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Guidelines on how to use the ‘Do You Want to Stay Fat?’ diet-sheet with clients

The following is suggested text for use with the diet-sheet ‘Do You Want to Stay Fat?’*

As you are reading out the text, point to the appropriate symbol. Many people with learning disabilities have better understanding if verbal speech is supported by signs. If this is the case it is important that you find out the local signs for words that are typed in bold.

*It is recommended that you use the ‘Healthy Eating and Gentle Exercise’ diet-sheet in conjunction with the‘Do You Want to Stay Fat?’ diet-sheet.

Front Page Suggested text Suggested actions/gestures Let’s look at this diet-sheet called ‘Do You Want to Stay Fat?’

Page 1 Suggested text Suggested actions/gestures If you are fat you may get knee pain, hip pain, back ache, breathless, sweaty.

You can get hot and sweaty – even with gentle exercise such as walking up steps, and you can become smelly.

Being fat can give you high blood pressure. Ask if the client has had their blood pressure taken by the doctor.

Ask the client if they get knee pain, hip pain, back ache, breathless, sweaty or have high blood pressure.

Point to each symbol in turn. Rub your knee, hip and back. Put your hand on your chest and breathe in and out deeply.

Act out wiping sweat from your forehead and pinching your nose against a bad smell.

Act out a cuff being placed on the arm and the balloon being compressed and decompressed. Use your hand to indicate the blood pressure going up.

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Page 2 Suggested text Suggested actions/gestures You may also get diabetes. Ask if the client has ever had their doctor take blood from them.The doctor can test to see how much sugar is in your blood. If there is lots of sugar in the blood the person is said to have diabetes. Do you know anyone that has diabetes?

The doctor can also test to see how much fat is in your blood. One type of fat is called cholesterol. Can you think of any adverts on TV that talk about cholesterol?

High cholesterol levels are bad for the heart. High cholesterol levels can cause chest pain and heart problems. What would happen if the heart stopped?

Mention that we know that being fat for a long time can give us high blood pressure. High blood pressure can give us a stroke. Do you know of anyone that uses a wheelchair? Ask if the person was born that way.

Mention that a stroke can happen to anyone even you and me. Mention that we can be fine one day and the next not able to use one side of our body.

Mention that you need others to help you get around and you lose your independence.

Being fat for a long time may also give you some types of cancer. (With cancer people are very sick, tired and often feel pain.They can also die.)

These are all things you do not want to get. If you lose weight you are less likely to get these things.

Do you have any questions?

Use your hand to indicate sugar levels going up.

Place a fist over your heart and indicate the heart beating, mention that the heart can have difficulty working and may stop.

Turn back a page and point to the fat person and high blood pressure symbols. Point to the stroke symbol.

Act out walking by dragging your leg, also sit and lift your arm from your side onto your lap.

Point to the symbol.

Use your right index finger and thumb to make the letter ‘C’. Your facial expression should be tired and sad.

Point to all the symbols on the page.

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Page 3 Suggested text Suggested actions/gestures If you are fat you may have difficulty in walking, this can make you constipated. If you are constipated you spend ages sitting on the toilet. You can feel bloated and you can be in pain.

You may also wet yourself as you cannot get to the toilet in time. I can think of very fat people who have great difficulty getting out of a chair because of their weight. They need to go to the toilet, but it takes them so long to struggle out of the chair and walk to the toilet that they don’t get there in time and wet themselves.

Act out the stomach distending; shake your hand in front of your stomach and rub your stomach.

Act struggling out of a chair.

Page 4 Suggested text Suggested actions/gestures If you are fat you may not be able to do all the activities you want to do.

What activities do you see here? If you are very fat you cannot get up onto a horse.You may not be able to get a swimming costume to fit you. You may also get too breathless trying to dance.

Not being able to do all the activities you want to do can make you sad, but you can lose weight and I can show you how by giving you a leaflet on ‘Healthy Eating and Gentle Exercise’.

Everyone, not just you, would benefit from having a healthy diet and taking gentle exercise.

Point to the appropriate pictures. Before each activity indicate ‘no’ by putting your right hand up and to the left and taking it sharply down to the right hand side of your body.

Swimming – act out breast stroke.

Dancing – bend arms and shake torso back and forward.

Make a sad face expression and point to the appropriate picture.

This information was produced for The Scottish Nutrition and Diet Resources Initiative and reviewed for Nutrition and Diet Resources UK (NDR-UK) by Registered Dietitians and other relevant health professionals. At the time of publication the information contained withinthe leaflet was, to the best of our knowledge, correct and up-to-date. Always consult a suitably qualified dietitian and/or your GP on health problems. NDR-UK cannot be held responsible for how clients/patients interpret and use the information within this resource.

Page 5 Suggested text Suggested actions/gestures Healthy eating and gentle exercise can help you lose weight and stay slim.

You will be more healthy and be able to do more of the activities you enjoy.

What activities would you like to do more often?

Give a ‘thumbs up’ sign.

Flex your muscles.

Page 6 Suggested text Suggested actions/gestures Healthy eating and gentle exercise can make your skin, nails and hair look good.

Mention that your nails are smooth and not dry or flaky and your hair is shiny and not dull.

It will also make you feel better about yourself.

Stroke or pinch the skin on the back of your hand.

Point to your nails and stroke your hair.

Give a ‘thumbs up’ sign.

Picture Communication Symbols © 1981-2007 by Mayer-Johnson LLC. All Rights ReservedWorldwide. Used with permission.

Part funded by the Scottish Government. NDR-UK – the UK’s practitioner-led nutrition and diet resource provider. Registered charity number SC041043, company number SC364677.

© NDR-UK Ref 9012, First Published 07/07Reviewed 05/09, 04/11, 04/17To re-order visit www.ndr-uk.org and follow instructions

This information was produced for The Scottish Nutrition and Diet Resources Initiative and reviewed for Nutrition and Diet Resources UK (NDR-UK) by Registered Dietitians and other relevant health professionals. At the time of publication the information contained withinthe leaflet was, to the best of our knowledge, correct and up-to-date. Always consult a suitably qualified dietitian and/or your GP on health problems. NDR-UK cannot be held responsible for how clients/patients interpret and use the information within this resource.