James Clark is a dietitian who spends a lot of time not putting people on a diet to help them get good eating habits on their menu.
He readily acknowledges that this approach to weight management or nutrition can surprise some people.
“So rather than spending my time putting people on a diet, which is what people assume a dietitian does, I spend a lot of time trying to get people to not be on a diet in that way and do something that’s much more realistic,” James explained.
“Because usually that’s quite unhelpful and that kind of weight cycling or yo-yo dieting, where you go on a very restrictive diet for a short period of time and then inevitably fall off it because it’s too difficult and then your weight goes up again, is really unhealthy.
“So people are surprised that it is all about helping to change behaviour – people maybe don’t realise and I think just assume that it’s all about information giving and that is a part of it too.
“But actually what you find a lot these days is it’s not that people have a lack of information. It’s often almost that they have too much information because there’s so much confusing and misleading information out there about nutrition and food that what you need to do is take away some of that stuff, particularly around weight loss and around dieting.”
James, who joined the Wallington Primary Care Network last year, knows that that there are a number of barriers to changing those behaviours and getting people to make healthy eating choices.
He said: “There are lots of barriers. Money is one thing that’s becoming more important, especially at the moment because people are really aware of food prices going up. Inflation is high, lots of things are going up in price so people have to cut back somewhere.
“If you don’t have good cooking skills or you’re not very confident that can be a bit of a barrier – or if you don’t have much time because you’ve got to work a lot or if you have mental health issues or a disability.”
Hosting group sessions is one way that James – and others like him – is trying to promote healthy eating habits, with each one being run for around a dozen people and lasting about 90 minutes.
He said: “Roughly half the session is based around a group discussion, facilitated by me. But it’s for the whole group to contribute to, which is a supportive discussion around how things have been going over the past week because the sessions usually run weekly.
“People can talk about any kind of challenges, discuss issues with other members of the group, which is usually really, really helpful. The feedback from the groups is that support from others is probably the most important thing for people.
“Then the other half of the group session is more about information-giving where we’ll discuss a certain topic – for example, we might talk about protein or we might talk about meal patterns or we might talk about how emotions affect your eating. And I try to make his interactive as possible – doing more activity-based stuff. No PowerPoint allowed!
“I think it’s important to try to make it as practical as possible and relatable, because getting preached to about healthy eating means people switch off so I think trying to make things as realistic as possible and getting the group talking about what they eat, what they like to eat is really important because it has to be realistic.
“You can’t only think about healthiness when you’re eating or choosing food. You have to consider what you like, what kind of things are important in terms of social events or the time of the year.
“Then if you can put that together with knowledge about health and some sensible decision making, you can have a healthy diet that’s sustainable.
“That’s what we’re trying to do – support people to have a healthy diet that they can keep going with, not just one that lasts for the length of the 10-week group course and then it’s an unsustainable.”
Another way James is providing support for healthy eating is through community events.
He said: “We’re trying to support lots of outreach events in the community. I went to one recently that was in supported housing for older people where we had presentations around diabetes and then had tea with the residents afterwards, and a question and answer session around food. I think that people got a lot out of that.”
James, who launched his dietitian career at St George’s Hospital after initially getting interested in nutrition as an amateur track and road cyclist, has also be working in partnership to help tackle health inequalities.
“With colleagues from Sutton Council and NHS South West London, we’re trying to target the areas where the need is the most and in underserved communities – where we can make the most difference,” he said.
“For example, sheltered housing, older people’s housing – there are a couple of different areas in Sutton that we’re that we’re trying to reach. We’re very much trying to make it co-developed so that it’s not just us going into those areas.
“We’re trying to work with what’s already happening in those areas. For example, in Roundshaw in Wallington, there’s loads of really good stuff going on around food that we’re just trying to support people to do rather than us just going in and trying to take a top down approach. It’s the same with the Shanklin estate.”
After completing a four-year degree course, including clinical placements, following a one-year course to get the right qualifications to go to university, James is well placed to continue with his aim of “supporting people to make healthy choices” without resorting to dieting.