Downsizing

by Tom Watson

  As it transpired, of course, circumstances around my fiftieth birthday prompted me to flick that mental switch and make a stark decision. I was the father of two beautiful children. I was a Member of Parliament. My life ought to have been a joy, not a trial. I could no longer bear the guilt of looking at my son and daughter and thinking that, if I didn’t do something, I might not be around to see them off to university, or to take Malachy to the pub for his first pint, or to give Saoirse away at her wedding. I went to war against my own diabetes not only because I wanted to save my own life, but also to be present in my kids’ lives.

  By now you’ll know how I addressed and tackled my type 2 diabetes. And you’ll know that my life has been totally transformed as a result. The impact of putting my condition into remission, and regaining my health, has gone far beyond shedding the pounds and sharpening my fitness. I have more energy and enthusiasm. I have a keener focus and a calmer disposition. I enjoy restorative sleep and rejuvenated mornings. Conquering your illness is an exhilarating experience. You discover a new zest for life, and a new zeal for the future. And, soon enough, friends, family and colleagues begin to notice the difference.

  ‘You’ve become much more kind and considerate since you lost the weight, Tom,’ someone very close to me remarked recently. ‘You’re like a different person, in fact.’

  I confess that I look back at some of my ‘old self’ behaviour with great shame and regret, probably in the same way that a reformed alcoholic reflects upon their days of excess boozing. Had I not been hampered by the double whammy of brain fog and body fatigue, I’d have been able to engage with my family and my colleagues much more meaningfully. With a clearer head, no doubt I could have read more books, and absorbed more knowledge. With more acuity and lucidity, maybe I could have performed better in some elements of my parliamentary work. I recently watched some of my archive Commons performances, and it was truly eye-opening. One in particular – a 2002 intervention demanding better diagnostic tests in sport, with reference to the brain trauma sustained by the late West Brom footballer, Jeff Astle – didn’t exactly show me in my best light. It was far too verbose – verging on the rambling, in fact – and it lacked sharpness. As I played it back, I wondered whether I was in the throes of a diabetic ‘hypo’ that afternoon, due to a dip in my blood glucose levels. One thing’s for sure: I’d have definitely headed for the Commons vending machine straight afterwards for my obligatory KitKat Chunky.

  *

  The revelation of my diagnosis at the ukactive Conference in 2018 (and having also spoken about it earlier on Good Morning Britain) proved to be a momentous step on my health journey. The prospect of speaking at the conference concerned me for two reasons. Firstly, by confessing that I was a T2D sufferer, I was publicly revealing something that could be construed as a weakness (not always a good move for a politician); and secondly, by talking about my recovery, I was adding to the diabetes-shaming narrative that places the onus on you to fix yourself post-diagnosis, because you’re at fault. As it turned out, opening up about my condition was liberating, and explaining how I’d driven my diabetes into remission unburdened me of a heavy weight. I really needn’t have been so nervous, either, since the response from my audience couldn’t have been more warm and encouraging.

  It is, of course, an intensely personal decision as to whether you openly discuss your own health matters, but, for people in the public eye, I believe such candour can have a hugely positive impact. Just sitting in a TV studio and saying ‘Guess what, I’m a type 2 diabetic’ can have an amazing ripple effect, in that it can resonate with millions of people across the nation. I would really love to see more high-profile individuals leading the way. Imagine if a world-famous actor or musician was prepared to speak out in public about their experience of living with T2D? It would make it so much easier to have a national debate about various issues that could ultimately save countless lives.

  In retrospect, I wished I’d had the courage to open up about my condition sooner, as I might have been able to influence public policy much earlier. But I was so glad that, in the end, I plucked up the courage to say my piece. My ukactive speech, and the ensuing media coverage, unleashed a huge wave of emails containing stories from type 2 diabetes sufferers across the country, some of whom were still battling with the disease and some of whom, like me, had managed to conquer it. Tellingly, and touchingly, I received many messages from men in their forties and fifties without a formal medical diagnosis who, having seen me on the telly, had recognised their own symptoms. As a consequence, they’d been prompted to visit their GP, or to confide in their partners, or both.

