Do you have questions about weight loss and dieting? Ask the Second Nature experts

[CeriMumsnet]

We all know it’s important to take care of our health, but with so much contradictory messaging out there around weight loss, dieting, and exercise, it can be really difficult to work out the best approach. That’s why we’ve invited the experts behind Second Nature, the weight-loss programme that’s been used by the NHS for over 7 years, to answer any questions you have around losing weight and creating new healthy habits.

Everyone who shares a question by Friday 23 May will be entered into a prize draw to win a free 6 month subscription to Second Nature for either their medication or non-medication programme (depending on the individual winner’s eligibility) T&Cs.

About the experts
Mike Gibbs - Cofounder and COO at Second Nature
Mike co-founded Second Nature over 10 years ago out of frustration of the status quo of the weight-loss industry: calorie counting, fad diets, and misleading nutrition advice. Mike has a Masters in Pharmacology from the University of Cambridge and is Second Nature’s leading health and nutrition geek. He’s had overall responsibility for the science behind Second Nature and health coaching for the last 10 years.

Rosie Carr - Head of Health Coaching at Second Nature
Rosie is an HCPC registered dietitian and has clinical knowledge and experience in remotely delivered weight and diabetes management services. Rosie has worked as a clinical dietitian within the NHS and in New Zealand, before joining Second Nature in 2019 to oversee the delivery of remote health coaching services. Rosie’s key areas of expertise include obesity and diabetes prevention and management, digital healthcare solutions and patient-centred care

Robbie Puddick - Content Lead at Second Nature
Robbie, a registered nutritionist who specialises in public health and behaviour change science, has been working with Second Nature since 2018. He completed his Bachelor's degree in Exercise and Health Science from the University of Brighton in 2011 and his Master's degree in Public Health Nutrition at the University of Westminster in 2017. Robbie has delivered and developed lectures for several universities, such as Greenwich, UCL, and Winchester, and holds a voluntary role with Sheffield Hallam University, supporting the development of their nutrition programmes.

Hiii! I struggle to keep weight off! I've lost 12kg over the last 5 months and I just don't know how to keep it off. Any tips?

I have PCOS and I go to the gym quite a lot. I've heard so many conflicting tips eg eat at maintenance calories, eat more if you train more then go on a calorie deficit, don't spike your glucose levels.

I'm lost with it all!

Ive lost weight via WLS but may need HRT, Im worried the HRT may undo some of the effects of the hormone changes that WLS gave me and make me eat more again (or try to), is there any need for me to worry about this?

Hi, I'm a clinical dietitian and have been for over 10 years! It all amazing what you have done / your background. Let me know if I can link in!

I stopped my hrt as I was bloated all the time but my weight is stuck. I feel I need to loose at least a stone but whatever I do nothing changes

Have you read Zoe Harcombe, link to BMJ article bjsm.bmj.com/content/51/24/1737 , do you believe the NHS healthy eating guidelines are science based?

I am trying to alter my diet now that I am perimenopausal. I realise I need less carbs as I have gained weight and feel bloated, but also need higher protein to maintain muscle. I am vegetarian and find it really difficult to know what I should be eating!

I've read that it's basically impossible to keep weight off because your base metabolic rate will fight to make you regain. So what's the trick to keeping weight off forever?

Hello, how can I increase my metabolism to help with my weightloss - I drink the recommended daily allowance of water and have 10,00 steps a day, but my loss is less than a pound a week. I feel I am putting a lot of effort in for little result.

What strength building exercised can I do at home to aid with a calorie controlled and protein rich meal plan - I can't afford a gym and walking and jogging are my only real options but not what I would call strength training.

Hope I'm not too late - I lost 2 stone in lockdown, then after having a trauma - started to emotionally eat again - anything and everything and all my hard work has gone - how do you best tackle emotional eating - It's my stressfull life I know with a neurodivergent child who can say the most hurtful things. How an I get my willpower back?

Hi @sharond101, the frustration of eating very little without seeing results is something many of us have experienced, and it can feel both disheartening and confusing. This situation often points to how the traditional diet industry has led us astray with its singular focus on eating less.

One of the most counterintuitive but evidence-backed insights about weight loss is that eating too little can actually work against us. When we severely restrict our food intake, our bodies can respond by slowing metabolism, increasing hunger hormones, and holding onto fat stores; a natural survival mechanism that evolved to protect us during times of scarcity.

