Downsizing - Prologue

How I lost eight stone, reversed my diabetes and regained my health

In advance of the publication of Lose Weight 4 Life, I am grateful to my publishers for giving permission to serialise my first health book, Downsizing, exclusively to readers of this newsletter. I’ll be sending a new chapter each Wednesday morning.

On a chilly evening in December 2012 I attended a festive get-together hosted by a former colleague. Leanne Johnstone had worked alongside Gordon Brown in Downing Street for a couple of years – she’d organised his diary – but had relocated to the United States in 2010. She returned to England every Christmas to spend time with her extended family, though, and this particular year had also decided to organise a meet-up in a central London pub for her old Westminster friends.

"The place was full of familiar faces, including a clutch of MPs and civil servants. With a pint of Guinness in one hand and a pork pie in the other, I found myself chatting with a workmate’s husband, a consultant dermatologist by the name of Dr Sunil Chopra. I had never really spoken to him at length before, but I found him to be a really interesting and engaging character. He told me all about his research work, notably the development of an ointment to treat basal cell carcinoma, one of the world’s most prevalent cancers. ‘All being well, it’ll have the potential to save thousands of lives,’ he said. ‘That’s incredible,’ I replied. ‘Sounds like you’ve made a great breakthrough.’ Sunil then quizzed me about various parliamentary goings-on, including my involvement in the News International phone-hacking inquiry that had taken place that year. ‘Loved the way you took the Murdochs to task.’ He smiled. He was referring to the Commons’ Culture, Media and Sport select committee meeting that I’d spearheaded in the midst of the scandal. ‘I’ve got a copy of the final News of the World framed on my office wall at Westminster,’ I said, smiling back. ‘Can’t say that I miss it.’

Dr Chopra and I continued chatting for a few minutes, until our conversation hit a slight lull. I noticed him nervously running his hand through his hair, as if something was vexing him. ‘Everything all right?’ I asked. ‘Listen, Tom, I’ve really enjoyed speaking with you,’ he said, lowering his voice to a near-whisper, ‘but there’s something else I’d like to discuss, if you don’t mind.’ ‘Go ahead,’ I replied, assuming that he was going to ask me about the Tory government’s cuts to medical research, or something along those lines. ‘There’s no easy way of saying this,’ he went on, taking a deep breath, ‘but I have a feeling you may be diabetic.’

What the hell… yelled a voice in my head as I took a few moments to process this bolt from the blue. Sunil, meanwhile, shifted uneasily from one foot to the other. ‘I know I may be stepping out of line here,’ he said, ‘but I’m just a little worried that you could—’ ‘Hang on a minute,’ I interrupted, a little testily, ‘you’re assuming that just by looking at me? I mean, I know I’m overweight, but…’ ‘I’m a medic, Tom, and I just happen to know a little bit about type 2 diabetes,’ he said, offering me a sympathetic smile. ‘My hunch could be wrong – I hope it is – but I really think you need to get yourself checked out.’ ‘Maybe we should go somewhere a little more private,’ I replied, mindful of eavesdroppers in this pub full of revellers. I’d been a parliamentarian long enough to know how quickly gossip could spread through Westminster.

So, in a quiet corner away from the hubbub, Sunil outlined the various ‘markers’ that had triggered his diabetes radar. He began, perhaps unsurprisingly, with my chunky frame, which, as per usual, was clad in a black, baggy suit. I rarely weighed myself, but I guessed I was edging toward 22 stone (140 kilos). I cringed slightly as Sunil suggested that my solid pot belly could be an indicator of excess deep abdominal body fat – so-called ‘visceral’ fat – a small amount of which normally surrounds vital organs such as the liver and pancreas. This condition often pointed toward insulin insensitivity, he explained, which was a precursor to developing type 2 diabetes. My frequent trips to the loo that evening (probably averaging about three per hour) had also given him cause for concern – I hadn’t realised he was keeping a toilet tally, I told him – and he was worried about my general appearance, too, blushing slightly as he described me as ‘a little bit clammy-looking’ (he was spot on, to be fair; I never went anywhere without a pocket handkerchief to dab my damp brow). While Sunil reeled off a litany of diabetes indicators, as the strains of ‘Jingle Bell Rock’ floated across the pub, I actually felt a little sorry for him. Informing a relative stranger that he might be suffering with a serious, life-changing disease can’t have been an easy thing to do in the circumstances. ‘

