This is a CRACKER of an episode!

Join me as I chat to Dr Ed Pooley, GP…..

Ed works as an NHS GP with an interest in the interface between psychology and health. Prior to medical school he was a researcher in molecular biology, neuropathology and behavioural genetics.

When not working in primary care, Ed works as a communications consultant training doctors and healthcare teams to communicate more effectively with each other and with their patients (if you work in the medical profession you can buy Ed’s book here) – and all that experience certainly made for an interesting conversation!

We talk about the complexities of fat loss, body image and the influence of social media, bariatric surgery and the options for overweight people on the NHS, and even Slimming F*cking World gets a mention!

If you believe that the answer to obesity is ‘eat less, move more’ then you might wanna open your ears (and your mind), to listen to this.

If you loved this episode, please leave us a review.

If you’d like a question answered here on the podcast, just send it in to hayley@food.ninja and I’ll do my best!

And finally, if you’d like to hang out with a bunch of like-minded people, all focused on finding their version of healthy, you can join my FREE Facebook group here.

Enjoy the show!

Transcript
Speaker:

​ Hayley Food Ninja: Hello and welcome

Speaker:

Podcast with me, Hayley Food Ninja.

Speaker:

And today I am very excited to have a guest that I think we've been trying

Speaker:

to do this for a while, haven't we?

Speaker:

Because I've always thought, Oh, you'd be good to put a podcast because I know that

Speaker:

you watched some of my Facebook Lives and you always had a lot of good comments.

Speaker:

I was like, I'd like to talk to Dr.

Speaker:

Ed

Dr Ed Pooley:

Yeah, I think I just used to spring up and mildly troll you a bit.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And go, That's a great idea.

Dr Ed Pooley:

Or have you thought about this?

Dr Ed Pooley:

So yeah, it's, I've been looking forward to this for a long time.

Dr Ed Pooley:

Yeah.

Hayley Food Ninja:

Amazing.

Hayley Food Ninja:

So yes, my guest today is Dr.

Hayley Food Ninja:

Ed Pooley, Ed, do you wanna tell us a little bit about what you do, because

Hayley Food Ninja:

you are not just a doctor, you do a few other things as well, don't you?

Hayley Food Ninja:

Do you wanna tell us a little bit about that?

Dr Ed Pooley:

I currently work as a GP in Nottingham.

Dr Ed Pooley:

Before being a GP, I did lots of things before, so I was a

Dr Ed Pooley:

molecular biologist for a bit.

Dr Ed Pooley:

Then I was a geneticist, a neuropathologist, which

Dr Ed Pooley:

is what my PhD's in.

Dr Ed Pooley:

And then now that I've moved into general practice, I also work as a

Dr Ed Pooley:

communication skills trainer for doctors.

Dr Ed Pooley:

So I teach doctors how to communicate better with each

Dr Ed Pooley:

other and more effectively with their patients, particularly.

Dr Ed Pooley:

Challenging topics like obesity, exercise, health promotion, and things like that.

Hayley Food Ninja:

Wow, that is like fascinating.

Hayley Food Ninja:

I can't wait to talk to you about all this stuff because obviously I

Hayley Food Ninja:

have a lot of kind of stories, good and bad from my clients about their

Hayley Food Ninja:

experience with that kind of thing and people's language around it and stuff.

Hayley Food Ninja:

So that is super interesting.

Hayley Food Ninja:

And you've also written a book, haven't you?

Hayley Food Ninja:

Am I right in thinking, yes.

Dr Ed Pooley:

The first book I wrote was on time management.

Dr Ed Pooley:

It was about systems in general practice mainly in general practice, but how to

Dr Ed Pooley:

consult more effectively and the second book's out this year, which is on,

Dr Ed Pooley:

consultation styles and how to communicate more effectively with patients.

Hayley Food Ninja:

Oh, that'll be interesting for me to read.

Hayley Food Ninja:

Cause I'm always reading.

Hayley Food Ninja:

I like to read a lot of the books about, like motivational interviewing

Hayley Food Ninja:

and stuff like that because a lot of the type of clients that I

Hayley Food Ninja:

generally get tend to be chronic dieters, you might be a bit resistant

Hayley Food Ninja:

to change and that kind of stuff.

Hayley Food Ninja:

So I'm always interested in new ways to try and communicate with people and.

Hayley Food Ninja:

I guess be a little bit persuasive in terms of trying to get people to

Hayley Food Ninja:

change their behaviours and stuff.

Dr Ed Pooley:

It is, It's really interesting actually, that if you look

Dr Ed Pooley:

at the things that keep people stuck where they are, it's this sort of balance

Dr Ed Pooley:

of fear between wanting an outcome but being a bit fearful of the change.

Dr Ed Pooley:

Sometimes we get stuck in these psychological ruts of it.

Dr Ed Pooley:

It's better the devil, yeah.

Dr Ed Pooley:

And we become a bit change resistant and then the environment around

Dr Ed Pooley:

us becomes a bit change resistant.

Dr Ed Pooley:

Sometimes we get pushback from family members or friends who know us a

Dr Ed Pooley:

particular way and don't want us to change, or don't want us to to alter

Dr Ed Pooley:

that dynamic that may already exist.

Hayley Food Ninja:

Yeah I actually always make a joke of this cause I do

Hayley Food Ninja:

a little bit of role play around stuff like that because I've had so many

Hayley Food Ninja:

situations where people are in a group of friends, for example, if they're

Hayley Food Ninja:

the fat friend, The other friends don't want them to change because

Hayley Food Ninja:

who's gonna be the fat friend then?

Hayley Food Ninja:

You know it's gonna be one of them.

Hayley Food Ninja:

And it's really interesting, that dynamic, isn't it, where people have, they put

Hayley Food Ninja:

a label on you or you fulfill a certain role in a group, whether that be a

Hayley Food Ninja:

family or a community or whatever, and people have feel really uncomfortable

Hayley Food Ninja:

when you want to change that.

Dr Ed Pooley:

Hugely, when we get used to internalizing the language that people use

Dr Ed Pooley:

to describe us as well, we in some ways we do adopt that role and it becomes part of.

Dr Ed Pooley:

It's almost like a coat that's given to us that we put on and

Dr Ed Pooley:

we're not allowed to take it off.

Dr Ed Pooley:

And if we do, then we can feel a bit vulnerable, even if we don't

Dr Ed Pooley:

really like how the coat feels.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

Because we worry about being seen as something different

Dr Ed Pooley:

or something that's changed.

Dr Ed Pooley:

So yeah there's all of that.

Dr Ed Pooley:

That dynamic that goes on is fascinating.

Dr Ed Pooley:

Both in terms of weight, in terms of health, your psychology,

Dr Ed Pooley:

mental health particularly.

Dr Ed Pooley:

It's absolutely fascinating.

Hayley Food Ninja:

Yeah, I think it's probably the most favourite part of

Hayley Food Ninja:

what I do, because I realized really quickly when I started working with

Hayley Food Ninja:

people that I didn't actually have that many conversations about what to eat.

Hayley Food Ninja:

People know that, don't they?

Hayley Food Ninja:

They know what to eat, but there's so many things that prevent them from adopting

Hayley Food Ninja:

those behaviors family circumstances, stress, all of that kind of stuff.

Hayley Food Ninja:

So it's, I feel.

Hayley Food Ninja:

That stuff is harder to sort out for sure with clients, but is so much

Hayley Food Ninja:

more impactful because it lasts so much longer than telling someone,

Hayley Food Ninja:

Hey, just eat a bit more protein.