  Others who’d trodden similar paths to mine got in touch, too.

  ‘Hi Tom,’ began one of the emails that hit my inbox that autumn. ‘Lots of fellow diabetics want to join you in your plight. We have reversed the condition in exactly the same way. Low carb. It’s so exciting to read about your goals. Please count us in. We are here to support you and take forward the cause any way we can. Changes need to happen and the faster the better. Thanks.’

  ‘Well done in your “battle” with type 2 diabetes,’ commented the husband of a T2D patient. ‘My wife has also done well by sorting out both her diet and her exercise levels. I am really proud of her for her efforts, and I am glad to read of another sufferer who has decided to tackle the problem face-on.’

  ‘Congratulations, Tom! Bravo!’ wrote a well-wisher. ‘Well done and best wishes for a healthy future. Best thing you’ve done so far for the British people (and probably the world). For the mass target population (when you’re in government) we surely need the food industry to co-operate and almost certainly some amount of legislation (and never mind the misplaced howls of “nanny state” from the usual quarters). All best.’

  Once my diagnosis was in the public domain, I soon found myself deploying my ultra-sensitive T2D radar. Sometimes I’d spot a colleague with a telltale clammy face and protruding belly – just as I’d exhibited, back in the day – and would try to find a tactful way in which to broach this most sensitive of issues. I felt compelled to do so; I had developed an almost evangelical desire to get the early-diagnosis message out there.

  ‘Hi mate, how are you doing these days?’ I’d ask as we both filed into the Commons voting lobby, purposely initiating a conversation that, I hoped, would be rounded off with a friendly suggestion to perhaps visit a GP, or consider getting a blood test. I couldn’t bear the thought of anyone suffering with ill-health, like I’d done for so long.

  I grew up in the trade union movement and, since then, every aspect of my politics has been shaped and underpinned by the principles of endeavour and collective action. The power of that movement, after all, was to take what were private and individual tragedies (which were often tinged with shame) and turn them into a shared struggle for justice. Whether it was someone unfairly losing their job, experiencing bullying at work or being paid less due to their gender, these inequities would be addressed and resolved together, in partnership.

  I believe that we diabetics ought to take a leaf out of the trade union playbook. We should speak up, in unison, about what we need. That way we will be harder to ignore. That way, too, the personal battle we each face – to obtain the information, the support and the treatment that we require – will be taken out of the private sphere of the doctor’s surgery and into the public realm of governance, where the big decisions are made.

  Sadly, the political class continue to ignore us. The lazy stereotype of diabetics – that we are fat, indolent and lacking in self-control and self-respect – is a powerful one, and it gives politicians (and occasionally the media) a convenient excuse to turn a blind eye. We are to blame, so the logic goes, and therefore we are never the priority. We are presented as somehow less deserving than those who suffer with other illnesses.

  It is this passive disregard that leads to the ‘upstream’ spending of billions of pounds on the complications of diabetes – the amputations, the strokes, the dem
entia – that could easily be avoided ‘downstream’ (I don’t think I’m divulging any trade secrets when I confess that we British politicians aren’t exactly known for our long-termism, or for our grasp of logic).

  But what about intervening much, much earlier? What about catching people before they fall into illness? Currently, government attention in this area is focused on those presenting with pre-diabetes, whose blood sugar levels are dangerously high, but not so much that they can be diagnosed as diabetics. These people are further back on the timeline to potentially having their feet removed by an NHS surgeon or being treated for impending blindness. Naturally, it’s right and proper that we intervene at this stage – I wish that I’d been able to tackle my illness before it developed into full-blown diabetes – but the truth is that we could be starting a whole lot earlier. And in doing so we could be heading diabetes off at the pass for millions of people, before it starts to wreak significant damage. What if we could start addressing nutrition before the pre-diabetes stage?

