I've been meaning to do a proper teardown of the NHS 12-week plan for some time, and never got around to it. So here goes. I'm going to try to keep this reasonably factual, even though the plan itself invites ridicule rather than a rational critique.
The most obvious problem is the simplistic premise on which it's based:
"The plan is designed to help you lose weight at a safe rate of 0.5kg to 1kg (1lb to 2lb) each week by sticking to a daily calorie allowance."
Now, we all know from bitter experience that it doesn't work like that. A linear, glitch-free weight loss down to a target weight? Seriously? Has this ever happened for any human being in the history of the world? It certainly hasn't happened for me or anyone I know. Maybe the NHS have a secret cohort of engineered humans in a cage somewhere, who respond as required to caloric restriction. But the rest of us stubbornly run on the laws of physics and biochemistry, steadfastly refusing to lose bodyfat in the way popular theory dictates.
Anyway, I'm not going to gripe about this too much. I'm more interested in the food items prescribed. Any "diet" should transition seamlessly into a healthy-eating routine, because if it doesn't, your initial weight loss is neither here nor there: it'll come right back again.
To be fair, there is some reasonable advice in the plan. "Don't stock junk food" and "Get more active" are hard to argue with. Unfortunately, these are mixed up with ideas that are either pointless or counterproductive. Here's one example:
'Apple pie' porridge
(breakfast)
50g porridge oats
200ml semi-skimmed milk
1 medium dessert apple, diced
Pinch of cinnamon
In my world, this is a dessert. It's the sort of thing everyone (in the country I live in, at least) recognizes as a fattening, indulgent treat. Using semi-skimmed milk doesn't make it less so - it just makes it less tasty.
But wait! There's another healthy alternative:
Baked beans on wholemeal toast: not only are they naturally low in fat, but baked beans are also packed with fibre and protein, making them a vegetarian source of protein.
Yes, they're low in fat. So what? A bag of Gummi Bears is low in fat. Baked beans are junk food, and we've just been advised not to stock junk food. Almost anything that comes in a tin is cheap rubbish filled out with modified starches, sugar, and dubious flavourings. If the NHS were advising people to make their own baked beans (ie., beans stewed with tomatoes, spices, and a chunk of greasy pork) and bake their own bread, I'd be right on board. But they're not. They're advising people to buy rubbish, and to serve it on a slice of fake wholemeal bread.
If there's any overarching theme, everything in the plan is low-fat. Foods that are naturally fatty have had the fat artificially removed or sliced off. That inevitably means the whole thing is extremely high in carbs. But here's where it all gets a bit odd:
Very berry smoothie: take 1 banana, 140g of frozen summer berries or forest fruits, 40g of low-fat natural yoghurt and about 100ml of apple juice. Blend the banana and berries until smooth. With the blades whirring, pour in apple juice to achieve the consistency you like. Limit the amount of fruit juice and smoothies you drink to a combined total of 150ml a day.
Why do we have to limit our smoothies? Could it be because they are unnaturally high in fructose? It can't be anything to do with fat. But we're not told outright.
There's even a recipe for an English Breakfast Muffin, which begs the question: how is this any different to a McDonald's Breakfast Muffin, particularly if one is buying muffins from the supermarket? Again: we're not told.
Let's move on a bit (to Week 3), in which we're advised to eat reduced-fat spread (a synthetic fat with added colours and flavouring), and Weetabix (a highly-processed carbohydrate product with a high GI). I'll leave you to draw your own conclusions about that.
In Week 4 we're told to remove all the fat from everything (leaving, by default, only the carbs) and that food cravings caused by malnutrition and caloric restriction are all in our heads. It's no wonder people end up with eating disorders.
In Week 7 we're being admonished again to delete all fat from our diets - particularly fried foods, butter, and cheese. We have still not been told why. This is what is currently known as a "balanced diet".
In Week 8 we're told to eat more salads, but - surprise! - we're not allowed to add anything fatty. That might make it taste nice, and we can't have that.
In Week 9 we're told that it's OK to eat crisps as long as they're home-made (which miraculously makes them healthy), that popcorn is better than pork scratchings, that malt loaf isn't cake, and cereal bars are bad for you ... although back in Week 1 we were told how to make cereal bars. Confused yet?
Weeks 10 and 11 are just wonderful. If you haven't read it, you really must. It addresses those people who have concluded, after 10 weeks of purgatory, that all this doesn't work.
And when we get to Week 12, we're told the bad news: even if our results have been mediocre, we have to do this for the rest of our lives or the weight will come back on again. Well, at least that bit is correct, even if it's likely to make one head off down the pub for pie and chips in despair.
