Text: Interview by William Türler
Photo: Philippe Getaz

“You have to be aware of your sensations.”

To truly enjoy a meal, people need to focus on the present moment and tune out all other interference. That’s what is recommended by Véronique Di Vetta, dietitian with the Obesity Prevention and Treatment Consultations Unit at the CHUV. Interview.

IV What recommendations would you give to someone who wants to control their appetite?
VDV They should ask themselves four main questions. Am I hungry when I eat? Am I aware that I’m eating? Do I know how to recognise when I’ve eaten enough? Does my meal satisfy me? This is a key point in distinguishing between hunger and the urge to eat. Hunger is a physiological sensation that is generally felt every four hours. It arises with a slight drop in blood sugar level resulting in a hollow feeling in the stomach, weakness or even irritability. The urge to eat more often leads to overeating, but these cravings can also be triggered by wanting to compensate for emotions such as sadness or anger.

IV How do we know when we’re full?
VDV You have to be aware of your sensations. The feeling of satiety comes after twenty minutes or so. That’s why it’s essential to eat more slowly and chew thoroughly. Putting off meal times makes it more difficult to perceive your sensations. Hunger will be stronger, so you risk eating faster and therefore overeating.

IV Stevia is a sugar substitute currently on everyone’s lips. What are its nutritional properties?
VDV Extracts from the Stevia rebaudiana plant are used to produce this no-calorie sweetener that has gained popularity due to its reputation for being “natural”. The problem is that this type of product maintains people’s sweet tooth, which is not what we want. I would instead suggest consuming regular sugar, but in smaller amounts. That said, stevia can temporarily help someone who wants to reduce their caloric intake. And the other advantage is that it doesn’t cause cavities.

IV In short, how can we maximise satisfaction from a meal?
VDV It is important to make your meal time a full experience, to focus on the taste, texture and smell of food, without doing anything else at the same time (computer, TV, reading). Eating should be a time of pleasure, a break. Meals should be taken seated at a table, in a calm environment, so that you can savour the food.

“I was desperate”

OO.* is currently about age 50. She is a former patient from the Obesity Centre at the CHUV and agreed to meet with In Vivo to share her experience of stabilising at a weight of about 90 kilos, down from 120 kilos.

“I never exercised again after finishing school. I kept gaining weight until I reached 120 kilos, at 1.68 metres tall. I knew that I was moving in the wrong direction. In 2009, I realised that I couldn’t stand anything sweet. I would break into a sweat, get headaches and felt incredibly tired. So I decided to change my eating habits, by eating less and avoiding sweet foods. But I still felt sharp hunger pangs.

“And I wasn’t losing any weight. Two years later, I got very sick with a bad cold. For seven days, I could only drink smoothies and mineral water. For the rest of the month, I ate perhaps one-fifth of what I would normally eat. And again, I hardly lost any weight, barely 2 kilos. That wasn’t normal. I was desperate.

“I was having trouble walking, suffered from tachycardia and felt intense pain in my hips. I decided to make an appointment at the Obesity Centre at the CHUV because I really wanted all that to change. We planned on doing a gastric bypass. This surgical procedure reduces the size of the stomach and reconstructs the gastro-intestinal tract, but the operation requires extremely restrictive, lifelong commitments. Plus, you are supposed to eat more proteins and starches rather than vegetables. I love vegetables!

“For me, it wasn’t the natural choice. We finally opted for another solution. I was prescribed metformin, a drug used to reduce glucose intolerance and regulate metabolic processes. It was very effective on me. I quickly felt less hungry and lost about 20 kilos in a few months. By the end of 2012, my weight had stabilised at about 90 kilos. Today, I still take metformin every morning and evening, for a total of 2 grams per day. I try to eat vegetables as much as possible and avoid eating too much in the evening. I also avoid soft drinks, instead drinking fruit juice. I don’t feel any side effects, and my weight has remained stable.”

*Name given to the reporting staff