Woman's Hour - 18/12/2025

Episode Date: December 18, 2025

Women's voices and women's lives - topical conversations to inform, challenge and inspire.

Hello, I'm Anita Rani and welcome to Woman's Hour from BBC Radio 4. Just to say that for rights reasons, the music in the original radio broadcast has been removed for this podcast. Good morning and welcome to the programme, as you've just heard in the bulletin. The government are announcing a major new strategy to tackle violence against women and girls, which has been declared a national emergency. But what are they pledging and how will it actually protect our girls, you and your children? We'll be tucking into a Christmas book, disappearing into a romantic castle in Scotland. Jenny Colgern will be telling us about her latest novel, The Secret Christmas Library.

1.5 million people in the UK are on weight loss jabs, but what happens when you come off them? We'll be discussing this with a doctor. If this is you, we would love to hear from you. Are you injecting the drugs, trying to come off them, have come off them, and are you back to square one? If you have any questions for our doctor, get them in, and of course you can remain anonymous. And musical sensation, Amara Akereke, is currently starring in the 1930s musical Top Hat, full of classic hits such as Putting on the Ritz, cheek to cheek, and let's face the music and dance. She's popping in to see us this morning, and as a festive treat, she's going to be singing live.

If you'd like to get in touch with the program about anything you hear and would like to share your experiences, have any questions, or your stories, then I encourage you to do so by texting us. It's 84844. You can WhatsAppers on 03-700. 100-800-4-4-4 and email the program by going to our website. And if you'd like to follow us on social media, it's at BBC Women's Hour. That text number once again, 84844. But first, a national emergency. That's what the scale of violence against women and girls has been deemed and not for the first time.

Today, the government sets out its strategy to deal with it, the details of which we can bring you in full with the minister responsible. But as for the scale of this, here's some statistics. for you. Violence against women and girls make up, and it makes up nearly 20% of all recorded crime in England and Wales. Over the last year alone, one in every eight women was a victim of domestic abuse, sexual assault or stalking according to home office figures. Educating boys on misogyny is a key aim of today's strategy and figures show that nearly one in five boys aged 13 to 15 are said to hold a positive view of the self-proclaimed misogynist

Andrew Tate, according to a UGov poll, and a reminder that a key manifesto commitment of this government is to halve this violence against women and girls within the next decade. Well, Alex Davis-Jones is the Minister for Victims and Tackling Violence against Women and Girls and joins me now in the studio. Good morning. Welcome. Good morning. 20 million pounds will be spent as part of this strategy for going into schools. Tell me how that money is going to be spent first, Alex. So this money will go towards supporting teachers. It will go towards insurance. that we have experts and specialists coming into our schools to teach our young children

about healthy relationships, about consent, about misogyny and really to try and tackle those dangerous, harmful behaviours that we are sadly seeing in our schools, that our young boys are displaying and it is hurting them as much as it is hurting our young girls and we need to tackle this. How is it going to differ to what many teachers and pupils say is already happening in schools? So this is different because we're actually. bringing the experts in directly. So we're going to be working with specialists, bringing them in because our teachers are overwhelmed as it is. They just want to get on and teach. And they're

trying their best and dealing with very difficult situations right now. Every time I go into a school, whether it's in my own constituency in Pontiprieve or another one across the country, teachers are crying out for support and guidance. And also that expert knowledge on how to tackle this, how to deal with this. So that's exactly what this money is. So experts will be coming into schools to work alongside teachers. Yes. Many critics are saying it's not enough. For example, Nicole Jacobs, the Domestic Abuse Commissioner for England and Wales, has said the level of investment falls seriously short.

So we're investing over a billion pound in victim support services alone as part of this strategy. We're investing in police to go after perpetrators directly. We're establishing a brand new centre to tackle violence against women and girls in policing. We are investing in our schools, in our healthcare. This is a 10-year strategy and it is fully costed and fully funded. and the Chancellor and the Prime Minister are totally behind this. Schools will be able to send high-risk students to get extra care and support, including behavioural courses, to tackle prejudice against women and girls.

What evidence is there that these kinds of courses work? So, again, this is something that hasn't been done before, but we can't just keep doing the same thing and hoping for a different result. As you mentioned, this is a national emergency. The scale of violence against women and girls is totally intolerable in our country. And those statistics that you reeled off at the start, are really stark. Shocking.

