NHS Choices: Live well

Sex after hysterectomy

NHS Choices — Tue, 03 Jan 2012 11:21:00 GMT

Sex after hysterectomy

Having a hysterectomy doesn’t mean the end of having sex. Find out how a hysterectomy might affect your sex life, how long you should wait before having sex again, and how to cope with issues such as vaginal dryness.

When you have a hysterectomy, you’ll be advised not to have sex for around four to six weeks. If you don’t feel ready after six weeks, don’t worry – different women feel ready at different times. It takes time to recover from any surgery, but having a hysterectomy can have a strong emotional impact too, which can affect how you feel about sex.

It’s worth bearing in mind that a study of 413 women in the Netherlands found that sexual wellbeing improved after hysterectomy, and that there was some reduction in sexual problems (such as pain) after the surgery. However, around 1 in 5 women developed new sexual problems after hysterectomy. If you experience problems with sex after your operation, don’t suffer in silence. There is help – you can talk to your GP, a counsellor or an organisation such as the Hysterectomy Association.

Feeling sexually attractive

A hysterectomy is the removal of the uterus (womb), and sometimes the ovaries, fallopian tubes or cervix as well. Which organs are removed will depend on your own circumstances, and why you’re having the hysterectomy. You can find out about the different types of hysterectomy.

Losing the uterus can make many women worry about feeling less womanly after their operation, or losing their sexual attractiveness. Many women also talk about feelings of loss or sadness after a hysterectomy. These feelings should pass. You may find it helps to focus on your recovery – eating healthily, getting some exercise (your doctor will tell you how much activity you should aim for) and talking to your partner or friends about how you’re feeling.

If you’re finding it hard to cope with these emotions, talk to your consultant or your GP. You may be able to have counselling to help you work through your feelings. You can find a counsellor near you.

It can also help to read about how other women have got through similar experiences. You can read about women’s experiences of hysterectomy at healthtalkonline.

Sex and menopause

Having your ovaries removed will trigger the menopause, whatever your age. The changing hormone levels during menopause can affect your sex life. Find out more about sex after menopause, and how to deal with any problems.

Sex drive

Some women have less interest in sex after having a hysterectomy. If this happens to you, your interest in sex may return in time as your recovery progresses. If you and your partner feel it’s a problem, try to talk about it together so that it doesn’t become an unspoken issue between you. You can also talk to your GP, or find a counsellor who can offer help with sexual problems. You can find out some tips from a psychosexual therapist on talking about sex.

Lack of sex drive can be made worse by depression, menopausal symptoms, relationship problems and stress. These problems are often temporary, but if symptoms of menopause or depression persist then see a doctor for treatment. Treating menopausal symptoms may boost your sex drive indirectly by improving your general wellbeing and energy levels.

Find out more about keeping the lust alive.

Sensation and orgasm

Having a hysterectomy doesn’t mean you can’t have an orgasm. You still have your clitoris and labia, which are highly sensitive. It’s not known what role the cervix may play in orgasm – some experts have argued that removing the cervix can have an adverse affect, but others have found that it doesn’t.

In a study comparing different surgical methods of hysterectomy, a number of women noticed reduced sexual sensation. This included reduced feeling when their partner penetrated their vagina, a dry vagina and less intense orgasms. If, before hysterectomy, you had noticeable uterine contractions during orgasm you may miss these afterwards.

If you find that your hysterectomy has made your vagina feel more dry than it used to, try using a sexual lubricant. You can buy these over the counter at a pharmacy.

Your surgeon will have advised you to do pelvic floor exercises to help your recovery. These exercises can also tone up the muscles of your vagina and help improve sexual sensation. You can find out more about pelvic floor exercises.

Other women in the surgical study pointed out that their hysterectomy had removed their pre-surgery symptoms (for example, heaving bleeding or pain), and they had a greater sense of wellbeing and happiness.

Further information

How hysterectomy is carried out

Recovering from hysterectomy

Heavy periods

Endometriosis

Menopause

Female sexual problems

Top 10 diets review

NHS Choices — Tue, 20 Dec 2011 00:00:00 GMT

Top 10 diets review

Internet searches for diets spike in January, but with so many options to choose from it can be hard to find a weight loss plan that’s right for you.

To help, the British Dietetic Association (BDA) here examines the pros and cons and gives its verdict on the 10 most searched-for commercial diets.

Many of the diets listed here are quick fixes and may not be sustainable or healthy in the long term. They could make your weight more likely to fluctuate or ‘yo-yo’. The key to losing weight and keeping it off is to reduce your calorie intake and be more active. Read Start losing weight for more information.

Dukan diet

The Dukan diet is a low-carbohydrate (carb), high-protein diet. There’s no limit to how much you can eat during the plan’s four phases, providing you stick to the rules of the plan. During phase one, you’re on a strict lean protein diet. This is based on a list of 72 reasonably low-fat protein-rich foods, such as chicken, turkey, eggs, fish and fat-free dairy. This is for an average of five days to achieve quick weight loss. Carbs are off limits except for a small amount of oat bran. Unlike the Atkins diet, Dukan’s phase one bans vegetables and seriously restricts fat. The next three phases of the plan see the gradual introduction of some fruit, veg and carbs and eventually all foods. The aim is gradual weight loss of up to 2lb a week and to promote long-term weight management. There’s no time limit to the final phase, which involves having a protein-only day once a week and taking regular exercise.

Pros:
You can lose weight very quickly, which can be motivating. It’s a very strict and prescriptive diet and some people like that. It’s easy to follow. You don’t need to weigh food or count calories. Apart from keeping to low-fat, low-salt and high-protein foods, there’s no restriction on how much you can eat during your first two weeks.

Cons:
At the start of the diet you may experience side effects such as bad breath, a dry mouth, tiredness, dizziness, insomnia and nausea from cutting out carbs. The lack of wholegrains, fruit and veg in the early stages of the diet could cause problems such as constipation.

BDA verdict:
Rapid weight loss can be motivating but it is unsustainable and unhealthy. The Dukan diet isn’t nutritionally balanced, which is acknowledged by the fact that you need a vitamin supplement and a fibre top up in the form of oat bran. There’s a danger this type of diet could increase your risk of long-term health problems if you don’t stick to the rules. The diet lacks variety in the initial phases so there’s a risk you’ll get bored quickly and give up.

Evidence shows that the best way to lose weight is to make long-term changes to how many calories you consume and how active you are. Aim to lose weight at around 0.5kg to 1kg a week (1lb to 2lb), until you achieve a healthy BMI.

