# GPs to prescribe very low calorie diets in hope of reversing diabetes



## Northerner

Thousands of people are to be offered a very low calorie diet (VLCD) by their GPs in the hope of reversing their type 2 diabetes, NHS England has announced.

The 800-calories-a-day regimen, made up of soups and shakes, has been shown to help people lose excess weight that has caused fat to build up around their internal organs including the pancreas, leading to type 2 diabetes. About 10% of the NHS budget is spent on treating diabetes, which can have serious complications including blindness and the need for amputation.

The NHS has announced a further package of measures to tackle the soaring numbers with obesity-related disease. In 2016, two-thirds of the adult population and a third of children in England were overweight or obese and there were 617,000 obesity-related admissions to hospital.

https://www.theguardian.com/society...w-calorie-diets-in-hope-of-reversing-diabetes

It will be interesting to see what results emerge from this extension of the trial. I hope that those put on it who don't succeed are not made to feel like they have 'failed', given that in the trial mentioned it only worked for half of them. I wonder also what criteria they are using to determine which people may be more likely to be successful with this approach. I've always wondered too if this sort of artificial replacement diet actually educates people properly about real food suitable for maintaining good blood sugar levels.


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## travellor

https://www.diabetes.org.uk/researc...ht/research-spotlight-low-calorie-liquid-diet


I am fortunate enough to be able to afford a healthy diet admittedly,  but as to the education;
If you do manage to reverse diabetes, any food is suitable for maintaining good blood sugar levels.
It's quantity that will lead to weight gain.

Which isn't saying that going back to your previous diet is a good idea.
But I found the Newcastle diet breaks your eating habits.
And most eating is habit, so when you have spent 8 weeks on a 800 calorie diet, it's fairly easy to eat less afterwards.

I found I lost my sweet tooth, so all the cakes, donuts, crisps, chocolate, didn't reappear in  my diet.
I cut out the fats and oils, eat little red meat, sausage and bacon.
A lot less bread.

So my diet now has a lot less calories than before.
Which is really all its about at the end of the day for me to maintain a healthy weight.


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## Bloden

Veeeeery dodgy!  I should think only a tiny number of people would have the determination and willpower to do this. It’s not exactly teaching people to live more healthily in the long term. It’s more likely to hurl people into an eating disorder, IMHO. Diet, binge, diet, binge...that’s a hard roller coaster to get off.


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## Northerner

Bloden said:


> Veeeeery dodgy!  I should think only a tiny number of people would have the determination and willpower to do this. It’s not exactly teaching people to live more healthily in the long term. It’s more likely to hurl people into an eating disorder, IMHO. Diet, binge, diet, binge...that’s a hard roller coaster to get off.


Yes, think much depends on the kind of support that is offered and how people are selected as suitable for inclusion. They had a guy on the tv that was on the earlier trial and he appeared to havev very close one-to-one home-based support, but whether that is the level that will be offered on this wider scale remains to be seen - we all know how CCGs will seek to cut short-term spending despite the prospect of longer-term gains (test strips, anyone? )


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## Lucy Honeychurch

I bet they taste vile


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## travellor

Bloden said:


> Veeeeery dodgy!  I should think only a tiny number of people would have the determination and willpower to do this. It’s not exactly teaching people to live more healthily in the long term. It’s more likely to hurl people into an eating disorder, IMHO. Diet, binge, diet, binge...that’s a hard roller coaster to get off.



Not really.

I think there is an odd fear of diets, when the reality is as a nation we are overeating.


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## travellor

Lucy Honeychurch said:


> I bet they taste vile



No, vanilla and strawberry, and chocolate.
Quite pleasant.

Don't rubbish what you haven't tried.

Then again.
Would you prefer a lifetime as a type 2? Or a few weeks to resolve it?


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## grovesy

Maybe we should not rubbish it because we have not tried it. Though we know we could not not do .
I lost a lot of weight initially by adopting a way of eating that was not sustainable for me long term. That was 15 years ago. I later on reduced my portion size which helped me to lose weight and maintain that weight loss. I learnt that for me I had to maintain a way that I could maintain most of the time.


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## Lucy Honeychurch

travellor said:


> No, vanilla and strawberry, and chocolate.
> Quite pleasant.
> 
> Don't rubbish what you haven't tried.
> 
> Then again.
> Would you prefer a lifetime as a type 2? Or a few weeks to resolve it?




Unfortunately these shakes can't cure my diabetes


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## travellor

Lucy Honeychurch said:


> Unfortunately these shakes can't cure my diabetes



Yes, I had noticed a bit of negativity appearing on this thread.
However they can for type 2's, and any benefit to any of us is a good thing.


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## SadhbhFiadh

I can see where it can serve to break a pattern of eating, but I think more support will benefit most people to create a longer term result. I've always believed in the sustainable kind of answer to most of life. Moderation in all things. I agree with @grovesy


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## trophywench

Thing is though, traveller, you are obviously intelligent enough to be able to recognise (or you've been educated and listened) the foods that were causing the problem, and also had the sense to not reintroduce them onto your plate,  It's not to say everyone can, or will.

You are also prepared to do stuff to help yourself - rather than assume the NHS can or will, whatever it is.  There are people who neither wash their feet nor cut their own toenails once they've had a prob and been referred to Podiatry, since they regard it as not their job - not talking about ancient folk who are incapable either.

Not everyone has the determination to do anything much at all!


