  wanted to help sleep as well. So some of them were smoking
• 22:09
  cannabis to help them sleep. Some of them were taking Class A
• 22:12
  drugs. Some of them, one lady just
• 22:14
  said, I want to escape this cage of doom.
• 22:16
  And we had over 1300 responses in a very short space of time.
• 22:20
  And it made me weep literally reading these comments.
• 22:24
  We're letting down people, but think and also, you know, 5% of
• 22:28
  them had increased gambling as well.
• 22:30
  Yeah, yeah, so and it's so easy now to gamble on the your phone.
• 22:34
  It's you don't have to go and make a left. 33 million active
• 22:38
  online gambling users. Which?
• 22:41
  Really shocking. It's so shocking.
• 22:43
  So we're doing some more research with the charity Gordon
• 22:45
  Rudy about the role of hormones and hormone changes with with
• 22:49
  gambling. But it's it that's a bit that
• 22:52
  people almost just think, oh, that's just for down and out
• 22:56
  people. That's just a small proportion.
• 22:58
  But I think it's a big hidden epidemic, actually, the
• 23:01
  gambling, the addiction. It doesn't just affect the
• 23:03
  individual like. Of course it does like.
• 23:05
  It really affects the nuclear family and also workplace and
• 23:09
  the community, so it ripples through.
• 23:11
  So you have to look beyond just purely the gamble.
• 23:13
  I think I saw one stat which showed that 7% of the UK
• 23:17
  population is either directly or indirectly affected by someone
• 23:21
  who's gambling or they are themselves have problematic
• 23:24
  gambling use. So it is an area that needs to
• 23:26
  be explored. And it's just one of those other
• 23:28
  ways of of looking for that dopamine here, as you say,
• 23:31
  trying to either manage or treat in some way that you can use
• 23:36
  that word an other underlying issue which isn't being
• 23:40
  addressed. Absolutely.
• 23:41
  And I think that goes into one of your other pillars is about
• 23:43
  relationships with people. Yeah, because people think
• 23:47
  lonelier probably than they have been before and partners
• 23:52
  relationships can really change. And I think if you haven't got
• 23:56
  that, it's so important, you know, that oxytocin just from
• 24:01
  having a hug, the social connections.
• 24:03
  And, you know, I'm quite socially awkward.
• 24:06
  I don't really enjoy going out at the thought of going to a pub
• 24:09
  and talking to people. Just I can't stand because I'm
• 24:11
  not sure to go home and read. And you know, but I'm very
• 24:14
  lucky. I meet lots of people with my
• 24:16
  job and my work, and I have a very social job like you.
• 24:19
  Aren't quite surprised that you. Yeah, no, I'm very socially
• 24:23
  awkward. Yeah, it's really interesting.
• 24:25
  I'm quite a complicated person. So we, we have a very people
• 24:29
  person, you know, people job. Whereas if I was sitting behind
• 24:32
  a screen working from home all the time and didn't have good
• 24:36
  social connection. And I have a very solid
• 24:38
  relationship with my lovely husband and I'm very fortunate
• 24:41
  with my family. But you know, you can see how
• 24:44
  it's different to maybe it was 20-30 years ago for a lot of
• 24:47
  people. Because it's more than just
• 24:50
  being connected to people and having.
• 24:53
  Yeah. Friends.
• 24:53
  Because it's deeper than that. Because actually, if you look at
• 24:57
  the highest rates of loneliness, it's in young people.
• 25:00
  It is. And they have lots of
• 25:01
  technically social connections, like if you add it up, you can
• 25:04
  draw out a really nice map. But they report highest levels
• 25:08
  of loneliness. And so we're talking about
• 25:10
  quality of relationships. And for me actually, I have all
• 25:14
  the pillars in my own lifestyle journey.
• 25:16
  I know we've talked about physical activity, etcetera.