Atkins diet

The Atkins diet is a low-carb, high-protein weight loss programme. You start with a low-carb diet designed for rapid weight loss. This lasts at least two weeks depending on your weight loss goal. During this phase, you’re on a protein, fat and very low-carb diet, including meat, seafood, eggs, cheese, some veg, butter and oils. In contrast to the Dukan diet, Atkins allows unlimited fat and some veg, such as peppers, cucumber and iceberg lettuce, during phase one. During the next three phases, the weight loss is likely to be more gradual, and regular exercise is encouraged. More carbs, fruit and veg are introduced to your diet with the aim of working out what your ideal carb intake is to maintain a healthy weight for life. Phase one is designed to help you lose up to 15lb in two weeks, reducing to 2lb to 3lb during phase two.

Pros:
You can lose weight very quickly, which can be motivating. The diet also encourages people to cut out most processed carbs and alcohol. With its diet of red meat, butter, cream, cheese and mayonnaise, it’s one of the few diets out there that appeals to men.

Cons:
Initial side effects can include bad breath, a dry mouth, tiredness, dizziness, insomnia, nausea and constipation from cutting out carbs and fibre. The high intake of saturated fat may increase your risk of heart disease and there are concerns that a lack of fruit, veg and dairy products and a high protein intake may affect bone and kidney health in the long term.

BDA verdict:
Rapid weight loss can be motivating but it is unsustainable. The Atkins diet isn’t nutritionally balanced. By limiting fruit and veg it contradicts all the advice on healthy eating that we have tried so hard to pass on to people. The meal choices are limited so there’s a risk many people will get bored quickly and drop out or take a ‘pick and mix’ approach.

Cambridge diet

The Cambridge Weight Plans are based around buying and eating a range of meal-replacement products with the promise of rapid weight loss. There are six flexible diet plans ranging from 415kcal to 1,500kcal or more a day, depending on your weight loss goal. There is also a long-term weight management programme. The bars, soups, porridges and shakes can be used as your sole source of nutrition or together with low-calorie regular meals. While on the programme, you receive advice and support on healthy eating and exercise from a Cambridge adviser.

Pros:
Many people on very low-calorie diets (VLCDs) find the weight loss to be sudden and quite dramatic. The meal replacements are all nutritionally balanced so you're likely to be getting all the vitamins and minerals you need albeit not from real food.

Cons:
Initial side effects can include bad breath, a dry mouth, tiredness, dizziness, insomnia, nausea and constipation from cutting down on carbs and fibre. The hardest part of the plan is sticking to it. Giving up normal meals and swapping them for a snack bar or a shake can be boring and feel socially isolating. This isn’t a plan you can stick to in the long term.

BDA verdict:
You need to like the meal-replacement products to stay with the plan. Rapid weight loss can be motivating but it is unsustainable. A VLCD that involves eating 1,000 calories a day or fewer should not be followed for more than 12 continuous weeks. If you are eating fewer than 600 calories a day, you should have medical supervision.

South Beach Diet

The South Beach Diet is a low-GI diet originally developed for heart patients in the US. There’s no calorie counting and no limits on portions. You're encouraged to eat three meals and two snacks a day and follow an exercise plan. People who have more than 10lb to lose start with phase one. This is a two-week quick weight loss regime where you eat lean protein, including meat, fish and poultry, as well as some low-GI vegetables and unsaturated fats. Low-GI carbs are re-introduced during phases two and three, which encourage gradual and sustainable weight loss.

Pros:
If you can avoid phase one and start on phase two, there are fewer dietary restrictions in the rest of the plan than some other popular diets. After phase one, the diet broadly follows the basic principles of healthy eating. No major food groups are eliminated and plenty of fruit, veg and low-GI carbs are recommended.

Cons:
The severe dietary restrictions of phase one may leave you feeling weak and missing out on some vitamins, minerals and fibre. You may initially experience side effects such as bad breath, a dry mouth, tiredness, dizziness, insomnia, nausea and constipation.

BDA verdict:
The first two weeks are the most difficult to get through. We’re concerned that this diet promises such a large weight loss, up to 13lb, in the first two weeks. Although this won't be all fat. Some of this weight loss will include water and carbs - both of which will be replaced when you begin eating more normally. Once you get past the initial phase, the diet follows the basic principles of healthy eating and should provide the nutrients you need to stay healthy.

Slimming World diet

Slimming World’s weight loss plan encourages you to swap high-fat foods for low-fat foods that are naturally filling. You choose your food from a list of low-fat foods they call 'Free Foods', such as fruit, vegetables, pasta, potatoes, rice, lean meat, fish and eggs, which you can eat in unlimited amounts. There’s no calorie counting, no foods are banned and you’re still allowed the occasional treat. You can get support from fellow slimmers at weekly group meetings and follow an exercise plan to become gradually more active. The plan is designed to help you lose about 1lb to 2lb a week.

Pros:
No foods are banned so meals offer balance and variety and are family-friendly. The portion size from each food group will vary depending which plan you follow. The 'Body Magic' booklet they provide gives ideas to help you raise your activity levels. Meeting as a group can provide valuable support.

Cons:
Slimming World doesn’t educate you about calories. Without having learned about calories and portion sizes, you may struggle to keep the weight off in the long term when you come off the programme.

BDA verdict:
The group meetings encourage members to share successes, ideas and recipes with each other but they may not appeal to everyone. While the meal plans may lack some flexibility, they are generally balanced. However, without learning about calories and portion sizes, you may struggle to make healthy choices once you’ve left the programme.

Slim-Fast diet

The Slim-Fast diet is a low-calorie meal replacement plan for people with a BMI of 25 and over. It uses Slim-Fast’s range of products. The plan recommends three snacks a day from an extensive list, including crisps and chocolate, two meal replacement shakes or bars and one regular meal, taken from a list of recipes on the Slim-Fast website. You can stay on the diet for as long as you want depending on your weight loss goal. Once reached, you’re advised to have one meal replacement shake a day, up to two low-fat snacks and two healthy meals. The plan is designed to help you lose about 1lb to 2lb a week and you can follow the diet for as long as you want.

Pros:
Meal-replacement diets can be effective at helping some people to lose weight and keep it off. The plan is convenient as the products take the guesswork out of portion control and calorie counting. No foods are forbidden although you are encouraged to eat lean protein, fruit and vegetables.

Cons:
On their own, meal-replacement diets do little to educate people about their eating habits and change their behaviour. There’s a risk of putting the weight back on again once you stop using the products. You may find it hard to get your 5 a day of fruit and veg without careful planning.

BDA verdict:
If you don’t like the taste of the meal replacement products, you won't stay with the plan. The Slim-Fast plan can be useful to kickstart your weight loss regime, but it’s important that you make full use of the online support to learn about the principles of healthy eating and how to manage everyday food and drink.