The diet industry has conditioned us to believe that weight loss is primarily about calorie restriction, when research increasingly shows that the quality of our food matters significantly more than simply reducing quantity. Focusing on nutrient-dense whole foods that support hormone balance, blood sugar regulation, and gut health often yields better results than simply eating less of everything.

Many of our members find that shifting away from restriction towards nourishment by ensuring adequate protein, healthy fats, fibre-rich vegetables, and complex carbohydrates, actually improves their results while making the process more sustainable. This approach supports our metabolism rather than working against it.

The psychological impact of severe restriction also deserves attention. When we try to be extremely strict with our eating, we often trigger a psychological response called the 'what-the-hell effect', where even small deviations from our rigid plan can cascade into more significant overeating. This psychological pattern contributes significantly to the yo-yo cycle many of us have experienced.

If you're eating very little and not seeing results, working with a registered dietitian or nutritionist who specialises in metabolic health can be invaluable. They can help identify potential hormonal imbalances, medication effects, or other factors that might be affecting your progress, while guiding you toward an approach that nourishes your body appropriately rather than simply restricting further.

At Second Nature, our coaches help members transition from restriction-focused approaches to more sustainable patterns that support both physical and psychological wellbeing, creating lasting changes rather than quick fixes that ultimately backfire.

Robbie

Hi @easypeasylemonn First, congratulations on your impressive 12kg weight loss. That's a significant achievement that shows your dedication and hard work. The challenge of maintenance is actually where many of us struggle, and it's completely normal to feel confused by all the conflicting advice out there, especially with PCOS adding another layer of complexity.

For women with PCOS, maintaining weight loss can be particularly challenging because of how this condition affects insulin resistance. Research shows that about 70% of women with PCOS experience insulin resistance, which can make your body more likely to store fat and experience stronger cravings and hunger signals.

Rather than focusing on rigid calorie targets that can be mentally exhausting to track long-term, many of our members with PCOS find success by prioritising consistent eating patterns that support blood sugar stability. This means including protein (25-30g) at each meal, incorporating healthy fats, and choosing complex carbohydrates like whole grains, sweet potatoes, and legumes rather than refined options.

The concern about 'glucose spikes' has some merit for PCOS, but this doesn't mean avoiding all carbohydrates. Rather, it's about choosing high-fibre complex carbohydrates and pairing them with protein and fat to slow digestion and promote more stable blood sugar levels. This approach helps manage the insulin resistance that's common with PCOS while providing the energy you need for your gym sessions.

Speaking of exercise, the fact that you're already active is fantastic. Strength training is particularly beneficial for PCOS as it helps improve insulin sensitivity and maintains metabolically active tissue. The key is finding a sustainable balance where your nutrition supports your activity level without feeling restricted or depleted.

Many of our members find that shifting from a 'diet mindset' to a 'lifestyle approach' makes maintenance more achievable. This means creating habits that feel sustainable rather than perfect, focusing on consistency over time rather than day-to-day perfection.

At Second Nature, our approach has helped thousands of women with PCOS maintain their weight loss by addressing both the physiological aspects (insulin resistance, inflammation) and psychological components of eating. The combination of these strategies creates a foundation for lasting results rather than the frustrating cycle of loss and regain.

Rosie

Hi @soupyspoon First, congratulations on your progress so far through weight-loss surgery. Your concern about hormone replacement therapy potentially affecting your appetite and weight is completely understandable, especially after working so hard to achieve your results.

The good news is that research suggests you likely don't need to worry about HRT undermining your weight-loss success. In fact, the evidence seems to point in the opposite direction. Studies suggest that hormone replacement therapy can actually be beneficial for weight loss.

Research indicates that HRT can help prevent the shift in fat distribution that typically occurs during menopause (where fat tends to accumulate around the abdomen). This central weight gain is often associated with increased metabolic risks, so HRT may offer protective benefits in this regard.

What's particularly relevant for your situation is that HRT has been shown to improve insulin sensitivity in many women. This is important because better insulin regulation supports more stable blood-sugar levels, which can help manage appetite and reduce cravings; concerns that are often top of mind for people who've had weight-loss surgery.

Many women also report that HRT helps reduce the intensity of other menopausal symptoms that can interfere with maintaining healthy habits, such as disrupted sleep, mood changes, and fatigue. By addressing these symptoms, HRT may actually make it easier to maintain the lifestyle changes that support your weight loss maintenance.

