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Covid-19 Update:

We are accepting all appropriate referrals into the service. Most consultations will remain remotely delivered, however where it is deemed clinically appropriate support will be offered face to face in a clinic venue or with you at home. 


The Specialist Weight Management Service in Leeds is a 12 month programme run by experienced healthcare professionals, including:

  • consultant physician (who specialises in obesity medicine)
  • physiotherapist
  • dietitians
  • mental health specialists

During the programme, the team will support you to make sustainable diet and life changes to improve your health. We may also refer you for further investigations or support from other services.

The sections below contain a range of useful links and resources.

What do I want to work on?

Being specific about areas that you want to focus on is important in creating a good plan that will help you with your goals.

Which of these are true for you?

Physical activity

  • I set myself goals for how active I’ll be each day or week
  • I follow an exercise plan/routine
  • When I’m being active, I push myself to my limits
  • I keep track of the physical activity that I do

Controlling cravings and mindfulness

  • If I feel like eating but am trying not to, I make myself wait a certain amount of time to see if the craving passes
  • If I feel like eating but am trying not to, I pause and ask myself if I’m hungry
  • I use smaller plates, bowls and glasses when eating to help with my portion control
  • I slow down how quickly I eat in an effort to eat less

Support and wellbeing

  • I acknowledge negative emotions and can speak to somebody, use technology or specific techniques (e.g. meditation) to help with these
  • I’ve tried to get my friends and family to support me in managing my weight
  • I belong to a group of people who are trying to lose weight together (e.g. an online discussion forum)
  • I use a weight loss service to help manage my weight (e.g. Weight Watchers, Slimming World, Lighter Life)

Meal and grocery planning

  • When I’m grocery shopping and items of food look similar, I make my choice based on the nutritional information on the food labels
  • I plan my food shopping in advance to help me stick to me stick to my plan (e.g. use a shopping list)
  • To avoid eating and drinking things that don’t fit with my plan, I don’t keep them at home
  • When I am food shopping, there are certain foods I stay away from to help me stick to my plan

Weight loss planning and monitoring

  • I use a chart, diary or app to track my progress in losing weight
  • I use a book, website, or app to look up the nutritional information and/or calorie content of the foods I eat
  • I check the portion sizes of the things I eat
  • I have a weight management plan, but I allow myself to be flexible about what I do depending on circumstances

Adapted from OxFAB Taxonomy and questionnaire: Hartmann-Boyce et al., (2016). Development of tools to study personal weight control strategies: OxFAB taxonomy. Obesity, 24(2), pp. 314–320

Select 1 or 2 sections from above that you want to focus on for the next few weeks. Click on these sections below for useful and practical information to support you.

Tips for making it easier to be active in your home

Getting your home environment ready for activity will make it easier to do it every day.

  • Do your activity at the same time each day. Think about the other people in your house and choose a time that is the easiest for you to fit in.
  • Start small and build up. If every day is unrealistic, start with 2 or 3 times a week.
  • Tell other people in your house your plan. Either ask them to join in or stay out of the way.
  • If you have space in your home, you can make an area that is specifically for your activity.
  • If you live alone, tell friends or family so they do not call you during this time.
  • Write ‘activity’ on your calendar or in your phone, as a daily reminder.
  • Find clothes that are comfortable to be active in and get them ready, e.g. if your activity is in the morning, get them out the night before.
  • Celebrate every time you complete an activity! Whatever you have done is better than nothing, so congratulate yourself. Think of the positive things you would say to a friend who had just done this, now say them to yourself.
  • Think about your common reasons for not doing activity and how you can avoid this ‘danger zone’. For example:

Danger Zone 

Planned Action

I want to do my activity after I have finished my working day, but I am always too hungry.  I will have a snack (fruit, crackers) one hour before my working day finishes.
I am stressed and don’t think I have the energy to do my activity today.  I will remind myself that exercise will help reduce stress and improve my mood.
I have been invited to a zoom call during my scheduled activity.  I will get changed into my exercise clothes and call my friends after I have done my activity.

References:

Fogg, B.J. (2019) Tiny Habits. London: Virgin Books.

Otto, M. & Smits, J (2011). Exercise for Mood and Anxiety: Proven Strategies for Overcoming Depression and Enhancing Well-bring. Oxford University Press.

