What is my approach

Firstly we start with a 60 minute consultation where we carry out a in depth medical interview about health, risk factor, family illness, medication and a full physical examination. It is important to get an idea of your physical fitness and we take some measurements of health including height and abdominal measurements, along with an exercise walking test where we monitor your breathing, heart and  blood glucose. We usually carry out some basic blood tests including a glucose tolerance test and thyroid function but if these have been carried out recently then results are fine.

We then spend time looking at the results and designing a strength based exercise intervention under medical supervision.

We of course take into account risk factors and your lifestyle needs, but we both understand it takes support from me and my team, but also you and your family and friends to make health choices and change lifestyle.

We favour a low carbohydrate diet approach and increase your fat and protein macronutrients, but a gradual change in lifestyle with improvements in cardiac , metabolic and psychological health alongside getting stronger, healthier and active

progression of exercise loads

Information from World Health Organisation 2015

Obesity can be defined as "abnormal or excessive fat accumulation that may impair health"

Body mass index (BMI) – the weight in kilograms divided by the square of the height in meters (kg/m2) – is a commonly used index to classify overweight and obesity in adults. WHO defines overweight as a BMI equal to or more than 25, and obesity as a BMI equal to or more than 30.

More than 1.4 billion adults were overweight in 2008, and more than half a billion obese

In 2008, more than 1.4 billion adults were overweight and more than half a billion were obese. At least 2.8 million people each year die as a result of being overweight or obese. The prevalence of obesity has nearly doubled between 1980 and 2008. Once associated with high-income countries, obesity is now also prevalent in low- and middle-income countries.

Globally, 42 million preschool children were overweight in 2013

Childhood obesity is one of the most serious public health challenges of the 21st century. Overweight children are likely to become obese adults. They are more likely than non-overweight children to develop diabetes and cardiovascular diseases at a younger age, which in turn are associated with a higher chance of premature death and disability.

Overweight and obesity are linked to more deaths worldwide than underweight

65% of the world's population live in a country where overweight and obesity kills more people than underweight. This includes all high-income and middle-income countries. Globally, 44% of diabetes, 23% of ischaemic heart disease and 7–41% of certain cancers are attributable to overweight and obesity.

For an individual, obesity is usually the result of an imbalance between calories consumed and calories expended

An increased consumption of highly calorific foods, without an equal increase in physical activity, leads to an unhealthy increase in weight. Decreased levels of physical activity will also result in an energy imbalance and lead to weight gain

Children's choices, diet and physical activity habits are influenced by their surrounding environment

Social and economic development as well as policies in the areas of agriculture, transport, urban planning, environment, education, food processing, distribution and marketing influence children's dietary habits and preferences as well as their physical activity patterns. Increasingly, these influences are promoting unhealthy weight gain leading to a steady rise in the prevalence of childhood obesity.


What about your Health

Type 2 Diabetes

  • More than 25 million adult Americans have diabetes.
  • Another 79 million Americans are prediabetic, which means they have prolonged or uncontrolled elevated blood sugar levels that can contribute to the development of diabetes.
  • Approximately 215,000 individuals under the age of 20 have diabetes and two million adolescents ages 12 to 19 have pre-diabetes.
  • Diabetes is the seventh leading cause of death in the United States and accounts for $245 billion in total U.S. healthcare costs annually.
  • More than 80 percent of people with diabetes are overweight.
  • The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) found that a 7 percent weight loss together with moderate levels of physical activity (walking 30 minutes a day, five days a week) decreased the number of new diabetes cases by 58 percent among people at risk for diabetes.

Heart Disease and Stroke

  • One in four Americans has some form of cardiovascular disease.
  • One in three adults has high blood pressure, high blood pressure is the leading cause of stroke and more than 75 percent of cases of hypertension may be attributable to obesity.
  • Heart disease is the leading cause of death in the United States, and stroke is the fourth leading cause.
  • Physically inactive people are twice as likely to develop coronary heart disease compared with regularly active people.


  • Cancer is the second leading cause of death in the United States.
  • Approximately 20 percent of cancer cases among women and 15 percent of cancer cases among men is attributable to obesity.
  • Obesity increases risk for endometrial (uterine) cancer by 39 percent, esophageal cancer by 37 percent, kidney cancer by 25 percent, colon cancer by 11 percent and post-menopausal cancer by 9 percent.

Physical activity can reduce a person's risk for a number of types of cancer, including colon cancer by 30 percent to 40 percent, breast cancer by at least 20 percent, endometrial (uterine) cancer by 20



  • Obesity is a known risk factor for the development and progression of osteoarthritis of the knee and possibly of other joints. Obese adults are up to four times more likely to develop osteoarthritis of the knee than healthy-weight adults.
  • 8 percent of individuals diagnosed with arthritis are overweight or obese.
  • For every pound of body weight lost, there is a 4 percent reduction in knee joint stress among overweight and obese people with osteoarthritis of the knee.

Adults with arthritis are significantly less likely to participate in leisure time physical activity compared to those without arthritis.