Compliance is

"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

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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.

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