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## Eddy Edson

trophywench said:


> Thing is though, traveller, you are obviously intelligent enough to be able to recognise (or you've been educated and listened) the foods that were causing the problem, and also had the sense to not reintroduce them onto your plate,  It's not to say everyone can, or will.
> 
> You are also prepared to do stuff to help yourself - rather than assume the NHS can or will, whatever it is.  There are people who neither wash their feet nor cut their own toenails once they've had a prob and been referred to Podiatry, since they regard it as not their job - not talking about ancient folk who are incapable either.
> 
> Not everyone has the determination to do anything much at all!



And for those who are incorrigible in not getting a grip on things, I guess there's not much that can be done beyond medication. But so what, in this context? For those T2's who are amenable, this intervention - it's not a "diet", really - offers a significant prospect of something like an actual *cure*, a huge inducement to changing lifestyle post-intervention.

I really don't understand the negativity.


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## silentsquirrel

travellor said:


> Yes, I had noticed a bit of negativity appearing on this thread.
> However they can for type 2's, and any benefit to any of us is a good thing.



You missed out the word 'some'.    They apparently can for *SOME* T2s - which is a good thing for them, maybe not so good for those it does not help.


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## travellor

trophywench said:


> Thing is though, traveller, you are obviously intelligent enough to be able to recognise (or you've been educated and listened) the foods that were causing the problem, and also had the sense to not reintroduce them onto your plate,  It's not to say everyone can, or will.
> 
> You are also prepared to do stuff to help yourself - rather than assume the NHS can or will, whatever it is.  There are people who neither wash their feet nor cut their own toenails once they've had a prob and been referred to Podiatry, since they regard it as not their job - not talking about ancient folk who are incapable either.
> 
> Not everyone has the determination to do anything much at all!



"The foods that were causing the problem"?

It does seem that there is a need to identify foods types as the cause at times.
Personally, based on my experiences, I wouldn't say any food was an issue.
Too much of all food was my issue.

It is true I made a choice not to eat unhealthily after I was diagnosed.

However, I also decided my best option would to be to attempt to reverse my diabetes, so I could eat normally again.
To me, that was critical.
The hard bit was finding the information, the diet was easy. Many will find is easy also.
The odd few won't, or won't want to, but the majority will.

You're right some people may go back to overeating.
However, some won't.

If you structure this within the NHS framework, this treatment followed by leading onto the eatwell plate, and the structured approach to the amount to eat in the day, it'll work well for many.


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## travellor

silentsquirrel said:


> You missed out the word 'some'.    They apparently can for *SOME* T2s - which is a good thing for them, maybe not so good for those it does not help.



If you really want to change the sentence to include some, you need to change the verb to *WILL*
"Can" is the ability, or the possibility of an event happening.
"Will" is a statement it is going to happen
.
However they _*CAN*_ for type 2's.
However they *WILL* for _*SOME *_type2's.


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## travellor

Eddy Edson said:


> And for those who are incorrigible in not getting a grip on things, I guess there's not much that can be done beyond medication. But so what, in this context? For those T2's who are amenable, this intervention - it's not a "diet", really - offers a significant prospect of something like an actual *cure*, a huge inducement to changing lifestyle post-intervention.
> 
> I really don't understand the negativity.



I am puzzled by the opposition to the treatment being offered by the NHS as well.
Personally, early intervention to "cure" type 2 can only be good.


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## Benny G

GPs to prescribe very low calorie diets in hope of reversing *"Type 2"* diabetes.


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## mikeyB

I don’t see much wrong with this plan. Clearly, it’s a contract between doctor and patient, and with proper support the benefits produced should help the patient to realise that it’s food that is the answer. It’s a change in mindset that should happen.

If it doesn’t work, so be it. But there’s absolutely no reason not to try. 

And it’s not a criticism of any T2 on this forum. It’s accepted it only works in 50% of cases, but that’s just T2. A 50% ‘cure’ rate is remarkable, it should be shouted from the rooftops, not criticised.


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## Northerner

I'm fully supportive of the programme, just conscious that people need to be fully supported throughout the process and for it not to turn into a half-day 'introduction' and a pamphlet. One thing that was emphasised on a tv interview was that many HCPs will have to change their mindsets also. Most certainly, information and understanding of this option has increased considerably since I first read about those 10 or so folk on the original Newcastle trials a few years ago


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## Pine Marten

Tom Watson was interviewed on BBC Breakfast this morning about his success (before Brexit was mentioned again...).

He welcomed the new plan, but tactfully said that he would have liked to see different plans for different people, and said that his own method was to cut out starchy carbs and sugars (I haven't seen carbs mentioned in this new plan, only fewer calories), which meant huge weight loss and him coming off medication. He also said that he would like to see something about long term maintenance, and called it his 'diabetes going into remission' not reversing it... I think these points are very important, and if you start eating to the old pattern you'll end up with D again.

My daughter works part time in catering at a well-known hospital, and despairs at the people on the diabetic ward, who insist on their treacle sponge & custard, whatever, and then end up returning to hospital several times to have toes amputated or worse! Some people just don't want to listen.


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## travellor

Pine Marten said:


> Tom Watson was interviewed on BBC Breakfast this morning about his success (before Brexit was mentioned again...).
> 
> He welcomed the new plan, but tactfully said that he would have liked to see different plans for different people, and said that his own method was to cut out starchy carbs and sugars (I haven't seen carbs mentioned in this new plan, only fewer calories), which meant huge weight loss and him coming off medication. He also said that he would like to see something about long term maintenance, and called it his 'diabetes going into remission' not reversing it... I think these points are very important, and if you start eating to the old pattern you'll end up with D again.
> 
> My daughter works part time in catering at a well-known hospital, and despairs at the people on the diabetic ward, who insist on their treacle sponge & custard, whatever, and then end up returning to hospital several times to have toes amputated or worse! Some people just don't want to listen.