That said, every person's body responds uniquely to hormonal changes. The most effective approach would be to work closely with healthcare providers who understand both your WLS history and hormone needs. They can monitor your response to HRT and make adjustments if needed to ensure it supports rather than hinders your continued health journey.

Remember that maintaining weight loss after surgery involves many factors beyond hormones alone; including our mindset, relationship with food, nutrition, physical activity, stress management, and sleep quality. Focusing on these foundational habits remains important regardless of whether you start HRT.

At Second Nature, we support many women navigating similar transitions by helping them develop sustainable habits that work with their changing physiology, rather than against it.

Rosie

Hi @Becca3451 Thank you, we appreciate the support! The best thing to do will be to follow us on LinkedIn, if we have any job openings or opportunities there, we'll share them on our LinkedIn page :)

Mike

Hi @Kattya The frustration you're experiencing is completely understandable. Feeling caught between uncomfortable HRT side effects and stubborn weight is genuinely challenging. This situation reflects the complex relationship between hormones and weight management during menopause that many women navigate.

The bloating you experienced on HRT is a common side effect that typically improves after the first few months as your body adjusts to the hormonal changes. However, stopping HRT might actually be working against your weight-management goals. Research suggests that the hormonal shifts during menopause can significantly impact how our bodies regulate weight, with estrogen playing a crucial role in fat distribution and metabolism.

During menopause, research shows that ghrelin (our hunger hormone) can increase up to 9-fold, which can make weight management particularly challenging. HRT can help moderate these hormonal shifts and potentially support weight management rather than hinder it.

Rather than viewing this as a choice between uncomfortable bloating or stubborn weight, there might be middle-ground solutions worth exploring. Some women find that adjusting the type, dose, or delivery method of HRT can significantly reduce side effects while still providing hormonal benefits. Speaking with your doctor about these options could be valuable.

Beyond hormones, focusing on nutrition quality rather than just restriction can be beneficial. Many of our members find success by ensuring adequate protein (25-30g) at each meal, which helps manage the hunger signals that can increase during menopause. Combining this with regular strength training can help preserve lean muscle and bone tissues.

The feeling of being stuck despite your best efforts isn't a reflection of failure; it's a sign that your approach might need adjustment to work with your changing physiology rather than against it.

Would you feel comfortable discussing alternative HRT options with your healthcare provider that might provide hormonal support with fewer side effects?

Rosie

Hi!

Do you have any advice on handling criticism after weight loss? I've lost 20kg (and have another 5kg to go) in two years after being in the obese category. I had high blood pressure, painful knees etc. Some weight went back on during breast cancer treatment but I'm very close to my target weight now and looking and feeling great (I'm 168cm and 68kg, size 12) but now I'm getting comments from friends and family like 'Oh, you've lost enough' 'Don't get any thinner or you'll disappear' etc.

I've lost the weight through sheer hard work and discipline and it's so frustrating no one has actually said to me 'You look great!' I exercise daily, eat healthily through the week but enjoy a nice meal in a restaurant at the weekend - I don't sit there picking at a salad!

Especially menopausal women who have fractured their spine (which has healed) but with a damaged disc which cannot be treated! And don't suggest swimming because I cannot afford the cost.

Im peri menopausal and following keto, I only have a half stone to lose is this diet the best way to achieve this? Im not obsessed with macros as I have a long (past) history with anorexia. I dont want to be weighing, counting every morsel. Cutting carbs feels easy

Thanks to everyone who took part in our Ask the Expert with Second Nature, we hope you found it useful and informative. And thanks to our experts Mike, Rosie and Robbie for your detailed answers.

The winner of the 6-month subscription to Second Nature is @MrSpocksWife - congratulations!

Hi @Sajacas This is an excellent question that highlights the ongoing discussions within nutrition science about how we translate research into practical guidance for the public.

Broadly speaking, yes, the NHS healthy eating guidelines are evidence-based and provide a solid foundation for public health nutrition. They emphasise the consumption of whole foods, sufficient protein sources, fruits and vegetables, and they encourage limiting ultra-processed foods and added sugars. These recommendations align with decades of nutritional research showing the benefits of these dietary patterns for reducing chronic disease risk.

The guidelines serve an important role in providing accessible guidance for the general population, helping people move away from highly processed foods towards more nutritious options. For many people, following these recommendations would represent a significant improvement in their diet quality.