Dr Ed Pooley:

Yeah, and I think what I really like about your

Dr Ed Pooley:

approach particularly is that you incorporate that aspect of things

Dr Ed Pooley:

because I think just in the same way that I could give someone a tablet.

Dr Ed Pooley:

To take, to lower their blood pressure if they don't understand why they're

Dr Ed Pooley:

taking it or what the benefits versus the risk or, sometimes the way that they

Dr Ed Pooley:

might feel initially on that or that once that, that change starts to happen.

Dr Ed Pooley:

There's that sort of behavioral inertia that we have.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And it's really hard to shift initially, and we are really resistant to it.

Dr Ed Pooley:

And then once that shift starts to happen, we get that positive feedback and

Dr Ed Pooley:

then it makes it so much easier to do.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

Particularly when it's something that we associate with unpleasantness

Dr Ed Pooley:

or something that is challenging or going to alter the way that we live.

Dr Ed Pooley:

Because a lot of people, Particularly it comes to food.

Dr Ed Pooley:

They will structure their lives around food.

Dr Ed Pooley:

And we see this particularly with mental health issues, when people become

Dr Ed Pooley:

depressed, they'll either stop eating or they'll eat more, or they'll withdraw

Dr Ed Pooley:

a bit and everything becomes about.

Dr Ed Pooley:

Waking and going to bed.

Dr Ed Pooley:

And then they get a little bit better and a little bit further on that journey,

Dr Ed Pooley:

they'll start structuring around I've gotta get up cause I've gotta eat

Dr Ed Pooley:

breakfast and I've gotta eat lunch.

Dr Ed Pooley:

It's something to almost look forward to.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And it's a really hard line to tread in making food something that

Dr Ed Pooley:

you do that is part of your normal existence and also reframing it as

Dr Ed Pooley:

something that doesn't have to define

Dr Ed Pooley:

your existence.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And I think lots of people who work in nutrition often take this

Dr Ed Pooley:

kind of food is fuel extreme and it becomes really difficult to then.

Dr Ed Pooley:

Convince people that actually food is more than fuel.

Dr Ed Pooley:

It's about social interaction.

Dr Ed Pooley:

It's about sharing.

Dr Ed Pooley:

It's about connecting with people.

Dr Ed Pooley:

It's about shared enjoyment.

Dr Ed Pooley:

It's it's a bit like going to the theater and you are the one who's overdone it.

Dr Ed Pooley:

So you are in the corner with a blindfold and earphones on.

Dr Ed Pooley:

It takes away that, that humanness of it.

Dr Ed Pooley:

And if we don't, if we don't acknowledge that, how do we change anything?

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

I think that is so important because, food is emotional whether we like it or not.

Hayley Food Ninja:

We all emotionally eat, don't we?

Hayley Food Ninja:

Whether that's.

Hayley Food Ninja:

Because we are sad or because we are happy or because we're celebrating

Hayley Food Ninja:

food has got this really strong correlation with our emotions.

Hayley Food Ninja:

And I always say to people, it's not bad to eat emotionally as long

Hayley Food Ninja:

as you get the desired effect from it, maybe I feel a little bit sad,

Hayley Food Ninja:

so I might eat a bit of rice, put in with a blob jam in the middle.

Hayley Food Ninja:

Cause my nan used to give me that and it makes me feel happy.

Hayley Food Ninja:

But then if.

Hayley Food Ninja:

10 bowls of it and three packets of crisps and then I feel like shit and I

Hayley Food Ninja:

feel ashamed and guilty and embarrassed.

Hayley Food Ninja:

That's when the emotional eating isn't really working.

Hayley Food Ninja:

Cause it's not making you feel better.

Hayley Food Ninja:

It's making you feel worse.

Dr Ed Pooley:

I think there is something about addressing that inner

Dr Ed Pooley:

child that comes out, if we think.

Dr Ed Pooley:

From a kind of childhood perspective, you are in the family home.

Dr Ed Pooley:

You are being given food.

Dr Ed Pooley:

If you're being fed as an infant, you don't have much control over that.

Dr Ed Pooley:

You are fed.

Dr Ed Pooley:

That is your source of connection.

Dr Ed Pooley:

That's how you interact with people primarily.

Dr Ed Pooley:

And there is something about understanding that inner child

Dr Ed Pooley:

and that inner child's need.

Dr Ed Pooley:

Something, Food does that very much.

Dr Ed Pooley:

And then we add all of these unfortunate social layers on top where we then

Dr Ed Pooley:

associate, you can do a certain amount of something and that's great if you

Dr Ed Pooley:

do too little, that's also a worry.

Dr Ed Pooley:

I see lots of parents who will bring children in because they're not eating

Dr Ed Pooley:

enough, and then you, there's an optimum that somebody has set and then there's

Dr Ed Pooley:

too much, and then that's where it starts to tip into this shame cycle.

Dr Ed Pooley:

Yeah, and we know that shaming people for what they eat doesn't work because

Dr Ed Pooley:

if you shame people, they will just feel bad about themselves or they

Dr Ed Pooley:

will become even more change resistant because they then develop a mindset of

Dr Ed Pooley:

you don't understand what it's like.

Dr Ed Pooley:

And yeah, then there's almost more entrenchment and more difficulty

Dr Ed Pooley:

surrounding the need to change.

Dr Ed Pooley:

. Hayley Food Ninja: Yeah.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

It's, it is I could just talk to you for three hours about this one thing, . cause

Dr Ed Pooley:

it, I find it just so fascinating and I spend a lot of time thinking and talking

Dr Ed Pooley:

about this because I know that it's the one thing that seems to make a difference.

Dr Ed Pooley:

It doesn't, it's not somebody's macros or whatever.

Dr Ed Pooley:

It's just trying to figure out what is that thing that, like you.

Dr Ed Pooley:

It's hard to motivate people with health behaviors because

Dr Ed Pooley:

the payoff is not immediate.

Dr Ed Pooley:

It's like really slow.

Dr Ed Pooley:

So it's the really hard sell to go, Hey, just do this one thing.

Dr Ed Pooley:

They're like, Do it every day for 12 weeks.

Dr Ed Pooley:

It's really boring, and eventually you'll see some benefit.

Dr Ed Pooley:

People are like, What?

Dr Ed Pooley:

? Dr Ed Pooley: Yeah.

Dr Ed Pooley:

You can't really market it as this one weird trick that has

Dr Ed Pooley:

doctors furious or whatever.

Dr Ed Pooley:

, the latest internet click bait is going to.

Dr Ed Pooley:

Because people see through it, people, you get people's hopes up and then

Dr Ed Pooley:

it doesn't deliver, and then they get into this spiral of, just shame

Dr Ed Pooley:

and feeling that it's their problem.

Dr Ed Pooley:

They're the ones who didn't work hard enough or didn't try hard enough.

Dr Ed Pooley:

And yeah it's it's a very horrible industry, I think in

Dr Ed Pooley:

some places when it's done badly.

Hayley Food Ninja:

It absolutely is.

Hayley Food Ninja:

There's so many tactics and things that I see where you just think,

Hayley Food Ninja:

...My first thought when I work with someone is I mustn't leave

Hayley Food Ninja:

them worse than when I found them.

Hayley Food Ninja:

Obviously I have more optimistic hopes than that.

Hayley Food Ninja:

For sure I should never leave someone worse off than I found them.

Hayley Food Ninja:

And you see just people who are chronically stressed and everything

Hayley Food Ninja:

and they've just got a macro coach screaming at them going, Why

Hayley Food Ninja:

didn't you hit your protein today?