I'm not impressed by his tweet.

"Whether it's by low calorie diets or reducing sugars and starchy carbs, what today's NHS England announcement demonstrates is that 2m of us can achieve what I have - and put type 2 diabetes into remission and get off the meds. Remission for all! Now! "

Not what has been said at all.
Very specifically it's a low calorie diet, proven by real world trials.
The study was nothing to do with carbs at all.
It's weight loss, over a short period of time.
And the last line somehow implies it's actually being kept from us, and we have a right to be given remission?

A lot of showboating, which isn't helping anyone, and as you say, just confusing the actual message that the NHS have put out.


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## Lilian

[QUOTE=" It’s more likely to hurl people into an eating disorder,[/QUOTE]     An eating disorder is a mental condition.    If you are prone to it or have it then this will not help.    If you are not then whatever else it might do,  it will not give anyone an eating disorder.


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## Pine Marten

Yeah, well, I don't do Twitter, I reported what he said this morning in the interview. I still think maintenance is important, as he mentioned, as dramatic weight loss on liquids will just end up as weight gain if you don't maintain a healthy eating pattern.


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## Lilian

[QUOTE="My daughter works part time in catering at a well-known hospital, and despairs at the people on the diabetic ward, who insist on their treacle sponge & custard, whatever, and then end up returning to hospital several times to have toes amputated or worse! Some people just don't want to listen.[/QUOTE]
On the other hand I despair at the food offered to people, especially diabetics, in hospital.     For breakfast for example one has a choice of cereal and toast or cereal or toast.    If you tried to follow a low carb diet in hospital you would starve.


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## nonethewiser

Surely it can only be a good thing to encourage patients to reverse their type 2, just imagine the huge savings to the nhs if only half of them succeeded.


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## Northerner

travellor said:


> I'm not impressed by his tweet.
> 
> "Whether it's by low calorie diets or reducing sugars and starchy carbs, what today's NHS England announcement demonstrates is that 2m of us can achieve what I have - and put type 2 diabetes into remission and get off the meds. Remission for all! Now! "
> 
> Not what has been said at all.
> Very specifically it's a low calorie diet, proven by real world trials.
> The study was nothing to do with carbs at all.
> It's weight loss, over a short period of time.
> And the last line somehow implies it's actually being kept from us, and we have a right to be given remission?
> 
> A lot of showboating, which isn't helping anyone, and as you say, just confusing the actual message that the NHS have put out.


I don't quite understand what is wrong with his tweet  He says whether by (this) low calorie diet OR by reducing sugars and starchy carbs (his personal solution) etc. etc.. In his last line he's simply saying that the message needs to get out there more so people are aware of the possibilities.

That's how I would read it anyway!


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## Pine Marten

Lilian said:


> [QUOTE="My daughter works part time in catering at a well-known hospital, and despairs at the people on the diabetic ward, who insist on their treacle sponge & custard, whatever, and then end up returning to hospital several times to have toes amputated or worse! Some people just don't want to listen.


On the other hand I despair at the food offered to people, especially diabetics, in hospital.     For breakfast for example one has a choice of cereal and toast or cereal or toast.    If you tried to follow a low carb diet in hospital you would starve.[/QUOTE]

That's true, there is often little choice. The ones my daughter comments on are the ones who seem not to take care of themselves at all, like the ones @trophywench commented on further up, who insist on their sponge & custard regardless.

[tangent] don't know what happened to the quote there..??[/tangent]


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## travellor

Pine Marten said:


> Yeah, well, I don't do Twitter, I reported what he said this morning in the interview. I still think maintenance is important, as he mentioned, as dramatic weight loss on liquids will just end up as weight gain if you don't maintain a healthy eating pattern.



Many people seem to think the Newcastle diet is some sort of yo yo diet. I think that reflects more on their own attitude to weight loss, rather than the medical intervention it actually is.


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## travellor

Pine Marten said:


> On the other hand I despair at the food offered to people, especially diabetics, in hospital.     For breakfast for example one has a choice of cereal and toast or cereal or toast.    If you tried to follow a low carb diet in hospital you would starve.



That's true, there is often little choice. The ones my daughter comments on are the ones who seem not to take care of themselves at all, like the ones @trophywench commented on further up, who insist on their sponge & custard regardless.

[tangent] don't know what happened to the quote there..??[/tangent][/QUOTE]

You don't need to if you can successfully reverse your diabetes.
That's the aim behind this treatment.
Then the NHS  will have more resources to focus on the rest.


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## Austin Mini

trophywench said:


> Thing is though, traveller, you are obviously intelligent enough to be able to recognise (or you've been educated and listened) the foods that were causing the problem, and also had the sense to not reintroduce them onto your plate,  It's not to say everyone can, or will.
> 
> You are also prepared to do stuff to help yourself - rather than assume the NHS can or will, whatever it is.  There are people who neither wash their feet nor cut their own toenails once they've had a prob and been referred to Podiatry, since they regard it as not their job - not talking about ancient folk who are incapable either.
> 
> Not everyone has the determination to do anything much at all!


You always say the right thing Jenny


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## Bloden

travellor said:


> No, vanilla and strawberry, and chocolate.
> Quite pleasant.
> Don't rubbish what you haven't tried.



I have tried! They were rank and left me feeling a failure. 