Pilling, S & Newman, R (2012). Braintree self help guide. London: London Strategic Health Authority

Recommended equipment:
Thera bands – choose multi-level bands with handles (suitable for everyone and can be bought online)
Weighing scales – choose digital ones to easily track any weight changes (can be bought online or from big supermarkets)

Intermediate Home Exercises

AT HOME WEIGHT MANAGEMENT

Exercise

Duration

Reps

Sets

1 Jogging on the spot 1xmin    
2 Dynamic sidesteps 1xmin    
3 Running butt kicks 1xmin    
4 Warm-up / Jumping Jack 1xmin    
5 Small And Tall 1xmin    
6 Boxing with weights in hands      
7 Skipping rope      
8 Walking      
9 Chair stand   12-15 3-4
10 45 degrees Push Ups   12-15 3-4
11 Push-ups on knees   12-15 3-4
12 Leg Raise / Abduction   12-15 3-4
13 Side Plank Knees Bent 30 seconds 4  
14 Mountain climber 30 seconds 4  
15 Squat-curl-press combo   12-15 3-4
16 Shrugs with weight   12-15 3-4
17 Shoulder abduction with band (90°)   12-15 3-4
18 Front raise with band   12-15 3-4
19 Bent-Over Row   12-15 3-4

Number 1-5 is for warming up. Number 6,15-19 can be done with shopping bags filled with water bottles 1L = 1 KG if too easy or tins around the house. Search YouTube for Home exercise videos. Aerobics classes on Youtube, Dancing If you have a Fitbit or Apple watch, anything that gets your heart rate up to 120bpm will be good.

Adults - More Links

Exercise with children and young people

Cravings and mindfulness Advice

What is mindfulness?

“The awareness that arises from paying attention, on purpose, in the present moment and non-judgmentally.” Jon Kabat-Zinn

What is mindful eating?

“Using all your senses in choosing to eat food that is both satisfying to you and nourishing to your body… Becoming aware of physical hunger and satiety cues to guide your decisions to begin and end eating.” Megrette Fletcher

An image of the Hunger scale

Benefits of mindful eating

  • Helps develop a better relationship with food and body image
  • Has been shown to help with weight loss and improve food choices
  • No strict rules, no cost and can be simple to practice
  • Can help reduce stress and anxiety levels

Mindful breathing

Try this technique on a regular basis, when you have cravings or during times of stress.

  1. Sit comfortably but upright and close your eyes.
  2. Watch the breath without changing it. Observe the feeling in the nose, rise and fall of chest, etc.
  3. Thoughts will arise. Notice these but do not fight or ‘feed’ them.
  4. Bring the attention back to the breath. Don’t worry if you are bringing your attention back many times – this is the practice.
  5. Start with a 5 minute practice and increase gradually. Setting a timer is helpful to prevent checking the time during the practice.

Top tips!

  • Use the hunger scale to rate your hunger before, halfway through and after eating.
  • Create a pleasant eating environment and try to minimise distractions.
  • Slow down your pace of eating by chewing more and putting your knife and fork down at regular intervals
  • Use smaller sized plates and bowls.
  • Focus on the present moment whilst eating: the smell of the food, texture and the various tastes of the food. Notice how all these things change moment by moment.
  • When you have a craving, try the mindful breathing exercise above and allow at least 30 minutes to see if the craving reduces.

More Links

Tips on how to make a daily schedule

Making a schedule at this time might seem like a difficult or strenuous task but it will make it easier to organise your daily life. If you live with other people (family, friends) consider making a schedule together, to take into account everyone’s needs and requirements. A routine can help to break up the day, support mental wellbeing and help promote positive eating and physical activity habits.