But they are also, those statistics aren't just numbers. They are people who are really, really hurting right now. And if we want to change things, if we want to prevent this violence against women and girls from happening and from perpetrating in our society,

then we have to try something new. This hasn't been done before, but we have to give it a go. And we will be evidence-led and we will be working with those experts. We are learning from other countries who have been trying to tackle this and doing these pilots.

And this will be a pilot to begin with. so that we can see if it's working. So it's a bit of trial and error? It has to be. It has to be trialing something to see what works. Because, again, at the minute, it is a national emergency and we have to pull every single lever to try and tackle it. So we don't really know is the answer.

Well, again, that's quite that. That is part of the problem here is that we know that perpetrator programs can work. There have been some success with them in terms of tackling, harmful behaviours around going after the root causes of why certain individuals, carry out these awful crimes, whether that is because of their own trauma, whether that is because of drug and alcohol. And I'm not making excuses here. There are no excuses for violence against women and girls.

I want to be really clear about that. But we do know that we need it to stop and we need to prevent it from happening in the first place. And these programs are just one way of we can do that. Obviously schools have some level of responsibility, but not solely on them. So let's look elsewhere. like where these young men and boys are being radicalised in the first place, doesn't more need to be done to stop the spread of misogynistic content which they are accessing online?

Absolutely. This is a huge problem across society and what is happening now online is proliferating into the real world. It's causing real world harm. We are seeing that in our statistics. And the Online Safety Act, the new child codes offcom as a regulator, are responsible for enforcing the act, putting more onus on tech companies to stop this type of content

from proliferating online but we need to do more and we need to go further we're working with the tech companies directly we are bringing in new policies and the strategy that will be announced later today in Parliament to try and tackle some of this online dangerous behaviour we are bringing in new laws

to prevent the creation of deep fake intimate images and to prevent the sharing of this content We're trying to bring in new measures in order so that you can get these taken down quickly. There really isn't a stone left unturned here in trying to tackle this problem. But doesn't this strategy let tech companies off the hook a little bit? The Financial Times reported earlier this week that firms would be encouraged to make a default setting on phones that would scan for nude images and block them unless the user passes an age check. When you read it out like that, it seems so obvious, doesn't it?

but ministers had decided against actively forcing companies to implement this. And also Politico reported this morning that a ban on so-called nudification apps, the apps which should address photos of people, were expected to be part of today's strategy but aren't. Well, I would just urge some caution there. So my colleague and my sort of partner in this, Jess Phillips, the Minister for Safeguarding, will be making a statement in Parliament later today, outlining a number of measures that are in the strategy that I'm not yet,

able to talk about because Parliament is sovereign and has to be told first. But I would just urge caution there and await to see what is exactly in the strategy later today. Okay. So then let's look at women in general and the trust or the lack of trust that they have in the systems which are put in place to protect them. Delays in rape trials are a huge part of this problem to some victims waiting seven or eight years and others dropping their cases, as you know, due to delays. It's something we talk about women's hour a lot. What's being done to tackle those? So again, we can't keep doing the same thing

and expecting a different outcome here. As you mentioned, we inherited a criminal justice system in crisis and part of my role is to try and rebuild trust in that process so that women, victims, survivors, feel like justice is done because that age all saying, we hear it all the time justice delayed is justice denied. We've had the stats out just this morning about the current court backlog, 79,000.

cases in our Crown Court backlog, which is wholly unacceptable. And again, these are people whose lives are on hold whilst they're waiting for justice. I will never ever forget meeting one rape victim who told me that going through the court process and the trauma of the criminal justice system made her want to die. No one should ever, ever feel that way about the criminal justice system, a system that is meant to support them and bring them justice and closure. So we need to get on the, we need to fix it. And we've announced our response to Sir Brian Leveson.

We asked Sir Brian Levison, who's one of the most eminent senior members of the justice world, to do a huge review for us into the Crown Court system to look at how we can fix this, what options are available in order to really bear down the, on the backlog. Because funding sitting days, which we are doing to record levels, which is the amount of times that judges are able to sit in Crown Court, isn't just going to be enough. We have to do something different. And he came up with a swath of measures

on extending magistrate sentencing powers so that we can move more cases into the magistrates courts where there is less of a backlog where cases can be heard swifter, where we can remove the right to elect, which is where defendants have the right to either elect to have a judge or a jury trial.

