Diabetic Dialogue – Fast Fix Diabetes With Dr Zoe Williams

Welcome to Diabetic Dialogue. We are keeping the conversation going about diabetes. We are fighting that battle and fighting that war on diabetes. I would like to welcome today's guest, Dr. Zoe Williams. And Zoe is known for sharing her medical expertise on ITV's this Morning and is an NHGP in London. Welcome, Zoe, and thank you for taking the time to talk to us on Women's Radio today. Thank you so much for having me. It's a pleasure to be here. You are very welcome. Zoe, listen up. This is what we brought you in here for. You recently took part in a two part show looking at reversing diabetes. Can you tell our listeners about this and who was involved in this? Yeah. So it's a show that aired on ITV last month in June, and we took five participants and we subjected them to an intervention as a treatment for their type 2 diabetes. And that intervention was a dietary intervention which restricted them to 800 calories per day for eight weeks. And the calories came in the form of shakes. So essentially they didn't chew any food for eight weeks. The first four weeks we had them as inpatients in our fast fix clinic. And then the second four weeks they continued the low calorie diet at home. And then the final part was the reintroduction phase where we supported them whilst they gradually reintroduced real food in place of the Shakespeare. Wow. And I mean, what we were really looking at, there were five people who had type 2 diabetes. They were all taking medication for their type 2. And we wanted to see if with that very low calorie diet, we could get them off their medication and into remission of their type 2 diabetes within that period. That was very interesting. So the patients you picked though, did they have to meet a certain criteria? Were they really obese or, you know, was it just people with type 2 that were a general weight? Please advise what you how you made your choices. Okay, well, it was the production team that recruited the participants and really the main criteria was that they had type 2 diabetes. And one of the things that I think was quite important was that we represented the average person who has type 2. Most people are aware of the fact that obesity and type 2 diabetes are very closely linked and obesity is the main driver, but not the only driver of type 2 diabetes. But I think for many the misconception is that you would need to be very obese before you'll be affected by type two. And that's just not the case. I see patients every day who are not even obese, maybe just in that overweight range, which two thirds of the UK population are overweight and one third of the UK population are obese. So these aren't people who look the way that the media often portrays obesity. These are just normal people that we walk past in the street every day, that we see every day. And type 2 diabetes predominantly affects people who are above a healthy weight, but not necessarily always. It can even affect people sometimes who are a healthy weight if they've got a very strong genetic predisposition or there's another factor that means they're at higher risk of type 2. I appreciate that because I'm Zoe. I'm one of those people who probably, to the outside world looked what you'd call normal in quotation marks, but obviously I was diagnosed with type 2 diabetes last year and wasn't showing physical signs of it, but obviously, you know, the stats were up against me. So we appreciate you telling our listeners that. Yeah. And do you have a family history of type 2? I do have a family history of it, but I think I've told our listeners this before. I did sort of choose to ignore whatever symptoms were in front of me. I knew perhaps a little bit about it, but hadn't put the package together that I was actually a walking sort of like ticking time bomb for it. So listeners out there, if you do have any symptoms of what we know of things like thirst and, you know, if you're just feeling generally unwell, do visit your gp. So that's an important message. Well, back to our subject, though. In terms of drinking the 800 calories, I know that these patients were closely supervised over four weeks. Now, could they have done this for longer? Or was there a limit on the actual, you know, the shakes that they could have. Could they have had them for like, six weeks? So they did it for eight weeks. Oh, was it actually an eight week total? But they did the rest at home, didn't they? Yeah, four weeks in the clinic and then four weeks at home. Yeah, it can be done for longer, but you're absolutely right, they were closely supervised by myself and they had a lot of support from a dietitian. And I guess an important thing for your listeners is to anybody out there who has type 2 diabetes, it can be very dangerous to do this without support, particularly if you're taking insulin or gliclazide medication, then actually this could be life threatening. So do do it with support, but it is safe to do it for longer than eight weeks if you're doing it with support and being monitored. And if whoever is supporting you says to do so. In fact, some of our participants, we actually recommended at the end of the eight weeks that they continued for another four weeks because they hadn't quite got to where they needed to be with their weight loss. Wow, that's really interesting. So do listen to what Zoe has said, listeners. It's very important. But what were your findings and what will you