Hayley Food Ninja:

And my last guest, Kristin last.

Hayley Food Ninja:

Week, who is actually part of the fitness industry.

Hayley Food Ninja:

She's a CrossFit box owner, and she's talking about a very well

Hayley Food Ninja:

known nutrition program that actually gave her an eating disorder.

Hayley Food Ninja:

And this is someone with a lot of awareness and stuff.

Hayley Food Ninja:

So I just think yes, the industry is in a terrible mess and I think

Hayley Food Ninja:

if people would, just adopt that one thing of let's not leave this

Hayley Food Ninja:

person worse off than I found them.

Hayley Food Ninja:

That would improve things straightaway, let alone trying to

Hayley Food Ninja:

actually improve their situation.

Dr Ed Pooley:

I agree.

Dr Ed Pooley:

I wish that more people took the approach that you do.

Dr Ed Pooley:

Yeah I see the consequences of it when it isn't done appropriately.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And then when it, when something that is, starts off as normal but maybe not

Dr Ed Pooley:

optimal, then becomes damaged in some way or the, that, that psychological

Dr Ed Pooley:

connection is disrupted, then it becomes illness and then that's the bit I see.

Dr Ed Pooley:

And it, you just, it's so much harder to try to help someone from

Dr Ed Pooley:

an illness perspective than trying to maintain them when they've got those

Dr Ed Pooley:

physical and mental resources to do something differently

Dr Ed Pooley:

earlier in that journey.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

They were they've actually got, a bit of resilience and capacity and stuff

Hayley Food Ninja:

and I imagine by the time they get to you, that's just completely gone.

Dr Ed Pooley:

It is, and it put, by the time they get to me, there's

Dr Ed Pooley:

often a desire to look for either medical fixes or some sort of

Dr Ed Pooley:

wonder drug that's gonna help.

Dr Ed Pooley:

And there is some research in the area and there are some interesting medications

Dr Ed Pooley:

that help, but fundamentally, there, there is a need to understand the psychological

Dr Ed Pooley:

process and to deal with that.

Dr Ed Pooley:

In a helpful way.

Dr Ed Pooley:

I think one of the things we've spoken about before is things like

Dr Ed Pooley:

bariatric surgery, for example.

Dr Ed Pooley:

Where you are essentially limiting the body's ability to absorb food.

Dr Ed Pooley:

So you are in effect, it is a calorie reduction.

Dr Ed Pooley:

With some hormonal changes that happen as a consequence of surgery

Dr Ed Pooley:

and also reduced intake, but it's a fixed thing that happens to the body.

Dr Ed Pooley:

You can't half do surgery.

Dr Ed Pooley:

It's just done.

Dr Ed Pooley:

So it's like a fixed thing that is done.

Dr Ed Pooley:

And so therefore the evidence for it working is fairly high because unlike

Dr Ed Pooley:

a diet, you could advise people to go on a calorie control diet, but data

Dr Ed Pooley:

looks less good than say, surgery.

Dr Ed Pooley:

There's lots of issues with the analysis in that.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

But we know that if you take two groups of people, one who you do intensive

Dr Ed Pooley:

psychological interventions with and then bariatric surgery and one

Dr Ed Pooley:

that you just do bariatric surgery with the one, the group with the

Dr Ed Pooley:

psychological interventions do better.

Dr Ed Pooley:

And that's quite a big thing cuz the NHS particularly does the psychological

Dr Ed Pooley:

interventions because it wants to try.

Dr Ed Pooley:

Not put someone through surgery.

Dr Ed Pooley:

So if the psychological stuff is enough, that's where that patient's

Dr Ed Pooley:

journey kind of ends for now.

Dr Ed Pooley:

But a lot of people obviously are saving up for surgery and they're having it done

Dr Ed Pooley:

privately where they don't get as much of the psychological support, for example.

Dr Ed Pooley:

So it's a big thing.

Dr Ed Pooley:

It's a big issue that needs to be Brought out into the daylight and discussed

Dr Ed Pooley:

in ways that can move how we do things forward and how we can do them better.

Hayley Food Ninja:

Yeah, like you said, we've spoken about it before.

Hayley Food Ninja:

Cuz I, I find this fascinating because I've now had is it five, either five

Hayley Food Ninja:

or six clients who have had bariatric surgery before they became my client.

Hayley Food Ninja:

And I can think of one example in particular of someone who was 40

Hayley Food Ninja:

stone, they had bariatric surgery and actual the bypass, not just a sleeve.

Hayley Food Ninja:

And they lost 20 stone and then they put it all back on again.

Hayley Food Ninja:

And to me that is obviously it's terrible, but it's also fascinating because this

Hayley Food Ninja:

isn't person who's had a sleeve, which from my understanding, it's probably quite

Hayley Food Ninja:

easy to actually start over eating again.

Hayley Food Ninja:

But to have part of your stomach removed, , but then put on 20 stone

Hayley Food Ninja:

again because there wasn't any counseling or psychological or emotional support.

Hayley Food Ninja:

That's like serious shit, right?

Hayley Food Ninja:

That's not to mention, obviously people have these bypasses that it, that's.

Hayley Food Ninja:

Lifelong that has lifelong implications, doesn't it?

Hayley Food Ninja:

For your health and your digestive system

Dr Ed Pooley:

And stuff.

Dr Ed Pooley:

It does, and it fundamentally affects how you eat forever.

Dr Ed Pooley:

It changes how you absorb various vitamins.

Dr Ed Pooley:

You have to take vitamin pills and supplements and things like that

Dr Ed Pooley:

to, to compensate for that surgery.

Dr Ed Pooley:

And there are some people for whom surgery is probably the best option.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

Because the risk and benefit profile in terms of, their risk of developing

Dr Ed Pooley:

diabetes and the consequences of that the effects on the musculoskeletal system.

Dr Ed Pooley:

The cardiovascular system, it's the best option.

Dr Ed Pooley:

And for a lot of people it works brilliantly, but there are some

Dr Ed Pooley:

people who it doesn't work for and we don't talk about that group because

Dr Ed Pooley:

it's almost like they've, it's a bit like medicine has gone well.

Dr Ed Pooley:

We did our best effort and.

Dr Ed Pooley:

Here we are again.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And you think what?

Dr Ed Pooley:

Let's study that group of people and find out what happened what made the difference

Dr Ed Pooley:

or what didn't quite go to plan?

Dr Ed Pooley:

Because if you don't, you can't make the process and the things

Dr Ed Pooley:

that we provide better and that's ultimately what we want to do.

Dr Ed Pooley:

That would be my take on it.

Hayley Food Ninja:

Yeah so you said that there is quite good kind of psychological

Hayley Food Ninja:

support now if you go down the NHS route, which obviously based on the

Hayley Food Ninja:

experience with the clients that I've had, I know that it wasn't there for them.

Hayley Food Ninja:

So that's interesting.

Hayley Food Ninja:

Is that like a recent development?

Dr Ed Pooley:

So it's becoming more part of a process, so

Dr Ed Pooley:

it's more of a pathway really.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And it does vary depending on where you are in the uk, on the nhs.

Dr Ed Pooley:

And it probably varies as well in different healthcare

Dr Ed Pooley:

systems in different countries.

Dr Ed Pooley:

They're constantly changing it and the thing that they change

Dr Ed Pooley:

most is the entry criteria.

Dr Ed Pooley:

You've gotta be over a certain BMI to get in.