So again, we are one of the only systems in the world where that is possible. And it does seem quite perverse. that that is a system where we know defendants are gaming the system in order to wait it out. Because the backlog is so high, victims are withdrawing from the process and they are choosing to just actually give up on the criminal justice system. So we need to do things differently. We will be bringing forward legislation to ensure that we bring forward Crown Court reform

in order to fix this backlog because victims and survivors are waiting far too long. That is unacceptable. Defendants are waiting too long too. and it is making a mockery of our criminal justice system. How do you regain the trust that women have lost in the system? It's going to take time. We have to rebuild it. We have to ensure them that we have got a criminal justice system

that is putting victims back at the heart of it, whether that's tackling the so-called rape myths and stereotypes in the courtroom. We are making legislative changes on that. We are providing independent legal advisors for adult rape victims so that they feel like they have somebody on their side, providing them with that support and advice in the courtroom. All of these changes might seem small on their own, but together, as part of this strategy that we're announcing today,

it will hopefully go some way to halving the levels of violence against women and girls and rebuilding that trust that has been lost, whether that being the police or the justice system. So you can tackle the systems, you can look at what tech companies are doing, you can go into schools, but what Alex can be done with an issue that is endemic? It's cultural change. Yeah, in society. So how do you even begin to,

I mean, look at what these boys are accessing at home, what they're seeing with their own fathers, their uncles, role models that they're being influenced by in their day-to-day lives outside of school. And it's not just in the UK. This is a global problem. It's a global problem. We're not on our own here in terms of the issue and the national emergency of violence against women and girls. But we are working with everyone to try and solve it. And it is going to take everyone, as you rightly say, it's, I mean, me as a politician in a government department in white, can create a strategy working with colleagues, working with every government department and every government department has been pulled into this strategy in order to make it robust, effective and deliverable. But ultimately, this is going to take all of us across society in order to change that culture. And it can be done. It has been done before on issues.

You know, we've moved and society has moved with the times, whether that be on wearing a seatbelt in the car, whether that be on teenage pregnancy, for example. It can be done. It's not going to be easy and it is ambitious but it has to be because of the scale of the problem but I'm appealing to your listeners I'm appealing to the public to parents to society to work with us on this and to be committed to really tackling the problem well if you're talking directly to listeners there will be some probably listening to this program that don't think it's an issue that's relevant to them how do you intend to speak to them this is about reaching everybody and making everyone aware that violence against women and girls touches all of our lives

sadly the likelihood is that we all know a victim or a survivor of these awful crimes and the likelihood is as well that we know a perpetrator because this is how endemic it is in our society and whether we are impacted because of the financial cost to the state as a result of violence against women and girls it is valued at billions in terms of the impact that it is having but also the the real world impact it's having on people and their lives. It is taking, it's costing people their lives. It is stripping them away from their with, you're stripping their dignity away from them and we need to change things. There's been some frustration from some survivors and campaigners this week who say the fact that is being published

on the last day of Parliament sends a message the government isn't taking it seriously enough. How can you reassure them? I would robustly reject that. I would say that since we came into office 18 months ago, we have stressed every senior. We haven't stopped. We haven't stopped. in terms of getting on with the job of trying to tackle this, whether that is creating new criminal offences, clarifying the law on spiking, outlawing the deep fake intimate images, abuse, really trying to bear down on stalking

and creating our domestic abuse protection orders, funding victim support services to record levels. This is something that we haven't rested on our laurels with because we haven't got time to. We needed to make sure the strategy was right. We could have published it sooner, but it wouldn't have been, it wouldn't have hit the mark. and that's not good enough because it has to be it has to be right well why has it taken so long it's

been delayed three times despite the government declaring this a national emergency so the strategy has been delayed but I would restate we haven't delayed in terms of our action so that has carried on that has been swift we have been moving very very quickly in terms of bringing in that legislation bringing in the new policies trying to fix the criminal justice system that we inherited in order to make sure that we we bear down on the issue of violence against women and girls but the strategy has been challenging at times. I won't deny that in terms of trying to bring

all the government departments to the table who haven't necessarily been involved in something like this before because, again, we talked about it being a whole societal approach to this issue. It has to be a whole government approach to this issue because it's not just a criminal justice one to solve. It's not for me in the Ministry of Justice

or Jess Phillips in the home office to tackle. We needed West Streeting in the health department. We needed Bridget Phillips and in the education department. Pat McFadden, in the DWP. Everyone working together. You mentioned technology. Liz Kendall in the Department for Science, Innovation and Technology. Everyone, all of us being led by the Prime Minister who deeply cares about this. This is personal to him pulling together in order to make this right. And we needed to make sure it was right. We needed to make sure it was fully funded. And most importantly,

we had victims and survivors lived experience at the heart of this. Their experiences built this strategy. The people on the ground delivering the services on the front line. have been integral to this process and I want to thank all of them for their input. And I won't apologise for it for getting it right and wanting it to be as robust as possible. I'm just going to read out a message that's come in from one of our listeners who's a teacher saying this needs to be tackled in the home. By the time they get to us, these attitudes are ingrained. They think we're preaching. Social media is having a hugely negative attitude. There are schools and colleges, they're in school and college for less than half a week.

