Frequently Asked Questions

What to expect at the initial appointment?

This will last 50 minutes and will include:

  • A thorough assessment
  • Nutrition education-scientifically based and translated into practical advice
  • Initial goal setting
  • Personalised treatment plan

During this appointment, you will be asked questions about your medical history, weight history, lifestyle habits, current symptoms, usual food choices, eating patterns and eating behaviours. This will enable me to assess your current nutritional status and comfort level for behavioural change. Based on your individual needs I will develop a personalised treatment plan to support you to achieve your goals. I will also discuss how many sessions you might require to meet your goals and whether a referral to another healthcare professional is recommended.

What to expect at follow-up appointments?

These last 50 minutes during which your progress will be assessed and the treatment programme will be adjusted to overcome any obstacles you encounter to support you to achieve your goals.

What is bariatric surgery?

Bariatric surgery is also known as weight loss surgery. Bariatric surgery is not only effective at producing rapid and dramatic weight loss but also leads to significant improvements to many obesity-related conditions such as type 2 diabetes, high blood pressure, high cholesterol, sleep apnoea and fatty liver disease.

NICE guidelines suggest that bariatric surgery should be considered if you have a body mass index (BMI) of 40 or more or a BMI between 35 and 40 with an obesity-related condition such as type 2 diabetes or high blood pressure or fatty liver disease. Bariatric surgery is usually considered once  you’ve tried all other weight loss methods, such as dieting and exercise but have struggled to lose weight or keep it off.

There are several types of weight loss surgeries. The most common types are:

  • gastric band – a band is placed around the stomach, so you don’t need to eat as much to feel full
  • gastric bypass – the top part of the stomach is joined to the small intestine, so you feel fuller sooner and don’t absorb as many calories from food
  • sleeve gastrectomy – some of the stomach is removed, so you can’t eat as much as you could before and you’ll feel full sooner

All these operations can lead to significant weight loss and each has its advantages and disadvantages. It is therefore important that you are physically and mentally prepared for the operation.

Additionally, although weight loss surgery can achieve dramatic weight loss, it is not a cure for obesity on its own. It is important that you are aware of what  changes you need to make and when to avoid putting weight back on.

What is Binge Eating Disorder?

Binge eating disorder is characterised by episodes of eating a much larger amount of food than most people would eat in a 2-hour period accompanied by feelings of loss of control (feeling that one cannot stop eating or control what or how much one is eating)

The binge-eating episodes are associated with three (or more) of the following:

  • eating much more rapidly than normal
  • eating until feeling uncomfortably full
  • eating large amounts of food when not feeling physically hungry
  • eating alone because of feeling embarrassed by how much one is eating
  • Feelings of guilt and shame afterwards

Binge eating disorder is a recognised eating disorder in the Diagnostic and Statistical Manual of Mental Health Disorders and requires specialist input to allow you to regain a sense of control over your eating. Binge Eating disorder can not only wreak havoc with your weight but also adversely affect your mood, sleep and sense of self-worth. My role is to help you identify your own triggers to bingeing, whether it be physiological or emotional, and support you in breaking the binge cycles, normalising your eating behaviours and improve your relationship with food.

Gaining control over binge eating is particularly important if you are thinking about having bariatric surgery as research has shown that addressing binge eating prior to surgery improves long-term weight loss outcomes

What is Bulimia Nervosa?

Bulimia Nervosa is characterized by episodes of bingeing on large amounts of food in a short space of time followed by compensatory behaviours (to avoid weight gain) such as vomiting, laxative use and/o excessive exercise. Bulimia Nervosa can result in severe medical complications including electrolyte abnormalities (especially low potassium) which can lead to heart abnormalities, gastrointestinal problems, esophageal bleeding/rupture, dental problems, dehydration amongst others. Without treatment, bulimic symptoms can get out of control and the physical and emotional damage can be severe. Early intervention is critical to prevent long-term physical damage maximize one’s chance of a full recovery. I am trained to help people of all ages to identify the triggers to bingeing in an effort to break the binge-purge cycle. I also support patients on correcting nutritional complications that may result from bulimic behaviours by creating a personalised nutritional treatment plan.

What is Anorexia Nervosa?

Anorexia Nervosa is characterised by:

  • Restricting food intake leading to a significantly low body weight and
  • Intense fear of gaining weight or becoming fat, even though one is actually underweight and
  • Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

Warning Signs Include:

  • Significant weight loss
  • Distorted body image
  • Intense fear/anxiety about gaining weight
  • Preoccupation with weight, calories, food, etc.
  • Feelings of guilt after eating
  • Denial of low weight
  • High levels of anxiety and/or depression
  • Low self-esteem
  • Withdrawal from friends and activities
  • Excuses for not eating/denial of hunger
  • Food rituals
  • Intense, dramatic mood swings
  • Pale appearance/yellowish skin-tone
  • Thin, dull, and dry hair, skin, and nails
  • Feeling cold all the time
  • Fatigue/fainting
  • Excessive and compulsive exercise

Anorexia Nervosa can severely affect ones physical, psychological and social wellbeing. Some health complications include:

  • Amenorrhea (cessation of menstrual cycle)
  • Abnormally slow and/or irregular heartbeat
  • Low blood pressure
  • Anaemia
  • Poor circulation in hands and feet
  • Growth of lanugo hair
  • Muscle loss and weakness (including the heart)
  • Dehydration/kidney failure
  • Oedema/swelling around ankles due to fluid retention
  • Bone density loss/Osteoporosis
  • Memory loss/disorientation/poor concentration/difficulty making decisions
  • Depression
  • Anxiety
  • Obsessive behaviour

 

While Anorexia Nervosa is the 3rd most common chronic illness among adolescents, eating disorders do not discriminate between age, gender, race or class.

If you think you may have Anorexia Nervosa the most important thing you can do is seek treatment. Research shows that early intervention is associated with better recovery rates and the longer the anorexia persists the more it affects your physical and psychological health.

People with Anorexia Nervosa need to gain weight slowly to prevent refeeding syndrome which is a potentially fatal condition that occurs when someone starts to eat again. With refeeding, metabolic and hormonal changes occur which can cause electrolyte shifts that can cause heart and respiratory failure. I can support you in prescribing the correct number of calories alongside prophylactic vitamin treatment and blood test monitoring to prevent refeeding syndrome. I can also provide you with insights into the effects of Anorexia Nervosa on your metabolism, body composition, physical health and psychological wellbeing. When you are ready I can support you with slow weight restoration at a rate that is manageable for you and help you to improve your relationship with food and your body.

How can I go about arranging an appointment with you?

Whether you’re overweight or underweight or just looking for a bit of extra guidance and support, a nutrition consultation may be all it takes to help you achieve your goals. I offer private consultations in either Marylebone or Finchley. I am also able to offer home visits and telephone/Skype appointments if preferred. Please feel free to get in contact to arrange an appointment/consultation .

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