LighterLife diet

The LighterLife weight loss plans combine a very low-calorie meal-replacement diet with weekly counselling. With LighterLife Total, for people with a BMI of 30 or more, you eat four 'food packs' a day, consisting of shakes, soups, mousses or bars, and no conventional food. LighterLife Lite, for those with a BMI of 25-30, involves eating three food packs a day plus one meal from a list of approved foods. You stay on the plans until you reach your target weight. The meal plans can lead to very rapid weight loss and you’re advised to see your GP before starting. How long you stay on the diet depends on how much weight you have to lose.

Pros:
The counselling can help you understand your relationship with food, so hopefully you can make lasting changes to keep the weight off for good. With the meal replacements, there’s no weighing or measuring, so it’s a hassle-free approach to weight loss.

Cons:
Initial side effects of the diet can include bad breath, a dry mouth, tiredness, dizziness, insomnia, nausea and constipation from cutting down on carbs and fibre. Surviving on a strict diet of shakes and soups and other meal replacements isn’t much fun and can feel socially isolating.

BDA verdict:
Rapid weight loss can be motivating but it is unsustainable. LighterLife’s VLCD and its counselling component may work for some, particularly people who have struggled to lose weight for years, have health problems as a result of their weight and are clinically obese with a BMI of more than 30. A VLCD that involves eating 1,000 calories a day or fewer should not be followed for more than 12 continuous weeks. If you are eating fewer than 600 calories a day, you should have medical supervision.

WeightWatchers diet

The WeightWatchers plan is based on the ProPoints system, which gives a value to foods and drink based on protein, carbs, fat and fibre content. It is essentially a calorie-controlled diet where you get a personal daily ProPoints allowance, which you can use how you like. There’s no limit on the amount of fruit and most veg you can eat. You also get a weekly ProPoints safety net in case you go over your allowance, and an individual exercise plan. The weekly meetings and confidential weigh-ins provide support and extra motivation to encourage long-term behaviour change. The plan is designed to help you lose up to 2lb a week.

Pros:
No foods are banned so you can eat and drink what you want providing you stick to your points allowance. The ProPoints system is easier to follow for some than calorie-counting and less restrictive than other plans. This is because it introduces a safety net of points, which can be saved up for a special occasion, such as a night out, a small amount of alcohol or treats.

Cons:
When you begin, working out the points system can be just as time consuming as simply counting calories. Some people feel pressured into purchasing WeightWatchers branded foods.

BDA verdict:
The ProPoints plan is generally well balanced and can be a foundation for long-term changes in dietary habits. The support group approach can help keep people motivated and educate them about healthy eating. But it’s vital that you make the connection between the points system and calories if you want to avoid putting the weight back on once you leave the programme.

Rosemary Conley diet

Rosemary Conley’s Diet and Fitness plans combine a low-fat, low-GI diet with regular exercise. You can follow her recipes or buy from her range of calorie-controlled ready meals and snacks. You’re encouraged to eat food with 5% or less fat, with the exception of oily fish, porridge oats and lean meat. A network of local Rosemary Conley clubs offers weekly exercise classes, support and motivation. You learn about calorie counting and portion size, which can help you sustain your weight loss beyond the programme. The diet is designed to help you lose a stone in seven weeks. How long you stay on the plan depends on your weight loss goal.

Pros:
The programme is based around calories, with a focus on cutting fat. The 'portion pots', which are used to measure foods such as rice, cereal, pasta and baked beans, teach you about portion control. Physical activity is an integral part of the weight loss plan, with exercise sessions suitable for all ages, sizes and abilities offered at their weekly classes with trained leaders.

Cons:
Some low-fat products aren't necessarily more healthy because they can still be high in sugar and calories. It is unrealistic to expect people to go out with their portion pots and, therefore, portion control may be more tricky away from the home.

BDA verdict:
The diet and exercise plans offer a balanced approach to weight loss that teaches you about portion size, the importance of regular exercise for weight management and making healthier choices. The educational element is very useful for long-term weight management once you have left the programme.

Jenny Craig diet

The Jenny Craig programme has three main features: one-to-one support, a meal delivery service and tailored exercise plans. The weekly, personalised telephone consultations provide advice, motivation and support. The diet adviser assesses your reasons for gaining weight and, over the course of the programme, helps you to change your behaviour. The meals and snacks are packed into single-sized portions to suit your weight-loss needs. You need to add certain fresh fruits, veg and low-fat dairy products. The programme is designed to help you lose between 1lb and 2lb a week until you reach your target weight.

Pros:
All the meals, including snacks, are calorie-counted, portion-controlled and delivered to your door. You eat real food, receive telephone support and learn about portion size, calories and exercise, which can all help you make healthier choices beyond the programme.

Cons:
The meals don’t contain fruit, veg or dairy, which will be an additional expense. This isn’t an approach that you can stick to in the long term so it’s vital to learn how to prepare or choose healthy food yourself rather than relying on someone else.

BDA verdict:
If you don’t like the Jenny Craig meals then this diet won’t work for you. If you want a diet where most of the work is done for you then the Jenny Craig programme can be a good solution. The concern with pre-packaged meals is whether dieters will realise there is no magic trick and be able to replicate the meals, with the same portion sizes and calories, once they are on their own.

10 myths about stop smoking treatments

NHS Choices — Mon, 12 Dec 2011 10:09:00 GMT

10 myths about stop smoking treatments

There are many myths and misconceptions surrounding stop smoking medicines such as nicotine replacement therapy (NRT) and prescription tablets. Here are 10 common myths, and the truth behind them.

Types of NRT:

patches
gum
mouth spray
nasal spray
lozenges
microtabs - tablets you put under your tongue which dissolve and release nicotine
inhalator - a plastic mouthpiece plus nicotine cartridges that you draw on like a cigarette, releasing nicotine vapour into your mouth and throat (not lungs)

Quitting smoking isn’t easy. But a growing number of stop smoking medicines make it easier than ever for you to break your addiction to nicotine.

The three types of NHS-endorsed stop smoking aids available to help you quit are:

nicotine replacement therapy (including patches, gum, lozenges, microtabs, inhalators and mouth and nasal sprays)
Champix (varenicline) tablets
Zyban (bupropion) tablets

An NHS stop smoking adviser can help you find the medication that suits you, but you can try them in any order and sometimes more than one product can be used at the same time. They are generally used for 12 weeks, with the option of using them for longer if you need to.

Read more about stop smoking treatments.