I may be a T1 now, but in my distant past I had binge eating disorder. I struggled for 10 years with the binge-starve-binge cycle and yo-yo-ing weight. I’m arguing for sympathy and support and long-lasting lifestyle changes, which is what worked for me.


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## Martin Canty

While not a fan of structured diets, I can see how this would help some people who need a kick-start into changing their lifestyles

People need to be motivated to change their lifestyles (and not just their diet)
People should not see this as a way to loose a few pounds so they can go back to their old ways, only to try it again sometime in the future
People need to be educated in the value of "real food" i.e. made from scratch
Personally, this would have probably not worked for me as I wasn't that much overweight, but D has caused me to very much rethink my diet in terms of bulking up on veg rather than carbs....


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## travellor

Martin Canty said:


> While not a fan of structured diets, I can see how this would help some people who need a kick-start into changing their lifestyles
> 
> People need to be motivated to change their lifestyles (and not just their diet)
> People should not see this as a way to loose a few pounds so they can go back to their old ways, only to try it again sometime in the future
> People need to be educated in the value of "real food" i.e. made from scratch
> Personally, this would have probably not worked for me as I wasn't that much overweight, but D has caused me to very much rethink my diet in terms of bulking up on veg rather than carbs....



This was exactly was the structured treatment the NHS presented to me. 
So, adding the Newcastle Diet into the approach seems to be ideal, as I did do it, but had to find it for myself, and take it back to my doctor.


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## Bruce Stephens

An opinion piece in today's paper, https://www.theguardian.com/comment...d-diet-going-to-succeed-when-most-others-dont


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## travellor

Bruce Stephens said:


> An opinion piece in today's paper, https://www.theguardian.com/comment...d-diet-going-to-succeed-when-most-others-dont



I guess it depends on your mindset.
If you are saying type 2 is predominantly associated with overweight yo yo dieters, maybe it will be doomed to fail at outset.
If you say the Newcastle diet is the first line of treatment in attempting remission, maybe it won't be.

I think you have to let each type 2 decide how they approach the treatment, not pre judge them as incapable, and just going to get fat again.
Bad article to be honest.


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## mikeyB

I thought that article might get a mention when I read it. I don’t think it was a bad article - it’s true, for example, that these liquid diets do often result in post diet weight gain, and the yo-yo effect on weight. The thing that was missing was the perception of the dieter - the effect on the diabetes. That is potent reason for changing the diet afterwards. 

Though why you can’t just start with a low carb diet, I don’t know.


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## HOBIE

I have just been in hosp & the fella in the same ward was a T2 & the nurses asked him every day to get out of bed to easy his bed sores. NO NO he said. Would not get out of his bed ? ??


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## Karsten

the VLCD diet was rubbished by most GPs and a lot of the NHS,
now its a wonder  cure?

It was initially said to cure all.. now its down to 40% and mostly people newly diagnosed and that didn't do any exercising except very light exercise.
The Cambridge diet and Newcastle diet do help some, but if you have been on oral medication for some years then it probably will only reduce your sugars while you are on it and will not be permanent.

If you research it you will read that its the losing quickly weight that works as it uses up your *Visceral* fat which is them main problem with most type 2s but not all!
Most research is on people that are not at work and taking time off?
Who has 8 weeks holiday?

Try working a full day on 700cal.. its knackering and your mental concentration goes out the door.

I hope the NHS doesn't ask Bus, Lorry, Train drivers,pilots or anyone in charge of dangerous machinery to do this diet without making sure their work knows. 

Asians that get diagnosed often reverse it by changing their diet and using Indian solutions like curries with lentils, 'Bitter Lemon', Fenugreek seeds.., ditching bread and starchy dishes.  Its an ancient response to diabetes.
I've not seen much research about that.

I suspect the longer you have been on M medication the less chance you have of reversing it.

Asda do a meal replacement that is quite cheap and has all the vital vitamins..  just add milk..
for something different ;
an egg is ~80 cals (2 about 150-160), a chicken breast is  ~ 150  so you can get down to 700 eating some food..and replacing one or two drinks..
Quorn with chill flakes and a stock cube makes a good low cal meal.

The meal replacement drinks are meant to make sure you get enough vitamins and nutrition.   They aren't medicine.

Still have not seen a link to an official page where you can apply?
Where is the support going to come from my GP?? ROFLMAO

Been there done it.. They didn't know anything about it.. at all.


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## travellor

Karsten said:


> the VLCD diet was rubbished by most GPs and a lot of the NHS,
> now its a wonder  cure?
> 
> It was initially said to cure all.. now its down to 40% and mostly people newly diagnosed and that didn't do any exercising except very light exercise.
> The Cambridge diet and Newcastle diet do help some, but if you have been on oral medication for some years then it probably will only reduce your sugars while you are on it and will not be permanent.
> 
> If you research it you will read that its the losing quickly weight that works as it uses up your *Visceral* fat which is them main problem with most type 2s but not all!
> Most research is on people that are not at work and taking time off?
> Who has 8 weeks holiday?
> 
> Try working a full day on 700cal.. its knackering and your mental concentration goes out the door.
> 
> I hope the NHS doesn't ask Bus, Lorry, Train drivers,pilots or anyone in charge of dangerous machinery to do this diet without making sure their work knows.
> 
> Asians that get diagnosed often reverse it by changing their diet and using Indian solutions like curries with lentils, 'Bitter Lemon', Fenugreek seeds.., ditching bread and starchy dishes.  Its an ancient response to diabetes.
> I've not seen much research about that.
> 
> I suspect the longer you have been on M medication the less chance you have of reversing it.
> 
> Asda do a meal replacement that is quite cheap and has all the vital vitamins..  just add milk..
> for something different ;
> an egg is ~80 cals (2 about 150-160), a chicken breast is  ~ 150  so you can get down to 700 eating some food..and replacing one or two drinks..
> Quorn with chill flakes and a stock cube makes a good low cal meal.
> 
> The meal replacement drinks are meant to make sure you get enough vitamins and nutrition.   They aren't medicine.
> 
> Still have not seen a link to an official page where you can apply?
> Where is the support going to come from my GP?? ROFLMAO
> 
> Been there done it.. They didn't know anything about it.. at all.