So the teacher is saying by the time they get to them, it's too late. The responsibility is on all of us, on us as parents, on us as society. It's on our organisations. You know, Jess and I were speaking with the Girl Guides recently and the Scout groups. It's on our sports clubs. This is everywhere. It is endemic. And it's in the workplace in schools on public transport, online, in the home.

And we have to tackle it everywhere. And there is a responsibility on all of us to do better. Alex Davis Jones. Thank you for joining us this morning. 84844 is the number to text. Keep your thoughts and opinions coming in. Now, as we approach Christmas, you might need to sharpen up your negotiation skills.

Who's cooking the dinner? What family are you visiting? The list goes on. If this sounds like you, then I would recommend checking out the latest episode of CBB's Parenting Download, the podcast that unpacks the stories that have got parents really talking.

From viral trends and dilemmas to the news stories lighting up your group chats, Well, this week, Katie Thistleton and Governor B explore the art of negotiation with the top tips every parent should know. Joining them in that conversation is former international hostage and crisis negotiator, Nikki Perfect, who gave some expert advice on navigating Christmas as a co-parent. So number one, recognise that it's an emotional conversation. Number two, recognise that you'll probably come at that conversation from your own perspective.

Number three, if you're able to come at it from the other person's perspective, perspective and the young person's perspective, the conversation and the end result will be better. I'll just share my own experience. I happen to be married to a female. I have a stepdaughter. And when our stepdaughter was younger, we used to live very close to Dad. So it wasn't an issue. And then we moved away.

So Christmas then became an issue. Then she had younger siblings in her life. And she wanted to go and spend Christmas Day with Dad because she's got younger siblings. And of course, you're like, no, I want you to stay with me. Because it breaks my heart to see you go, of course you have all of those emotions. I think somewhere along the line, you have to press the pause button and go, okay, what does this really look like? It's a day in my life. What do you want?

And she was like, I want to go and spend it with my siblings. And as heartbreaking as that is, it's like, okay, this is your Christmas. You go and do that and we'll do it in a different way. And as long as you've got that in place, then you can make a decision about what you do on that day because then you have choice. Nikki Perfect's there giving some advice and let me repeat that she is a former international hostage and crisis negotiator who's helping you tackle Christmas with your family

and you can listen to that episode in full on BBC Sounds or wherever you get your podcasts you can also watch it on iPlayer, just search CBB's Parenting Download and don't forget to hit subscribe now with the long, cold and dark evenings it feels like the perfect time to curl up indoors and get lost in a delicious book

Well, if you're looking for something cozy to read over Christmas, look no further than Jenny Colgan. Her books have been Sunday Times and New York Times bestsellers, selling more than 15 million copies worldwide. And Jenny joins me now to talk about her latest novel, The Secret Christmas Library, set in the snowy landscape of the Scottish Highlands. You are in Scotland now. Hello there, Jenny. Welcome. Hello, Anita. Do you know, I'm sitting here with the Lurgy, as I issue loads of you.

Your listeners also have a bit of the lurgy. Don't worry. You're going to fit in perfectly because I think half the country has the lurgy. So you're all right. You're representing a lot of people. Is that why we've kept you in Scotland and away from the studio? I am locked away. But the wonderful writer Eva Ibittson once said,

I write for a very clever woman who have the flu. Very good. And that's how I feel this morning. Wonderful. Quite a lot on the Women's Hour team. So let's talk about this book. We meet Mirren Sutherland. She's a quantity surveyor.

day by day, but a book lover at all other times. Tell me a bit more about her and the task that she's been given to find this hidden book in a Scottish castle. Yes, she's trying to find a very valuable book that is hidden in this big old crumbling estate. And it was very much the kind of book that I like to read, which is a very good way to start writing anyway. And I kind of finished it and I gave it to someone to read and they went, Jen, you've written a famous five. That's very much the kind of vibe. It's adventure. It is a bit of an adventure.