1. MYTH: Stop smoking treatments don’t really work

THE FACTS: Research suggests that nicotine replacement therapies and the prescription stop smoking tablets (Champix and Zyban) can double and sometimes even triple your chances of successfully quitting.

All stop smoking treatments work best when used as part of a programme that includes:

setting a quit date
having a plan for dealing with things that make you reach for a cigarette
getting support from a doctor or trained stop smoking adviser

2. MYTH: Nicotine therapy causes cancer

THE FACTS: This is wrong. Nicotine doesn’t cause cancer. It’s the other toxic chemicals in cigarettes, such as tar and carbon monoxide, that damage your health. Nicotine replacement therapy gets nicotine into your body without the dangerous poisons.

3. MYTH: It's dangerous to use more than one nicotine replacement product at a time

THE FACTS: No, it isn’t. In fact, using more than one product at a time – known as combination therapy – can be a good thing as it often increases your chances of success. A popular strategy is to use nicotine patches to reduce everyday cravings plus a nasal spray, gum, lozenges, inhalator or mouth spray for sudden cravings.

Read more about how to cope with cravings.

4. MYTH: Champix will make me feel depressed

THE FACTS: Champix has been linked with occasional reports of depression and even suicidal thoughts. However, it’s not clear whether these side effects were due to the medicine or quitting smoking, and for most people it’s perfectly safe.

Talk over any concerns with your doctor or NHS stop smoking adviser beforehand, especially if you’ve had depression or another mental illness before. Be aware of your moods while you’re taking the tablets and tell your doctor if you notice any change.

5. MYTH: Nicotine replacement therapy is expensive

THE FACTS: You can get NRT either free, or on prescription at a cost of £7.20 each week, from your local NHS Stop Smoking Service or your GP. That’s up to a third cheaper than buying your patches or gum from the pharmacy and is a lot cheaper than continuing to smoke.

As with a lot of medication, it’s important to complete the full course, in this case to make sure you’re properly weaned off nicotine.

Zyban and Champix are nicotine-free pills you take to reduce your craving for tobacco and help with withdrawal symptoms. In studies, Champix has been shown to work better than Zyban.

6. MYTH: Stop smoking treatments will cure me

THE FACTS: NRT and prescription medicines are not a miracle cure. They reduce cravings and withdrawal symptoms but they don’t make them go away completely.

You will still need to put a lot of effort into quitting but, as thousands of ex-smokers will testify, the medications really help.

7. MYTH: I can’t use stop smoking treatments if I’m pregnant

THE FACTS: If you’re pregnant, it’s a great time to quit as smoking is much more dangerous to you and your baby.

Talk to your stop smoking adviser or midwife about your treatment options as the prescription tablets Champix and Zyban are not recommended in pregnancy. However, NRT products such as patches, gum, lozenges, microtabs, the inhalator and nasal sprays may be recommended if you're finding it hard to quit.

You can also call the NHS Pregnancy Smoking Helpline on 0800 169 9 169.

Read about stopping smoking in pregnancy.

8. MYTH: I’ve had a heart attack so I can’t use NRT

THE FACTS: Nicotine replacement therapy has been shown to be safe in most people with heart disease. However, because nicotine can increase your heart rate and blood pressure, it’s a good idea to talk to your doctor before using nicotine replacement products if you’ve had a heart attack or if you have serious heart problems, such as an irregular or rapid heartbeat (arrhythmia) or chest pain (angina).

9. MYTH: Nicotine replacement products are as addictive as smoking

THE FACTS: Most people using nicotine products do not become dependent on them. In fact, the biggest problem with NRT is that people don't use enough of it for long enough. The nicotine from patches, gum and so on is released into your system much more slowly and in a different way than nicotine from a cigarette. Your body absorbs it more slowly and less reaches your brain.

10. MYTH: I shouldn't take Zyban because it causes seizures

THE FACTS: There is a very small risk of having seizures (fits) when using Zyban. The risk increases if you’ve had seizures in the past. Therefore, it isn’t recommended for anyone with a condition such as epilepsy.

NHS stop smoking advisers help you quit

NHS Choices — Tue, 06 Dec 2011 12:47:00 GMT

NHS stop smoking advisers help you quit

NHS stop smoking advisers are free, friendly and flexible and can massively boost your chances of quitting for good.

Find your local NHS Stop Smoking Service in:

Did you know that wherever you live in the UK, you have easy access to a free service that’s proven to help you stop smoking?

The NHS Stop Smoking Service is a national network of advisers who are trained to help you quit. They will give you accurate information and advice on how to quit, and give you professional support during the first few weeks after you have stopped smoking.

They also make it easy and affordable for you to get stop smoking treatment, such as Champix (varenicline) or Zyban (bupropion) if it’s suitable for you, or nicotine replacement therapy such as patches and gum.

You will normally be offered a one-to-one appointment with an adviser, but many areas also offer group and drop-in services as well. Depending on where you live, the venue could be a local GP surgery, pharmacy, high street shop or even a mobile bus clinic.

Jennifer Percival, who trains NHS stop smoking advisers, says that a combination of support and treatment is proven to give you the best chance of stopping smoking.

“The majority of people who see an adviser will get through the first month after quitting without smoking a cigarette. And overall, you’re up to four times more likely to stop smoking for good if you receive help from an NHS Stop Smoking Service,” she says.

How to contact a stop smoking adviser

Your GP can refer you, or you can phone your local NHS Stop Smoking Service to make an appointment with an adviser:

In England

Find stop smoking services in England.
Call the free NHS Smokefree Helpline on 0800 022 4332.

In Scotland

Find stop smoking services in Scotland.
Call the free Smokeline on 0800 84 84 84.

In Wales

Call the free Stop Smoking Wales Helpline on 0800 085 2219.

In Northern Ireland

Call the free Smokers’ Helpline on 0800 85 85 85.

What happens at the first stop smoking session?

At your first meeting with an adviser, you’ll talk about why you smoke and why you want to quit, as well as any past attempts to quit that you've made. You'll also be able to decide on a quit date.

You’ll be offered a breath test which shows the level of carbon monoxide (a poisonous gas in cigarette smoke) in your body.

“You don’t need to be sure you want to quit or have a quit plan in mind before this meeting,” says Jennifer. “You can use the time to talk your situation through with the adviser without making a commitment. If you do decide to quit, the adviser can help you form an action plan and set a quit date, usually in a week or so.”

Stop smoking aids

At your first session, you’ll also discuss NHS-endorsed treatments available to help you stop smoking. These are nicotine replacement therapy – including patches, gum, lozenges, microtabs, inhalators and mouth and nasal sprays – and the stop smoking tablets Champix (varenicline) and Zyban (bupropion).

