A Lesson in Health

It’s time for a lesson in health. I’m going back to school, and I’m inviting you to come with me. Don’t worry, this is going to be way more fun than regular school. Definitely more fun than home school (she says as she shudders violently).

It all started after I spoke to a journalist the other day. Yes, you heard me right. That’s something I do now. Anyway, she was writing a piece on weight loss and diet culture and we were having a really interesting discussion. And when she asked, “surely you agree that obesity is bad for your health”, I had to stop and think for a moment.

Is that something I believe in?

Lesson in Physical Health

Before I can answer that question, I’m going to need you to define two things for me. The first is the word “bad”. The second is the word “health”. What outcomes are you measuring exactly? Is it life expectancy? Risk of diabetes? How many press ups you can do before collapsing in to a heap on the floor?

Because the answers are “probably not”, “yes” and “the two are not related”, respectively. We cannot possibly decide whether obesity is bad for your health until we first define health. And the good news is, I went to university to study health so I am exactly the right person to talk about it.

Photo by Sarah Cervantes

Health is complicated

Except, not so much. Because health is complex. I’ve alluded to this in previous posts. One thing I can tell you is that doctors are always being encouraged to take a “holistic approach” to medicine.

Holistic medicine means consideration of the complete person, physically, psychologically, socially, and spiritually, in the management and prevention of disease. It is underpinned by the concept that there is a link between our physical health and our more general ‘well-being’. In an holistic approach to medicine, there is the belief that our well-being relies not just on what is going on in our body physically in terms of illness or disease, but also on the close inter-relation of this with our psychological, emotional, social, spiritual and environmental state. These different states can be equally important. They should be managed together so that a person is treated as a whole. 

Clinical Knowledge Summaries

So health is not just a physical thing. In fact, it only makes up a small part of our whole being. So why are we so obsessed with the physical aspect of health? And we do we think it is okay to ignore the psychological, emotional, social, spiritual and environmental factors in our pursuit of physical perfection?

What about mental health?

We all know that our physical health and our mental health are interconnected. In acute stress, your sympathetic nervous system is flooded with Noradrenaline and Adrenaline. This has a number of short term effects on the body. But if you’re chronically stressed, your adrenal cortex (which sits above your kidneys) releases a hormone called cortisol.

Cortisol is a steroid. Steroids have numerous detrimental effects on the body. They reduce our immunity, which is our body’s ability to fight off infection. That’s why we tend to get more colds and coughs when we’re stressed (something to think about in the middle of a COVID pandemic). They make us gain weight. There is also a possible link with cancer.

Lesson in Mental Health

Mental health is all about how we feel, what we think and how we behave. When we don’t take care of our mental health, it affects all three of these things. We find it harder to concentrate and make good decisions. We become less efficient and productive. Our tempers are frayed and we get in to more arguments. We are more prone to anxiety, low mood, insomnia, and in severe cases, depression and suicidal thoughts.

Poor mental health can results in a number of self-destructive behaviours including self-harm, self-medicating with alcohol or your drug of choice, gambling and other addictions. In short, poor mental health can affect every aspect of your life, not just your physical health.

And yet, the message from our health professionals seems to be that physical health should be our number one priority. Irrespective of how this impacts our mental health and well-being.

Photo by Suzy Hazelwood

What causes mental illness?

There are lots of factors that impact our mental health. Genetics, brain chemistry and family history all come in to it. But nothing comes close to the long terms effects of trauma, abuse and significant life events. These things can totally alter the physiology of our brain and unless we find a way to deal with them, we will never really be in good mental health.

The first time I featured in an article, I made the mistake of reading the comments. I know you’re not supposed to, but I got carried away. Don’t worry, I soon learned my lesson. One woman read about my struggles with my mental health and suggested I “get over it”. Because people have experienced worse and I needed to stop feeling sorry for myself and blaming my weight issues on my childhood.

And you know what? That was a very reasonable point to make. That’s what we’ve been taught in today’s society. We are not allowed to speak about our emotional pain or the way our past trauma has affected us. If we do, we’re reminded that people have it worse. Or we just need to put a smile on our face and make a decision to get on with our lives.

Photo by Nadine Shaabana

The cost of poor mental health

I get the sentiment. I really do. I’d quite like to be able to just “get over it”. It would have saved me a lot of money on therapy bills, if nothing else! People talk about the cost of obesity on the healthcare system, but do they ever stop to talk about the financial impact of poor mental health?

I’m not just talking about the cost of referrals to mental health services. I’m talking about the number of cases of back pain, gastrointestinal conditions, and medically unexplained symptoms that have been clinically proven to have a psychological component. Do we stop to think about the amount of money we spend investigating and treating symptoms that we all know have no pathological cause?

Ask any GP out there – what is the number one issue that you face on a day-to-day basis with your patients. I bet you they will agree that it is poor mental health. Coughs and colds are easily treated. High blood pressure can be controlled with medication. But patients with mental health conditions and/or physical health conditions that are psychosomatic (ie. psychological in origin) are the hardest to treat. That has been my experience, at any rate.