• 25:18
  It was the healthy relationship one that was the first one I did
• 25:22
  because to, in order to really combat that addiction to food
• 25:25
  that I had, I really leaned in on my relationship with my wife,
• 25:30
  relationship with close friends. I needed people to help me to
• 25:33
  see things I couldn't see. I was clouded and they really
• 25:39
  supported me on that and kind of gave me advice and helped to
• 25:42
  sort of shift my decision making and realise other things.
• 25:46
  And so I think healthy relationships gets ignored.
• 25:49
  It does and I think relationships are very
• 25:51
  different. You know, I even, I apologise to
• 25:53
  you before we came on air because this is about social
• 25:56
  media, you know, I see that you had an awful injury, you fell
• 26:00
  off your bike and I was like oh pussy, that's really awful.
• 26:03
  And I did I reach out to you the first few weeks?
• 26:05
  No, I didn't because I just, no, but it just, it just shows that
• 26:09
  we're very, it's very different. Like in years gone by, you
• 26:12
  probably would have phoned me or written me a letter and said,
• 26:14
  oh, I've been, you know, had this sort of injury and I would
• 26:16
  have gone, Oh my goodness, are you OK?
• 26:17
  Can I do anything? But it's that sort of thing.
• 26:20
  And then when you get so many likes on your social media, it's
• 26:23
  like, oh, I'm really popular. Like it means nothing really.
• 26:27
  I mean, of course, don't get me wrong.
• 26:28
  My social media is very important way of educating
• 26:31
  people. But I don't have friends.
• 26:33
  I don't know these people. And I know when I do a public
• 26:36
  facing event and afterwards if I do a book signing and I can feel
• 26:40
  the energy of those people, it's the most amazing feeling ever to
• 26:44
  have real people. And that's where change happens
• 26:47
  as well. And I can see when you're
• 26:49
  running with other people. Yeah.
• 26:51
  It's this camaraderie. It's it's changing together.
• 26:54
  And I think that's what we need to focus on a lot as healthcare
• 26:57
  professionals as well. Yeah.
• 26:59
  Like generally when you do things together, the perceived
• 27:03
  effort drops. Like we just talk about physical
• 27:05
  activity. We know from the evidence that
• 27:07
  group exercise really improves motivation, improves the sort of
• 27:12
  longevity that you do the particular activity, and it also
• 27:16
  reduces the perception of effort.
• 27:17
  Like that's brilliant. You can do that.
• 27:19
  And that's one of the reasons why the practice that I'm based
• 27:23
  at, we do community physical activity.
• 27:25
  Sessions. Where we don't even call it
• 27:27
  exercise, we frame it as a support group, as a place for
• 27:30
  people to come and chat and to move outside.
• 27:33
  We're very lucky in Leamington. We've got beautiful parks,
• 27:35
  beautiful places to to move and it just, it just makes it so
• 27:40
  much more effortless. The number one thing that
• 27:42
  patients tell me they go, firstly, I've never walked all
• 27:45
  around 5 kilometres before my life and I did that and I didn't
• 27:48
  even find it that difficult. I didn't even realise to the end
• 27:51
  when when I showed them on my watch that we'd done this
• 27:53
  distance. Like really, we've done that.
• 27:55
  Just because they were just. Tatting and having fun and and
• 27:58
  and just enjoying people's company.
• 28:00
  And so like look to see how can you develop more of those closer
• 28:05
  relationships. Maybe work on some of the
• 28:07
  relationships you already have. It's also the inverse.
• 28:10
  There may be toxic relationships going on in your life that you
• 28:13
  need to manage. Some of them you can't cut off
• 28:16
  for various reasons, but you can look to manage and control to
• 28:19
  limit the. Impacting so and I think, you
• 28:22
  know, we learned that quite early on in general practice.
• 28:25
  It's how you feel with other people.
• 28:27
  And I, I was very lucky when I was trained as AGP, my trainer
• 28:30
  was really good at the consultation models and
• 28:33
  everything else. But you know, if you're with
• 28:35
  someone and you're feeling a bit nervous, it's taken me a while
• 28:39
  to realise that it's actually 'cause they're nervous, yes.
