‘I’m proof diet pills can work,’ says SARAH VINE. But society must stop seeing fat people as greedy failures who deserve to be punished
By SARAH VINE FOR THE DAILY MAIL
PUBLISHED: 20:00 EDT, 28 August 2018 | UPDATED: 20:55 EDT, 28 August 2018
As someone who has spent their entire life striving to lose weight — and keep it off — I devoured the news that a new appetite suppressant called lorcaserin has been successfully trialled in America.
In a three-year study of 12,000 patients, 37 per cent lost 5 per cent of their body weight — and 15 per cent lost more than 10 per cent. The average weight loss was 9lb 3oz a year, with many attendant health benefits, such as lower blood pressure and heart rate.
Crucially, there was no evidence of cardiovascular damage, which in the past has been a problem with weight loss medication.
The success of this study has obvious implications for the fight against obesity — and offers hope for millions who, like me, are engaged in a never-ending battle against the bulge.
But the real reason I was so struck by the news is that, by coincidence, I have been using a very similar medication to lorcaserin for the past two months. And it has been transformative.
Sarah Vine said diet aid pills can work after she transformed her own body. The tablets have been demonised after recent deaths as unscrupulous sellers used toxic ingredients
Let me explain. This time last year I tipped the scales at 16½ st. All my life I have been a bit on the heavy side — even when I was in my 20s and a size 12 my weight never dipped much below 12st. I knew I needed to take action.
My motivation was not exclusively aesthetic. My doctor had expressed concerns, and my blood pressure was high. Although in some ways my weight was understandable — I have, for many years, suffered from an under-active thyroid, for which I take medication, and, at 50, I was in the throes of the menopause — it was not acceptable.
I realised I had a choice: act now, or spend the rest of my life in a fug of ill-health and self-loathing.
The self-loathing is key. Fat people are often defensive or defiant about their condition. But that is rarely because we enjoy being overweight. We are sick of being judged for our inability to keep the pounds off, and frustrated by a culture that equates thin-ness with moral virtue.
From a young age I was indoctrinated by this pernicious notion. It led me to crash-diet and, at one stage in my life, I was diagnosed with an eating disorder.
Still, I knew that I needed to get the situation under control, so I embarked on a serious programme of weight reduction, beginning with a trip to an Austrian fat farm (easily the most miserable few days of my life) and culminating in a punishing regime of calorie restriction and exercise.
Using all my determination, I managed to lose 2st. I looked and felt so much better. I dropped a dress size, my joints didn’t hurt, sleep improved, my blood pressure started to come down — in short, everything was easier.
And then I realised I had a problem. Unless I stuck to my drastically reduced rations and strict exercise programme, I was going to put it all back on. I had to make a permanent change in the way I lived my life in relation to food.
In other words, I would have to spend my life, like Julia Roberts’s character in the film Notting Hill, being permanently hungry.
I stepped up my efforts. I started following the 16:8 fasting diet, which is a bit like the 5:2, only in hours instead of days. It involves eating only within an eight-hour window in any given 24 hours, allowing the body to rest in between. So I would fast until 11am each day, then have a healthy brunch before eating again at around 7pm. Boring, but it worked. The weight stayed off. Just.
In February I went for my annual check-up with my endocrinologist. It transpired that my thyroid medication was too low, and I was prescribed a higher dose. He also started me on a drug called metformin. Often prescribed for diabetics, it helps stabilise blood sugar levels by improving the way the body deals with insulin.
It has also been found to lower LDL (bad) cholesterol, reduce blood fat levels and lessen the risk of cardiovascular disease — and even been associated with a lower risk of dementia.
So a bit of a wonder drug, then. Save for one thing: very unpleasant gastro-intestinal side-effects.
Still, I endured. My life was now so devoid of epicurean pleasure I started refusing dinner invitations, preferring instead to go to bed before the News at Ten. At least if I was asleep, I couldn’t be gaining any weight.
I was wrong. Shortly after my 51st birthday in April, I stepped on the scales and saw to my dismay that after six months of hell, not only had I not reached my target weight of 13st — I was putting the pounds on again.