“No one is forced to use treatment,” says Jennifer, “but we will encourage it because the results are better. All the treatments we recommend can double your chances of quitting.

“We can help you decide which type of treatment is right for you and how to use it. In some cases, we can directly supply you with the treatment before you leave, or we can arrange for you to receive a prescription or a voucher for it. In the case of nicotine replacement therapy, it often works out at least a third cheaper than buying it from a pharmacy.”

She points out that NHS advisers only provide evidence-based treatments. “We won’t suggest or recommend hypnosis or acupuncture as there’s not enough evidence they help you stop smoking.”

Read more about stop smoking treatments.

Preventing relapse

As a general rule, you will have weekly face-to-face or phone contact with your adviser for the first four weeks after you quit smoking, then less frequently for a further eight weeks.

At each meeting, you’ll receive a supply of treatment or a prescription for it, and have your carbon monoxide level measured. You’ll have an emergency number for out-of-hours times when you crave a cigarette and want help to avoid lighting up.

“Going on the 12-week programme requires you to commit to not having a single puff of a cigarette,” says Jennifer. “Measuring carbon monoxide levels is not about checking up on you. It’s more to motivate you to stay smokefree by showing how you body is already recovering."

NHS stop smoking advisers are also very experienced in helping you identify difficult situations when there may be a strong temptation to relapse and start smoking. And they can help you come up with ways to cope with or avoid these situations.

“If you do relapse, we won’t judge or nag you or take it personally. We’re a friendly face that understands how difficult it is to quit, and we’ll help you get back on track to becoming a non-smoker," says Jennifer.

Find out how to cope with cravings.

Common quit smoking questions

Read the answers to common questions about stopping smoking, including:

Get tested for HIV if you think you've been at risk

NHS Choices — Tue, 29 Nov 2011 14:41:00 GMT

Get tested for HIV if you think you've been at risk

If you’re worried you could have HIV, get tested now. The sooner you are diagnosed, the better your chances of staying healthy and living a normal life span. Find out why and how to get an HIV test.

Getting tested for HIV means that, if you’re HIV positive, you can start your treatment before the infection causes too much damage to your body and health. This is known as ‘early diagnosis’.

Why to get tested

It’s important to get tested because someone with undiagnosed HIV can look and feel healthy for years, but the infection will be damaging their health. They can also pass the infection on to others.

Jason Warriner, clinical director at HIV charity the Terrence Higgins Trust (THT), says: “If the infection is diagnosed early, when a person is fit and well, and they get treatment and care, we’re looking at normal life expectancy. But they’ve got to be getting treatment and care, and it’s got to start early.”

It’s estimated that 91,500 people in the UK have HIV, and around 1 in 4 of these people (22,000 in total) don’t know they have it.

HIV is passed on via bodily fluids (such as blood, semen or vaginal fluid), for example during sex without a condom, or through sharing needles to inject drugs. Find out more about getting HIV.

Early diagnosis and treatment

Once HIV is in a person’s body, it infects and destroys cells (called CD4 cells) in the blood. CD4 cells are responsible for fighting infection, and are vital for your immune system.

If you know you have HIV, doctors can regularly test your blood to see how your immune system is doing. The tests measure the number of CD4 cells in your blood (your CD4 count), and the amount of HIV in your blood (the viral load).

Your doctor will know when it’s best for you to start HIV treatment, which is usually given as a combination of tablets. Starting treatment can raise your CD4 count and lower your viral load.

“We try to get people started on treatment when their CD4 count is 350,” says Warriner. A healthy adult who doesn’t have HIV can have a CD4 count of between 600 and 1,200. “When the CD4 gets down to 200, opportunistic infections can start, such as TB, oral candida, Kaposi’s sarcoma (KS) and pneumonia.”

Why late diagnosis is serious

If you have HIV and it isn’t treated, the HIV will eventually damage your immune system so much that you are likely to develop a serious, life-threatening condition, such as pneumonia. It typically takes about 5 to 10 years for the virus to damage the immune system in this way.

If you’re diagnosed with HIV at this stage (known as ‘late diagnosis’), antiretroviral drug treatment will work. However, your overall prognosis (your health outlook) may be affected. In 2009, half of adults diagnosed with HIV were diagnosed late.

“The vast majority of people who die from HIV are those who are diagnosed late,” says Warriner. “When people aren’t diagnosed with HIV until they present late, at A&E or their GP, with symptoms of a serious infection, then that can affect their prognosis.”

Getting an HIV test

The only way to know whether you have HIV is to have an HIV test. You may feel worried about getting tested, but if you do have HIV, the sooner you find out, the better.

You can get tested at:

sexual health clinics or genitourinary medicine (GUM) clinics at hospitals (find sexual health services near you)
your GP surgery (ask your doctor or practice nurse whether your surgery offers HIV testing)
some contraception and young people’s clinics
Fastest clinics, which are rapid testing clinics run by THT
a private clinic
an antenatal clinic, if you are pregnant
local drugs agencies, if you are an injecting drug user

It is up to you to choose where you would feel most comfortable being tested.

Prevent HIV

You can protect yourself against HIV by using a condom every time you have vaginal, anal or oral sex. This will also help prevent you passing on the infection if you have it.

Find out more about:

Foot problems and the podiatrist

NHS Choices — Fri, 11 Nov 2011 14:14:00 GMT

Foot problems and the podiatrist

A podiatrist or chiropodist can help you with common foot problems, including ingrown toenails and bunions.

What does a podiatrist do?

Podiatrists can be thought of as a type of foot doctor. They can give you and your family advice on how to look after your feet and what type of shoes to wear. They can also treat and alleviate day-to-day foot problems including:

toenail problems such as thickened, fungal or ingrown toenails
corns and calluses
verrucas
athlete's foot
smelly feet
dry and cracked heels
flat feet
bunions

How can a podiatrist help?

You may want to see a podiatrist for advice and treatment if you have painful feet, thickened or discoloured toenails, cracks or cuts in the skin, growths such as warts, scaling or peeling on the soles or any other foot-related problem.

Podiatrists can also supply orthotics, which are tailor-made insoles, padding and arch supports to relieve arch or heel pain. You put the orthotic device into your shoe to re-align your foot, take pressure off vulnerable areas of your foot or simply to make your shoes more comfortable.

Even if your feet are generally in good condition, you might consider having a single session of podiatry to have the hard skin on your feet removed, toenails clipped, to find out if you’re wearing the right shoes (take your shoes with you for specific advice on footwear) or just to check that you’re looking after your feet properly.

What’s the difference between a podiatrist and a chiropodist?