However, we do recognise that there may be more room for personalisation than the current guidelines suggest. Individual responses to different macronutrient ratios can vary significantly based on factors like genetics, activity levels, metabolic health, and personal preferences. What works optimally for one person might not be the best approach for another.

At Second Nature, we use our balanced plate model as a foundation that provides everyone with what they need to thrive whilst allowing for individual customisation. Our approach emphasises whole foods, adequate protein, healthy fats, and high-fibre carbohydrates, but we recognise that the specific proportions of these macronutrients can be adjusted based on what works best for each individual's health goals and lifestyle.

This personalised approach allows people to find their own balance within an evidence-based framework, whether that means following a slightly lower-carbohydrate approach, incorporating more plant-based options, or adjusting portions based on activity levels and genetics.

You can read more about our approach to balanced nutrition here: www.secondnature.io/guides/nutrition/balanced-diet

The key is finding an approach that's both scientifically sound and sustainable for your individual circumstances and preferences.

Robbie

Hi @Wotrewelookinat Your instinct about prioritising protein during perimenopause is spot on, and it's completely understandable to feel confused about navigating these dietary changes as a vegetarian. The hormonal shifts during this transition make protein particularly important for maintaining muscle mass and supporting metabolism.

Regarding carbohydrates, they're certainly not the enemy, but many women find that eating fewer refined carbohydrates during perimenopause allows them to include more protein and fibre-rich foods in their meals.

This shift often helps with the bloating and weight gain you're experiencing. The key is focusing on balance rather than eliminating or demonising entire food groups.

For vegetarian protein sources, there are many excellent options that can help you reach that important target of 25-30g protein per meal:

High-protein vegetarian foods include:

• Greek yoghurt (especially plain, full-fat varieties) - around 15-20g protein per 150g pot
• Eggs - about 6g protein each, so 2-3 eggs provide substantial protein
• Cottage cheese - roughly 14g protein per 100g serving
• Tofu and tempeh - 15-20g protein per 100g serving when prepared well
• Legumes like lentils, chickpeas, and beans - 7-9g protein per 80g portion
• Nuts and seeds, particularly hemp seeds, pumpkin seeds, and almonds
• Protein-rich grains like quinoa
• Cheese (in moderation) for additional protein

The trick is combining these sources strategically. For example, Greek yoghurt with nuts and seeds, or lentil-based dishes with some cheese can provide 25-30g protein whilst still including vegetables and moderate amounts of complex carbohydrates.

You can also add protein powders by adding them to smoothies, soups, stews, or other sauce-based dinners to ensure the meal contains sufficient protein.

Many of our vegetarian members find success by building meals around their protein source first, then adding vegetables and a smaller portion of complex carbohydrates like quinoa, sweet potato, or legumes. This approach helps manage the bloating whilst ensuring adequate nutrition during this important transition.

Rosie

Hi @Butterflyarms You've touched on a real phenomenon called metabolic adaptation, which many people experience after significant weight loss. The research behind this is legitimate, but it's not quite the inevitable doom scenario it's often portrayed as.

Metabolic adaptation tends to be most pronounced when people lose weight through crash dieting or very low-calorie approaches.

When we drastically cut calories, our bodies can respond by slowing metabolism, increasing hunger hormones, and reducing non-exercise activity (like fidgeting) to conserve energy. This response developed as a survival mechanism to protect us during times of genuine scarcity.

However, the severity of this adaptation can be significantly influenced by how weight loss is achieved. Research shows that more moderate approaches to calorie reduction, particularly those high in protein, fibre, and fats from whole foods, tend to minimise this response whilst still supporting sustainable weight loss.

When we focus on whole foods that nourish our body and control hunger, we can create a moderate energy deficit without triggering the extreme hunger and metabolic slowdown associated with restrictive dieting.

Protein is particularly important because it helps preserve muscle mass during weight loss, and muscle tissue is metabolically active, helping to maintain a healthier metabolic rate.

Building sustainable habits rather than following temporary restriction also makes a crucial difference. People who maintain weight loss long-term typically develop consistent eating patterns, regular physical activity (especially strength training), and more helpful thinking patterns.

Hi @pushchairprincess First, I want to acknowledge that less than a pound a week might feel frustrating, but you're actually achieving exactly what research shows leads to the most sustainable, long-term success. The habits you're building, staying well-hydrated and maintaining 10,000 steps daily, can be a strong part of your foundation for sustainable results rather than quick fixes that often lead to regain.