do with the outcome? So what did you find from all of this? So, I mean, we have to remember that with our program it was just five people. So whatever happens to five people doesn't stand up in scientific research. This doesn't count as research, it is just anecdotal. But really what we were aiming to do was demonstrate the findings of quite a large study that's been done recently called the Direct trial. And in that trial, 300 participants took part, all who had type 2 diabetes. Half of them acted as a control group and just had sort of normal dietary advice and the other half did this very low calorie liquid diet. And the results are very reassuring. We've got the 12 month results which came in actually whilst we were filming. And for me, as a professional, as a scientist, as a doctor, when those results came in, you know, it was a massive sigh of relief actually, because up until that point I felt that this was a bit of a risk. But when those results came in, that reassured me that, okay, we're doing the right thing here. We're sharing with the general public what this study has shown us. So the scientific community, doctors and nurses who are interested in diabetes are all aware of this direct trial, but the general public often don't necessarily look at scientific research and wouldn't necessarily be able to understand what's been shown. So I think what we've done with the program is we've demonstrated in quite an entertaining way what that research has found on a bigger scale. So the 12 month data from that clinical trial showed that over. Sorry, no, it didn't show up. Half, just under half of the people who managed to successfully do the diet had their type 2 diabetes in remission at 12 months. Okay, that's very, very good. Now in terms of. Because I know that you worked with Professor Jason Gill. Yes. What was his interest in diabetes? I know that he sort of looks at metabolism. Yes. So does he plan to go any way further with this? So Jason's brilliant. I really enjoyed working with him. He's such a smart guy and a lot of his work to date has been looking at metabolism. And obviously type 2 diabetes is a disease of the Metabolism, in a way. And he's actually had some input into the director trial that I've been talking about. So he's been working up in Glasgow with Professor Mike Lean, who's one of the two professors who's responsible for the direct trial. The other one's Professor Roy Taylor from Newcastle. So I think he has a vested interest in whether Steven study is to date. But we even need to. Even though the 12 month data from the direct trial is really, really promising and interesting, even that in the world of science at 12 months is still limited. We need to see what happens at two years and three years and even five years. And often it takes a long time before the NHS medical practice changes because we want to see what the long term results are. Having said that, a lot of clinicians, including myself in my practice, we think that there's enough of a positive hint from the trial so far to suggest that it's worthwhile offering this as an option for patients. If they're willing to do this radical diet, which is radical and is difficult, but if they're willing to do it, then I feel that's something we should be offering. That's really, really quite interesting. So what has been the response? I know that there's not one size fits all and you've said that already. What's the response from, let's say, because we've got things like Diabetes uk. Have you had a response from anybody sort of maybe perhaps not happy about it? Just give us an idea of what has happened. Not really. The response has been mostly positive. I think Diabetes UK have made a statement about the program and they've said kind of what I've just said, really, that, you know, a program of five people doesn't necessarily mean that this is going to work for everybody. And they supported the direct trial. Diabetes UK funded the direct trial. But even with that, you know, we must reserve judgment until we have that longer term data before we make a huge shift in what we do. But if some people, I think they also support the fact that we do need to empower patients and advise patients that there are other ways potentially of treating type 2 other than just medication and thinking of it as a chronic disease that they'll always have. We do have to think outside the box. You're exactly right. Right. We're going to take a short break now and if you just join us in about five minutes, we will be listening to Zoe Williams. Once again, thank you very much for listening. Welcome to women's radio station, the voice of women worldwide. So I do glitter for a living. Coming up next on women's radio station wrs. Women's radio station. Hey, this is Jessie and I'm a life architect. So what has made you say effort enrage or effort enjoy this week? 