We all know, in theory, what to do to lose weight: cut down on refined carbohydrates, for example, and eat more fruit and vegetables, lean protein and essential fatty acids. Yet most of us find it almost impossible to stick to a healthier regime - even if our health is at risk.
But the citizens of Norway have a new diet guru - and his book is now on sale here. Dr Fedon Lindberg is not trumpeting any new and faddy gimmick. His book brings together his experience running one of Europe's most successful health clinics, where his unique approach has led thousands of patients to adopt lifestyle changes and - crucially - enabled them to stick to them.
Dr Lindberg is originally Greek, though his clinics are in Norway, where his book, The Greek Doctor's Diet, is a publishing sensation. It has been on the bestseller lists there for years, and a Gallup poll found that 23 per cent of the country's entire population have changed their diet as a result of reading it.
His regime is nothing new in itself. It is based on a modern version of the Mediterranean diet which, he says, "has been shown to prolong life and prevent many of our worst lifestyle diseases. It's based on minimally processed foods - fruits, vegetables, pulses, whole grains, lean protein sources and healthy fats - and it's also both low glycaemic and strongly anti-inflammatory in nature."
A major study published in April involving over 74,000 people found "a statistically significant reduction of mortality by 8 per cent for every 2 points you get closer to the Mediterranean diet, on a scale from 0 to 10". An 18 month intervention study on 200 subjects to see how much Dr Lindberg's diet can reduce risk factors is currently under way at Oslo University.
So what makes Dr Lindberg's approach so effective? His crucial insight is that it's no good telling people to change, you have to help them. "Compliance is a key issue," says Dr Lindberg, "and making lifestyle changes is like trying to write with the wrong hand. You can do it but it takes effort and you have to have a good reason to begin with."
Dr Lindberg has four clinics in Norway, which have now treated 12,000 patients, mainly with weight, heart and cardiovascular problems. Two more are due to open in Sweden and Spain later this year. "We have a gym attached to the clinic with specialized fitness instructors," explained Dr Lindberg, "together with several nutritionists, lifestyle coaches and a psychologist." The results are impressive: weight loss, lower blood pressure and reductions is diabetes medication.
When Vigdis Oalann visited Dr Lindberg's clinic, she hadn't felt really well for some time. In her forties and looking after four children, she was overweight and had been prescribed pills to lower her cholesterol and her blood pressure. "I felt tired most of the time and although I knew I should lose weight and take more exercise, sometimesfood was the only thing that cheered me up."
"Dr Lindberg took some blood tests that showed I had diabetes; this wasn't a big surprise because both my parents had died of it," she says. "My regular doctor had told me to 'live like a diabetic' but he never gave me any concrete advice."
Oalann was told to exercise and to cut out high glycaemic food and eat more protein and vegetables. However, rather than being left to battle with the challenge of implementing these changes on her own, she had a team of experts to help her.
At the clinic, nurses and other health personnel run seminars and there are cooking classes. Within a few months on this programme, Oalann no longer needed the pills to lower blood pressure and cholesterol. "And if I take a blood sugar tolerance test you can't see that I'm diabetic."
The clinics are private and an initial consultation plus a range of blood tests and health assessment is £110 while £42 a month buys you 10 consultations with a physician and a nutritionist, lab tests and lectures.
Many of the patients find the hardest thing is to start exercising, which is why having a gymis key. "If you start going to a normal gym to get fit," says the head physiotherapist Linda Andersson Syversen, "and you miss a few sessions, no-one cares. But here as soon as someone doesn't turn up twice we are on the phone."
Some patients still have problems eating as they are supposed to. That's when Marta Thorsheim is called in. She is a behavioural psychologist with a background in Gestalt therapy. "Usually the person will have tried many times before to make changes," she says, "so I start by trying to find out what goes wrong. Often you find some sort of trauma in childhood when something was hard to handle."
The effect of this is that the link between their emotional brain and their body is cut and so they become very bad at recognising the physical sensations that go with emotions. "The butterflies in the stomach feeling that goes with anxiety is felt as hunger and they learn that by filling themselves it goes away, at least for a while." Thorsheim gives the patient simple techniques to deal with this.
This is a far more sophisticated level of support than is found elsewhere. Although as yet there is no formal trial-based evidence that it works, far simpler regimes have been shown to be very effective.
Only last March, for instance, a large American study found that putting 2,390 patients with a number of risk factors through 12 weeks of exercise counselling and nutrition training resulted in a big improvement. Over 60 per cent achieved healthy blood pressure, 23 per cent hit their cholesterol target and 37 per cent got their blood sugar to a safe level.
With the latest reports that nearly 2 million people in the UK have type 2 diabetes and that treating this costs 1.7 billion a year, Dr Lindberg must be worth taking seriously.
The secrets of Dr Lindberg's weight-loss technique
Many of Dr Lindberg's patients have a raised blood-sugar level which is a sign of insulin resistance and can lead in turn to diabetes. The diet followed at Dr Lindberg's clinics is specifically designed to return blood-sugar levels to normal. Its basic principles are:
* Eat frequent and not very large meals, waiting no more than four hours between them. This helps to keep blood sugar levels stable and aids metabolism.
* Eat lots of vegetables, fruit and berries. This assures a rich variety of vitamins, minerals and anti-oxidants, which protect the body's cells and stimulate various crucial cellular processes. Vegetables help to stabilize blood sugar.
* Include a good source of protein in each meal, to help maintain muscle mass, keep blood sugar levels stable and brings a feeling of being full.
* Choose fats from among cold pressed oils, avocado, nuts, seeds and fatty fish, not margarine, soy oil or other warm pressed oils. These "good fats" help to stimulate the immune system and ameliorate inflammation.
* Eat very little sugar and few flour products or potatoes. This will help keep blood sugar level, lower insulin production and will consequently reduces fat storage, while improving fat metabolism and also helping to reduce inflammation.
* All types of food belong in a healthy, balanced diet. How much of which sorts of food you eat is what makes the difference, as well as when you eat them.