Dr Ed Pooley:

You've got to have one or more comorbidities.

Dr Ed Pooley:

Because more and more people are pushing for it because they see

Dr Ed Pooley:

the, they see people on television, you've had gastric surgery and

Dr Ed Pooley:

that they go that's what I want.

Dr Ed Pooley:

And it is.

Dr Ed Pooley:

It does have a consequence.

Dr Ed Pooley:

And for most people they do.

Dr Ed Pooley:

They do see that dramatic amount of weight loss.

Dr Ed Pooley:

It's just whether that could be achieved through other methods.

Dr Ed Pooley:

That I think is the bit we don't do as well.

Dr Ed Pooley:

Yeah,

Hayley Food Ninja:

definitely.

Hayley Food Ninja:

I think that, people have always wanted a quick fix with weight loss, haven't they?

Hayley Food Ninja:

That's why you get, drop a dress size in a week and six week shreds until

Hayley Food Ninja:

you can see your abs and all that crap.

Hayley Food Ninja:

. So there has always been that, but I noticed.

Hayley Food Ninja:

That is even worse now and I imagine this will happen to me today because

Hayley Food Ninja:

we've been talking about it, but when I've been speaking about bariatric

Hayley Food Ninja:

surgery before, I then get targeted by Facebook of ads of asking me if I want

Hayley Food Ninja:

bariatric surgery in Turkey for two and a half thousand pounds and I can do it

Hayley Food Ninja:

on a payment plan and I can be fixed and I can have a lovely holiday after.

Hayley Food Ninja:

And then you just fly off and that's your life, whereas there's no talk about.

Hayley Food Ninja:

You're gonna have this surgery and it's gonna affect your hormonal profile and how

Hayley Food Ninja:

your digestive system and how you absorb your food and all of that kind of stuff.

Hayley Food Ninja:

So I feel maybe cuz of the celebrity culture it's almost just normal

Hayley Food Ninja:

to consider surgery, isn't it?

Hayley Food Ninja:

It's just Oh yeah, I'll just go and have some surgery.

Hayley Food Ninja:

. Dr Ed Pooley: It is, I mean

Hayley Food Ninja:

Is social media generated?

Hayley Food Ninja:

We used to talk about the impact of print media on eating disorder particularly.

Hayley Food Ninja:

That was always the thing when I was at medical school.

Hayley Food Ninja:

It's if they put pictures of models who look a particular way,

Hayley Food Ninja:

that's gonna have an influence on.

Hayley Food Ninja:

People who go on to develop eating disorders, and you just think now

Hayley Food Ninja:

everyone lives in this reality where there is their authentic self,

Hayley Food Ninja:

which is the bit behind the camera.

Hayley Food Ninja:

And then there's this projected sort of perfect version of themselves

Hayley Food Ninja:

that gets all the validation.

Hayley Food Ninja:

And so you, the further apart that authenticity is from that

Hayley Food Ninja:

projected ideal, the more difficult it is to combat because you're.

Hayley Food Ninja:

people on social media are rich, young, successful, attractive.

Hayley Food Ninja:

There's a certain look, there's a certain way of behaving, and we see

Hayley Food Ninja:

that desire for anything that will move you from where you are now to that.

Hayley Food Ninja:

That sort of ideal.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

We see it in terms of body shape.

Hayley Food Ninja:

We see it in terms of, for particularly men, the rise of body dysmorphic

Hayley Food Ninja:

disorder is just going up and up.

Hayley Food Ninja:

Wow.

Hayley Food Ninja:

We see it in terms of, even surgery on people's genitals

Hayley Food Ninja:

to, to look more perfect.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

And you just think where did it go wrong?

Hayley Food Ninja:

That everything, every way that we judge people is about

Hayley Food Ninja:

how they look about how they.

Hayley Food Ninja:

How much money they have about how they project themselves.

Hayley Food Ninja:

Because and I know that what tends to happen with people who

Hayley Food Ninja:

struggle with their weight is that the weight becomes the fixation.

Hayley Food Ninja:

Everything about their worth, about their confidence becomes about the weight, and

Hayley Food Ninja:

which is why if you don't tackle that, if you don't split that apart when they lose

Hayley Food Ninja:

the weight and they don't feel any better.

Hayley Food Ninja:

Because they're like, Oh, I'm three stone lighter, but I'm not more confident.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

They don't know why that's happened, because everything

Hayley Food Ninja:

has centered around this ideal.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

It's a really challenging thing to, to overcome.

Hayley Food Ninja:

I don't think we have a, I don't think we have enough information and.

Hayley Food Ninja:

Trials of different techniques to find an optimal way forward

Hayley Food Ninja:

because different people are gonna respond to different things.

Hayley Food Ninja:

For some people, it's gonna be weight loss surgery.

Hayley Food Ninja:

For some people, it's gonna be having a coach who will talk them through things.

Hayley Food Ninja:

For other people, it'll be psychotherapy input.

Hayley Food Ninja:

For other people, it'll just be moving out of the situation they're

Hayley Food Ninja:

in and starting a new somewhere else.

Hayley Food Ninja:

As potentially a different.

Hayley Food Ninja:

A different persona that they can adopt.

Hayley Food Ninja:

When people go from say, school to university or university to

Hayley Food Ninja:

the workplace, there's almost that option to adopt a new persona.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

And we often see things like weight loss and changes in

Hayley Food Ninja:

behavior happen at that point.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

Yeah, that's really interesting because that's

Hayley Food Ninja:

something that I work with my clients on, is talking about this alter ego.

Hayley Food Ninja:

At the beginning when I say to them, what would you like to be like?

Hayley Food Ninja:

What would, how would you like to feel?

Hayley Food Ninja:

What would you like to be able to do?

Hayley Food Ninja:

And.

Hayley Food Ninja:

, just imagine, create this sort of alter ego.

Hayley Food Ninja:

And at the beginning it's always about, I'd like to look a certain way.

Hayley Food Ninja:

And then as you've progress them through and they go on that journey of.

Hayley Food Ninja:

Actually, I'm starting to feel a bit better.

Hayley Food Ninja:

Maybe how I look isn't quite as important cause now I've got a bit more energy

Hayley Food Ninja:

or I've found a sport that I like.

Hayley Food Ninja:

And then the alter ego sort of changes from a very, I'd like to be a sized

Hayley Food Ninja:

10 to, I'd like to be able to play football three times a week or and

Hayley Food Ninja:

it's really interesting because.

Hayley Food Ninja:

I always tell them to use this alter ego, because I always say to people,

Hayley Food Ninja:

if you don't do that, if you don't for one a better phrase, squash the

Hayley Food Ninja:

fat person that lives in your head.

Hayley Food Ninja:

When you become, or get to a healthy weight, whatever that means for you.

Hayley Food Ninja:

If you are still thinking in that way, those behaviors will pull you back

Hayley Food Ninja:

and you know exactly what you've said.

Hayley Food Ninja:

You, you won't really have changed in any meaningful way.

Hayley Food Ninja:

. Dr Ed Pooley: Absolutely.

Hayley Food Ninja:

It's that little bit of doubt in your head that is tied up with the experiences

Hayley Food Ninja:

that the overweight version of you has.

Hayley Food Ninja:

The looks from people, the not being picked for the school teams, the someone

Hayley Food Ninja:

looking at you, hoping you don't sit next to them on bus, for example.

Hayley Food Ninja:

All of these tiny little things that, that add up that just chip away at

Hayley Food Ninja:

a person's self worth their sense of identity is really challenging.