Luckily, of course, human bodies aren't fundamentally broken, they're not allergic to fat, and if you avoid fake food, processed starches, and sugar, most bodies will get themselves onto an even keel. But I guess we wouldn't want to make this too easy. What would all those dieticians do for a living?
Written by
TheAwfulToad
Ambassador
To view profiles and participate in discussions please or .
54 Replies
•
When I saw the heading and that you were going to have a rant I knew I was in for a good read. I wasn’t disappointed 😀
Thought provoking as usual AwfulToad 😀 and as far as I'm concerned accurate. I messed around yoyo dieting for years and got no where with plans similar to the 12 weeks. Not untill i learned to eat fat did the weight seriously start to shift xx
Love, love, love your rant. I see people joining the weight loss forum, mentioning the 12 week plan, and it takes all my self control not to YELL at my computer. — Finally, for the first time in my life, thanks to LCHF, I’m free to eat and enjoy wonderful food, along with endless healthy salads and veggies, and go long periods without hunger and cravings, and the huge build up of weight is steadily dropping off relatively effortlessly. I’m so angry that it has taken this long, and that when I have asked for guidance from GP, more than once, the advice just prolonged my weight gain and self-disgust.
Thank you to everyone here for the advice and blunt openness. It has changed my life. 😊
Anger was my first reaction too, when I figured out I'd been taken for a ride. I'm a bit more philosophical about it now, but I occasionally feel the need to take a few jabs at those responsible. Hence the rant.
Go Toad! Loved this post. Unfortunately “It's the sort of thing everyone (in this country at least) recognizes as a fattening, indulgent treat.” is not true - because if I’d read that recipe last year I would have believed it was the perfect low fat breakfast for me, as advocated and approved by my GP and nurse at the practice advising me on eating less fat to lose weight. Unfortunately over decades the idea of low fat diets has gathered pace and volume like a snowball rolling downhill. It’s going to take time to slow it down and send it back uphill, but keep up the good work, there’s more of us joining in the effort!
Ah, sorry, I wasn't entirely clear there. I live in the Far East - by "this country" I meant my present residence. It's really only the UK, the US, and a handful of other countries that have adopted this bizarre high-carb low-fat religion. Everyone else just scratches their heads, shrugs, and gets on with eating normal food Over here, it's common knowledge that sugar and refined carbs make you fat, and it's been common knowledge for ... ooh, a few centuries at least.
But yes, there are definitely more and more people taking on the task of slowing it down and pushing it all back uphill! It'll happen sooner or later.
That makes sense now, I hadn’t realised you were in Far East. Here in UK people used to accept smoking in cinemas, restaurants, pubs and endless supplies of free plastic carrier bags at checkouts. It’s amazing how quickly attitudes can change to accept a different “norm” so there is hope :))
I agree, attitudes and behaviour can change when a critical mass builds up. I remember being very irritated about being required to use a seat belt but I soon grew up and saw sense
Many people come to the Weight Loss forum with their mind set on the 12 week plan, as was mine, and it isn't easy to start questioning or challenging that from the outset, especially if they have "professional" backing for it.
For me, it was losing weight in those first 12 weeks and - mist of all - engaging with the forum, that then led me to focus much more on the what rather than the how much, which has led me down a much happier path.
Regarding your point about linear weight loss, S11m is the only person I've come across who has been able to lose weight in linear fashion, initially 2lbs per week, then 1lb a week, every week. If he found he was below his target for the week, he would then eat something extra and that would get him to his target. He's recently posted his end of year report titled Linear Weight Loss on the Weight Loss and Fasting and Furious Forums.
Females find it difficult to lose weight consistently every week.
I live alone and I am retired so keeping to my scheme is easy.
I have ignored official advice all my life - so I have not damaged my metabolism with pseudo-healthy food!
(I did Stay the Same (STS) one week - but I still lost six pounds in three weeks... and I made the graph look better by deleting the intervening plots.)
Unique, I would say. Men, as well as women, find it difficult to lose weight at exactly the same rate each week, and to know exactly how much intake will give a specific weight gain over a very short time scale, as when you have been below your target weight.
The NHS now think that they cannot recommend anything that has not been proved by umpteen double-blind trials... and the ignore what research has been published and reviewed.
The ridiculous thing is that they started advising high, carb, low fat in response to the Keys study - which was a biassed observational study of six or seven countries - after he had conveniently omitted the data from the other 15 countries he initially looked at.
I think his "research" was funded by a sugar company.
