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Most body fat is stored in fat cells called adipocytes. Around 50,000–60,000 calories of energy are stored as triglycerides in fat cells throughout the body, both under the skin and around the delicate organs. That’s enough stored energy to walk briskly non-stop for 500–600 miles, or from London to Land’s End. The body also stores fat between the muscle fibres, generally holding about 2,000–3,000 calories, enough to walk briskly non-stop for 20–30 miles. So before we even start to consume food for energy, our bodies are holding on to an awful lot of energy in the form of stored fat.
Where the fat is stored creates quite distinctive body shapes. Storage of body fat around the middle, resembling more of an apple or ‘android shape’, is characteristic among males and is associated with a higher risk of cardiovascular disease. Storage of body fat around the hips and thighs, creating a more rounded pear or ‘gynoid’ shape, is the most common body type among pre-menopausal women. The role of hormones in the way we store fat differs between men and women and affects how each lose weight.
Two hormones are particularly associated with fat distribution. Lipoprotein lipase (LPL) and hormone-sensitive lipase (HSL) directly affect whether we store fat or encourage it to be distributed in the blood and then burnt off. LPL tends to encourage fat storage, and HSL tends to encourage fat to be burnt off. The amount of LPL and HSL we have tends to vary between men and women, between individuals, in different areas of the body and at various stages of a woman’s life. Men tend to have more LPL in the belly and less HSL in the lower hip area. This creates the more pronounced apple or android body shape seen in overweight men, with more body fat distributed around the belly. Women tend to have more LPL in the hips and backs of the arms and less HSL in the upper body. This classically creates more of the traditional pear or gynoid shape. When women lose weight, they generally still have more LPL in the hips so retain a pear shape, even though they may be a smaller pear shape.
It therefore seems obvious that getting more HSL can be only a good thing for aiding weight loss. HSL is stimulated by the hormone epinephrine, and what is really exciting is that exercise causes greater amounts of epinephrine to be released, and as you get fitter your body becomes more adept at using even small amounts of epinephrine to burn fat. So that’s a great reason to get moving and keep moving.
A body that is significantly overweight or obese, however, will require higher amounts of epinephrine to stimulate fat-burning. For this reason it is vital that overweight people include gradual, progressive cardiovascular exercise into their weight-loss efforts. Walking is a fabulous way to do this.
The crucial difference between male and female fat loss is down to hormone receptors, which are located on the fat cell walls. There are two types of hormone receptor: alpha-receptors and beta-receptors. Alpha-receptors tend to inhibit fat breakdown while beta-receptors encourage it. Men and women don’t have the same amount of these crucial hormone receptors. Men tend to have more of the fat-busting beta-receptors and fewer of the fat-storing alpha-receptors in their abdomen, while women tend to have fewer beta-receptors and more alpha-receptors. The more beta-receptors there are in the abdomen, the easier it is to lose middle-age spread. So when a man loses weight, it will be easier for him to drop inches off the midriff area than it would be for a woman. Finally, the last infuriating piece of evidence that it’s easier for men to lose weight is that, even at rest, a man will be burning more calories than a woman. This is because their fat cells are smaller than women’s!
The Oestrogen Effect
Another factor in the weight-loss battle of the sexes relates to the female sex hormone oestrogen. Oestrogen has an impact on fat storage in a number of ways:
It encourages epinephrine production, which helps the breakdown of fat
It prevents the fat-storing LPL from working as effectively
It encourages the production of growth hormone, which increases the release of fatty acids from the fat cells
It is also thought to inhibit the production of insulin, encouraging the body to use fat rather than glucose as a source of energy
During menopause, however, the amount of oestrogen decreases, so its ability to help break down fat is diminished. This causes weight gain in the midriff to become more prevalent in women than in men.
It’s not all doom and gloom, however, as oestrogen also increases the production of nitric oxide, which encourages the blood vessels to relax. High nitric oxide concentrations are associated with migraine, and it is often reported that migraine sufferers experience less frequent and severe migraines after menopause.
Weight Gain and Stress
Stress is another factor that can lead to weight gain and middle-age spread. Scientists are just beginning to discover that long-term emotional stress can contribute to age-related weight gain, especially in older women.
For more on stress and other emotional challenges, see Chapter 2.