  • Try to go to bed and get up at the same time. It may be tempting to lie in, especially if you do not need to get up for work, but doing this on a regular basis can disrupt your sleep
  • Get dressed for the day, even if you’re not going anywhere.
  • Set yourself small goals that are easily achieved and celebrate when you are successful at these.
  • In your schedule, include:

- When you will eat (also think about when you will go shopping and planning meals)

- When you will do your physical activity, e.g. going for a walk or an exercise routine at home

- When you will work (if you are working) – try to stick to your normal work times

- When you will do your chores / household jobs

- When you will do something that is good for your mental wellbeing, e.g. speaking to friends / family on the telephone, reading, doing a jigsaw, watching a film

  • If you can, find some space where you can work if you are working from home – make it your ‘office – place for work’.
  • Try to get some fresh air every day, even if it’s just a walk around the garden.
  • Be flexible! The schedule is a guide; it is ok go with the flow sometimes.
  • If you are spending a lot of time at home, you may find it helpful to keep things clean and tidy

References

UNICEF (2020) How to organize time in home quarantine. [Online] Serbia: UNICEF. Available from: <How to organize time in home quarantine | UNICEF Serbia> [Accessed 30.04.2020].

Mind (2020) Coronavirus and your wellbeing. [Online] Mind. Available from: <Coronavirus - looking after your mental wellbeing | Mind, the mental health charity - help for mental health problems> [Accessed 01 May 2020].

NHS (2019) How to get to sleep. [Online] NHS. Available from: < How to get to sleep - NHS (www.nhs.uk)> [Accessed 01 May 2020]

 

Support and wellbeing

Reflecting on how you feel

  • Take time to think about your feelings and emotions. Writing these down may help.
  • Are these positive, negative or neutral?
  • How often do you feel negative emotions and are there common triggers?
  • When do you feel more positive and what helps with this?
  • How does your mood effect your weight loss plan?
  • How many hours do you sleep and is it disturbed, light or deep?

A scale to rate your confidence and motivation from 0 No motivation to 5 Fairly Motivated to 10 Extremely motivated. How can you increase your motivation? You do not need to aim for a 10 - if you scored 6 then think about what you need to do to get to 7 o

Getting the support you need 

Who can support me?

  • Friends and family: speak to them about your goals. What can they do to help you?
  • Online weight loss groups and forums
  • Speak with your GP
  • See the links on our website under Support and Wellbeing
  • Weight loss apps and websites
  • NHS Mental Health and Wellbeing website for tips on reducing stress, anxiety and improving sleep

Adults - More Links

Meal and grocery planning

Traffic light system

Look out for the food products with green, amber or red coloured labels on the front of the pack. At a glance, they show you if the product has low, medium or high amounts of fat, saturated fat, sugars and salt, helping you make a better choice.

RED - It’s fine to have this food occasionally or as a treat, but think how often you choose it and how much of it you eat.

AMBER - A better option than red and it is fine to have this in moderation. This would be an ok choice.

GREEN - This means a healthier choice.

Front of pack labelling system

  • Calories, fat, saturated fat, sugar, salt
  • Traffic lights
  • Serving size
  1. Look out for the serving size. How does this compare to your portion size?
  2. The colours represent the Traffic Light System, a useful guide to help choose the healthier option.
  3. The % are based on ‘reference intakes’ similar to GDA. Remember these are not accurate for everyone.
  4. Energy: Lower calorie (kcal) content foods can be useful when we are trying to lose weight, but check ingredients on the back - what is it made from?
  5. There is information per 100g on the front. For energy, you can compare different products with different serving sizes ie. another cereal that shows information per 50g.

Front of pack labelling system with an image of a food label and five textboxes linking to it: Look out for the serving size. How does this compare to your portion size? The colours represent the Traffic Light System, a useful guide to help choose the heaTop tips!

  • Plan your main meals and snacks for the week ahead. It may help to put this up somewhere visible, like on the fridge.
  • Before you go shopping, make a list using your weekly meal plan. This will help to reduce impulse buys.
  • Use food labels to make healthy choices when in the supermarket.
  • If you cook and shop with other people in the house then try to create the meal plan and shopping list together.
  • If other people in the house have higher calorie snacks or you have these as occasional treats then put somewhere not easily visible, e.g. back of the cupboard. 

 

More links

 

Weight loss planning and monitoring

Why long-term change is important

What determines my body weight?

There is a pre-set weight at which your body will work best. This does not always fit into the healthy BMI range that many health professionals talk about.

This is the weight your body naturally returns to after short term under or over eating or exercising.

If your weight has been increasing for a long time, your body may forget what your natural pre-set weight is, and keep returning to your increased weight. This can make it hard to lose weight and keep it off.