So I did what any sensible woman would do in the circumstances: I rang my hairdresser.
I should stress that my hairdresser is no ordinary hairdresser. Her specialisation is female hair loss in all its forms, from tricotillimania (a nervous disorder which compels people to pull out their hair) to female pattern loss (an affliction that has plagued me since I was a teenager); she is also, in the manner of wise women everywhere, plugged in to a vast network of professionals.
And so I found myself sitting in the office of Marcus Reddy, consultant laparoscopic surgeon at St George’s, Tooting.
Reddy’s passion is the science of weight loss: he’s performed more gastric bypasses on super-obese patients than you and I have had (calorie-controlled) hot dinners.
Unlike so many in the medical profession, who will simply urge you to eat less, as though that were as simple as breathing, he understands the difficulties some have in controlling their weight, and has first-hand clinical experience of the challenges facing patients in my situation.
For him, drugs such as the new diet pill lorcaserin — which work by controlling hunger hormones in the gut and suppressing appetite — are a useful addition to the arsenal in the fight against obesity. They act as a kind of chemical gastric sleeve, tricking the brain into thinking the stomach is full without the need for invasive surgery.
Lorcaserin is not yet available in the UK. But a very similar drug is: liraglutide.
Initially used to treat Type 2 diabetes, liraglutide was also found to induce slow but gradual weight loss in patients.
It’s this that I have been taking, under the brand name Saxenda. Since starting on it just over six weeks ago, my weight — which had crept back up to almost 15st — is back down to just over 14st.
Unlike lorcaserin, which is a pill, Saxenda is administered by daily self-injection, like an insulin jab. It performs the same function as the pill — albeit via a different pathway in the body — and has been licensed since 2010.
Quite why it’s not widely known is a bit of a mystery. Perhaps the fact you have to inject it puts people off. In any case, I found it quick and painless to administer and, apart from having to keep the pens in the fridge, hassle-free.
From day one, starting on the lowest dose before building up over a few days to the full dose in order to minimise side-effects (mostly headaches and nausea, though I experienced neither), I began to feel the benefits.
Whereas before I would clear my plate and still not feel full, now it takes just a few mouthfuls before I put down my knife and fork. I still feel hungry at times during the day, but it takes very little to satisfy that hunger.
Psychologically, it’s also had a noticeable effect. I no longer fear food in the way I used to. That may sound a little strange, but as someone who has always had, shall we say, a healthy appetite, I can never really trust myself around food. At dinner times I would panic at the prospect of descending into a feeding frenzy which I’d not be able to control.
Now you could put the most delicious plate of my favourite pasta in front of me, and I would enjoy it in a calm, controlled manner, safe in the knowledge I won’t be able to finish it.
It’s important to stress that Saxenda is not a silver bullet. Patients can’t just take it and expect everything to be all right. You need to combine it with a healthy diet and exercise. But what it does provide very effectively is a boost, that bit of a leg-up in the daily battle.
It stops the occasional lapse in willpower from becoming a slippery slope back to hell.
There is just one problem. Saxenda costs around £180 for a month’s supply (£240 when you add the pharmacist’s mark-up, and that was after I haggled) — which may be worth it for a determined individual such as myself, but which for the NHS would be considered costly.
But if you ask me, it’s worth every penny — especially when you consider the long-term benefits of losing weight and the savings when it comes to obesity-related conditions such as diabetes and heart disease.
Not to mention the mental health of all those fat people who, like me, feel horribly ashamed and depressed about their condition.
Certainly, I would far rather the NHS spent money on that than unnecessary prescriptions for skin cream and painkillers that can be bought cheaply over the counter. And yet, beneficial as these treatments are, I fear we are a long way off the NHS deploying them widely.
Because unlike almost every other condition that afflicts humans — from anxiety to angina — being overweight is considered a moral failing, a self-inflicted illness that marks the person out as weak, shameful and in some way deserving of their suffering.
Until society revises that belief, we will never overcome the obesity epidemic in this country.