"Been there done it.. They didn't know anything about it.. at all"

So, we've both done the actual Newcastle Diet?

How recently did you do it?
What was your result in relation to diabetes?


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## travellor

mikeyB said:


> I thought that article might get a mention when I read it. I don’t think it was a bad article - it’s true, for example, that these liquid diets do often result in post diet weight gain, and the yo-yo effect on weight. The thing that was missing was the perception of the dieter - the effect on the diabetes. That is potent reason for changing the diet afterwards.
> 
> Though why you can’t just start with a low carb diet, I don’t know.



Why is it a bad article?

I think there is enough blame already about diabetes being caused by fat people simply overeating themselves to into it, without then going on to say you can't expect any diet to work on them, even if you offer them a course of treatment designed to reverse diabetes by losing weight, all they will do is simply eat it back on later, so why bother?

It even seems to be a well supported opinion on this forum it seems.

Sadly by people that seem not to have actually tried this particular course of treatment, so why are they writing it off so quickly?
Is it  their opinion that they don't think they couldn't do it themselves, and writing off every other diabetic that would do it?
Are they anti-diet, and don't accept a medical treatment that seems to be a "diet"?
Or do they believe that we simply can't change, so we're doomed to failure ? Once a diabetic, always a diabetic?

I think many diabetics would appreciate a second chance.
I certainly did.


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## Eddy Edson

travellor said:


> Why is it a bad article?
> 
> I think there is enough blame already about diabetes being caused by fat people simply overeating themselves to into it, without then going on to say you can't expect any diet to work on them, even if you offer them a course of treatment designed to reverse diabetes by losing weight, all they will do is simply eat it back on later, so why bother?
> 
> It even seems to be a well supported opinion on this forum it seems.
> 
> Sadly by people that seem not to have actually tried this particular course of treatment, so why are they writing it off so quickly?
> Is it  their opinion that they don't think they couldn't do it themselves, and writing off every other diabetic that would do it?
> Are they anti-diet, and don't accept a medical treatment that seems to be a "diet"?
> Or do they believe that we simply can't change, so we're doomed to failure ? Once a diabetic, always a diabetic?
> 
> I think many diabetics would appreciate a second chance.
> I certainly did.



It seems similar in some ways to the perception I remember from the olden days that very few smokers could be expected to actually quit. It took a while to change that, including punitive tax measures & long-term education  - but the huge amount of medical evidence certainly played a big role. At any particular age level, your chances of dying from CV causes are about one-third of what they would have been in 1970: chalk up a big chunk of that to reduction in smoking (as well as statins, better BP medication and reduced satfat intake).

Behaviours can actually change in the medium term, if there's a big enough, visible enough carrot (and, I guess, a big enough downside stick).


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## trophywench

I don't disagree with it, at all!  BUT because I know TOO well that the bulk of people 'labelled' T2 (a good proportion of them being really LADA in the first place anyway, not T2) and are NOT well supported by the medical profession I will literally be speechless if it 'works' as well as it could, were that support ready and waiting to be called upon.

How many professionals are trained, ready and waiting for the influx of applicants?

For those who are prepared to learn how to help themselves in partnership with the NHS - then fine.  I asked constantly for well over 10 years to get on a 'DAFNE' course - and when Coventry eventually decided it might be a good idea (the bean counters I'm referring to here - NOT the clinicians) it was ONLY by the 2 DSNs and the Dietician at Rugby diabetes clinic offering to pay their own travelling and accommodation fees in order to go to BDEC and get the training - which they did - after all following that personal investment by themselves they all knew it should make their jobs a bit easier re the T1s apart from the patients! - that it came into being in this area as early as they were able to get it up and running.

'They' had immediately discounted DAFNE itself and all the consultants and their staff had to constantly badger them at every opportunity to even consider the BDEC version (because we've already looked at this and it's far too expensive/not our priority)

I think it's like the cure for T1s, isn't it?  It's been on the cards in the next 10 years from the day I was diagnosed and clinicians are STILL telling new T1s that now!


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## Bruce Stephens

travellor said:


> I am puzzled by the opposition to the treatment being offered by the NHS as well.
> Personally, early intervention to "cure" type 2 can only be good.



As the article says, it's a trial involving 5000 people with Type 2.

Which does seem like an obviously good thing to do. With any luck they'll gain information on practicalities (how much support is required, etc.) as well as effectiveness.


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## mikeyB

Or find out how much it does cost and kick the idea into the long grass. Our government auditors don’t do forward cost benefits.


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## Madeline

I’m not enamoured, it seems like another stick with which to beat someone, and I’m only too used to sticks. People see me with an O2 tank and automatically assume I’m COPD and have been a heavy smoker, when it couldn’t be further from the truth. And now I’ve got the T2 crap and even my family are bleating about weight, when I’m a) only slightly overweight, and b) I’ve been on daily high dose steroids (15-40mg) for 3+ years plus am housebound due to immunodeficiency, and unable to exercise.