How the GI Walking Diet Can Help
You will lose weight on the GI Walking Diet. The combination of the physical activity and eating plans allows you to follow a flexible or more structured approach to your goal. All you have to do is choose which approach suits you, and you are on your way to losing 5–10 per cent of your excess body weight. Losing weight can be an intimidating process – sometimes the amount of weight we feel we have to lose can be off-putting – but the positive news is that even a small amount of weight loss can improve your health. In fact, research shows that a drop of just 6 per cent will significantly improve your health.
If you are carrying excess weight, an initial goal of losing 5–10 per cent of your starting weight is both realistic and valuable. Plus, by following the six-week plan, you will be more likely to keep the weight off, maintaining your health improvements.
If I said to you – in six weeks from today you could be 6 per cent lighter, far healthier, fitter and energetic, wouldn’t you want to take action?
2 Emotional Challenges (#)
Life’s too short to sweat the small stuff.
Can your emotions affect your health? Evidence now suggests the answer is ‘yes’. One study of pre-menopausal, peri-menopausal and post-menopausal women found that emotions like anger, depression and anxiety increase the risk of developing metabolic syndrome. Other studies have confirmed that long-term stress causes the shape-shifting phenomenon of middle-age spread due to too much sugar being converted to fat, which gets deposited in the midriff area. Researchers have also established a link between stress and poor health. And, of course, when we are stressed, sad, angry, afraid, hurt, worried, lonely, frustrated or depressed we reach for food as a source of emotional comfort.
Emotional Stress (#)
Most experts define emotional stress as a person’s reaction to any situation that places special physical or psychological demands on them so as to unbalance their equilibrium and take them outside their comfort zone. These situations can give rise to feelings of fear, anger or anxiety as the body responds to the perceived threat to its wellbeing. Emotional stress varies from person to person so is difficult to measure. It is highly subjective and influenced by personality and experience; everyone has a different sensitivity to stressful events – what may be stressful to one person can be perceived as quite manageable to another.
The concept of emotional stress pioneered by Dr Hans Seyle proposes that during stressful situations, the sympathetic nervous system sets in motion a series of physiological responses. Various hormones produced by the adrenal cortex, including cortisol and epinephrine, prepare the body for an instant state of readiness, the classic ‘fight or flight’ response. It is also theorized that once the ‘stress-invoking threat’ has passed, the body returns to a state of normality and balance. However, recent research shows that long-term elevated cortisol levels can lead to weight gain, especially in the belly.
Although both men and women may be uncomfortable with some of the changes to their faces and bodies as they get older, women often feel more vulnerable as society places such a high value on their physical appearance. For women over 40, excess weight can become more difficult to shift, and this is often compounded by emotional challenges. At this stage of life, emotional issues that have been suppressed for years can resurface. Additionally, divorce, financial burdens, concerns about retirement, career moves and residential changes often occur alongside unpleasant menopausal symptoms. With the children now grown up and out of the family home, many people begin to question their own identity, which was typically being the family caregiver. This loss of identity can be unsettling for many, and may coincide with a new role of becoming the ‘parent’ to their own ill or ageing parents.
Emotional challenges can be difficult at any age. In later life, emotional stress can be harder to deal with if we are no longer physically fit and healthy. Coping with an age-related medical condition – such as arthritis, diabetes, high blood pressure, heart disease or osteoporosis – can be a considerable burden. Physical problems combined with emotional challenges – such as periods of mourning, feelings of increased isolation in retirement and a changing social role – can all contribute to a sense of loss of control and helplessness. This makes people vulnerable to depression.
Emotional Eating (#)
We all know food can make us feel good, providing a great source of psychological fulfilment. From infancy, we are taught that love and food are intertwined. A baby cries – we feed it to calm it down; a child does well and is rewarded with a food treat; and of course seduction and food have been entwined since Creation – just think of Adam and Eve! In later life we have a whole catalogue of food memories associated with holidays, celebrations and happy times, so it’s really no wonder that we equate food with positive feelings. When emotionally stressed, some people strive to recapture those happy feelings by comforting themselves with food. It has recently been shown that we are more likely to engage in emotional eating if our basic human needs – such as security, love and belonging – are unfulfilled. Prolonged periods of depression and anxiety also tend to cause emotional eating, leading to cravings for sweet and fatty foods.
Many parents and grandparents mistakenly use food as a reward for positive behaviour: ‘If you are a good girl or boy today you will get a treat.’ This strategy may create a lasting unconscious desire to reward oneself with sweet, high-calorie foods when under emotional stress. This may develop into unhealthy eating habits, so that being overweight becomes a self-fulfilling prophecy. Aim to reward younger members of the family with non-food treats, such as a trip to a park, a treasure hunt or a physical activity. This will have a much more positive impact on their health.