Hayley Food Ninja:

And particularly as a gp, one of the, one of the things that.

Hayley Food Ninja:

People will often say not a thin guy.

Hayley Food Ninja:

So in some ways it helps is that people come into surgeries and particularly

Hayley Food Ninja:

if they have an issue with weight, you could almost see a reluctance to come

Hayley Food Ninja:

in because they're almost expecting the doctors to say, Have you lost any weight?

Hayley Food Ninja:

Or, and sometimes doctors do that.

Hayley Food Ninja:

A lot of times it's the expectation that the doctor's gonna do

Hayley Food Ninja:

that, that gets the conversation dynamic off on the wrong start.

Hayley Food Ninja:

And sometimes doctors just aren't very good at bringing it up.

Hayley Food Ninja:

One of the things I am particularly keen on teaching doctors

Hayley Food Ninja:

to do is to ask permission.

Hayley Food Ninja:

That's verbal permission for, Is it okay if we talk.

Hayley Food Ninja:

How your weight might be impacting on this.

Hayley Food Ninja:

And if they say no, I'll say That's fine.

Hayley Food Ninja:

I, you didn't come in here for a lecture.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

Let's look at everything that could be contributing and then we

Hayley Food Ninja:

can work out the best way forward.

Hayley Food Ninja:

But if you don't do that, and if you just see the person with the

Hayley Food Ninja:

arthritic knees or the back pain, and you're like you need to lose weight.

Hayley Food Ninja:

It's not gonna help.

Hayley Food Ninja:

It's not gonna make the person magically go, Oh yes.

Hayley Food Ninja:

You're right.

Hayley Food Ninja:

I never knew that.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

But if you've asked permission or if they've said know my weight's

Hayley Food Ninja:

not helping actually, that, that can be a really powerful conversation

Hayley Food Ninja:

about starting things, moving.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

And approaching things in a more holistic way.

Hayley Food Ninja:

I think the frustration I have is not really having an easy way

Hayley Food Ninja:

forward for many people who are struggling with their weight.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

We have NHS dieticians who are brilliant, but the majority of their time is

Hayley Food Ninja:

spent focusing on disease management.

Hayley Food Ninja:

So diabetes, children with very specialized diets helping people through

Hayley Food Ninja:

chemotherapy and optimal nutrition.

Hayley Food Ninja:

We don't really have a readily accessible.

Hayley Food Ninja:

Way forward to help people with weight other than sometimes medication,

Hayley Food Ninja:

which to be honest, has either fairly awful side effects or Yeah.

Hayley Food Ninja:

may not work because people just eat what they're gonna eat anyway.

Hayley Food Ninja:

And it's, it doesn't, for a lot of it, it doesn't help.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

And then we fall into the, these sort of quick fix things.

Hayley Food Ninja:

So I think when people in the NHS are thinking how do we sort out the

Hayley Food Ninja:

weight, the obesity epidemic, and then someone will go, Oh, let's try

Hayley Food Ninja:

Slimming World, or Weight Watchers, or something like that because

Hayley Food Ninja:

they work and you're like, Oh, just

Hayley Food Ninja:

This is something I wanted to ask you about because.

Hayley Food Ninja:

Obviously, anyone who follows me on the internet knows my

Hayley Food Ninja:

thoughts about Slimming World.

Hayley Food Ninja:

And people always say to me like, Why are you so hard on them?

Hayley Food Ninja:

Why do you know?

Hayley Food Ninja:

I had a bit of a rant about Slimming World and it went viral on TikTok,

Hayley Food Ninja:

it's like a hundred thousand views and there's a lot of hate on the post

Hayley Food Ninja:

from people who do Slimming World.

Hayley Food Ninja:

But I always say it's only.

Hayley Food Ninja:

Much like you said that, you only get people when they've, they're desperate

Hayley Food Ninja:

and they've tried everything else.

Hayley Food Ninja:

I generally get the people who've been at Slimming World for 20 years and

Hayley Food Ninja:

can't understand why they don't know anything about food and energy balance.

Hayley Food Ninja:

Why they believe that they are a bad person for what they eat and

Hayley Food Ninja:

what they put in their mouths.

Hayley Food Ninja:

Why they call some food sins, And that whole connotation of I'm a terrible

Hayley Food Ninja:

person or starving themselves before weigh day and then getting weighed and

Hayley Food Ninja:

then going home and eating chips and cake and chocolate on the way home.

Hayley Food Ninja:

And that is why I'm so hard on them because it creates and promotes

Hayley Food Ninja:

such a terrible relationship with food that I have to spend a lot

Hayley Food Ninja:

of time unpicking with my clients.

Hayley Food Ninja:

. So my question was gonna be to you.

Hayley Food Ninja:

, do you have any idea why?

Hayley Food Ninja:

Why doctors or health authorities think it's okay to signpost

Hayley Food Ninja:

people to Slimming World?

Hayley Food Ninja:

Because I know that's really common and I know, I dunno if

Hayley Food Ninja:

you have it in your area, but.

Hayley Food Ninja:

Here we have the Live scheme where people basically go see their doctor

Hayley Food Ninja:

for smoking cessation as well, isn't it?

Hayley Food Ninja:

And obesity, that kind of thing.

Hayley Food Ninja:

And Slimming World is a place where they get signposts, they

Hayley Food Ninja:

get referred to live well.

Hayley Food Ninja:

And then the Live person says, Oh, I'll just hook you up with

Hayley Food Ninja:

a slimmer well consultant.

Hayley Food Ninja:

And I just wondered, obviously you are not responsible for that policy,

Hayley Food Ninja:

but what's the thinking behind that and what's happened basically

Hayley Food Ninja:

? Dr Ed Pooley: think there's a

Hayley Food Ninja:

There, there are people, and there'll be people who watch this.

Hayley Food Ninja:

Video in this episode, Who Sliming World and Weight Watchers has worked for.

Hayley Food Ninja:

That's great.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

But I suppose I'm coming at it from a perspective of the people that

Hayley Food Ninja:

it hasn't helped and the things that I can see that make no sense.

Hayley Food Ninja:

So I agree with you.

Hayley Food Ninja:

This whole concept of the circle of shame, that puts most people back.

Hayley Food Ninja:

If they've had weight problems for a long time, that's just like taking

Hayley Food Ninja:

an overweight child and shaming them.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

And so overweight children will do lots of things to, to

Hayley Food Ninja:

overcome that sense of shame.

Hayley Food Ninja:

They'll starve themselves, then they'll reward themselves for feeling okay.

Hayley Food Ninja:

. But what you tend to see over time is if it worked, you wouldn't see the same

Hayley Food Ninja:

bunch of people again and again and again.

Hayley Food Ninja:

So there is clearly a bunch of people that it doesn't work for and

Hayley Food Ninja:

they have a lifelong membership.

Hayley Food Ninja:

They

Dr Ed Pooley:

do , which kind of implies that it doesn't work

Dr Ed Pooley:

because they're not selling.

Dr Ed Pooley:

They frame it in terms of healthy eating, and I guess for some people

Dr Ed Pooley:

it is a healthier form of eating, but I don't like the thinking behind it.

Dr Ed Pooley:

For example, if eat a whole banana, that is somehow better

Dr Ed Pooley:

than eating puree banana.

Dr Ed Pooley:

That doesn't it, the only thing that changes is the ability of your

Dr Ed Pooley:

gut to use the fiber within the.

Dr Ed Pooley:

Yeah, but nothing else.

Dr Ed Pooley:

You're still getting the same number of calories.