And I’m not convinced I’m T2, this has all happened within 6 weeks. I was on massive amounts of medication whilst in a coma and my BG was constantly monitored - in fact having spent a 5th of the previous year inside it’s probably been monitored more than your average T2. I’ve never had an issue with it, and I’ve low cholesterol and normal BP 

Sorry for rant. I’m a wee bit cross today.


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## PaulLa

I was diagnosed T2 in August with hba1c of 51. Since then on diet and exercise alone (no meds), I've lost 4 stone, hba1c 42 at my 3 month review, cholesterol down to 5.1 from 5.7 (HDL ratio now 3.4 instead of 5.7) and triglycerides less than half. All fasting and post meal bgt are within the official 'normal' range - as low as 4.7 fasting (6 hours after beans on toast breakfast). last week I experimented with an Indian meal of 120 carbs and got 7.2 2 hours later). I'm still at it, albeit with increased calories and carbs and hope to improve more on the numbers as I lose weight.

I mention all this because, while I have not done the ND, I've done this through restricting carbs and calories (to way less than 1500 a day to start with). I would not have known any of this was possible if it wasn't for David Cavans book and this forum. Not everyone would stumble across the potential for themselves in this way. Had I just followed NHS info Id not have done anything as anywhere near as radical and no doubt would not have got anywhere near the results in such a short time - and probably not at all.

The new NHS position and it's publicity, for one, has shown the profound positive effect diet can have and that remission is a genuine possibility for some. Had this announcement been made pre my diagnosis I would have jumped at the chance to go on the ND programme - it being significantly less in cals and carbs would presumably have achieved at least as good and probably better results than the random diet Ive been practicing.

I'm sure there are many more like me who upon being diagnosed would do anything to try and retrieve the situation as best as possibleand will be quick on the uptake (personally I fully blame myself for years of excess and burrying my head in the sand - this mindset has made it easy for me to deprive myself of my old eating habits). In fact despite my good results so far, Im still considering the ND while I still have enough weight left to lose.

As long as the NHS announcement/position doesn't raise expectations too high, I believe it can only be a good thing.


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## trophywench

Madeline - long use of steroids can and does cause T2 in some people - it may not be one of the more common reasons but it is well-known in the diabetes community and amongst the medical profession that it can - hence exactly why they kept testing your BG in hospital.

Any illness condition or disease that needs ongoing steroid treatment (or even high doses for a relatively short time) is going to have, or have had, a detrimental effect on your whole body, inside or out.  So the fact it's brought on something else isn't really all that surprising.  If your body can no longer cope with eating as many grams of carbs as you feel like at the drop of a hat all day every day with little effect on your BG - then you have diabetes.   It certainly isn't T1, nor LADA or MODY, neither is it any other condition - so you're stuck with T2 like it or not.

If people are so ignorant about diabetes they are going to make sweeping assumptions about what caused your T2 without taking the trouble to ask - and unless you (or anyone else) has told them - then because it's so utterly rude to make comments about whatever anyone has wrong with them - frankly they aren't people I want in my life thanks.

You are going to grow a thicker skin - since I was 22 it doesn't matter whether I had a cold, flu or broke a fingernail people including some medics) assume 'it must be because of your diabetes'- and now I'm 68 almost every person who has only just met me and it comes up that I have diabetes - assume I must be T2 and I get a few comments about being odd cos you're not that overweight, are you? - and they soon regret saying that cos they get quite a diatribe from me about obviously not having the slightest clue about what actually causes diabetes and perhaps it would be better not to say things like that to some people - cos others get very upset!


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## Madeline

Thank you Jenny lovely, that’s probably exactly what I needed to hear. And yes, I do need a thicker skin, people can be so bloody hurtful, even when they don’t realise, or mean to. 

Also v helpful about the type, I think in my ignorance I’d expected type 2 to creep up on me, not to suddenly spring into my life, and because I didn’t ‘tick’ other boxes like high BP or cholesterol, or being very overweight, I panicked. Thank you.


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## mikeyB

It’s not just the general public that assume I’m T2, it’s doctors in other specialties. I make a point of telling them I’m T1 from the get go. The assumption is too easy, because only 10% of folk with diabetes are T1. The reverse happens with thin T2s.

It’s a pain in the fundament. It’s the same with my chronic pancreatitis. I haven’t got CP, I’ve got CP not due to alcohol, because that is the commonest cause. Doctors always assume I was a heavy drinker, probably because I was a doctor


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## Lilian

A while ago I was looking at a TV series about how food can be used to cure  medical conditions instead of medication.     A person would come with a specific medical condition and they put them on a special diet for that condition, which seemed to do the trick.    However when a person who had type 2 diabetes and was heavily overweight was seen they were told that the only thing that could be done for them was to put them on shakes three times a day.


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## Matt Cycle

mikeyB said:


> It’s not just the general public that assume I’m T2, it’s doctors in other specialties. I make a point of telling them I’m T1 from the get go. The assumption is too easy, because only 10% of folk with diabetes are T1. The reverse happens with thin T2s.
> 
> It’s a pain in the fundament. It’s the same with my chronic pancreatitis. I haven’t got CP, I’ve got CP not due to alcohol, because that is the commonest cause. Doctors always assume I was a heavy drinker, probably because I was a doctor



Another one of my annoyances.  What do they think happens to Type 1's as you get older?  I generally make a point now of saying I'm Type 1.  Most people haven't got a clue.  I was talking to someone at work and said I'm a *Type 1* diabetic, he said 'what you on? tablets?'.  I said no I'm Type 1, I'm on insulin. He said 'oh, you're on insulin are you'.