There’s no difference between a podiatrist and chiropodist, but podiatrist is a more modern name.

What happens at the consultation?

At every consultation, the podiatrist will cut your toenails, remove any hard skin and check your feet for other minor problems such as corns, calluses or verrucas. Usually, any minor problems that are picked up can be treated on the spot. It’s usually completely painless (even pleasant) and takes between 30 and 60 minutes.

Can I get podiatry on the NHS?

Yes, you can. If you want NHS podiatry treatment, the first step is to see your GP, practice nurse or health visitor. They can refer you to an NHS podiatrist if you qualify for free treatment.

Podiatry is available on the NHS free of charge in most parts of the UK, although availability will vary from region to region.

Each case is assessed individually. This means that whether or not you receive free treatment will depend on how serious your condition is and how quickly it needs to be treated.

If you have diabetes, arthritis or blood circulation problems, you’ll be given priority for NHS treatment by a chiropodist or podiatrist. Otherwise, you’ll be put on a waiting list.

If your condition is not affecting your health or mobility – such as a verruca that looks ugly but doesn’t hurt when you walk – you probably won’t be eligible for NHS podiatry.

Can I see a podiatrist at home?

If your foot problems are so bad that you find it difficult to walk, it may be possible to arrange for a chiropodist to come to your home. Tell your GP if you need to have a home visit and they should be able to find you a suitable chiropodist or podiatrist.

Can I see a podiatrist privately?

If free NHS treatment isn’t available, your GP can still refer you to a local clinic for private treatment, but you will have to pay.

You can also book an appointment with a podiatrist directly, without a GP’s referral.

You can use The Society of Chiropodists & Podiatrists' website to find a local podiatrist or chiropodist.

How can I make sure the podiatrist is qualified?

Anyone who calls themselves a podiatrist or chiropodist must register with the Health Professions Council (HPC).

Go to the HPC website to check if your podiatrist or chiropodist is registered.

It’s also worth checking that they are a member of one of the following organisations:

How much does private podiatry cost?

Private fees can vary depending on where you live and the podiatrist’s experience. Ring a few local podiatry clinics to check their prices.

"Being a mentor was an amazing experience"

NHS Choices — Tue, 25 Oct 2011 14:28:00 GMT

"Being a mentor was an amazing experience"

Karen, 42, volunteered for Kids Company as a mentor for 18 months, working with a six-year-old boy from a disadvantaged background in London.

“I decided to volunteer because I saw a lot of children and young people in my neighbourhood who were missing out, through no fault of their own. I felt that I was in a good place in my life, and that I had experiences that I could share to make a positive contribution and help somebody.

"I’d heard of a local charity called Kids Company, that works with vulnerable inner-city children. The focus of the charity is entirely on the child, and aims to give them ways of leading more positive and fulfilling lives.

"The volunteer mentors help children and young people to achieve goals, build confidence and self-esteem and have some fun. Sometimes that increase in confidence comes from you encouraging them to have a go at an activity that they fancy trying but feel a bit shy about, like dancing, or a sport. Once they do it, they can gain a real sense of achievement.

"Sometimes it’s the fact that you spend one-to-one time with them, doing things that are completely focused on the child. These children may have a parent or carer that isn’t able to provide as much of that one-to-one time as they want to, for all sorts of reasons, and that’s why the mentors have such a valuable role.”

Getting started

“Once I’d approached the charity and they’d accepted my application, I had an interview, a CRB (Criminal Records Bureau) check and then two days’ group training. One day was spent learning some psychology theory, and another day with a psychologist and other potential mentors, where we talked about our life experiences and what we could bring to a mentoring relationship.

"We practiced scenarios, doing role plays, applying what we know to different situations, and then getting practical advice on what to do if your mentee, or their parent or guardian, acts in a certain way. Mostly this was about learning to deal with difficult behaviour, in case it should arise. So, for example, how to talk to your mentee if they behave in a challenging way. It helps you to be prepared. We also attended ongoing group counselling sessions, to talk about any difficulties we may be having.”

Being a mentor

“My mentee was six when I first met him. He’s a lovely boy, very polite, funny and lively. He loves football, so I wanted to find out a lot about it. He was always impressed if I could say which club a certain footballer played for, or talked to him about his football cards. It helped to build a relationship and a rapport with him.

"My role was described by the charity as a skilled helper; you don’t try to be another parent or a social worker. My time with him was about taking him out, and letting him enjoy himself, and offer him some fun. We had a lot of trips out; we went to the beach by train, we spent an afternoon at London Zoo, and I took him to the Maritime Museum. But, most of all he enjoyed physical activities, like playing football in the park, going to an adventure playground, and swimming.

"I gradually introduced some interesting facts and topics of conversation, found out what he enjoyed at school, and encouraged him to do a bit of reading. My aim was to stimulate his thinking and build on his interests.

"For the mentors that work with older children, teenagers and young people, it’s more about helping them with life skills. So mentors can explain what they do for a living, and maybe use this as an opportunity to help the mentees find out what they might enjoy doing as a job, and find their place in life.

"I spent four hours with my mentee every other weekend. We were asked to spend a minumim of an hour a week, but you have to think about what would be beneficial for the mentee, and to make sure you have enough time to gain their trust and build up a bit of a rapport, as well as time to do an activity together.

"Mentors had to complete paperwork after every session, which included a brief run-through of what we’d done, some observations about the child, what they seemed to enjoy, and so on. Plus, we would have to alert the charity if there was an issue we were concerned about, for instance if we felt that the child’s safety was at risk.

"The charity asks that you commit to a child for a minimum of six months, and I did it for 18 months. I felt as though we covered a lot of ground in that time, which was great for both of us.”

I’d recommend it to anyone

“Mentoring is one of the best things I’ve ever done. You shouldn’t expect to get a thank you as such, but it’s a really rewarding experience; it had a great feelgood factor. Being able to connect with my mentee felt like such an achievement, and making a positive impact on his life gave me a real sense of purpose.

"I learnt a lot about myself through this experience, too. It taught me that my assumptions about life weren’t always right, and that you never really know what people’s circumstances are until you get to know them. I try not to judge people so much.

"I would recommend mentoring to anyone. Everybody has some experience they could share with someone else, and it can be a meaningful exchange for both sides. I was surprised to find that all sorts of people, from every background and all ages, enjoy mentoring. I definitely plan to be a mentor again in the future.”

Teeth whitening

NHS Choices — Fri, 21 Oct 2011 13:39:00 GMT

Teeth whitening

More and more people are paying for brighter, whiter teeth. But does teeth whitening work and is it safe? Here are the answers to common questions about the treatment.