How can I change my weight?

The longer you have been a certain weight, the more difficult it is to ‘re-set’ your body to its natural weight. The good news is it can still be done!

It requires a lot of will power and effort. Usually you must remain at your new weight for 6–12 months before your body agrees that it is your natural weight.

Being able to stay on track and keep motivated in the long term is really important in your journey to success.

How are your new healthy changes going? Record the following:

A healthy change you are achieving

What is going well? e.g. getting up 5 minutes earlier is no problem and I can manage it everyday

A healthy change you are finding difficult e.g. doing everyday activity

What is holding you back? e.g. I have fallen out of the habit

Date

Weight

Goal

     
     
     

Top tips!

  • Create a sensible long term goal, e.g. between 5 and 10% weight loss in 6 months.
  • Weigh yourself weekly or fortnightly.
  • Track your weight changes by making a graph, use an app or simply write down your weight in the table opposite.
  • Write down your weight loss plan, make it specific and put it up somewhere you can see, e.g. on the fridge.
  • Recognise and celebrate positive changes made!

 

Weighing Scales

Below is a list of weighing scales that are available to buy for your own use at home.

Please note NONE of the models listed below are specifically endorsed by our service.

Before you make a purchase we would recommend you;

  • Read reviews of a product before you buy it
  • Choose digital scales if possible
  • Consider how heavy it is (in case you want to move it)
  • Consider how low to the ground it is (for ease of stepping onto them)
  • Consider whether the company offer a refund or guarantee
  • Consider whether it comes with batteries

Capacity – up to 180kg

https://www.argos.co.uk/product/8154776 maximum weight 182kg (Argos): £15
https://www.wilko.com/en-uk/salter-compact-glass-electronic-bathroom-scales-9208-bk3r/p/0488256

maximum weight 180kg (Wilko):  £12.00

https://www.johnlewis.com/john-lewis-partners-white-glass-digital-bathroom-scale/p3991112 maximum weight: 180kg (John Lewis): £25.00
http://www.salterhousewares.co.uk/bathroom-scales/salter-digital-bathroom-scales/salter-glass-electronic-digital-bathroom-scales.html maximum weight 180kg (Salter): £25
https://www.victorianplumbing.co.uk/pink-tempered-glass-bathroom-scale  

maximum weight 180kg (Victorian Plumbing): £24.95

https://www.amazon.co.uk/Etekcity-Precision-Bathroom-Technology-Backlight/dp/B016QN8QDM

 maximum weight 180kg (Etekcity): £16.98

Capacity – up to 250kg

https://www.argos.co.uk/product/9210255   maximum weight 250kg (Argos): £25
https://www.stressnomore.co.uk/extra-wide-talking-scale-92642.html maximum weight 250kg (Stress no more): £35
https://www.ebay.co.uk/c/1023757814

maximum weight 200kg (Uten): £13.99

More Links

The Leeds Specialist Weight Management Service provides a comprehensive programme to support people with weight loss where there have been significant previous challenges. As well as support from Physicians, Dieticians and Physiotherapy, the programme includes access to mental health professionals through Leeds and York Partnership NHS Foundation Trust. They will be able to assess and work with you to establish any psychological components of your weight management which may be a current barrier to weight loss.

The psychological services available through the specialist weight management programme in Leeds include:

  • A one hour assessment delivered by a Consultant Psychiatrist
  • One to one follow up from a Consultant Psychiatrist – the number of sessions and frequency will be based on individual need
  • Cognitive Behavioural Therapy: one to one sessions delivered by a Cognitive Behavioural Psychotherapist
  • A cognitive behavioural therapy group specifically for Binge Eating Disorder delivered by a Cognitive Behavioural Psychotherapist

Psychiatry

It may be identified that it could be beneficial for you to explore whether there is a psychological component of your weight management. If you consent, you will be referred for an assessment with a Consultant Psychiatrist. This will involve meeting our Psychiatrist face to face for approximately one hour. You will be asked questions around your past and current mental health and how this is impacting on your current problem with weight management. From this assessment, a plan will be agreed with you. This could include medication, therapy or a combination of the two. If required, follow-up appointments with the Psychiatrist will be arranged.

