A The cutting of red stones on the beach of Southport in the west of England is at the front line of one of the big questions facing the NHS: what is the best solution for our growth in the obesity problem?
Dr David Unwin believes he has the answer. He has championed a low-carb lifestyle that not only helps patients lose weight but also, in half of his patients on diet, he managed to reverse type 2 diabetes, considered an incurable and progressive disease.
The results are remarkable and come under scrutiny from NHS officials who are now rolling out a new low-carb diet plan to tackle obesity and type 2 diabetes, which can lead to serious health problems. and early death.
Unwin has also seen what one expert calls “magical things” that motivate his patients to stick to lifestyle changes for several years.
Unwin’s work may be important. When the weight loss drug Wegovy was approved for use on the NHS and it was reported that the authorities believed that the drug could be given to 12 million people in the UK, there was no connection to the outcome. of Unwin with drugs. .
Sitting in his practice, Unwin said he was close to quitting as a GP in 2012 because he felt inadequate. He said: “If I was honest with myself, I felt that I did not make a difference. I began to see the evil that nothing was better. The people I saw, especially the disease and obesity.
He was inspired to start the low-cost lifestyle program and continue to work as a GP when he was advised by a patient with type 2 diabetes. “I wrote it because I was worried that he would not take his metformin [a drug to treat type 2 diabetes] and that’s why I invite him to preach,” he said.
When the patient arrived for consultation, Unwin noticed that she had lost around 19kg (3 stone) and put her illness down to a poor diet. Research has shown that it can lower the level of glucose in the blood and reduce body weight.
Unwin said: “He was furious. He said: ‘You’ve been giving me metformin for about 10 years and you haven’t asked me about the side effects or given me a an option. Now I’ve learned about cutting carbs. I’ve lost weight and I’m so happy.'” A blood sugar test, known as a hemoglobin A1c test ( HbA1c), his blood sugar was found to be in the normal range and it was found that he had drug-free from type 2 diabetes.
Unwin said: “He did something I never knew was possible. I always saw type 2 diabetes as a chronic disease that needed treatment and it didn’t show up. knowledge about the real cause of chronic illness.I feel like I’m falling asleep.
Together with his wife, Jen, a psychologist, Unwin started a program in practice in 2013 that provides a low-fat diet to patients with diabetes type 2. Every Monday, there is a group support where Unwin and his wife provided unpaid assistance. Regular weight data and blood tests help patients stay on track.
One by one, patients begin to lose weight and feel better. A variety of indicators of physical health improved, from blood pressure to cholesterol levels. Some patients were able to stop taking their medications.
The observational study published by Unwin and four other authors in BMJ Nutrition, Prevention & Health in January looked at a group of 186 patients in the Norwood study for the average duration of eating. of 33 months and received the full color of diabetes type 2 was found in 51% of cases. The report found that a fifth of all patients in the practice with diabetes type 2 achieved remission, with 77% of those following the program in the first year of the disease found in money.
Marcia Mawdsley, 55, started eating with support from work about four years ago. He lost more than 20kg and stopped taking insulin for his type 2 diabetes. “It’s not easy in the beginning, but the first thing you notice is that you’re not hungry,” he says. . “It’s not about being thin – it’s about being healthy. I have strength now.
Audrey Jones, 78, has battled type 2 diabetes for years and was on the Unwin program last May when she was denied a transplant. He lost more than 10kg and his blood pressure test results dropped significantly. The doctors gave the go ahead for the operation in November.
Jones stopped taking metformin for type 2 diabetes five months ago. He said: “I am very happy. I’ve been taking it for about five years and I think I’ll be going for the rest of my life.
after the news release
The magnitude of the problem is alarming. Almost four years ago, there were only 57 patients at Norwood surgery with type 2 diabetes, which is closely related to obesity, and none were under 55 years of age. . diabetes, with more than 70 under 55 years.
Dr Simon Tobin, senior partner at the Norwood Surgery in Southport, who is a fast-track follower of the low-fat diet, said, “Most of our patients have been low-fat for six, eight or 10 years, so it’s completely gone. stable. If you have a drug that does half of what we did with the low-cost method, it’s worth the money. Nothing. shout about it because it’s not a drug that makes money for a big drug company.
In 2016, Unwin was the national winner of the NHS Innovator of the Year award and now believes he has demonstrated “proof of concept”, supported by case studies of his patients and published in research. Other activities in the UK and around the world have followed his work, but he wants to see the program more supported in the NHS, with appropriate government measures to fight obesity.
Dr David Oliver and Dr Kim Andrews set up the Freshwell Low Carb Project at Freshwell Health Centre, near Braintree in Essex, and have reported significant weight loss in patients.
An observational study published in October 2021 showed that 774 patients were given nutritional advice, and 339 underwent an assessment and their weight was measured. They lost 1,103kg, with an average weight loss of 2.5kg.
Dr Oliver, a senior fellow at the centre, said that, like Unwin and Tobin, there was no competing interest in the published research, he said: “When people stop eating the food and nutrients, they are not hungry and lose weight. They are better.”
A May 2021 report by the government’s Scientific Advisory Committee on Nutrition recommended that adults with type 2 diabetes who are overweight should choose a low-carb diet as an option. short (for six months) but must limit the intake of saturated fats. considering dietary advice for the general public. The report highlighted the limited data on long-term interactions with food.
In England, the NHS is promoting a program of low-fat diets to treat obesity and type 2 diabetes in primary care, which is also reflected in attempts to include type 2 diabetes in the Forgiveness and help participants lose weight.
Professor Roy Taylor, a leading researcher in type 2 diabetes and director of the Magnetic Resonance Center at the University of Newcastle, said he was one of the co-authors with Unwin of the study published in January. , said to be a low-fat diet with “magic elements” inherited by Unwin of built-in support and regular GP reviews with a weight scale.
Taylor said it may be difficult for people to follow a low-calorie diet, but there is significant research with control groups that shows a low-calorie diet can be effective for the general population. He said that the NHS should be supported by a low-cost food program by a healthy health plan to fight obesity, which could significantly reduce the multibillion-pound medical bill.
Unwin is calling for a portion of the money he makes, and others like him, to save on medical bills to be used to fund new life-saving programs.
Unwin said: “We need fair pay and incentives to improve lifestyles against long-term treatment. We spend around £68,000 a year more than the average for the area in medicine I want half of those savings to fund more services, but there is no incentive for GP practices to do this.