Hayley Food Ninja:

But in Slimming world, they'll tell you that it makes

Hayley Food Ninja:

the sugar more readily available.

Hayley Food Ninja:

. Dr Ed Pooley: So that would assume

Hayley Food Ninja:

and enters the same way that it leaves, which is yeah, pretty evident.

Hayley Food Ninja:

Not the case . So yeah, I, it's a very odd thing in, in terms of health policy.

Hayley Food Ninja:

When you look at health policy, a lot of it is determined on is there

Hayley Food Ninja:

something I can buy in that fixes a need?

Hayley Food Ninja:

Is it costed?

Hayley Food Ninja:

Is it available to a large group of people?

Hayley Food Ninja:

And is there some evidence that it reduces people's weight?

Hayley Food Ninja:

And I think Sliming World and Weight Watchers, Would succeed

Hayley Food Ninja:

on all of those metrics.

Hayley Food Ninja:

It's a prepackaged product that somebody who is deciding health policy

Hayley Food Ninja:

can easily suggest as an option.

Hayley Food Ninja:

And like I say, for some people it will work, but there are a lot of people for

Hayley Food Ninja:

whom it really won't work, and then we'll never see those again and we've lost

Hayley Food Ninja:

an opportunity to do something useful.

Hayley Food Ninja:

And that's the thing that annoys me because actually people

Hayley Food Ninja:

have very distorted views.

Hayley Food Ninja:

Diet on weight control.

Hayley Food Ninja:

Even the biggest one I see is probably people who come in and they'll say I

Hayley Food Ninja:

can't exercise because of X, Y, and Z.

Hayley Food Ninja:

That's, that with exercise is not the best way of, altering your physical

Hayley Food Ninja:

shape in terms of energy balance.

Hayley Food Ninja:

It's not an efficient way of doing that.

Hayley Food Ninja:

There are more efficient ways but we never look at people in a holistic way.

Hayley Food Ninja:

It's Give them a healthy eating program and send them on the way.

Hayley Food Ninja:

It feels like tokenism to me.

Hayley Food Ninja:

. Yeah.

Hayley Food Ninja:

And I think that's why I don't like it, but I can see why it's done.

Hayley Food Ninja:

Because the NHS is for all its good Bits is a rationed healthcare system, and

Hayley Food Ninja:

you have to make a decision on how do you adequately fund a system to do the

Hayley Food Ninja:

bits that we know help a lot of people.

Hayley Food Ninja:

and it focuses on those people.

Hayley Food Ninja:

It's not a national wellness service and there are some parts of me

Hayley Food Ninja:

that the was, but that would need a huge amount of funding, yeah.

Hayley Food Ninja:

That would need people to really take on board and run very tailored

Hayley Food Ninja:

programs about energy balance, about optimal nutrition, about exercise,

Hayley Food Ninja:

about the psychology of eating.

Hayley Food Ninja:

We struggle to do that with things like how to live a normal

Hayley Food Ninja:

life after a heart attack.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

Trying to do it for something as complex as the psychosocial impact of a dietary

Hayley Food Ninja:

change is one step further more difficult.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

And I think that's why it's done.

Hayley Food Ninja:

I saw a handout the other day for people with diabetes advocating a

Hayley Food Ninja:

12 week meal replacement program.

Hayley Food Ninja:

It was all about dietary shakes, and I thought, have we not moved on from that?

Hayley Food Ninja:

Because what's really interesting is I've worked with about 15 patients, not

Hayley Food Ninja:

a huge number, but people who've been very interested in wanting to tackle

Hayley Food Ninja:

their diabetes, and we've talked about diet, we've talked about exercise, we've

Hayley Food Ninja:

talked about the psychology of it, and.

Hayley Food Ninja:

About 12 of those 15 have now resolved their diabetes because they've had

Hayley Food Ninja:

that kind of one on one type care.

Hayley Food Ninja:

And that, that was back in about eight years ago when we had a

Hayley Food Ninja:

little bit more time and space to do things and there weren't the

Hayley Food Ninja:

pressures on the healthcare system.

Hayley Food Ninja:

We can see that there are other options.

Hayley Food Ninja:

One size doesn't fit all.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

Some people who need medication, some people who need surgery, some people who.

Hayley Food Ninja:

Psychological input.

Hayley Food Ninja:

Some people who just need to know what to do and some people who need

Hayley Food Ninja:

their entire family situation to change because actually there are

Hayley Food Ninja:

those maintaining and those factors that will keep a behavior going.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

And that's a really difficult thing.

Hayley Food Ninja:

You must have clients that have family members who also

Hayley Food Ninja:

struggle with their weight.

Hayley Food Ninja:

Yeah there's a bit of me that thinks, I wonder what would happen if we could

Hayley Food Ninja:

get someone to live with them for three months and just sort out all of

Hayley Food Ninja:

the cooking and all of the meal prep and all of those sorts of things.

Hayley Food Ninja:

I wonder what the impact of that would be.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

But obviously that would be prohibitively expensive for

Hayley Food Ninja:

healthcare systems to provide.

Hayley Food Ninja:

Yeah,

Hayley Food Ninja:

no, absolutely.

Hayley Food Ninja:

I see it all the time with clients.

Hayley Food Ninja:

It will either be, their home environment, it will be their relationships, it

Hayley Food Ninja:

will be, the ways that they choose to respond to different stressors.

Hayley Food Ninja:

It's always something other.

Hayley Food Ninja:

What am I supposed to eat?

Hayley Food Ninja:

Obviously there will be some people who don't have that level of knowledge

Hayley Food Ninja:

in terms of what to eat and stuff, and I always wonder it in terms of

Hayley Food Ninja:

kind of very basic nutrition advice.

Hayley Food Ninja:

Why do you think that a lot of doctors are just either, not able to do that, or

Hayley Food Ninja:

for instance we know that there's shed loads of evidence to, to point to the

Hayley Food Ninja:

fact that everyone should eat a lot more protein than the recommended daily amount.

Hayley Food Ninja:

Even for things like, preventing age related sarcopenia so that

Hayley Food Ninja:

people remain stronger and you.

Hayley Food Ninja:

When they get older and then they'll get less falls and broken

Hayley Food Ninja:

bones and all that kind of stuff.

Hayley Food Ninja:

When something so simple could have such a massive impact.

Hayley Food Ninja:

Why do you think that?

Hayley Food Ninja:

People are often either not allowed to give that advice or

Hayley Food Ninja:

are not able to for any reason.

Hayley Food Ninja:

And then they obviously just decide, oh, we'll point them to Slimming

Hayley Food Ninja:

World instead, who will tell them to eat unlimited Muller corners.

Dr Ed Pooley:

I think that a lot of the times it's, sometimes

Dr Ed Pooley:

it's a knowledge gap, but I think that's probably in the minority.

Dr Ed Pooley:

I think there are lots of doctors who are, who know what to do and what to

Dr Ed Pooley:

advise, and it's not really a case of.

Dr Ed Pooley:

Not being able to advise it because we are, as long as it's sensible

Dr Ed Pooley:

and we're not telling them to eat something that's, or do something that

Dr Ed Pooley:

is, is ridiculous, but where there's a clearly defined, pushed outcome.

Dr Ed Pooley:

, then I think that's often what we'll do, yeah.

Dr Ed Pooley:

If we're, if we have a 10 minute appointment and nine of those minutes

Dr Ed Pooley:

is talk is focused on adjusting diabetic medication or dealing with someone's

Dr Ed Pooley:

mental distress because of the impact of mental health and chronic illness,

Dr Ed Pooley:

you just don't have the time to do it.