Earlier this year, we went to the allergy and free from show, and had come home with too much stuff (it was our first visit, so we went a bit overboard with all the new things), and I had a day that was pretty much an NHS meal plan: wholemeal (gluten free) toast for breakfast (butter instead of spread, woops!), a wholemeal (gluten free) Bagel with low fat fillings for lunch, a low sugar cereal bar as a snack, and some pasta with chicken, peppers, mushrooms and pesto for dinner.
I realised quite a few things doing it:
1. This, by our current dietary standards, wasn't that unhealthy a day - low-ish in fat, full of fibre things, emphasis on carbs, but lacking in the 5-a-day.
2. This is a pretty typical day for a lot of people.
3. It was possible to get through most of a day, without eating a single bit of fruit/veg following dietary guidelines
4. I felt like cr*p afterwards - and when I think that this was a diet I had eaten for years, I gotta wonder how I functioned.
Calorie wise though, I probably came in around the 1400-1600 bracket, but if you want to set your watch by the calories in / calories out mantra, you completely miss the point of making people healthier!
Sorry, yes I meant different from NHS 12 week, not different 'unusual'. IF is the fastest growing 'diet' these days, according to my Google news feed, often with a LCHF edge to the eating, to stave off hunger.
The current UK NICE guidelines, October 17 on the Management of Obesity, still advise Health professionals to promote a low calorie diet with low fat meals based around starchy foods including bread, rice, pasta and potatoes. An example of lunch is Jacket potato with baked beans ( no butter) and a scone ( no butter). What an unpleasant prospect that dry lunch is, few could face such a diet long term. Even sadder is the lack of any physiological reason why this approach might work.
This is why I refer to low-fat as a religion. You need religious belief in something to override hard observations in the real world.
I'm absolutely certain that when the brown stuff hits the impeller, a lot of people are going to get sued . A lot of malpractice lawyers are going to take early retirement and buy big houses in rural France.
The NHS itself will probably be shielded from the worst of it - at least I hope it is, for the long-term sake of the country - but people on the fringes are going to be thrown under the bus to achieve that. I suspect, for example, that the BDA will be hauled over the coals, since their input forms the core of NICE/NHS advice.
I would love to know how this works. I can't help wondering if there's a situation similar to Australia, where their equivalent of their BDA were so politically powerful that they were able to censure doctors - people far more qualified than themselves to dispense dietary advice - and shut down any criticism of the low-fat mantra.
The NHS diet advice web pages have "approved by the BDA" stickers all over them. Why is the NHS beholden to the BDA? Don't they have their own experts? I suspect there's a huge tug-of-war going on internally.
Yes, the British Dietetic Association. All of the NHS dietary advice is "in assocation with the BDA". I find this ... strange, to say the least. It gives the impression that the NHS aren't allowed to give out dietary advice without the approval of the BDA.
When you google it, first up is diabetes.org.uk which suggests healthy breakfasts for people with Type 2 diabetes including "a bowl of wholegrain cereal with milk, two slices of wholegrain toast with olive oil-based spread, a pot of natural unsweetened yogurt and fruit". Their lunch options include "a chicken or tuna salad sandwich, a small pasta salad, soup with or without a wholegrain roll". I won't go on to dinner.
diabetes.co.uk is the one that promotes a low carb approach
I think also there are *some* people, (possibly very few) who do achieve tremendous weight loss and maintenance on a low fat diet, and who have then had a substantial media/booksales/DVDs career as a result, promoting their WOL.
Rosemary Conley is an example of this. She had gallbladder issues, went low fat and lost a lot of weight but particularly from her 'problem areas'.
The other issue is media reporting itself, borderline fake news but at the level of 'sleb weight loss!' Stories.
>> I think also there are *some* people, (possibly very few) who do achieve tremendous weight loss and maintenance on a low fat diet
It definitely happens. There's has been plenty of research on it: statistically speaking about 5% of the population will have long-term success on a low-fat, calorie-controlled diet. There are always a few outliers who are just naturally adapted to odd diets - I'm thinking of andyswarbs, who waxes evangelical about veganism. Nobody can deny that it works well for him, but in broader terms there are few people who can thrive on, or enjoy, a completely vegan diet.
I suspect that basically healthy people lose weight in spite of the low fat approach, rather than because of it. These diets by their nature are multi-variable interventions, with some things being useful (eg., reintroduction of natural, healthy foods and elimination of junk) and some things not so. The 12-week plan is a classic example of that: if they just stuck to handing out grandma's advice about not eating junk food and not snacking between meals, they would have said 70% of what needs saying.