Many people who lose weight more rapidly through restrictive methods find themselves struggling to maintain those results, whereas your steady approach is building a lifestyle that can genuinely last.

Regarding metabolism, there are a couple of evidence-based strategies that can help support your metabolic rate. Ensuring adequate protein intake (25-40g per meal) requires more energy to digest and helps preserve muscle mass, which is metabolically active tissue. Building muscle through strength training, even just 1-2 sessions per week, can also support your metabolic rate over time.

However, it's worth shifting focus from trying to dramatically increase metabolism to celebrating the process you're already engaged in. The habits you're developing - consistent movement, proper hydration, and presumably making nutritious food choices - are creating lasting changes in how your body functions and how you relate to health.

Weight loss that occurs at 1-2 pounds per week is not only sustainable but often indicates that you're losing fat rather than just water weight or muscle mass. This slower pace also allows your body to adjust gradually, reducing the likelihood of metabolic adaptation that can occur with more aggressive approaches.

Your consistency with movement and hydration shows you're building the foundation for lifelong health, which is far more valuable than rapid but unsustainable weight loss.

Rosie

Hi @DanBenandBud The good news is that effective strength training doesn't require expensive equipment or gym membership.

Bodyweight exercises can be incredibly effective for building and maintaining muscle mass, especially when you're starting out or returning to strength training.

Bodyweight exercises you can do at home include:

• Press-ups (start with wall press-ups or knee press-ups if needed, progressing to full press-ups)
• Squats (focusing on proper form and gradually increasing repetitions)
• Lunges (forward, reverse, or side lunges)
• Planks and modified planks for core strength
• Glute bridges to target your posterior chain
• Step-ups using stairs or a sturdy box
• Tricep dips using a chair or sofa edge

The key is progressive overload, gradually increasing repetitions, holding positions longer, or trying more challenging variations as you get stronger. For example, once regular squats become easy, you might progress to single-leg squats or jump squats.

If you're interested in adding some equipment without breaking the bank, charity shops and Facebook Marketplace often have excellent second-hand weights, resistance bands, or kettlebells at fraction of retail prices. Even a single set of dumbbells or a kettlebell can significantly expand your exercise options.

Resistance bands are another budget-friendly option that take up virtually no storage space and can provide variable resistance for most muscle groups. They're often available quite affordably and can make bodyweight exercises more challenging.

The combination of your walking and jogging for cardiovascular health, alongside 2-3 strength sessions per week using bodyweight exercises, creates an excellent foundation for supporting your protein-rich nutrition plan. This approach helps preserve and build muscle mass, which supports your metabolism and overall health goals.

Remember, consistency matters more than having perfect equipment. Starting with bodyweight exercises and building the habit is far more valuable than waiting until you can access a gym or purchase equipment.

Rosie

Hi @MrSpocksWife I'm sorry to hear about the challenges you're experiencing at the moment, caring for a neurodivergent child whilst managing trauma and stress would challenge anyone's relationship with food. The emotional eating you're describing isn't a character flaw or lack of willpower; it's a completely human response to overwhelming circumstances.

It's important to understand that emotional eating isn't really about willpower at all. When we're under chronic stress, our bodies produce cortisol, which can genuinely increase cravings for high-energy foods. Your brain is actually trying to help you cope with the enormous demands you're facing. This biological response happens to most of us under stress, regardless of how strong or disciplined we might be.

Rather than focusing on regaining willpower, which puts enormous pressure on you during an already difficult time, consider approaching this with the same compassion you'd show a friend in your situation. Small, gentle changes often work better than dramatic restrictions when we're already emotionally stretched.

This might mean ensuring you have regular, nourishing meals throughout the day to prevent the extreme hunger that can trigger emotional eating episodes. When we're caring for others intensively, we often forget to feed ourselves properly, which can make evening overeating almost inevitable.

Building a toolkit of non-food coping strategies can also help, though we recognise this is easier said than done when you're managing so much. Even five minutes of deep breathing, a brief walk outside, or reaching out to a supportive friend can sometimes interrupt the cycle.

If possible, seeking support through your GP, a counsellor experienced with family stress, or local support groups for parents of neurodivergent children could provide both practical strategies and emotional relief. You're carrying an enormous load, and you deserve support.

Rosie