Lena Osei had been through four programmes before this one, and could recite the pattern: intense start, early result, quiet collapse around month five.

Phase one changes two things and nothing else. Most participants find this insulting for about three weeks and survivable thereafter.

Two things, and no more

The diary runs for three weeks before any advice is given, because advice given to a guess is a guess with more confidence attached.

We build for the fifth month, because that’s when enthusiasm is gone and the habit has to carry it.

Ines Cardoso, dietetics

Month five

Maintenance is treated as a distinct phase with its own skills rather than as a victory lap, and the service is explicit that it is the harder half.

Eleven months in, she is past month five for the first time.

Contributing writer

Ines Cardoso

A demonstration byline created for this prototype. Not a real writer, and not a clinician.

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