'Patients need to feel in control to succeed'.

HOLLY is just one of 2,000 people on the books of the specialist weight management services clinic at Birmingham's Heartlands Hospital.

The team has had to expand to meet the needs of a population with expanding waistlines and head clinician for weight management Dr Shahrad Taheri says it is now the foremost centre in the country.

He says each patient is an individual and needs to be treated as such.

"Everybody has different issues which contribute to how and what they eat - that is why it is so important they are treated as individuals.

"It is like King's Cross station. Everyone has come from a different direction and has passed through various stations to reach us. We need to unravel that journey and find out how they got there and then look at which is the best direction for them.

"When they first come to the clinic they have a 2' hour thorough assessment in which there are questionnaires and discussions. We then sit as a team with every patient to ensure they are getting consistent messages." In some cases the best option may be surgery, in others it may be changing their diet and exercise regime. But Dr Taheri says it is imperative that the patient feels in control.

"We are always asking 'what do you want to do?. Because if a patient is not making their own choices they are less likely to follow it. We have a very good success rate here and that is because patients are making their own decisions..

"And we need to make sure people are aware of the causes of their eating patterns. Neither surgery nor changes to the diet will work if they have not addressed the underlying causes. For them, something then clicks and they are able to take back control of their lives." Also on the team is specialist dietitian Annmarie Field who says it is important for patients to receive the right response.

"I don't fire questions at people asking for a detailed list of what they eat as they may feel they are being judged.

"Instead we have a more relaxed approach in which I ask them to describe a typical day. The way they talk about food and what they choose to tell me can be very revealing.

"We are looking at a balanced diet and getting active. Giving someone a very detailed 'diet' that they have to follow often does not work for our patients. They often say they have tried dieting before and it did not work for them."

CAPTION(S):

Dr Shahrad Taheri and Annmarie Field.