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## HOBIE

There is a BIG difference between T1 & T2. Diabetes uk are always on about it ???


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## mikeyB

Doesn’t matter what Diabetes UK go on about, Hobie. Most folk get their diabetes information from the Daily Mail, Mirror, or Sun.


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## Lucy Honeychurch

When first diagnosed a work colleague (helpfully!) told me the hospital had made a mistake and I must be type 2 as I'm too old to be type 1


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## Martin Canty

Strangely enough, while I was working in Tampa, in our ERP development group (7 of us in all) we had 2 T2's & a T1


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## Anise

I have been following the VLCD from Newcastle University web site for nearly a month now and am finding it ideal for me.  
The advantages given for the diet - and those that suit me very well - are that the meal replacements are filling and I don’t get hungry. 
During this specific weight loss phase I don’t have to make decisions or plan what to buy and how much or what to eat. Feeding myself is quick and easy, which reduces temptation for me drastically. I did not clear my food store before I started - there is bread in my freezer and I have no desire for it at the moment.  

I am very encouraged by the weight I have lost so far. I have always felt that the problem of a lifetime of overweight is that in order to merely survive I have to buy and prepare food for myself. That is what has failed me for so long;  I can’t avoid it, like I might alcohol or cigarettes.

NHS VLCD support is not available yet in my home area but my clinic nurse has made a note of my intent so that I can get regular check ups in the coming months.  

I don’t know what will happen when I come off the diet in four weeks’ time but I am very encouraged to have found an albeit temporary regime that fits my needs. Who knows, I may be able to carry my success forward with some good eating habits and encouragement?

The incentive to lose weight is a very personal thing so I can’t comment on some of the posts in this thread.  
But thank you very much for the positive ones.


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## PaulLa

Anise said:


> I have been following the VLCD from Newcastle University web site for nearly a month now and am finding it ideal for me.
> The advantages given for the diet - and those that suit me very well - are that the meal replacements are filling and I don’t get hungry.
> During this specific weight loss phase I don’t have to make decisions or plan what to buy and how much or what to eat. Feeding myself is quick and easy, which reduces temptation for me drastically. I did not clear my food store before I started - there is bread in my freezer and I have no desire for it at the moment.
> 
> I am very encouraged by the weight I have lost so far. I have always felt that the problem of a lifetime of overweight is that in order to merely survive I have to buy and prepare food for myself. That is what has failed me for so long;  I can’t avoid it, like I might alcohol or cigarettes.
> 
> NHS VLCD support is not available yet in my home area but my clinic nurse has made a note of my intent so that I can get regular check ups in the coming months.
> 
> I don’t know what will happen when I come off the diet in four weeks’ time but I am very encouraged to have found an albeit temporary regime that fits my needs. Who knows, I may be able to carry my success forward with some good eating habits and encouragement?
> 
> The incentive to lose weight is a very personal thing so I can’t comment on some of the posts in this thread.
> But thank you very much for the positive ones.


Great to hear you're having success with the diet. Since diagnosis in August,I have lost 4st 5lb eating around 1500 Cal's a day (initially 1200 ( so it must fly off at 800 Cal's!). I'm still considering the Newcastle diet while I still have sufficient weight left to lose. All the best with continued success and adapting after coming off the diet.


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## Madeline

@Anise can I ask which shakes you are using?


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## trophywench

I think one of the keys to any successful diet is planning what you are going to cook and eat, ahead, shopping and only buying enough to make whatever's on the list, and sticking to it.  That takes discipline and self control, which you might find comes to you easier once you start seeing the results.

Good luck!


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## Anise

Thank you PaulLa! Weight not flying off as much as I was expecting.  Which is probably why it is recommended to take body measurements; and mine are changing. I need to learn more about the properties and function of various body fats - brown, white and, significantly, visceral....


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## Anise

Madeline said:


> @Anise can I ask which shakes you are using?


I am using XLS Nutrition, it’s not one of the Newcastle recommended formulas but that may be because it’s “new” in name and packaging from a product that used to be available.  As far as I can tell it is a proper meal replacement. I don't expect anything like a milk or ice cream shake but it’s alright.  There is no aftertaste of artificial sweetener in the vanilla flavour, which contains honey.  I blend it in a liquidiser, let it settle, and blend again as it doesn’t mix readily.  I have three portions a day plus permitted veg.  I also like the Keediet chicken and vegetable soups, which are very practical.


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## Anise

trophywench said:


> I think one of the keys to any successful diet is planning what you are going to cook and eat, ahead, shopping and only buying enough to make whatever's on the list, and sticking to it.  That takes discipline and self control, which you might find comes to you easier once you start seeing the results.
> 
> Good luck!


Thank you Jenny.  This phase doesn't take much D and S-C so I will have to work on that eventually!


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## Madeline

Thanks Anise


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## PaulLa

Anise said:


> Thank you PaulLa! Weight not flying off as much as I was expecting.  Which is probably why it is recommended to take body measurements; and mine are changing. I need to learn more about the properties and function of various body fats - brown, white and, significantly, visceral....


If you start an exercise regime along with your diet snd till ill then were relatively inactive sometimes the muscle gain detracts from weight loss (muscle is significantly heavier than fat). As you say it's the body measurements and monitoring of fat that shows how you are really progressing.


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## travellor

I relied on the scales, and the mirror. 
I could see the changes in myself as I did the diet.


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## Madeline

@travellor did you do the whole 8 weeks?


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## travellor

Madeline said:


> @travellor did you do the whole 8 weeks?