What is teeth whitening?

Teeth whitening involves bleaching your teeth to make them lighter. Teeth whitening can’t make your teeth brilliant white, but it can lighten the existing colour by several shades.

Who can perform teeth whitening?

The General Dental Council, the organisation that regulates dental professionals in the UK, has decided that teeth whitening is a form of dentistry. This means that you should only have your teeth whitened by a dentist or another dental professional, such as a dental hygienist or dental therapist, on the prescription of a dentist.

Some beauty salons offer teeth whitening, but this is illegal if there's no dental professional present, and it may put your oral health at risk.

You can also buy DIY home teeth whitening kits but these may also carry risks.

What happens during teeth whitening at the dentist?

If you have teeth whitening you will need to make several visits to the dental surgery over a couple of months.

The dentist will take an impression of your teeth to make a mouthguard and will instruct you how to use it with a bleaching gel. Then, using your mouthguard at home, you regularly apply the gel for a specified period of time over two to four weeks. Some whitening gels can be left on for up to eight hours at a time, which shortens the treatment period to one week.

Another type of teeth whitening system that a dentist can provide is called laser whitening, which is also known as power whitening. This is where a bleaching product is painted onto your teeth and then a light or laser is shone on them to activate the whitening. Laser whitening takes about an hour.

Can any dentist whiten teeth?

Yes, provided they are registered with the General Dental Council. Registered dental therapists and dental hygienists can also carry out teeth whitening on the prescription of a dentist.

To find out if a dental professional is registered with the GDC you can check online or call 0845 222 4141.

What about home kits and beauty salons for teeth whitening?

As a result of the General Dental Council's decision, you should only go to a registered dental professional for teeth whitening because whitening by people who aren't qualified, for example in beauty salons, is illegal. Home kits also carry risks.

What are the risks of home kits and salon teeth whitening?

Some home kits don’t contain enough of the whitening product to be effective. More generally, if a dental professional is not doing the whitening, the mouthguard provided may not fit properly so some of the bleaching gel may leak out onto your gums and into your mouth, causing blistering and sensitivity.

Where teeth whitening is carried out in beauty salons by staff without any training or dental qualifications it not only carries a risk to your oral health, but is also illegal.

Can you have your teeth whitened on the NHS?

You can only have your teeth whitened on the NHS if there's a medical reason for it. For example, this might be to lighten teeth that have discoloured because the nerve has died.

Otherwise, teeth whitening by a dentist or other dental professional can only be done privately because it’s considered to be a cosmetic treatment. Costs vary and, as a general rule, laser whitening is more expensive than professional bleaching.

Find out which dental treatments are available on the NHS.

How do you go about getting teeth whitening?

Your dentist will advise you whether whitening is right for you. It may be that teeth whitening isn’t suitable, for example if you have gum disease or crowns.

Find your nearest dentist here.

What questions should I ask the dentist before going ahead?

Don’t be afraid to ask simple questions about the types of whitening treatment available, what results you can expect and whether the work is guaranteed for a certain amount of time. Also, ask them what they consider to be the risks in your particular case, for example increasing sensitivity of the teeth.

Try to talk to other people who have had the same treatment or visit another dentist for a second opinion until you feel confident. Always ask for a written treatment plan and price estimate before going ahead.

Is teeth whitening permanent?

No, teeth whitening isn’t permanent. It can last from a few months to up to three years, but this varies from person to person. Generally, the whitening effect won’t last as long if you smoke or drink red wine, tea or coffee, which can all stain your teeth.

Will teeth whitening work on false teeth?

No. Teeth whitening won’t work on dentures, crowns, fillings or veneers.

What are the risks of teeth whitening?

No matter what treatment you use, there is a chance your gums can be sensitive to the chemicals used in teeth whitening, especially if you already have sensitive teeth. There’s also a chance of burns to gums and some of the whitening kits used at home can harm tooth enamel.

What if I’m not happy with the results?

If you’re concerned that teeth whitening by a dental professional has harmed you, contact the Dental Complaints Service on 08456 120540. This is an expert, free and independent service that can help if you have a complaint about private dental care.

If you think your teeth whitening has been carried out illegally (that is, by someone not qualified or registered to perform it) contact the General Dental Council on 0845 222 4141 or email illegalpractice@gdc-uk.org.

Read more about how to look after your teeth.

'Cystic fibrosis won't stop me singing'

NHS Choices — Thu, 13 Oct 2011 11:08:00 GMT

'Cystic fibrosis won't stop me singing'

Despite having a serious health condition, 22-year-old Bianca Nicholas has recorded her first single and dreams of becoming a professional recording artist.

What is cystic fibrosis?

Cystic fibrosis (CF) is one of the UK’s most common life-threatening inherited diseases.
Cystic fibrosis affects more than 9,000 people in the UK.
The disease affects the internal organs, especially the lungs and digestive system, by clogging them with thick, sticky mucus. This makes it hard to breathe and digest food.
There is no cure for CF, but there are therapies and medicines to make it easier to live with the condition.

Thousands of young women in the UK dream of becoming pop stars, but few have a serious illness to contend with on top of their musical commitments.

Bianca Nicholas from Beckenham in Kent has sung a duet with Will Young and performed for Prince William and Prince Harry and the Duchess of Cambridge. She’s just launched her debut single, Hold On To Your Dreams.

Bianca also has cystic fibrosis, an inherited disease which causes the internal organs, especially the lungs and digestive system, to become clogged with thick, sticky mucus. Symptoms of cystic fibrosis include a troublesome cough, repeated chest infections, digestion problems and poor weight gain.

The illness requires rigorous physiotherapy and medication. Each day, Bianca has to spend up to 20 minutes doing breathing exercises and takes between 30 and 40 tablets as well as using nebulisers and inhalers. She also has to inject herself each morning with growth hormone.

But she hasn’t allowed her illness to blight her passion for music. “My therapies and treatments are time-consuming and sometimes my illness get me down, but I find that singing really lifts my mood and cheers me up,” she says.

Bianca’s musical career started when, at 15, she was granted a wish by Starlight Children’s Foundation, a national charity that brightens the lives of seriously and terminally ill children by granting them once-in-a-lifetime wishes and providing entertainment in hospitals and hospices. Starlight arranged for Bianca to go to a top recording studio in London and record a number of cover singles for a special CD.

Bianca has gone on to sing live at many Cystic Fibrosis Trust and Starlight events over the last seven years, including the recent Boodles Boxing Ball where she launched her single by singing live in front of 850 high-profile guests, including Pippa Middleton and former Spice Girl Geri Halliwell.