Cognitive Behavioural Therapy

Following your assessment with the Psychiatrist, one of the recommendations may be for you to access Cognitive Behavioural Therapy (CBT). This is likely to be because you are experiencing depression and/or anxiety which are directly affecting your ability to start, maintain or continue with weight loss.

Cognitive Behavioural Therapy aims to support you to identify any unhelpful cycles that you may be currently stuck in by looking at your thoughts, feelings and behaviours. Often people with depression lack the motivation for doing the things that they know will be helpful for weight loss or they are stuck in a pattern of unhelpful and negative thinking. CBT can help identify ways to break the cycle so that you feel more positive and motivated and less anxious about your journey ahead.

Sessions will be on a one to one basis for an average of 6-8 sessions. This would usually be on a weekly basis.

Binge Eating Disorder Group

At assessment with the Psychiatrist, it may be identified that you are experiencing symptoms of Binge Eating Disorder. This condition is estimated to affect 20-40% of people who are overweight. The main features of the condition are eating large quantities of food over a short period of time, often in secret or alone. People who binge-eat regularly describe feeling depressed, guilty, ashamed or disgusted afterwards. This is a recognised eating disorder.

If you have symptoms of binge eating disorder, you will be offered a place in our cognitive behavioural therapy group specifically for Binge Eating Disorder. This is a closed group which means that once the group has started, no new members will join.

Sessions are weekly for ten weeks and then a further five sessions on an alternate week basis. If this is the recommended treatment for you, a separate leaflet on the group will be provided.

Contact us

Should you have any questions about the psychological interventions as part of the Weight Management Service, please contact:

Liaison Psychiatry Outpatients

Tel: 0113 8556730

Email: liaisonpsychiatry.lypft@ nhs.net

What is Binge Eating Disorder?

Binge Eating Disorder (BED) is a recognised mental health condition associated with eating an objectively large amount of food, over a short period of time. People with BED often feel that they cannot stop eating or control what or how much they are eating. It is common for people with BED to feel driven or compelled to eat and feel that they have no control over this.

BED is not about choosing to eat extra-large portions, nor are people who suffer from it just “overindulging” – far from being enjoyable, binges are very distressing afterwards. People will often describe feelings of guilt and disgust at themselves after a binge, frequently linked to their belief that they should have more self control. Binge Eating Disorder can affect anyone of any age, gender or background.

Treatment for Binge Eating Disorder

The National Institute for Clinical Excellence (NICE) have published guidelines which specify the most effective treatment for BED. They recommend that if self help is unsuccessful, group therapy specifically using a cognitive behavioural therapy approach should be offered.

What to expect from the group

Going to any group for the first time can feel very daunting. It can be really useful to remember that everyone attending the group will be experiencing very similar problems, regardless of their backgrounds, and most people will feel some degree of anxiety before coming. It can be helpful to understand the sorts of things that will be covered in the group, so we have provided a basic guide for you below.

  • What is binge eating disorder and programme overview
  • Cues and consequences
  • Thoughts, feelings and behaviours
  • How to challenge and re-structure your thoughts
  • Cues and chains of events
  • Impulsivity, self-control and mood enhancement
  • Body Image
  • Self-esteem
  • Stress management and problem solving
  • Assertiveness
  • Weight management
  • Relapse prevention including exposure to high risk foods and situations, and long term planning

If you feel unsure about the group or have any questions before attending, please call and speak to our lead therapist who will be able to talk you through what to expect in more detail and answer any questions you may have.

Accessing the group

Referral

To attend the group, you must be under the current care of the specialist weight management service in Leeds. You must be referred by one of the clinicians in the service specifically to the BED group.

Commitment

Attending group therapy of any type may feel like a significant commitment, both in your time and the emotional effort it takes. The group is 15 sessions in total over a period of 20 weeks. Whilst this may seem like a long time, we want to ensure that you are given the opportunity to really understand the information and strategies discussed as well as chance to make significant changes.

Contact us

If you have any questions about the group, please contact: Tel: 0113 855 6730

Tel: 0113 843 0894

Monday - Friday, 9:00am - 4:30pm

We offer a citywide service with our admin team operating out of:

Administrative Office
Parkside Community Health Centre
311 Dewsbury Road
LS11 5LQ

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