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Welcome back to Diabetic Dialogue and we are still continuing to keep the conversation going about diabetes and I'm with my guest Dr. Zoe Williams and Zoe is our medical expert from ITV's this Morning and is also an NHS GP in London. Welcome back, Zoe. Thank you. Zoe, you recently took part in a two part show looking at reversing diabetes. Now the question I want to ask you, have you followed up with any of these patients? What are they doing now? That's what I'm really interested to know. Yeah. To be honest, I keep up with them mostly through social media, on Instagram, and keep up with what they're doing because their lives have changed incredibly. Most of them. At the end of the eight week trial time, two of the five actually had their type 2 diabetes in remission. Six months later, when the program aired, three did and one was on the cusp. And now four of the five are in remission. It's great news that they've maintained it as well as achieving remission. The one who hasn't yet reached remission is on his way there and, you know, is trying hard, but he has reduced his medication. And just seeing what they've been up to is incredible because Tracy is a really good example of somebody who not only is her type 2 diabetes in remission, but she's got her life back. Prior to doing this fasting diet, she was quite low in mood. She has fibromyalgia as well. She struggled to be active and she'd lost her creativity. She would say that she'd lost her creativity. She wasn't doing the things that she used to enjoy doing. Now she's painting again. She's written a book, she's doing a podcast. She's in the gym. So previously she needed two handrails to get up the stairs. Now she can go out and run. So it's absolutely incredible. She's got her life back through this. So as doctors, often we focus on the numbers and the figures and whether the type 2 diagnosis, type 2, is in remission or not. For her, she's got her life back. That's a really good news story. And I'm in that story too, because it's a good news story for me. I'm also in remission, and I'm not sort of singing my own song, but I do feel great about it. So I understand where Tracy's coming from. And you look fantastic. I do appreciate you saying that. Same to you. It was just to say. So in terms of their eating, what do you think are your patients now? You know, these guinea pigs, are they eating healthily now? Is that what's keeping them going? So they've all chosen different strategies. Actually, one of them has chosen to continue using the shakes for breakfast and lunch, and then he eats with his family, whatever his family have. That's his way of doing it. One of them has chosen to go on a low carb diet and is doing extremely well with that. And one of the others is eating a normal diet, but just eating much less than they used to and making healthier choices. So they've all chosen slightly different approaches that suit them. But I think one of the things that, I guess one of my own criticisms of the program is, and this was because we didn't really have time, we were limited to two hours, and there was so much great content to show, is that we didn't feature much of the reintroduction phase. And a lot of people at home who watch the program, it concerned me slightly that they would think they can do this for eight weeks and then that's it. The reintroduction phase is just as important as the rapid weight loss phase, because actually, if you go back to your old habits, the diabetes will just come back. So the idea was, with them is that we gradually replaced one shake per day with a healthy meal that was no more than 400 calories. And it was a very gradual process over months of reintroducing food with a lot of education and support from a dietitian. So that's quite important. And it sounds like it's a complete lifestyle change. Now, although we've got you sitting here and we've talked about the fast fix diabetes, we want to know about you, Zoe, as well. We want to know what have you been doing. So I know that you're interested in improving health through lifestyle, you're interested in sports medicine. I've been stalking Zoe and Children's Health. Are you working on anything specific at the moment? I'm working on so many things, Sandra. I'd be here all day if I told you about all of them. I think I have plenty of time. Eight jobs at the last count. So the way I think of what I do is, first and foremost, I'm a gp, I'm a clinical GP and I work part time seeing patients in my practice in London. And then I have some roles that are sort of quite serious. So I work with Public Health England and the Royal College of General Practitioners and my local CCG in Southwark. And those roles are all around sort of being a champion for physical activity and lifestyle medicine. So it involves educating other healthcare professionals, flying the flag and trying to sort of improve services for people so that we can take more of a lifestyle approach around disease prevention and management, rather than just dishing out drugs. And then I have the other jobs that I do that are so much fun and I feel passionately about as well. So, as you already mentioned, I'm a TV doctor, I work on this morning on ITV and I'm also one of the presenters of BBC2's Trust Me. I'm a doctor. And I've been involved in a few other projects recently as well, like Fast Fix diabetes and the NHS itself 70 program. So that's lots of fun. But also, I think, a really important part of what I do because that means I can communicate these really important messages to millions of people. And then the other thing you mentioned, child health. So I have my own community interest company that I've set up with a colleague, Dawn. One of my real passions is helping children to achieve their potential and to aim high and have aspirations. Often children from areas of deprivation or who have very challenging lives. And I grew up myself in, you know, I wouldn't say we were poor, but we certainly weren't well off. Single parent, family on benefits, all of that. And I'm quite