Dr Ed Pooley:

And so there's an easy option and it's let's go down that route.

Dr Ed Pooley:

And it, you tick the box and I think.

Dr Ed Pooley:

It is a frustration for lots of doctors that we don't have the time

Dr Ed Pooley:

or the resource or the capacity to do a lot of the jobs that we want to do

Dr Ed Pooley:

in the way we would like to do them.

Dr Ed Pooley:

Yeah, and that's, there's, you could get me on my soapbox for hours about how the

Dr Ed Pooley:

NHS is structured and how it's funded.

Dr Ed Pooley:

. But it's it's very difficult.

Dr Ed Pooley:

We deal with lots and lots of illness of which nutrition

Dr Ed Pooley:

is one part of some of that.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And of that, of which one part is about energy balance rather than optimal

Dr Ed Pooley:

nutrition for chemotherapy say or trying to reverse the effects of malnutrition.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

So it becomes very small part of what we do.

Dr Ed Pooley:

, but we know that over time it becomes important.

Dr Ed Pooley:

So I think if I was designing a health service, I would put a lot of money

Dr Ed Pooley:

into preventative care, into educational resources for children, for families.

Dr Ed Pooley:

I would make.

Dr Ed Pooley:

I would make healthy food cheaper.

Dr Ed Pooley:

I wouldn't necessarily increase the cost of foods that are labeled as bad

Dr Ed Pooley:

cuz I don't think labeling foods as good or bad as particularly helpful.

Dr Ed Pooley:

But I think you could do lots of things that would encourage people

Dr Ed Pooley:

to adopt more healthy lifestyles without really realizing it.

Dr Ed Pooley:

So there's lots of work, for example, in architecture on how you make people.

Dr Ed Pooley:

Move around buildings in a way that causes them to expend more energy.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

Or there is a a move, for example, to talk about providing meals for workers so

Dr Ed Pooley:

that they don't have to think about the stresses of meal prep or things like that.

Dr Ed Pooley:

And anything that we can do that makes behavioral change.

Dr Ed Pooley:

Almost something you have to do or have to go with, and then you

Dr Ed Pooley:

enjoy and it takes some stress out of your life is much easier.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

Even things like funding free public transport, making people walk to

Dr Ed Pooley:

bus stops and get on and off buses and walk to their places of work.

Dr Ed Pooley:

Will get them a calorie expenditure they wouldn't have had by walking to their.

Dr Ed Pooley:

car.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And I think it needs those sorts of novel ideas to be embedded really.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

In society.

Hayley Food Ninja:

Like you said of making the healthy choice, like the easy,

Hayley Food Ninja:

easiest choice to make, essentially.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

And do you still, Cause I know that I've heard this as well

Hayley Food Ninja:

from various different people.

Hayley Food Ninja:

If you go down the route of almost prescribing, Diet or,

Hayley Food Ninja:

I know that some doctors like prescribe exercise, don't they?

Hayley Food Ninja:

Do you ever get the, a bit of a sort of reaction of outrage?

Hayley Food Ninja:

People have come to you to almost fix their problem with a pill or whatever

Hayley Food Ninja:

and you're Oh, if you did some diet and exercise that, does that get met with

Hayley Food Ninja:

a sort of, not a very good reaction?

Dr Ed Pooley:

It can get met with pushback.

Dr Ed Pooley:

I think that if you, obviously my most of my career now is about how to communicate

Dr Ed Pooley:

more effectively with patients.

Dr Ed Pooley:

So I tend not to get that degree of pushback.

Dr Ed Pooley:

, but there are ways of doing it that are more effective.

Dr Ed Pooley:

And we can do that for all sorts of illness where people don't need a tablet.

Dr Ed Pooley:

They actually need to do something or to do something differently

Dr Ed Pooley:

from what they're doing.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And it's about how you engage people in that process.

Dr Ed Pooley:

And there are some doctors who are very skilled at it.

Dr Ed Pooley:

There were some doctors who are less skilled at it, but they all want the

Dr Ed Pooley:

same thing, which is that person to be.

Dr Ed Pooley:

Healthier than they are now.

Dr Ed Pooley:

Yeah, and when we think about things like exercise prescription,

Dr Ed Pooley:

again, usually for most exercise prescription things it's something that

Dr Ed Pooley:

doesn't need to come from a doctor.

Dr Ed Pooley:

It doesn't need to come from a doctor to be validated.

Dr Ed Pooley:

It's why can't people just ring up a local gym and say, I'd like to get some exercise

Dr Ed Pooley:

please, because I've got this condition.

Dr Ed Pooley:

Here's the medication.

Dr Ed Pooley:

Can I just do it?

Dr Ed Pooley:

But one of the things that happens, particularly for gps, which is a

Dr Ed Pooley:

real frustration, is that everything almost has to be risk managed.

Dr Ed Pooley:

It's a bit like when you join a gym, have you got high blood pressure?

Dr Ed Pooley:

Go and see your gp.

Dr Ed Pooley:

It's why?

Dr Ed Pooley:

The exercise is going to bring down that pressure.

Dr Ed Pooley:

They're not going to be running a marathon on day one.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And stop if it starts to hurt a bit too much.

Dr Ed Pooley:

It doesn't need a GP to sign off and take the risk of that.

Dr Ed Pooley:

But unfortunately we get into this a bit of a spiral of someone taking the risk

Dr Ed Pooley:

for people's health rather than them taking the risk for their own health.

Dr Ed Pooley:

And we do live in a bit of an Amazon Prime mentality where everything has

Dr Ed Pooley:

to be done today or the next day.

Dr Ed Pooley:

And if it's not available, it's somehow not great.

Dr Ed Pooley:

And I think it trains us out.

Dr Ed Pooley:

being able to tolerate discomfort for longer periods of time.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And I think my worry is that will make things worse and worse because

Dr Ed Pooley:

the body doesn't fix itself in hours.

Dr Ed Pooley:

It fixes itself over days, weeks, months.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And it takes that time for behaviors and habits to embed

Dr Ed Pooley:

yeah, absolutely.

Dr Ed Pooley:

Unless it's the most amazing habit ever, it's not you wouldn't need 25

Dr Ed Pooley:

days or whatever the latest buzzword number is for a habit to stick.

Dr Ed Pooley:

If you were going to pick up 50 quid from the end of the street

Dr Ed Pooley:

each morning, you just go and do it.

Dr Ed Pooley:

There's no, it's not causing you any distress to do that.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

So I do wonder about all of these societal things that,

Dr Ed Pooley:

that feed into how peoplebehave.

Dr Ed Pooley:

No pun intended

Hayley Food Ninja:

yeah.

Hayley Food Ninja:

And actually on that because this is something obviously that is quite recent

Hayley Food Ninja:

I was wondering how your conversations.

Hayley Food Ninja:

That you're having with patients have changed if they have, in terms of the

Hayley Food Ninja:

health every size movement, because I know that there are a lot of people, and I'm

Hayley Food Ninja:

imagine I'm gonna get shot down in flames for this that clearly have health risks.

Hayley Food Ninja:

They're overweight to the point where they're, they are definitely at a

Hayley Food Ninja:

propensity to, or a bigger likelihood to get different metabolic diseases.

Hayley Food Ninja:

But because they subscribe to the health at every size movement you cannot

Hayley Food Ninja:

have that conversation with people.

