Having spent two years “following the science”, Dr Saira Hameed is hoping we can redirect that skill to another area: our weight. The endocrinologist at Imperial College London’s Weight Centre had for some time felt as though she was “leading this double life”: one in which she would read studies about “some cutting-edge breakthrough about the gut bacteria, or hormones or sleep”, which weren’t being translated into treatment for patients with weight concerns.
Standard weight-loss advice erred on the broad side of things: telling people to eat less and move more, and what and when to eat, but without rooting their guidance in new scientific findings. “I began thinking, why aren’t we telling our patients about this, because if they knew about it, I’m sure they’d fly with that knowledge,” she recalls.
So she set up the I-SatPro (Imperial Satiety Protocol) six years ago, a fortnightly programme at her clinic, convinced that “if you share the science,” being able to “understand how your body works” could lead to lasting physical change. That programme is recreated in her new book, The Full Diet, which she believes can match the 14 per cent weight loss rate at her in-patient clinic.
The programme’s approach is both full and full-on: from food to movement, sleep, gut bacteria and exercise, all bases are covered. Like everything else in the world, I-SatPro went virtual when Covid hit – which was something of a blessing, Dr Hameed says, because the 14 fortnightly sessions, previously restricted to whatever room wasn’t booked up at Imperial, had their reach expanded significantly. There is no typical patient in each 15-strong cohort, though three-quarters are women (reflective of referrals generally for weight loss): their ages run from late teens to those in their 80s, from all walks of life, with a BMI upwards of 35. Dr Hameed says she stopped reading fiction two decades ago, when she became a doctor, because “my patients’ stories are more interesting”.
The programme is stringent, I suggest – the book’s “Choose Not to Eat List” includes offenders such as bananas, mangoes and grapes, “bread of any kind”, couscous and porridge. But Dr Hameed sees the book as a science-driven sum of parts; at the end of each chapter, like I-SatPro, “you get given a series of choices” which enable readers to decide what to do for themselves. “That element of choice is so, so, so important,” Dr Hameed, 43, says. People need “agency and ownership” over their health – and a plethora of rules “is probably counterproductive… if you give people information about anything, they should be free, then, to make choices about how they implement that in their everyday life. I think that’s the only way it can work, long-term.”
Dr Hameed was on the Covid frontline until the summer of 2020 when she became pregnant with her fourth child: she believes most people “want to do the right thing” when it comes to protecting their health – particularly since the pandemic – but are often battling a tide of misinformation. One of the most common is around breakfast – which her patients routinely tell her they “know” is the most important meal of the day, and thus eat in spite of not being hungry. She tells them instead to wait until biology causes their hunger hormone to kick in, and to see each day’s food intake through the lens of an “eating window”.
Consuming anything – even the approved foods listed in the book – means sugar ending up in the blood, upping insulin levels that will convert fuel into fat storage; if we get up at 7am and are in bed by 11pm, that could mean 16 hours of food going in. Those following the programme can choose what their window looks like; either it opens or closes at a certain hour of the day, or lasts for a defined period of time. Not only does this keep insulin levels low – breaking down fat and assisting weight loss, as well as reducing the risk of insulin-driven diseases (such as type 2 diabetes) – but it will “give your body the time to carry out essential repairs and resets”.
