What I Did First

I was in a position where I knew that losing weight was going to require looking at my mental health, diet and exercise.  Any exercise I did had to be extremely low impact and also low cost.  Walking was the obvious thing but in order to do that, I had to leave the house.  At that point in time, there was no way I was able to do that alone as my anxiety was sky high.  My husband was often working and my circle of friends had really shrunk.  I knew if I was going to succeed in losing weight and being healthier, I had to start changing everything, one small step at a time.

We have done Slimming World before, back when it was red and green days, and knew the gyst of it so the plan was that we would start doing Slimming World by ourselves at home.  I was able to find a set of books so I knew the Syn values and what things were a Healthy Extra A and what things were a Healthy Extra B.  My husband was keen to do Slimming World with me.  He had a lot less weight to loss than me and is a very fit person who enjoys cycling, but he had a BMI over 30 at that time.  So we were both on board and knew what we wanted to do.

Skipping ahead slightly, doing it at home by ourselves was tough for so many reasons and we did eventually join a group, which we have been going to for over a year now.  I didn't know you can join as an online only member either, which gives you access to all the resources but no group.  I also didn't know that in some parts of the country you can get a free trial for 12 weeks, depending on what is funded locally.

Apart from that, I knew I needed as much support as I could get.  My first step was to look on my GP's website.  I found there were different organisations with websites I could look at and some things I could do self-referrals for.  I also made an appointment to speak to a Doctor.

I easiest thing was accessing the Healthy Cornwall website which is an organisation publicly funded to support people becoming healthier across Cornwall.  I looked at their services and there was no obvious fit for me.  They had links to walking groups and there was one in my town that met at a park.  It was at a time when I would have no access to a car.  At the time, just walking to the other end of the road to go to the shops by myself was a huge challenge both mentally and physically.  Walking to that park and back was too much to contemplate.  

I did contact them and they encouraged me to look at their website to see which services I wanted to access.  I think it's important to remember that these sorts of services often have a higher demand than they can support.  The staff do not have time to hold the hands of everyone that contacts them.  I wasn't confident enough to make anything they appeared to offer match me at that time.  But I had made a connection though and Healthy Cornwall has been a huge support in my journey, because at different times, there have been things that have been very helpful.

So for self-referrals I found I could refer myself to an organisation called Outlook SW, now NHS Talking Therapies.  They offered mental behaviour support focusing around a short course of Cognitive Behaviour Therapy.  What I thought I needed at the time was deeper psychological support around my eating habits and that just wasn't what they did.  When I had my first telephone call to assess me, it became clear I wasn't going to get what I wanted but it also was clear they could still help me.  We agreed to focus on my anxiety so that I could begin to leave the house by myself to go walking with my dog.  I had to wait only a couple of weeks before I began my online CBT sessions.  It took time to see improvements but it was hugely helpful.  My anxiety is no longer crippling.  I finished my first set of appointments at the end of the year and was then referred on for further support.  It took a while to come through but it gave me time to keep working on the things I had learnt.

The other useful self-referral is to physiotherapy.  I know I would not expect to actually see someone.  My husband had a work related injury to his wrist and he used the service.  It's online via an app, although he did have telephone contact with a Physio.  It's actually a service that has been suggested to me before.  I had a very painful knee a few years back and although it turned out to be muscular, I did have an x-ray.  They found I have the beginning of arthritis and am showing some wear to my knee joint.  This is not a huge surprise given my weight and that others in my family have similar issues.  It was suggested I use this physio service.  I didn't, but I did go and get a sports massage which sorted things out.  I have been thinking of doing a referral soon, because I can see I have some issues as well as the beginnings of arthritis.

I spoke with friends who had been starting to exercise more and some friends in Canada suggested Conqueror virtual challenges.  You pick a challenge and each time you complete an activity you add it to that challenge.  When you finish there is a lovely medal and on the way there are postcards and you get to have an environmental impact by planting trees or reducing ocean plastics as you reach milestones.  Its a great motivational tool and people use them for all sorts, not just sports.  My first challenge was the Amalfi Coast and I nearly completed it by the end of the year.

I also did other things, like I set myself up a scavenger hunt with different things to find each week randomly chosen from a big list.  That was fun and took my attention away from how bad my body felt and on to what I was seeing around me.  Walking was still tough.  I was going out a little but with the darker evenings, it was hard to find time to go out with my husband.  My walking was getting less and less as we came towards the end of the year.

The Doctors appointment wasn't straight away as it as definitely non-urgent.  He was impressed with the things I had already done and what I had set in motion.  The thing he was able to offer me was a referral to the Weight Management Service, although he had no idea what the current waiting time was.  It was the following Spring by the time I got my first appointment.  The NHS is wonderful and it gets there eventually, for most people.  I wasn't prepared to sit and wait for whatever they were going to offer me though.  I needed to continue my efforts in the mean time, stay focused and motivated and make some progress.

But...  we struggled doing Slimming World at home by ourselves.  I lost about a stone before we ground to a halt.  It was hard because my husband wasn't a 100% on it and I found it hard to maintain without him being focused.  We had made some basic changes though and I was not eating as badly and I didn't regain the weight I lost, even though we got to Christmas, which is a notoriously difficult time for weight loss.  I knew this was just a pause though and we would restart in the New Year, perhaps with a little more consideration on how we would do things diet wise, more work on my mental health so I could walk more.

My mental health was challenging but the sessions really helped me.  I always knew I was a little agoraphobic and thought that was the main issue but we found some social anxiety lurking too.  We were looking at exposure therapy and removing my supports, so doing things by myself without my crutches.  For me, this meant walking without my husband or my dog...  and I just couldn't do it.  I nearly gave up on CBT with that realisation but my session was actually great.  By finding what I was really terrified of, we started to uncovered the issues hidden behind my agoraphobia.  Plain and simple, it's stranger danger.

The problem with being terrified of people, especially men, because of the bad things that could happen, is that no one can tell you they won't happen.  I have lived here for some time and seen the town struggle and a rougher type of person appear on the streets.  Drug dealing is more obvious now.  Homeless people are everywhere in town.  There are some very difficult antisocial people around.  So by the end of my set number of sessions, we had identified more of my issues with going out alone and while they were not solved, I was approved for further sessions, though there would be a waiting time.  I had a variety of CBT tools to continue working with and needed time to process and implement things at a speed I could cope with.

So even though the diet and exercise had tailed off, it never felt permanent, because I was still working on things.  I think that has been key for me so far.  One piece of support has come in to place and then finished, then another has come from somewhere else.  So far, there has always been something coming along in the pipeline.  It has never felt like it has stopped.  Momentum may have shifted to a specific aspect for a time but that isn't a full stop.  So I think that would be my advice for those contemplating a long term weight loss journey...  Say yes to professional help and support and be prepared for waiting times.  Don't let things stop altogether and be prepared to shift focus.  Eventually barriers will disappear or lessen as time goes on and it will become easier.  Try and remain hopeful that change can happen.