• 28:42
  And the same, if someone's sad, you feel that sadness and happy,
• 28:46
  it's great, isn't it, You know? But the same with negativity, it
• 28:51
  can really affect you. And I feel very strongly that
• 28:56
  you've got to be positive. And this sounds a bit cheesy, I
• 29:00
  think, but it's true. And I have an, an affirmation
• 29:03
  diary that I write in every day. And my husband goes to me for my
• 29:07
  birthday. And every morning I have to
• 29:10
  write three things that I'm grateful for, three things that
• 29:13
  are going to make my day good and one thing that I just need
• 29:18
  to to remind myself about. And then in the evening, I write
• 29:21
  three things that have made my day good.
• 29:23
  And it's really like I, I'm quite an overthinker.
• 29:25
  So I was like, oh, I've got to get this right.
• 29:27
  And actually yesterday I was in a bit of a hurry and I thought,
• 29:30
  oh, so I was just happy to be alive.
• 29:32
  I'm happy to, you know, live in a peaceful country.
• 29:36
  And I'm happy to not have a migraine, you know, because
• 29:38
  they've just come out of having a really awful spell.
• 29:42
  It's quite. And I'm happy to have love and
• 29:44
  kindness. And, you know, it becomes very,
• 29:46
  very simple. It's not that I've got a new
• 29:47
  dress or I've got this or I've got that.
• 29:49
  It's not material things. And often it is friends and
• 29:53
  family and having a job. Yeah.
• 29:55
  And just and. We have to be intentional about
• 29:58
  identifying those positive things because we're naturally
• 30:00
  geared to want to look for negative things.
• 30:02
  Because it's going to. Help us survive, you know?
• 30:04
  Yeah. You know, those that survived
• 30:05
  were those that picked out the dangers in their environment.
• 30:08
  But in how we live at the moment, luckily our environment
• 30:10
  isn't filled with that many direct dangers.
• 30:13
  Yes, lots of lifestyle elements. That means long term.
• 30:16
  But we need to sometimes be able to be intentional to go, do you
• 30:19
  know what actually, what are the positive things happening?
• 30:21
  I had to do that big time in the accident because my brain went
• 30:24
  straight into negative mode. Oh my God, the whole 48 hours
• 30:28
  afterwards I was just telling my wife all the negative things and
• 30:31
  why this was the worst time that it could happen.
• 30:33
  And she told me a very important thing.
• 30:35
  She goes OK, when would be the best time for this to happen?
• 30:38
  And I was struggling to find the best time.
• 30:42
  And so it took me a bit of time. And I don't write it down, but
• 30:46
  for me, like I often will start, if I'm going to be sort of
• 30:49
  starting the day, I'll just think of, OK, what was I most
• 30:53
  proud of yesterday and what am I most looking forward to today?
• 30:57
  And so it can mean it's different things to different
• 30:59
  people, but just be intentional in trying to pick out the
• 31:02
  positive elements because no matter who you are, there are
• 31:05
  always positive things going on. And I love to speak to those
• 31:08
  that have gone through some incredible adversity.
• 31:11
  And often when you hear them, they still speak about the
• 31:14
  positive elements and the things that they're grateful for.
• 31:17
  And I'm thinking, goodness, like, how can you pick that out
• 31:20
  in an experience like? That so important.
• 31:22
  So gosh, we've covered a lot. There's so much, but you will
• 31:24
  come back, I'm sure the three things like it's a new year now,
• 31:28
  a new beginning. We all have these great new
• 31:31
  attentions, what we're going to do, and they often don't last
• 31:33
  beyond January. And I'm really keen for this
• 31:36
  conversation to be continued, to be thinking positive, to be
• 31:40
  thinking about your six pillars plus one hormones, and to be
• 31:44
  thinking about being true to yourself, to really being
• 31:50
  completely honest and thinking what else can I do to improve my
• 31:53
  lifestyle, my movements, my, my sleep, my nutrition, everything
• 31:58
  else as well. So what 3 tips for people not, I
• 32:04
  don't want to say New Year's resolutions.