As well as boosting her confidence, Bianca believes her singing has also improved her physical health.

One of the many effects of cystic fibrosis is that breathing is very difficult because of sticky mucus in the lungs. Bianca thinks that her singing helps to keep her lungs clear.

“I used to need to have my chest pummelled each morning to clear the mucus, but since I’ve been singing, my lungs have been clearer, and I generally only need to do breathing exercises. Singing is a type of deep breathing exercise and I feel it helps to strengthen my lungs, which in turn seems to help my condition.

“Having cystic fibrosis has never stopped me from trying to realise my dreams. I feel so lucky that the one thing I love doing more than anything else, singing, is keeping me healthy too.”

Why most of us should eat fewer calories

NHS Choices — Wed, 12 Oct 2011 14:56:00 GMT

Why most of us should eat fewer calories

Many of us are eating too much, and not being active enough. That’s why nearly two thirds of the adult population in England is overweight or obese.

Find out how much you should be eating, and how to cut the calories.

The latest research shows that in England over 60% of adults are overweight or obese. That means many of us are eating more than we need, and need to eat less.

Over time, consuming more calories than we need leads to weight gain, and carrying excess weight puts us at greater risk of a whole range of serious health problems

And it’s not just food we need to cut down on: some drinks can also be high in calories.

When we eat and drink more calories than we need, our bodies store the excess as body fat. If this continues over time we become overweight, and can become obese. Being overweight or obese causes an increased risk of type 2 diabetes, heart disease, stroke and some cancers.

Most adults need to lose weight, and to do this they need to eat and drink fewer calories. Combining these changes with increased physical activity is the best way to achieve a healthier weight.

You can find out whether you are a healthy weight by using our Healthy weight calculator.

How much should you eat?

The amount that you need to eat to maintain your body weight depends on a range of factors, including your size and how physically active you are.

As a guide the average man needs around 2,500 calories a day to maintain a healthy body weight, and the average woman needs around 2,000 calories a day.

Remember, if you are very physically active because of the type of job you do, or you are a professional athlete, you may need more calories than this to maintain a healthy weight. If you do very little physical activity – for example, you are housebound – or if you are overweight or obese, you may need fewer calories.

An important part of a healthy diet is eating the right amount of calories, so that you balance the energy you put into your body with the energy you use.

If you need to lose weight, aim to lose about 0.5-1kg (1-2Ib) a week until you reach a healthy weight for your height. You should be able to lose this amount if you eat and drink about 500 to 600 calories fewer a day than you need.

A healthy diet is not only about eating the right amount. It also means eating a wide range of foods, to ensure you get all the nutrients you need. You can still eat less when following a balanced diet. Learn more about a balanced diet in The eatwell plate.

How much are you eating?

Most of us are eating and drinking more than we need, and we often think we are more active than we actually are, too.

It is estimated that the average person eats around 10% more calories than they need every day. This might not sound much, but over time it will cause significant weight gain.

Foods and drinks that are high in fat or sugar contain lots of calories, and eating or drinking these often or in large amounts can make it easy to have more calories than you need.

If you are overweight or obese, you could be eating over 500 calories more than a person of a healthy weight does every day. So it’s time to think about where your extra calories are coming from, and to make changes to your diet to reduce the number of calories you consume.

It is likely that it’s not just one snack, meal or drink that you need to change: you are likely to be having more calories than you need across the whole day.

As a guide, the average man needs around 2,500 calories a day to maintain a healthy body weight, and the average woman needs around 2,000 calories a day

How you can eat less

You can reduce the number of calories you eat by making healthier choices when it comes to food and drink.

Often, that will mean swapping high fat or high-sugar foods for alternatives that contain fewer calories, or eating these foods in smaller portions or less often.

And it’s not just foods: drinks can be high in calories, too. To consume fewer calories you should choose drinks that are lower in fat and sugar or consume high-calorie drinks less often. Don't forget alcohol is also high in calories.

As well as choosing foods and drinks lower in fat and sugars, also think about reducing the size of your portions. Research suggests that we tend to eat more when we are served more, even when we don’t need the extra calories.

When serving yourself at home resist filling your plate, and think about if you are really hungry before having an extra helping. When eating out, avoid supersizing or choosing large portions of food or drink.

Knowing the calorie content of different foods and drinks can be useful when it comes to achieving or maintaining a healthy weight. It can help us to keep track of the amount of energy we put into our bodies, and ensure that we are not eating too much.

The calorie content of many foods and drinks is provided on the packaging as part of the nutrition label. You can look at the calorie figure to assess how a particular food or drink fits into your daily intake. Find out more in Understanding calories.

These tips can help you to get started:

Swap sugary fizzy drinks for diet versions with low or no calories. Even better, swap some soft drinks for sparkling water with a slice of lemon.
Swap the frying pan for the grill when cooking meat, you don’t need to add any oil.
Swap creamy or cheesy sauces for tomato or vegetable-based sauces on your pasta, or meat and fish dishes.
Choose wholegrains, including wholemeal and wholegrain bread, or wholegrain breakfast cereals. Wholegrain foods contain more fibre and other nutrients, and we digest wholegrain foods more slowly so they can help make us feel fuller for longer.
Swap a cake or biscuits for a currant bun, or some malt loaf, plain or with reduced-fat spread.
Read food labels: they can help you choose foods that are lower in calories, as well as lower in saturated fat and sugars.
Alcohol is also high in calories, so cutting down could help you control your weight.

Get more active

If you are overweight or obese, you should combine eating fewer calories with more physical activity in order to gradually lose weight and help you to keep the weight off.

Adults should do at least 150 minutes of moderate-intensity aerobic activity a week. Moderate-intensity activity means an activity that causes your heart rate to rise, and you to break a sweat: for example, fast walking or cycling.

You can split the 150 minutes into 30 minutes on five days of the week, and split that 30 minutes into sessions of at least 10 minutes. Physical activity can help you to achieve a healthy weight, and brings a range of other important health benefits.

After getting active, remember not to reward yourself with a treat that is high in calories. If you feel hungry from your activity try to choose foods or drinks that are lower in calories but still filling.

Learn more in 150 minutes your way.

Learn more

If you currently eat too much, then making changes towards a healthy, balanced diet will also help you to reduce the number of calories you eat and drink, as well as helping to make sure that you get all the nutrients you need.

You can learn about the foods we need to eat for a balanced diet in The eatwell plate.
Read about the steps you can take towards a healthy diet in Eight tips for healthy eating.
Get tips on cutting down on saturated fat in Eat less saturated fat.
Get tips on cutting down on sugar in Sugars.
Get tips on weight loss in Start losing weight.