Hayley Food Ninja:

Do you think that's gonna have a knock on effect on the conversations

Hayley Food Ninja:

that GPS have with people?

Hayley Food Ninja:

And do you think we are going to end up with a lot of people who are

Hayley Food Ninja:

in denial about some of the health problems that obesity can cause?

Dr Ed Pooley:

I think it's really challenging cuz I think

Dr Ed Pooley:

a lot of that movement came as a consequence of feeling marginalized.

Dr Ed Pooley:

Of feeling, shamed of feeling.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

That, any difference from a perfect, normal accepted figure was a bad thing.

Dr Ed Pooley:

And it isn't.

Dr Ed Pooley:

But we know that risk exists on a continuum.

Dr Ed Pooley:

It's not, if you are outside of 20 to 25 with your bmi, you are

Dr Ed Pooley:

suddenly at hugely increased risk.

Dr Ed Pooley:

It's a spectrum.

Dr Ed Pooley:

and you can be healthy and larger, that's okay.

Dr Ed Pooley:

You can be healthier and muscular, for example, and have a very high bmi.

Dr Ed Pooley:

But there is a continuum of risk.

Dr Ed Pooley:

And I think if we acknowledge it in terms of a continuum of risk and engaging with

Dr Ed Pooley:

people when they want to engage about their health if, for example, someone

Dr Ed Pooley:

is of a larger size and for example, their blood pressure is creeping up.

Dr Ed Pooley:

I would be medically remiss not to make a connection there, because actually

Dr Ed Pooley:

I know that reducing weight on the musculoskeletal system would improve

Dr Ed Pooley:

a person's blood pressure potentially.

Dr Ed Pooley:

And I could be accused of not doing the job that I'm supposed to do.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And I think that one of the problems of Movements where there is a, there's

Dr Ed Pooley:

almost like a direct challenges that it, it stifles debate a little bit.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

I'm not arguing that we should have conversations with people where

Dr Ed Pooley:

we're being insulting or that we are infringe on people's rights,

Dr Ed Pooley:

but we need to have conversations that I think are being pushed away

Dr Ed Pooley:

almost as unintended consequence.

Dr Ed Pooley:

And actually if everyone was just a bit kinder to each other and.

Dr Ed Pooley:

. We're trying to understand the person's perspective and looking at exercise

Dr Ed Pooley:

and diet and what we eat and how we eat in the context of actually

Dr Ed Pooley:

valuing that person, I think the conversation becomes much easier.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

. Hayley Food Ninja: Yeah, it, it is a

Dr Ed Pooley:

Because on the one hand, I think it has been positive in terms of people

Dr Ed Pooley:

who are bigger, who thought that maybe they didn't wanna try exercise and

Dr Ed Pooley:

stuff because they felt self-conscious.

Dr Ed Pooley:

Now that.

Dr Ed Pooley:

There are more people doing that and maybe it's encouraged people,

Dr Ed Pooley:

who are bigger to say do you know what other people are doing it?

Dr Ed Pooley:

I'm gonna go and do some exercise.

Dr Ed Pooley:

And so in that case, they are getting healthier.

Dr Ed Pooley:

But like you say, if you are on a continuum where you might be doing a

Dr Ed Pooley:

bit of exercise but still, your bmi or you are in the kind of morbidly

Dr Ed Pooley:

obese or, super morbidly obese, you can't ignore the fact that still

Dr Ed Pooley:

might have some health implications.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

So another fascinating subject, . Cool.

Dr Ed Pooley:

So finally my last question that I like to ask everybody is what does healthy

Dr Ed Pooley:

mean to you in terms of, maybe from a professional and a personal point of view?

Dr Ed Pooley:

What's your definition of health and what do you believe, how do you

Dr Ed Pooley:

create your own version of healthy.

Dr Ed Pooley:

I think, I mean from a medical perspective with there's back

Dr Ed Pooley:

and forth philosophical arguments about whether it's the absence of ill

Dr Ed Pooley:

health, whether it's about function.

Dr Ed Pooley:

I think to me, the things that mean that you have the best health you

Dr Ed Pooley:

can have boil down to seven factors.

Dr Ed Pooley:

And it boils down to nutrition.

Dr Ed Pooley:

Notice I'm not saying diet because nutrition obviously

Dr Ed Pooley:

is more nuanced than that.

Dr Ed Pooley:

Yes.

Dr Ed Pooley:

Movement and being able to move as you would want to rest.

Dr Ed Pooley:

That is time to yourself and sleep.

Dr Ed Pooley:

good quality, sleep connection.

Dr Ed Pooley:

Are there significant others in your life who are meaningful and bring you joy?

Dr Ed Pooley:

Are there less toxic people in your life?

Dr Ed Pooley:

Security that is freedom from threat and having enough money or

Dr Ed Pooley:

resources to do what you want to do.

Dr Ed Pooley:

Mindset, which is how you think about the world and how you

Dr Ed Pooley:

think about yourself and purpose.

Dr Ed Pooley:

If you have all of those things and you're able to do all of those things well,

Dr Ed Pooley:

that, that's what I would aim for in terms of health or optimal functioning.

Dr Ed Pooley:

So that, that would be it.

Dr Ed Pooley:

That's my way of skirting around all of the complex stuff

Dr Ed Pooley:

about, absence of disease.

Dr Ed Pooley:

Yeah.

Dr Ed Pooley:

And That would be my take on it.

Dr Ed Pooley:

Yeah.

Hayley Food Ninja:

I feel really happy now because that is essentially what

Hayley Food Ninja:

I shoe shoehorned that into a ninja acronym I couldn't say it properly then.

Hayley Food Ninja:

So I had to n was like neuro.

Hayley Food Ninja:

In terms of like brain health and stuff like that.

Hayley Food Ninja:

I was for intelligent Ninja in terms of upskilling yourself in

Hayley Food Ninja:

terms of the knowledge to look after yourself and learn about things.

Hayley Food Ninja:

Then I had n, which was network, which was all about.

Hayley Food Ninja:

Relationships and connection and stuff.

Hayley Food Ninja:

Jay was joyful, which was emotional health and having a handle on your

Hayley Food Ninja:

own emotions, and A was active, which is your movement bit.

Hayley Food Ninja:

So I feel like I should say that I am now medically approved

Hayley Food Ninja:

to deliver health to people.

Dr Ed Pooley:

I feel like I should knight you with a stick of broccoli or something.

Hayley Food Ninja:

Yeah.

Hayley Food Ninja:

That would be really good!

Hayley Food Ninja:

Good . Awesome.

Hayley Food Ninja:

Thank you so much for doing this.

Hayley Food Ninja:

I feel like we could just basically do an episode a week cause we have so

Hayley Food Ninja:

much stuff that I could talk about.

Hayley Food Ninja:

It's I just find it all fascinating.

Hayley Food Ninja:

Particularly, the work that you're doing around the communication and you.

Hayley Food Ninja:

Doctors talking to patients and all of that kind of language stuff, which

Hayley Food Ninja:

I find really interesting and all of the psychology of change, which

Hayley Food Ninja:

I think is the most interesting bit of changing people's health.

Hayley Food Ninja:

Awesome.

Hayley Food Ninja:

Thank you so much and maybe we'll get you back on in a few months

Hayley Food Ninja:

to talk about something else.

Dr Ed Pooley:

Perfect.

Dr Ed Pooley:

Look forward to it

Hayley Food Ninja:

awesome.

Hayley Food Ninja:

Thank you so much everybody for listening.

Hayley Food Ninja:

And I'll be back next week with another episode.

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