A principle Of Self-Love

I’m a Health Practitioner at Achieve Oxfordshire. When I first started it was a very different job title. It was wordy: ‘Specialist Mental Health Weight Management Practitioner’. And if you say specialist, you’re in that consultant range, which I certainly am not. I work specifically with people that have mental health conditions, either self or clinically diagnosed, to deliver Gloji Mind+. We call it a weight management programme, as opposed to a weight loss programme. It’s 12 weeks of one-to-one sessions, with the aim of around a 5% body weight loss. But actually, it's been a lot more about the background work, about people’s relationship with food and with their body more so than the scales. The bigger success is knowing that you actually feel more comfortable around food, more loving and accepting of your body, so that you have the motivation to start caring for that body. It’s such intimate work. There are some days where it is particularly heavy, but when you have a fulfilling day, you have such a fulfilling day.

We've got this KPI of weight. And I'm happy to weigh patients every week or month. But if they feel like that's going to demotivate them across time, we can just go entirely by feeling, entirely by clothes, because that's the stuff that matters to me. When I lost weight, I didn't jump on the scales once and then suddenly I did and I was like ‘oh, God!’ When I address not chasing the scales, I'll talk about my own journey. I was quite an overweight teenager, struggled with my weight for years and years. And even now I still have my moments where I completely struggle with how I look or what I'm eating. That's why a principle of self-love and self-reflection is far more important than anything that you see on the scales.

Seeing someone develop a better relationship with themself is such a beautiful thing to witness. I become someone that sort of guides, but for the most part, a lot of someone's journey is often guided by themselves. In the first week we ask people: How important are these lifestyle changes for you? And how confident are you on a scale of one to 10? When they’ve scored a seven or so, there are certain factors that give them momentum. Maybe they've gone to the grandkids and they couldn't be as energetic with them, or they've got a daughter's wedding lined up. The motivation that keeps people really on path, when you boil it down, is entirely intrinsic: I miss who I used to be. I miss being confident. I miss being energetic. I miss all those traits that I used to like about myself.

A lot of people referenced COVID-19, the negative impact of lockdown, and the difficulty of working from home. Having a break from home or that break with friends is important. I think all of that sort of stuff does actually affect your weight and your health. It's very easy to become quite sedentary and it just becomes like a domino effect. A few people even lost their jobs because their mental health got so bad. There is definitely something about being seen that keeps you afloat in a way, being social and being out in public also does. Having things to look forward to rather than it just being you and your home. I used to go for bike rides when all the gyms were closed and I’d always cycle past the McDonald's. No one there of course. The day that they opened up restaurants again it was queued all the way around the roundabout and I just thought: have we actually changed that much?

60% of our referrals are self-referrals and they're all through our Achieve Oxfordshire website. It’s often recommended by GPs, but we've also connected with local partners like Oxfordshire Mind, Aspire, Move Together, Oxford Health mental health teams, and we’ve also raised awareness through meetings and presentations. Each week we go over that person's week and integrate relevant nutritional information. It's also about trying to introduce more positive words into their narrative around themselves. It takes as long as it takes. I say to people: keep the tortoise in mind. Stay patient. About 75% of my clients are female, and one really big common thing that's come out is how much women will sacrifice their wellbeing to provide for their family. And it's concerning how normal sacrificing yourself is as a mum. It's something I admire completely, that level of selflessness. But I always say to them: how can you expect to do all of these things, always running on that 3% battery? You have got to take time to recharge.

Even though our services don't take on people with eating disorders, a lot of people don't get diagnosed. And it's very fluid. That's an area of health that is still quite difficult to navigate, especially in this profession when you’re talking about obsessive patterns or really unhealthy patterns with food. It can be quite a daunting thing where you feel like you're not actually trained enough in this. If a session goes beyond half an hour, it can turn into a counselling session. That can be fascinating when it comes to understanding someone’s approach to food. But maybe a person needs further help. You can have someone that binges, let's say, once or twice a week. But for them to go to actual professional care, it has to be at least three times a week. So even there it's a big safeguarding issue in the sense of how qualified are we to deal with this? And actually, does the training need to be revamped around this area just in case there are more extreme cases? That way, we can notice those patterns and say if someone needs something more, like tier-three help.

One thing I’ve come to realise is that sleep is one of the most overlooked things in mental health and physical health. It really affects someone's journey and their eating. A third of your life is spent sleeping. And it’s one of the most difficult habits to build, especially with a lot of the medications that people take. Some medications can mess up sleep hugely. Clients take their medication in the evening, they drop off and come the morning, they feel so sluggish and out of it that actually waking up can be a real struggle. Easily, 75% of my clients struggle with getting a solid eight hours of sleep. It's either very broken or very late bed times. If someone stays in late, they'll usually skip a meal, which can be a real difficult mindset change for a lot of people. They think I'm not eating till 12, why do I still need to eat three meals? It feels so controlled by their mental health or by their medication. We can discuss it. But it’s not like I can cure it. Sleep is so complex and we've only got half an hour in our sessions. So I'll give them all the tips that I can, how they can arrange a healthier bedtime, things they can do to wind down, things they can do to wake up more abruptly.

I’m a sensitive soul. I hate saying that goodbye when I see 12 weeks are up. But you've got to pull yourself out of it at some point. 12 weeks is a solid amount of time for people to bring their wellbeing, or the prioritisation of their wellbeing, to the forefront of their mind. I can support via telephone, video calls, and actually a lot of my clients are really responsive to texts. That expectation of half an hour can be too much for some people. So even a five to 10-minute call can help someone. My ideal program, the one that I think would make the most change, would be based in self-love. Because if you truly love yourself, then you will see the areas that you need to change. And I do think it's a lot. It's deep work. It's heavy work. But it would cause a lot more ingrained change, working from the inwards outwards, rather than just focusing on the surface level things.