• 32:06
  I don't want to say things for the new year.
• 32:08
  Three things that you think should be able to last
• 32:11
  throughout the year and beyond that people could do.
• 32:13
  OK. So tip number one, that is
• 32:17
  measure your goals correctly. So what I mean by that is don't
• 32:23
  always measure your changes in lifestyle from weight lost.
• 32:26
  I actually hate that as a measure because it doesn't give
• 32:29
  you a good picture of the work that you've put in.
• 32:32
  So many people will say I do so many things and I don't lose the
• 32:35
  weight and they get demotivated, they stop doing those things.
• 32:38
  But then I go, well, all those things were helping your
• 32:40
  cardiovascular health, they were improving your longevity, they
• 32:43
  were helping your mental health, etcetera, etcetera.
• 32:45
  So find various different ways of assessing the thing that
• 32:50
  you're going to do. Maybe you're going to measure on
• 32:52
  how it makes you feel or your anxiety levels, or maybe it's,
• 32:56
  you're going to measure how many people you're going to spend
• 32:58
  time with each week that that that you enjoy.
• 33:00
  So find measurements that are personal to you that you can use
• 33:03
  to track whatever it is that you want to do #2 is I want you to
• 33:08
  draw a circle on a piece of paper.
• 33:10
  I want you to split it up into those pillars that we've spoken
• 33:13
  about and I want you to fill in the amount of that particular
• 33:18
  slice that you feel confident that it's a strong pillar.
• 33:22
  So if you feel it's really strong, colour it all in.
• 33:24
  And then I want you to look at that pie chart and see which
• 33:28
  ones are currently deficient in and then target what you want to
• 33:33
  do to the pillar that you feel one has progress to make, but
• 33:38
  two you can. It's low hanging fruit.
• 33:42
  You go, do you know what? I can make some changes here
• 33:45
  that's going to make a difference early on.
• 33:47
  Start there before you tackle some of the bigger things that
• 33:50
  you're going to need to eventually start with small
• 33:52
  wins. Build up that confidence because
• 33:55
  as we talked about, it's interconnected.
• 33:56
  So if you can improve the other areas of the pie chart, it will
• 33:59
  make improving the other slice that maybe it's really low down
• 34:03
  easier to do. If you focus on where the fire
• 34:05
  is, then unless you have the whole systems in place
• 34:09
  elsewhere, you're going to find it really hard to control a
• 34:11
  difficult area. Then finally, and I really,
• 34:14
  really mean this, look to just bring more fun into your life.
• 34:20
  Because when I look back, yes, I was overweight, yes, I had high
• 34:22
  blood pressure, yes, my liver was was a mess, but I just
• 34:26
  wasn't enjoying life. I just wasn't having fun.
• 34:30
  I was constantly tired, I was constantly anxious.
• 34:34
  I had like self esteem that was non existent and I just moved to
• 34:38
  go. Let me just enjoy my life more.
• 34:41
  Let me have things in my day that made me laugh, things in
• 34:45
  that day that made me smile or made me, you know, feel, you
• 34:48
  know, shocked with surprise. Do that because that I promise
• 34:52
  you, whatever activity you find that makes you feel like that, I
• 34:56
  can nearly always guarantee it's going to be healthy for you.
• 35:00
  OK, so just have more fun because often people are
• 35:03
  struggling. They then take on a lifestyle
• 35:05
  change that's quite difficult and that causes even more
• 35:09
  struggle. And yes, it may be bringing some
• 35:11
  health benefits, but you're finding it really challenging
• 35:13
  and boring and, and, and difficult.
• 35:15
  Start with the fun. OK, if you're having loads of
• 35:17
  fun already, good for you. Then maybe take on some of the
• 35:20
  more difficult things, but start with firm.
• 35:22
  Love it. Thank you so much.
• 35:23
  It's been brilliant. Thanks.
• 35:25
  Thank you.