  Years before pre-diabetes, you become obese. That’s the trigger; that’s the early warning system. So why don’t we intervene then? The honest answer from ministers is rationing or, in other words, the controlled distribution of scarce resources. Too many of us are obese for the system to cope. Too many people are heading for diabetes, meaning that government cannot spend the money up front to prevent them reaching that terrible place. Fair enough, I suppose – there isn’t infinite cash to splash – but this is such a short-sighted view, even from the depressing vantage point of a bean-counting minister.

  My despair and embarrassment about my condition has since catalysed into determination and anger. Determination to get better and to help others to do so, and anger at all those politicians and food manufacturers who get in the way of mass recovery. I am committed to fighting my corner, however. Activism is in my blood. As an MP, I’ve always been a bit of a rebel with a taste for campaigning. I’ve resigned from frontbench positions under the last three Labour leaders and I’ve fought what looked like hopeless campaigns – against the Murdoch empire, for one – and have caused so much trouble for powerful people that at one point I was followed by private investigators who rifled through my bins on a nightly basis (only to find, back then, a lot of empty takeaway containers from the local curry house). Well, I’ve got a new mission nowadays. To channel my frustrations, and your frustrations, into real action for change. We are going to turn Remission for All into a reality.

  I have, as it happens, spent much of the last two years shaking the tree at Westminster. I’ve become an agitator, an irritant. I have asked awkward parliamentary questions of Conservative ministers (a method by which MPs keep these individuals on their toes, to demonstrate that an issue is important). They have been grilled about the impact of banning the advertising of high-sugar milk products on public transport, for example (the health secretary at the time said he’d not assessed it). They’ve been asked when the government would consider expanding the sugar levy from fizzy drinks to sweetened milk products (the then chancellor replied that he had no plans to extend it).

  I suppose it’s a bit like playing political cricket; I’m bowling questions at ministers to expose deficiencies in their thinking, and holes in their strategy. I am keen to maintain the pressure because I cannot think of another policy area – at such a senior level in government – in which a huge problem has received so little bandwidth. And those ministers’ answers tell me that our government is still in complacency mode when it comes to our health, and when it comes to our kids’ chances of avoiding the same traps that have ensnared previous generations.

  Eventually, through questions and scrutiny, you can establish facts that are so strong that ministers are compelled to take action. When I was investigating phone hacking it was the disclosure that journalists had intercepted the phone of a kidnapped schoolgirl that led to the prime minister being forced to act. In the case of type 2 diabetes, I thought my revelation that over 150 diabetes-related amputations are made each week in the UK might gain some traction, and might prompt the government to further resource some targeted prevention programmes. Sadly, although my parliamentary interventions attracted a bit of newspaper coverage, very little changed. It wasn’t just type 2 diabetics who ignored their own condition; there was a national collective denial about it, too.

  There are many good people working for charities and campaign groups who are trying to support people through type 2 diabetes. Talk to the leaders of these organisations, however, and they’ll tell you that the NHS will collapse if the rate of increase in T2D continues to rise. Yet their public demands of government are incremental, when what is needed is a massive step change. Type 2 diabetes is a public health emergency. It requires powerful leadership, a paradigm shift in thinking and the focused attention of legislators, regulators, retailers and food producers. Unfortunately, I fear that the charities that seek to speak for us are captured by the same complacency as our politicians. Many of them lack ambition and urgency. And others – through dodgy deals with PepsiCo, for example – are difficult to trust.

  In the spring of 2019 I decided that I needed to stimulate some fresh thinking. I needed to encourage an injection of new ideas that were deliverable, but that were not held back by the ‘computer says no’ approach shown by many of our health establishments. Taking this into account, I set up a small independent commission, on a shoestring budget, to answer a simple question:

  How do we halt the rise of type 2 diabetes over the lifetime of a single parliament?