I originally started dieting after I gained weight after starting a new job. I joined WW and started making changes to my diet but the thing that probably led to the biggest results was cutting out the mid morning sausage roll, the mid afternoon pastry and the evening bar of chocolate.
Well ... I get the feeling there are a few lurkers from the Weight Loss forum, plus random passersby who come here via Google. So it's not so bad really.
And finally, processed foods are the main culprits. Steer clear of them. Shop in a food hall instead of a supermarket, and you will come away with a completely different shop that is fresh food to cook from scratch. Whereas supermarkets are loaded isle after isle with processed food, can’t find the real stuff for the processed junk food. Sometimes I think it’s the way we have been conditioned to shop ie everything under one roof. The food hall where I shop is not expensive because there are not so many sidelines of processed food, I get the option of organic, which does not cost much more. If I bought large quantities then yes it would, but by cutting portion size it gives me the option of eating organic.
Great read theawfultoad, we have been brainwashed all our lives about so called "healthy diets", which in fact have been just the opposite. I am so glad I discovered the lchf way of life, I don't think of it as a diet. Thanks for all the info you provide in all your posts. ☺️
Wow, what a fantastic observation, you need to be employed by the NHS to put them right.
I couldn’t stop laughing about your observations you have a brilliant sense of humour and you do make me smile.
Unfortunately, the NHS is in the dark ages, I know as I have experienced this with my Thyroid journey.
I know someone diabetic and struggling with levels, I suggested the low carb diet to her and printed off a load of information off diet doctor, anyway she mentioned it to her diabetes nurse and they put the fear of god into her saying it was dangerous!!!, next time I saw her she then read in the paper (daily mail) about a low carb recipe book and ordered this and said she was going to try it, after reading it, it was the same information as the diet doctor.
I always remember when I helped my nana at the local hospital making teas and coffee for the patients that the dietician was obese, I thought how the hell do patients stand a chance when taking advice from her.
Thanks for the kind words! I read your thyroid story - sadly, my reaction was "yeah, that sounds about right". The world shouldn't be like this. I really, really don't know what's going on, but whatever it is, I hope it stops soon.
The sort of treatment your friend is getting is just disgraceful. I've heard that story so many times. If she gets that kind of thing again, she might want to respond with: "So, what you're saying is that natural, homecooked meat and vegetables are terribly dangerous?", or, alternatively, "So, given that I am losing the ability to process carbohydrates, you're advising me to eat more carbohydrates?". But I realise most people just aren't prepared to confront medical "authority". Doctor knows best!
I hope she at least gives the book a fair go. Once she's done it for a few weeks, I suspect she'll just feel that it's right, and carry on.
I can recall a story from MissisB (I think?) who mentioned a conversation with a dietician, who admitted she'd only had one successful patient ... and that one patient had ignored everything the dietician had said
Unfortunately, she’s an older lady in her 70s, and when I printed off the information for her, visual pictures about the carb content in fruits, vegetables, it turned out everything she was eating was too high in carbs,’bananas, pineapple, mango.
I suggested that maybe if she made just a few slight changes and not mention this to her diabetic nurse, but wait to see her results it would be best.
Too many opinions can get confusing, especially when she hasn’t got access to the internet for her own research.
I said give it a go as she was having trouble regulating her results.
I also suggested swapping her breakfast (porridge) for eggs and bacon maybe a few days a week, I even made her some keto bread rolls to try.
Well she went and mentioned to the nurse about the low carb eating, and that was when she put the fear of god into her saying it was dangerous.
As said she ordered a book a few weeks later, and everything I printed off basically had the same information in the book.
it appears the older generation always rely on what the professionals tell them, and never question this. My parents are the same, the doctors know best.
When I was under the NHS for my thyroid condition I went for my blood test with the nurse, she proceed to inform me she once had a thyroid condition and is no longer on thyroid medication and struggling to lose weight amongst other symptoms.
In fact when I went in to see her for my blood test, she had beads of sweat pouring down her face and was out of breath, she said she had been rushing to restock the medical cupboards before her first patient (me).
A couple of things that get me cross, and confirmed I knew more than her.
1: thyroid medication is for life, if your thyroid is working it will never recover by itself, weight gain is because your thyroid isn’t being regulated correctly. If she didn’t know that, then god help the patients that trust the NHS to get better.
Sweating from restocking the cupboards??? I sat there thinking don’t preach to me about healthy lifestyle, blah blah blah, they always ask you that nowadays don’t they, so they can blame it on something else rather than treat you for the actual condition, god forbid we get treated for the actual condition.