proud of what I've achieved. I've done quite well for somebody who came from where I come from. And I can think back and think of a few individuals who were really pivotal in that, who really told me, yes, you can. If you want to be a doctor, yes, you can. Although my school actually, when I said I wanted to be a doctor, thought that was very nice, but encouraged me to also look at more realistic options. So I think passionately about encouraging other children who have challenging lives, reaching out to them and through the means of physical activity as a vehicle helping them to reach for the stars and have higher aspirations. That's really positive in terms of children as well, though. I know, because I'm looking at just any child in society and I know that children are bigger than they used to be. I'm not sort of criticising or anything, but I'm just wondering, is there a message that you'd give to parents about looking after children and their health if you have an important message for them? Yeah. No, you're absolutely right. The obesity rates amongst children at the moment are very, very worrying. One in three children leaving primary school, they're above a healthy weight. And I think the most important message I would give is encouraging parents to try and recognise that. I completely understand that. When parents receive a letter home from school saying, your child is above a healthy weight, for most parents they just think, that's not right, this is a mistake, my child's actually healthy. And it's not because the parents are ignorant, it's not because the parents are silly, it's because actually they're comparing their child to all the other children. And actually one in three children age 11 are above a healthy weight. So a normal child is often overweight. So one thing I would say is if you are receiving that letter home as gps, we really want you to come and see us so that we can offer some advice. Where I work in Southwark, we're very, very lucky that we have incredible services for children and families who are suffering or struggling with their weight. And they're non judgmental, they're fun, they're free. You get together with other families, you do physical activity and just learn about how you can be healthier. But at the moment that service is in danger of being decommissioned because not enough people are using it. Parents, unfortunately don't often recognise overweight in their children. Doctors often don't recognize overweight in children. And I know that because I've tested it, because I give education around obesity to an overweight, to doctors. And one of the things I do is a little test where we look at images and doctors find it very difficult to spot a child who is overweight or who is very overweight. And that again, it comes back to the media when we see the world, childhood obesity in the media, we see images of children who are drastically overweight and actually a seven year old child who is healthy, you should be able to see their ribs through their skin. So why are children overweight? What are the reasons for this? Is it obvious? Could you tell us why you think people are overweight? It's the world that we live in today. It's predominantly about our environment. We live in an environment where food is everywhere, portion sizes are far too big and a lot of those foods contain high levels of fat and sugar. But also genetics play a part. So genetically you may be predisposed to that environment. If you're somebody who has a sweet tooth, for example, you're more likely to struggle in this environment than somebody who doesn't have a sweet tooth. And that's just one example of how genetics play a role that makes sense. My final question to you is what made you become a doctor? I know you've said that you wanted to be one. I know that you played Amazon everyone on Gladiators. I might got my aunt open in shock. She's a multitasker. Why did you do this? Were you just concerned with health? Well, Sandra, it's quite interesting. I think actually my mind was made up by the age of three. My, my grandma was a midwife and she, when I was 3 years old, bought me a doctor's kit with the stethoscope and everything else. And she asked me sort of quite proudly, when you grow up, are you going to be a midwife like me? At which apparently I stamped my feet and said, no, I'm going to be a doctor. And that sort of just stuck with me. I've always been fascinated by the human body. I suffered quite severe asthma as a child, so my doctors and nurses that looked after me sort of fed that desire even further. And I guess as cheesy as it sounds, I've always genuinely liked looking after people and helping people. And I feel that now, through the platform of television, I have hopefully an opportunity to change people's perceptions and people's behaviors on a grand scale. Zoe, thank you. You are an inspiration and everybody out there. So if you want to do what you want to do, listen to Zoe. She wants to be a doctor and she is a doctor. You are an inspiration. I would like to take the time to thank you, Zoe, for coming onto the show. Thank you for having me. I've really enjoyed your company and listening about the fast bit. It's so interesting. Thank you very much and we look forward to seeing you again. Thank you, Sandra. Keep doing the good work you're doing. Will do. Thank you. Thank you for listening to diabetic dialogue on Women's Radio Station. 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