Dr Liz Njire, Medical director – slimure
My Weight - Loss Journey
Chapter 1 - Introduction
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Let’s talk about weight, weight gain, weight loss! From a profession & a personal perspective…
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I’m sure we’ve all heard the various terms from your clinic appointments ‘ Mrs N or in my case Dr N, after taking your weight, measurements & working out your BMI, you are on ‘the heavier side shall we say’ followed by a code in your medical notes - overweight/ /obese class 1, 2 or 3 and then some strong advice ‘you really need to do something about your weight’
How about your polite friends ‘ooh dear that dress doesn’t quite suit you anymore, it’s a-bit too tight, it shows off too much, it’s not flattering, you seem a lot curvier than you used to be’
Or your relatives – you look very well fed these days; your husband is doing an outstanding job!
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It does not matter how it’s said the bottom line is you weigh too much and much as this can be the elephant in the room or ‘a rather sensitive topic’ we need to talk about it as excessive weight can have significant implications on your health. obesity is a rising problem globally, costing health care systems billions to manage the lifestyle diseases that come as a result ; diabetes, hypertension, high cholesterol that then increases the risk of heart attacks and strokes.
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Weight loss is a journey I am all too familiar with having struggled with my increasing weight for at least 15 years. Between comfort eating, baby weight, inadequate exercise to hormones in the later phase, well the scales tipped more & more to the right, going up a dress size progressively over the years. In this time, I tried all sorts of diets, intermittent fasting with prolonged periods of starvation, I joined a gym and wasted a lot of money as with repeated injuries & not enjoying exercising I would visit now & again, and the results would be - lose a few kgs then add them back, just yo-yoing…
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My first real concern was 3 years ago during my health check at 40yrs, when my Dr said ‘ your weight has gone up again, your BMI is now 28 ( I was obese!) and unfortunately your HBa1C ( diabetes test) is now in the diabetic range at 58 ( I had been made aware of being pre-diabetic 2 years before that appointment) not to mention your cholesterol is on the rise. I think it’s time to start you on some tablets’ ‘no thanks’ I said, it’s not that bad, il work on it seriously this time, give me a chance, I can reverse this. I hated the thought of taking medications daily but as a medical professional I knew these were not good terms & definitely not good numbers, the thought that I was now diabetic honestly worried me but I convinced myself it was possible to reverse it on my own, I had a plan instantly, I would diet ‘ seriously’ actually go to the gym at least 3 times as that’s what my hectic lifestyle would accommodate & walk more instead of driving…so I started another year full of determination & hope that this time round I would turn things around …
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Join me again next time as I share my journey of how I lost 30kgs, reversed type 2 diabetes and now enjoying a healthier, happier lifestyle, exercising, and eating well.
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Remember weight loss is an individual journey, there is no one size fits all, there are multiple factors to consider when deciding the best weight loss choice: life factors, age, ethnicity, hormones, weigh up the available options and embrace what works best for you. If you opt for weight loss medications including injectables, then ensure you get a proper consultation from an experienced clinician and a reputable weight loss clinic.
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By Dr Liz Njire
Family medicine/women’s health & menopause/ weight loss physician – UK based
Medical director – slimure
Dr Liz Njire, Medical director – slimure
My Weight - Loss Journey
Chapter 2 - The first year; Lifestyle changes
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After the news that I was now obese & had developed type 2 diabetes, as well as a rising cholesterol , I was committed to making lifestyle changes and started intermittent fasting strictly during the week but relaxed on weekends, I was walking my kids to school rather than drive and extending the walking distance and still managing the gym 2 – 3 times a week. I tried to be active at every opportunity, but the lack of energy, joint aches and pains were a real hindrance.
Most days were a real struggle due to hunger pans & strong food cravings, I was constantly battling food noise, but I persisted. I’ve always had a sweet tooth so cutting down on sugars & carbs was a key feature of the dietary changes I made.
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Facts on Type 2 Diabetes mellitus (T2DM)
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Type 2 diabetes is a major health issue globally, affecting millions and often leading to serious complications like heart disease, stroke, and blindness.
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Key risk factors include being overweight or obese, a family history of diabetes, older age, and certain ethnic backgrounds (Black African, African Caribbean, and South Asian people are at higher risk from a younger age).
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It is preventable and reversible in the early stages through lifestyle changes such as supporting a healthy weight, regular exercise, and a healthy diet.
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With T2DM food cravings and the lack of feeling full, is a big problem, as constant hunger makes it exceedingly difficult to manage.
Like many people I avoided the weighing scale at all costs but ‘felt lighter’ despite my clothes still fitting the same, I was determined not to weight myself until my yearly check as I did not want to the numbers to put me off.
The dreaded day finally arrived, and I anxiously went to see the nurse for the measurements before my follow -up appointment with my Dr. ‘So how do you think you’ve done in the past year’ was the first question and I quickly rumbled on and on about how well I thought I had done with all the changes & measures I had put in place as the nurse nodded with admiration. ‘Alright then, shall we get you onto the scales and see’
I nearly passed out when I looked down at the number! I think this weighing scale is broken I said, it can’t be right I yelled! It’s brand new and working perfectly fine the nurse replied, these are not the results we were hoping for Doc, you have added even more weight, I could sense the disappointment in her voice, but I was even more disappointed in myself.