It’s either, it’s all in your head and take antidepressants or another favourite it’s a virus will pass in a few days treat with ibuprofen and paracetamols.
well I don’t smoke or drink alcohol, ditched fizzy drinks and don’t buy convenience foods, so why the hell would I take advice off her.
I don’t know about all of you, but I don’t sweat when I restock my food cupboards. It’s not like we live in a hot climates.
Hi Peanut31, I agree with a lot of what you said and I can see why you get cross.
But what makes me cross is your generalisation about “the older generation” and I quote: “the older generation always rely on what the professionals tell them and never question them. The doctors know best”.
I belong to the generation you mention and you couldn’t be more wrong. I always do my own research and make up my mind about everything I read and hear, I don’t just take anybody’s word for it.
Which is why I too am on the LCHF way of life (not diet), not because of any health problems but because I believe it is the healthy thing to do.
So please don’t judge anybody by their age, I know young people as well as older ones who don’t think for themselves 🙄
Freesia, I think it's a case of "if the cap fits...". My mum (now 80) was a ward sister until the early 70s, and she often mentions in her "war stories" how the doctors in those days were incredibly overbearing, and patients were bullied into just doing as they were told. Even when the doctors were clearly wrong (one of her favourite stories was advising a doctor not to give a lethal dose of such-and-such a drug).
Doctors have changed (slightly!) since then, but I imagine people in her age group are still very much conditioned to follow orders. It was the spirit of the age. You just happen to be a bit of an outlier
I think I'd add to Peanut31 's observation: most people follow orders. And in a way, what else would you expect them to do? Unless you at least passed GCSE physics, chemistry, and biology, a lot of medical knowledge is inaccessible (not all, but certainly a good fraction of it). Not everyone wants to go back to school again. Not everyone wants to figure out for themselves what the problem is. So they follow orders. And mostly that works out just fine.
I'm an expert in my particular field, and although I don't mind explaining why such-and-such works the way it does, I get annoyed when people say, no, that can't be right. I'm sure doctors react in similar ways. What's truly bizarre is this: if I personally am wrong about something, it has disastrous results, so I make damn sure I'm not wrong. If someone questions me, I do at least check to see if their objection holds water. Doctors seem to be shielded from that feedback in many cases, sometimes by insisting "I can't possibly be wrong because I'm a doctor!", and sometimes by third parties (governments, nutritionists) who have a vested interest in perpetuating mistakes.
Come to think of it, the medical profession has always been at the bleeding edge of getting things wrong. With any new medical discovery, there's always a large group of grey-bearded diehards who insist they're right and the upstarts are wrong. For example, Igor Semmelweis figured out the basics of the germ theory of disease in the 1840s; he was mocked for it, had a nervous breakdown, and died in an asylum. It was another 20 years before anyone took him seriously. The interesting part of that story is that Semmelweis's patients knew a good result when they saw it - he had a modest cult following. He was the Robert Atkins of his day, and if he'd been a bit better at self-promotion, he probably would have ended up less dead and more famous.
On a similar theme: expert systems are now better at diagnosis than actual doctors, and they're now commercially available to qualified individuals. So if you see your doctor fiddling with his iPhone during a consultation, don't be too worried. The computer will probably get it right.
I agree with what you aresaying and also, like I said, with Peanut31, it was the ‘always’ and ‘never’ I objected to. I don’t think you should generalise about anything, everybody is an individual (e.g. I am Dutch but don’t wear clogs or live in a windmill 😉).
Even my mother, who was of the older generation a long time ago, questioned doctors and actually saved her own life by insisting on tests when her GP told the specialist (in a sealed letter as was the custom in those days, which didn’t deter my mother from reading it) that she was ‘cancerophobic’.
I must admit I have A-level physics and chemistry but I don’t believe you need to have an education to have an inquisitive mind and these days you can find any subject on the internet although, of course, there especially you have to think for yourself.
I actually learned initially about LCHF from you on this forum but didn’t embark on it (successfully, thank you!) until after a lot of research. After all, I have no idea where you got your extensive knowledge on the subject?
Thank you for replying, I always look forward to all of your posts.
By the way, I must admit I have never heard of Igor Semmelweis but will have a look 😉.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Over here, it's common knowledge that sugar and refined carbs make you fat, and it's been common knowledge for ... ooh, a few centuries at least.
I’m new here and getting with the programme
Damn the Torpedoes. Part 3. Fasting, Hunger and satiety.
Belly Fat reduction Challenge-Group-1
LCHF, Intermittent Fasting and Calories