Photo by Pixabay

How do I improve my mental health?

So why is mental health such a challenge to treat? Why is it draining the NHS of its resources and causing hard working GPs like myself to throw their hands up in despair most days? I think the answer is because we just don’t like to talk about it. The moment we try, we’re shut down and told to cheer up and get over it.

When people ask how you are, they expect you to say “fine”. But what if you’re not fine? What if you’re not OK? What are you supposed to do then? We’ve already established that your mental health is interconnected with all the other aspects of your health. So what are we supposed to do when our mental health is suffering and the rest of us is suffering along with it?

I am very fortunate to be teaming up with a fantastic mental health advocate and LinkedIn Changemaker called Ben West. He and I are going to do our first ever LinkedIn live event on Wednesday the 27th January, where we will be discussing the importance of mental health. It’s called Lockdown Live, and I’d love it if as many people as possible could join us.

[shameless plug over].

Photo by Matt Botsford 

Life lessons

There are very few things in life that everyone can agree on, but one of them is simple. All of us are only afforded a certain amount of trips around the sun. Life has to come to an end, and when it does there are very few things that we are going to care about.

I say this from personal experience. I have been there at the end on many occasions. For starters, I worked my way through medical school as a HCA in a hospice. I held many people’s hands as they took their last breath, including my own mother’s.

As a GP, I am privileged to be part of the end of my patients’ lives. As far as I am concerned, it is one of the most important things that I do and I often find myself having deep and meaningful conversations with people who are coming to the end of their time here on earth.

Photo by Johannes Plenio

The meaning of life

In my limited experience, we are all going to look back one day and ask ourselves one simple thing.

Did I do the best I could with the life that I was given?

Did I love enough? Laugh enough? Enjoy the everyday, ordinary things that people so often take for granted? Did I invest enough time and energy into the relationships that mattered? Did I grab life by the testicles and give it my best shot?

Right here, right now

Right now, in this moment, I am doing OK. Physically, emotionally, mentally, socially and even spiritually. Don’t get me wrong, life isn’t exactly perfect right now. After all, we are in the middle of a COVID pandemic. I have no idea what a “power verb” is, let alone how to teach it to my seven year old. I’m sick of being stuck indoors and I am desperate for a holiday.

But nevertheless, I feel good and for the first January that I can remember, I am NOT on a diet. Don’t get me wrong, I am getting lots of fresh air and exercise. I am eating lots of healthy nutritious food and I am getting plenty of good sleep and down time to relax. I am taking good care of my body.

But I am also taking good care of my mind. I am mindful of the things going on around me and I am making allowances for them. I am practicing self-compassion and not putting unrealistic expectations on myself that I will never be able to meet.

And you know what, peeps?

I think that makes me healthy.

Photo by Michael Fenton

4 thoughts on “A Lesson in Health”

  1. This was another fantastic blog post. I really appreciated your explanation of holistic medicine and the different types of health and way they impact on. Each other. Looking forward to your LinkedIn live event too.

  2. As someone who has struggled with weight issues all my life I really enjoyed reading your blog. Now at nearly 63 years old and having just lost 6 stone I am being to look at health and weight loss through different eyes. I so look forward to reading more of your thoughts and seeing how they compare to mine.

  3. Hi

    I saw a clip of you on ‘This Morning’. These are just my thoughts – more ramblings than coherent arguments 🙂

    I agree with you that: ‘Health is not just a physical thing. In fact, it only makes up a small part of our whole being’. You also said that people on diets tend to put the weight back on – this I believe is also backed by years of evidence. But, I do think that its possible to lose weight without being on a diet. I’ve been doing the ‘intermittent fast’ for a long time – in effect I have breakfast and lunch and no dinner. My weight went down by several kilos but for me this wasn’t the main reason – insulin regulation was more important (Between meals, as long as we don’t snack, our insulin levels will go down and our fat cells can then release their stored sugar, to be used as energy. We lose weight if we let our insulin levels go down as well as reduce cholesterol and blood pressure). I may also have a go at fasting occasionally – even here the weight loss will be a secondary benefit – the overall health benefits are more important.

    My understanding was that the evidence showed that fat around the waist is very harmful – what are your thoughts?

    I think the discussion around this needs to be more nuanced – the format and limited time of the ‘This Morning’ discussion turned the debate into something very cartoon like.

    Regards, Sunil

    1. Unfortunately that is the game we have to play if we want to spark a debate. Daytime television has a huge reach but it doesn’t allow for nuanced debate. I spent the last 9 months discussing a complex issue with a small audience. In order to take the campaign to end stigma forwards, we need a larger audience. And this is the price to pay. I do not plan on doing anymore daytime TV if I can avoid it. As for IF – I am afraid I wholeheartedly disagree. Whilst I hear the logic, there is very little evidence to back up your claim. I also do not understand why people insist on working against the body all the time when it is perfectly capable of regulating itself if you just let it. Sorry, but that is my humble opinion.

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