Mince pie, anyone?’ said Leanne, smiling, as she approached us with a large platter of festive nibbles. I took this as my cue to bring our chat to a close. ‘Certainly not the kind of conversation I expected to have at a Christmas party, Sunil,’ I said, firmly shaking his hand, ‘but maybe I should thank you for being so honest.’ ‘Just get yourself booked in for that blood test,’ he replied, perhaps relieved that I hadn’t told him to back off and mind his own bloody business, ‘and if I were you, I’d do it sooner rather than later.’

In February 2013, having spent a few weeks mulling over this bombshell, I found myself perched on the edge of a chair in the Westminster surgery of Dr Shaukat Nazeer, awaiting the results of my blood test. My GP, in his early seventies, with a shock of greyish-white hair, scanned the all-important printout, nodded his head and confirmed that yes, with my blood glucose levels coming in at 6.7 mmol/l (millimoles per litre), I did indeed have type 2 diabetes. I had officially joined the ranks of nearly three million sufferers in the UK. ‘I must say, you don’t seem very surprised, Tom,’ he said, peering at me over his wire-rimmed spectacles. ‘No I’m not, really,’ I responded, with a shrug of the shoulders. ‘I hadn’t exactly come here expecting good news.’

Indeed, in the lead-up to my appointment I’d consulted a wide variety of books, articles and websites relating to type 2 diabetes. Although I was very wary of presupposition and self-diagnosis, there was no doubting that many of my own signs and symptoms had tallied with those that I’d read about: a constant thirst, an uncontrollable appetite and poor sleep quality, to name but a few. Dr Nazeer, with typical pragmatism, then outlined the disease that, in all likelihood, I’d probably been suffering since I was in my thirties. Type 2 diabetes, he told me, was a long-term metabolic disorder that occurred when someone was severely insulin-resistant, or when their pancreas stopped producing enough of it. ‘Insulin is a hormone that helps your cells to absorb glucose, or blood sugar,’ he said. ‘If it’s lacking, or if you don’t respond well to it, too much glucose stays in the blood, and not enough reaches the body’s cells. And it’s that deficiency that makes you feel tired and hungry.’ ‘That makes sense, I guess,’ I said. ‘But what you need to realise, Tom, is that diabetes is a very serious condition,’ he added. ‘Raised blood sugars can increase the risk of strokes and cardiovascular disease, and can cause kidney, nerve and eye damage, so it’s really important you keep this under control.’ Given these circumstances, I’d have to get used to monitoring my blood sugar, which would be measured in two ways. Firstly, Dr Nazeer would regularly check my long-term glucose levels via the haemoglobin A1c (HbA1c) test, a basic but effective method that would ascertain how I was managing my condition. Secondly, I could also monitor things on a daily basis myself, using a finger-prick and test strips.

Dr Nazeer then wrote out a prescription for a powerful drug called metformin, which, all being well, would help to regulate my blood sugar levels, thus easing my symptoms and slowing down the disease’s progress. He also assigned me to a dedicated diabetes nurse, who I’d visit for regular check-ups and weigh-ins, and referred me to a consultant endocrinologist, who’d help me to gain a better understanding of the illness. In addition, I’d receive one-to-one advice from a specialist nutritionist, who’d assess and address my dietary habits.

I left the surgery and took a taxi home, feeling totally and utterly deflated. While the diagnosis hadn’t come as a surprise, the prognosis had knocked me sideways. I had been given the distinct impression that my type 2 diabetes was irreversible, that I’d be popping pills for the rest of my days and that I’d be shackled with this chronic and debilitating condition for ever. I felt like I’d been dished out a life sentence.

Tom’s sequel to Downsizing is published on 23rd June. Lose weight 4 Life is a blueprint for long term, sustainable weight loss.