  I was advised not to do it this way, simply because many people think it’s impossible to achieve, such is the degradation of our food supply. Yet how long are we going to leave it before we finally admit the game is up? How many more millions of lives do we want to see blighted before we address the root cause of type 2 diabetes, namely our national diet? How long before we confront the big food conglomerates and their army of lobbyists to say that enough is enough? The high prevalence of processed foods and sugar-laden products already means that one in three pupils is leaving primary school overweight or obese, and that more teenagers than ever are being diagnosed with T2D.

  I want to include type 2 diabetes as part of the debate at a general election, and with that in mind I’m hoping that my commission will report its findings in time for the political parties to promise meaningful changes in their manifestos. That’s my hope. But the complacency found within our health and political establishment does not fill me with optimism. So I need your help. Five million type 2 diabetics demanding Remission for All would do it, I’m sure.

  The tragedy of type 2 diabetes is that, if the research is accurate, at least two million of us can rid ourselves of the condition completely with simple nutritional changes, combined with a slightly more active life. As I discovered myself, when I eradicated takeaways, processed food, refined sugar and starchy carbs – as well as upping my exercise – my blood glucose levels returned to normal, and I no longer needed to be medicated. As a result of this change in diet and behaviour, my own type 2 diabetes went into remission, and I became physically and emotionally energised.

  My experience as a type 2 diabetes sufferer has made me think much harder about tackling obesity-related health problems. The first thing we need to do, I reckon, is to scrap once and for all the ridiculous notion that we all share the same behaviours and the same body chemistry. Key to my Remission for All movement would be a call to overhaul the ‘one size fits all’ dietary guidelines endorsed by the government. Many of us with T2D need to lose weight, but that doesn’t mean that we should have to follow a standardised eating plan. This is a simple fact that all doctors and politicians need to get their heads around – I can’t stress this enough – because the current passivity about dietary guidance and treatment plans is killing people. A single model of wellness is being adopted by health authorities before being applied to everyone, ignoring the evidence that we all have different bodies, with different biochemistr
y and with different triggers.

  Of the people I know who have put their diabetes in remission, the majority have done so by ignoring Public Health England’s controversial Eatwell Guide (the more recent incarnation of the Eatwell Plate). Don’t get me wrong, it helped me, to a degree, when I was first diagnosed. It showed me that my carbohydrate intake was off the scale and way beyond the ‘normal’ range, which helped me limit (but not eliminate) the rice, chips and bread that had formed the basis of a very poor diet.

  Many prominent healthcare professionals have since debunked the high-carb, low-fat Eatwell Guide. They have instead advocated a low-carb, low-sugar eating plan as a means of not only losing weight, but also tackling blood glucose issues, with a view to putting type 2 diabetes into remission. Having assiduously researched the subject, I carefully chose to follow a ketogenic nutrition eating plan, the principles of which, no matter how they were interpreted, directly contradicted the Eatwell Guide as regards the amount of carbohydrates a person should consume. But, to me, this regimented diet was a revelation. It enabled me to tackle my sucrose addiction, and it also allowed me to control my eating habits and curb my hunger cravings. The massive weight loss that ensued then liberated me to take up exercise and become more active.

  If we’re going to really crack this crisis, we need to give bespoke nutritional advice to diabetes sufferers. We should formulate individual eating plans that correspond to a particular patient’s requirements, rather than trying to be a catch-all for the whole population. We have to offer customised diets that consider everything we know about nutrition, instead of rigidly adhering to one dietary doctrine that has somehow won through at the top, and is now carved into stone like the Ten Commandments.

  Essentially, I believe that we have to ditch the Eatwell Guide as the bible of nutritional advice. I am not saying that it’s always wrong – I’m not saying that it’s always right, either – but I do feel that its dogmatic use by NHS practitioners is often counterproductive in terms of making people better, especially those with type 2 diabetes. Although abandoning Eatwell might seem a controversial move, I’m pretty sure that most local doctors would be receptive to the idea, particularly if they received training to understand why so many voice their concerns about its inflexibility. I get the distinct impression that most GPs (and medical students, for that matter) simply don’t receive adequate training in nutritional science, and as such are left wholly dependent on the unyielding orthodoxy of official advice.