She did the calculations and wrote them down and updated my notes as I stared in disbelief - weight 84kgs from 80 BMI 30 (still obese) from 28, waist circumference, so many inches etc…I was at my heaviest!
I went in and saw my Dr knowing very well what was coming ‘These results are worse than last year, your HbA1C is now up to 68, and your cholesterol is at 5.8, and I’m sure you’ve seen the rest of the numbers’. I know you are not keen on medications, but we really need to do something about your weight & diabetes. I would highly recommend I start you on metformin it might help with weight loss while managing the diabetes at the same time.
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Treatment options for T2DM
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There are several medications available to treat T2DM including the older tablets such as metformin, which can have a weight loss benefit in diabetic patients, newer ones eg) Rybelsus, injectables including insulin and the newer GLP/ GIPs such as Mounjaro, wegovy & ozempic.
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Most of the newer diabetes medications have a favourable effect on weight loss
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Other medications such as cholesterol tablets may also be recommended.
I took my prescription, left deflated, and disappointed that I had tried & failed, but there was still hope, I would take the medications, and I was sure i would walk out smiling at the next appointment.
There are several options that you can consider for weight loss, lifestyle & dietary changes are key alongside whatever option you choose but remember there are several other factors that influence weight loss and what works for one might therefore not work for another and vice versa. Therefore, explore options widely, do your research, look at the evidence and try to find what method might work best for your individual circumstances…
Join me again next time to hear more about my weight loss journey, and how I coped with the diabetes medications alongside lifestyle changes for my weight loss…
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By Dr Liz Njire
Family medicine/women’s health & menopause/ weight loss physician – UK based
Medical director – slimure
Dr Liz Njire, Medical director – slimure
My Weight - Loss Journey
Chapter 3 – The second year; medications plus the perimenopause
I started medications as planned on a low dose, gradually increasing with a planned review at 6 months. As anticipated I struggled with taking them daily but did my best to take them most days, I continued with the lifestyle & dietary measures eating what I thought was sensibly, minimal carbs but exercising was becoming increasingly difficult as the joint aches and pains got worse over time. I stopped running / jogging and settled for walking outdoors or on the treadmill over the colder months, swimming and some spinning or Zumba classes here & there.
It was during this year that other perimenopausal symptoms started to take a toll
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Key facts on the perimenopause
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The perimenopause is when your hormone levels start to change. But it’s before your periods stop completely. It can cause a wide range of symptoms, both physically and mentally. It commonly starts between 45 – 50 years but a lot of women will start to notice some symptoms in their early 40s.
Perimenopause symptoms are caused by the hormonal changes happening in your body. Some people won’t have any symptoms, but most will. For some people symptoms can be very severe and affect their daily lives. Everybody’s experience will vary, but physical perimenopause symptoms commonly include:
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changes in your menstrual cycle
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headaches
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dizziness
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vaginal dryness
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Weight gain, particularly around the waist
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joint aches and muscle pain
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difficulty sleeping
There are also other symptoms of the perimenopause that can affect your feelings and mental health. These include:
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Feeling depressed
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experiencing mood swings
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problems with memory &concentration – sometimes called “brain fog”
For me the joint aches and pains accompanied by the obvious weight gain around the middle were a real problem, it meant by the later half of the year exercising was minimal, I could just about manage a few non – weight bearing exercises and if felt almost impossible to shift any weight at all. At 6 months I had a medication review as I was not tolerating the higher dose of metformin therefore, I stayed on a medium dose, alongside a second medication.
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It therefore came as no surprise at the yearly check-up that I had not lost any weight and worse still the diabetes had got worse with the markers at 78, cholesterol was now at 7. It was not just the lack of general weight loss but the central obesity with an unattractive hanging belly that was getting me down, I felt completely defeated. I asked my Dr what next, knowing exactly what she would say… I needed a 3rd medication for the diabetes and a statin for the cholesterol as for the weight well…keep trying with the diet and exercise 😔 it felt helpless, I clearly was not getting anyway with this strategy, it was a losing battle!
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I thought to myself surely in this day and age, there must be other options, so I enquired what about the GIP/GLPs to manage both diabetes & weight loss (the medications were very new to the market, and there was a lot of hype about them at the time).She agreed they would be an excellent option, but unfortunately, I would not qualify at that point on the national health system funding criteria, I would need to be on 3 diabetes medications and still not well controlled for another year plus be obese. She recommended I see a private consultant who would be more familiar with these medications for guidance.
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This was a real wake up call for me; I desperately needed to take back control over my health otherwise it was only a matter of time before more profound consequences followed.
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Thus began my in-depth research into weight loss medications and an interest in weight loss medicine…please allow me to re-emphasise my earlier point about exploring all available options, doing your research, considering your individual circumstances, and tailoring your weight loss choices accordingly…
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See you next time to learn more about my weight loss journey…
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By Dr Liz Njire
Family medicine/women’s health & menopause/ weight loss physician – UK based
Medical director – slimure