Why People Eat Emotionally
In my experience with both female and male clients, people often find themselves trapped in a cycle of stress-eat-stress, feeling helpless to change. Significant weight gain can occur as a result. There may be unconscious reasons for this behaviour. You may want to prevent other people getting too close, and feel that a layer of fat on the body may protect you. Or it can represent an attitude of needing to let go and be out of control when all other aspects of your life have to be neat and in order.
Case Study
A male client, a city high-flyer, had a major problem with emotional eating late in the evening. After working with him for a month it became clear that the nature of his professional position meant he had to be in control and on top of his game 110 per cent of the time. There was no room for a slip-up. This was big business with big rewards. The client was exceedingly good at his job, but it came at a price to his health – 5 stone of excess weight gain. Although he ate healthily, and in moderation at work, it was all part of his professional approach. When he came home it was almost as if some element of being out of control was needed as light relief from the constant responsibility and challenges. Ice cream was the answer, and his excessive eating of it represented a rebellious act against all the constraints in his day-to-day life. After discussing this, we established a physical activity plan that introduced an element of stress management, as well as letting him create a little slack in other areas of his life, so that the ice cream eating was not his only outlet to let off steam and take his foot off the throttle.
Emotional stress is real, and it doesn’t go away quickly or simply. However, recognizing it is the first step to taking action. If you feel you are susceptible to emotional stress, try completing the following questionnaire. Often, it can be easier to express sensitive issues on paper rather than in a face-to-face discussion. You may find that the very act of completing the questionnaire provokes thought and introspection, creating an awareness of the role stress is playing in your life.
Emotional Stress Questionnaire
Using the scale below, rate the following items/events according to how frequently they cause you emotional stress in the form of sadness, anxiety, fear, anger, depression, worry or guilt:
1 – Never
2 – Occasionally (a few times a month or less)
3 – Sometimes (one to three times a week)
4 – Often (three or more times a week)
5 – Always (daily or more)
Job-related issues (unhappy with/change in/losing job) 1 2 3 4 5
Children (leaving/returning home, marital difficulties) 1 2 3 4 5
Relationship issues with loved ones 1 2 3 4 5
Separation or divorce 1 2 3 4 5
A new relationship 1 2 3 4 5
Loneliness 1 2 3 4 5
Concerns about personal health 1 2 3 4 5
Illness or death of a parent, close relative or friend 1 2 3 4 5
Thoughts about retirement 1 2 3 4 5
Worrying about finances 1 2 3 4 5
Food and eating 1 2 3 4 5
Your physical appearance/body weight 1 2 3 4 5
Your physical activity levels 1 2 3 4 5
Moving home 1 2 3 4 5
Feelings of general unhappiness 1 2 3 4 5
Other _______________________________ 1 2 3 4 5
Answer the following questions:
Have you experienced any recent or sudden weight gain? YES/NO
Do you have frequent, general feelings of sadness, anxiety, loneliness, despair, resentment, anger, guilt, shame, boredom or fear? YES/NO
Have these feelings interfered with your normal daily functioning, including lifestyle habits such as healthy eating, regular exercise, not smoking, drinking alcohol only in moderation? YES/NO
Do you reach for food when feeling emotionally stressed? YES/NO
If yes, what sort of food do you usually reach for? ________________
Do you feel better after eating these foods? YES/NO
Are you a (circle one) binge-eater/chronic dieter/emotional eater/purger?
Do you have difficulty sleeping? YES/NO
Are you (circle one) pre-/peri-/post-menopausal?
Do you experience any menopausal symptoms? YES/NO
If so, are they severe enough to interfere with daily living? YES/NO
Are you (circle one): happy | somewhat satisfied | dissatisfied – with your current body weight?
Do you regularly participate in any stress-relieving activities, such as listening to relaxation tapes, meditating or attending mind-body classes (such as yoga or t’ai chi), or do you participate in individual or group counselling sessions with a social worker or other mental health professional? YES/NO
Are you taking any anti-anxiety/anti-depression medication? YES/NO
How You Answered
The purpose of the first part of this questionnaire is to raise your awareness of certain issues or factors that can cause you stress. The second part is designed to highlight how you respond to specific events or situations.
Raising your level of regular physical activity – especially when it involves getting outside, as in the walking plan – has been shown to be a highly effective way to combat stress and limit depression. If your answers to the questionnaire highlighted several areas that could be improved, I’d encourage you to revisit the questionnaire after you have completed the six-week plan.