I initially did about a year on a low fat diet with the NHS dietitian, which lost a lot of weight, but didn't reverse my diabetes.
I finished off with just over 6 weeks on the Newcastle Diet, I stopped early as I was getting too gaunt, and had another personal commitment that meant I needed to eat normally as well.

It had worked by then though.

I did notice I lost a lot more on the slow diet, than I did on the Newcastle Diet.
I started the Newcastle with a "normal" BMI.
So, for me, slow weight loss didn't work.
I just changed from being a fat diabetic to a thin diabetic.
It did improve my BG enormously, but either I needed to lose more, from "normal" to "very thin", or the actual speed, or calorie deficiency had another metabolic effect.
I don't think I'm alone, as there are a lot of posters who seem to have changed their diet, and although have lost weight slowly, still have to avoid carbs as their BG still spikes.

More research is needed to find the mechanism to actually reverse diabetics, but at least this is a good start.


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## Madeline

Thanks, I’ve marked the end of each week as a goal. Just going to take it one day at a time, or my head will explode. 

Weirdly my BG has gone up! I’m sitting on mid 9s after 2 shakes. They’re lower calorie and carb than most, I was hoping to see a holy grail 5.


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## travellor

Madeline said:


> View attachment 10667 Thanks, I’ve marked the end of each week as a goal. Just going to take it one day at a time, or my head will explode.
> 
> Weirdly my BG has gone up! I’m sitting on mid 9s after 2 shakes. They’re lower calorie and carb than most, I was hoping to see a holy grail 5.



Your BG will settle down.
BG varies up and down for  week or so whenever you change your diet.

I have to be honest, personally I'm happy with any normal BG.
Be careful you don't start chasing your meter.
Some people do seem to think a very low BG is somehow better, it can become an obsession, I believe some even claim a "4 club".
It can become infectious.
My view is that's just diabetes winning by a back door.

Much the same as my view on trying to be "medication free".
I strove to stay on metformin after I researched it could be beneficial for other reasons.
Unfortunately my doctor eventually won.


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## Madeline

I’m trying to be happy with anything in single figures, and not number chase. It’s quite hard not to, I’m naturally quite an obsessive sort of person. Kids will give me a swift kick if I get annoying over it though.


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## Paul Hickling

travellor said:


> I'm not impressed by his tweet.
> 
> "Whether it's by low calorie diets or reducing sugars and starchy carbs, what today's NHS England announcement demonstrates is that 2m of us can achieve what I have - and put type 2 diabetes into remission and get off the meds. Remission for all! Now! "
> 
> Not what has been said at all.
> Very specifically it's a low calorie diet, proven by real world trials.
> The study was nothing to do with carbs at all.
> It's weight loss, over a short period of time.
> And the last line somehow implies it's actually being kept from us, and we have a right to be given remission?
> 
> A lot of showboating, which isn't helping anyone, and as you say, just confusing the actual message that the NHS have put out.


Hi it’s not always about weight I’m a M 
size thinking about weight training to gain muscle weight, I’m hoping this will help


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## travellor

Paul Hickling said:


> Hi it’s not always about weight I’m a M
> size thinking about weight training to gain muscle weight, I’m hoping this will help



The Newcastle diet didn't involve any exercise as far as I am aware.
If was specifically a very low calorie diet to reduce body fat.
It was measured in several ways to be fair, but in all honesty, the easiest way to measure how much fat you are losing is a simple set of scales.
If you do want to mix in exercise, you can reduce the fat and put on muscle if you are very lucky, but it's more likely you'll just reduce the speed of muscle loss along with the fat loss.
I didn't really notice any difference to my muscle tone as I still exercised throughout to try to reduce muscle loss, which seems to work well enough.
I think most of the weight I lost was unwanted fat



https://www.directclinicaltrial.org.uk/Documents/Patient Info Website Feb 2018.pdf

https://www.directclinicaltrial.org.uk/Documents/The Lean Team No Doubt Diet plan.pdf

https://www.directclinicaltrial.org.uk/Documents/Counterweight-Plus Screening Dec 2017.pdf

https://www.directclinicaltrial.org.uk/Documents/PRO800WeightLossPlanIndividuals.pdf


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## novonord

interesting comments on here about metformin, it was promoted in today's Lex column in the Financial Times, of all places, as a longevity anti-ageing drug seems it has effect in increasing destruction of 'zombie' cells that otherwise contribute to the ageing process.


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## travellor

novonord said:


> interesting comments on here about metformin, it was promoted in today's Lex column in the Financial Times, of all places, as a longevity anti-ageing drug seems it has effect in increasing destruction of 'zombie' cells that otherwise contribute to the ageing process.



I really wanted to stay on Metformin.
I hung on for 3 years before I lost the good fight.


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## PaulLa

I was diagnosed in August with hba1c of 51... Wasn't put on meds and at review on November hba1c was 42. I see not being on meds as a massive plus as to me it indicates my body is able to function reasonably well unassisted and therefore the prognosis for the future as we naturally deteriorate is better than if I already needed meds at this stage.

Proud? Certainly not...I'm more ashamed and angry with myself for leading the lifestyle that got me to such a weight and poor physical condition that no doubt brought on diabetes and sleep apnoea before that. People tell me I should be proud of the 4st 6lb Íve lost in the last 4 months but I am not at all and see this as just my trying to make up for those past excesses I continued to indulge in despite  sliding steadily downhill.


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## travellor

I agree with you entirely.
I feel exactly the same.
If I need to go back on meds I won't think I've failed now though.


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