Breaking the cycle of emotional stress can be hard, but the number one message to remember is that exercise – specifically cardiovascular activity – is a powerful tamer of emotional stress. Your six-week walking plan will help you alleviate anxiety and depression and boost self-esteem. You will lose excess body fat and feel more confident. So not only are you going to look better, you will feel better too.
As well as exercising, allocating a little time for yourself to engage in some form of self-nurture that doesn’t involve food can have a positive impact on how you feel about yourself. You could, for example, take a class, read or relax in the bath …
3 Making it Happen – Changing Habits and Attitudes (#)
Would you rather exercise for an hour a day – or be dead for 24 hours a day? Think about it…
If you are serious about losing weight and improving your health, you have to make some changes. Don’t panic – these don’t have to be drastic. However, these changes will essentially involve your existing habits and attitudes. At this stage in your life, your habits and attitudes will be well developed; you have had many years to put them into practice. Your habits may be so well grooved that they are a permanent feature of your life. They feel natural and you don’t give them much thought. For example, that mid-afternoon cup of tea and slice of cake or biscuit, your daily stroll with the dog, pint down the pub or G and T in the evening.
Get Active! (#)
Evidence has shown that we tend to overestimate how physically active we are. As I explained in the Introduction, many of us believe we are physically active when in fact we are geographically or mentally active. You may need to rethink and readjust your habits. For instance, you may believe that your daily saunter with the dog is enough for your fitness. It’s not that everyday activities are ineffective: the Chief Medical Officer’s report, ‘Health of the Nation’, clearly stated that activities such as walking and gardening are sufficient to incur health benefits. The problem, however, is that they are often not vigorous enough to produce real health benefits, let alone weight loss.
In my research for this book, time and time again respondents believed they were ‘doing enough’ and that they were ‘physically active’. On closer examination, however, the intensity and progression needed to provide health improvements and weight loss were missing. Seventy per cent of the respondents said the changes they primarily sought were weight loss and health improvements. Despite putting in time and effort to improve their health, they didn’t achieve the results they sought. This lack of results creates a sense of frustration and an element of ‘what’s the use?’
So, on your six-week plan, you may need to develop some new habits and attitudes. The great news is that some of the core habits you need may already be in place, but just need a little tweaking.
Stop kidding yourself you are doing enough
and start making your actions count.
Your attitude can directly affect your health and ageing process, either positively or negatively. By adjusting your habits and educating your attitudes, the actions you take become not only achievable but also sustainable, making the whole ageing process a far more positive experience. Together, all your habits and attitudes can lead you to an achievable major change to your health, your weight and how you feel about yourself.
Small Steps for Big Change (#)
To help you understand how you can make your existing habits and attitudes work for you, we need to introduce the concept of ‘small steps for big change’, which is central to the success of the six-week plan. This means that all the small actions you take, when put together and done progressively, can lead to a big change in your health and weight.
So often, I see people who are committed to improving their health but their actions fail. This is because their expectations are too great, and the changes they are trying to put in place are too drastic, unrealistic and unachievable for them. The six-week plan is about achievability, and the small steps for big change concept will be crucial to your success.
The six-week plan is about achievability and taking small steps to make a big change.
What Is a Habit? (#)
A habit is a series of behaviours we have got used to doing in response to a specific cue. When trying to adopt a new, healthy regime, we can often come unstuck as we try to ditch too many habits too quickly, and implement new actions which bear no resemblance to our existing life. Such a large change can be daunting, difficult to maintain and often leads to us dropping all the good actions we need to take. Implementing new habits does involve some planning and thought, but the new habits I am going to ask you to develop need not be a world away from some of the ones you already have.
To help us make habit-changing an achievable process, we need to understand a little about how we form habits.
Habit-forming in the Brain
Understanding how the brain works provides us with an insight into our behaviour and how habits are formed. Here is a very simple overview of how habits are formed in the brain.
The brain is responsible for receiving, processing and sending out messages based on vast amounts of information. Message carriers called neurons need to travel to specific destinations in the brain so that the information can be acted upon. The message carriers reach their destinations by travelling along neural pathways; you can think of these as a mini transport system. There are millions and millions of neurons in the brain, all carrying messages and travelling along neural pathways. Different parts of the brain deal with different types of information. If the message goes to the wrong part of the brain or doesn’t reach its correct destination, the information gets lost, never to be acted upon.