I have to say, I'm not going to give too much of the book away, but you sort of start with her travelling up to Scotland on a sleeper train. Having done the sleeper to Scotland and woken up at sunrise whilst going through the Kangolms, it's so romantic. I don't mean the story, the landscape. Yes. I mean, one of the nice things about my job is I travel to lots of libraries and things. And, you know, obviously I'm a bit biased,

but there are very few corners of Scotland that don't have something really amazingly pretty in them. You're going to read a little passage from the book. Can you tell us what we're going to hear? I am. It is, do you know, I was travelling up the north-east, which is full of castles, and from a distance they look amazing,

and then you get up close, and they're clearly falling apart and desperately trying to sell you a scorn. So that was kind of the inspiration. Here we go, this is Marin. It was more than a castle. It was practically a town. From the tallest of the turrets, a Scottish sultire flew proudly,

but from another was a long, fluttering pennant in red and yellow, following the breeze out to sea. Marin couldn't take her eyes off it. It was devastatingly romantic. Imagine. Imagine having a tower with a pennant, streaming like a princess in a storybook. It was glorious.

It sounds like a fairy tale. Were you inspired by a real, castle? Yeah, well there's kind of a law in Scotland and it is quite hard to kind of keep them going so yes they all kind of inspired me really because you do especially on the East Coast

where you get this very Scandinavian light a lot of the time and so you see these things perched out to sea and you think oh my goodness and then you get up and everything's peeling and I'm not by the way trying to feel sorry for people that own castles at this point but no exactly pour them in their castles that are

into bits. Is it true that you live in a castle, Jenny? Well, here's the thing. It looks like a castle, but it was built in like 1949. It doesn't matter when it was built. Is it a castle or it is still a castle? It is. It is. It is. I know. It is. So therefore, when I talk about bat issues and problems with heating the place, you know that I am speaking from a place of truth. You're not just lived in a castle. You lived in many countries around the world. How has coming back to Scotland informed your writing? Well, I think anyone that's lived overseas has the same experience which is that

you're never quite the same person afterwards whether you stay abroad or whether you come home you've changed you have more in common with people that have lived in two places my husband is a sea so that's why we travelled and so when I came back as a child in Scotland I was like oh gosh this is so boring and freezing

when my parents tried to point out beautiful sunsets but as an adult coming back with my own children I was like oh yeah this place is great You know, I saw it completely afresh and kind of really got it. We came back about 10 years ago and it's been a really wonderful and heartwarming thing that I would not have predicted when I was young. I would be so excited to live in Fife, you know, but it's great.

It's lovely. It's that kind of coming home feeling. You've written about Christmas before as well as including novels that are set in bookshops and libraries, which is obvious from this book as well, your love affair with books. what is it about Christmas and books that continues to fascinate you? Well, I mean, all writers are just readers, you know, two steps to the left, really. It's just as close as we could get to just sticking a book in front of our face all day. But Christmas is such a fertile ground for novelists because you have this ticking time bomb,

which is the 25th of December. You know, you're basically in a Tom Cruise film and everything's got to be right, you know, before. And you've got a whole bunch of... It's Mission Impossible. Plus you have a whole bunch of people that maybe don't like... get on in a room, always fertile for drama, you have family stuff, you have a lot of romance, a lot of proposals

happening at Christmas, and everybody's cut off and can't go anywhere else. So it's basically perfect. So what makes the perfect Christmas read? Oh, I like lots of food. I'm very much that generation that grew up reading the post-war rationing writers, like

Roll-Dal and Turkish delight and all that stuff. So you need snow, you need a lot of food, you need to be in the 1% of the country that has no mobile phone coverage. It's very helpful. And of course, everything needs to turn out perfectly well. Yeah, there's a lot of really delicious food and drink described in the Secret Christmas Library.

There's Yule Logs, fried potato scones, venison from the Castlesland, lots of steaming mugs of tea. So what's on your Christmas menu? Lemsip, mostly. Other drugs are available, obviously. Oh, sorry, yes, of course. But actually, my trip. children have just, the second one just left home this year, so they're coming back. And children really like, even adult children seem to like everything identical at Christmas

to how it's always been. So that's how we're doing it. We're doing it in exactly the same order. And even though they're all about six foot five inches tall, they'll all go to bed at eight o'clock on Christmas Eve. So Santa Ging. Very, of course, of course. Reading your book, it was just, it was an adventure. I disappeared into another world completely.

are now talking to you and realising that you live in a castle and that, you know, in my mind there is the whole, you know, parallels between your life and what was reading about. And you publish, sometimes publish two books a year. So I want to know a bit about your process. Like when do you write and how are you, it's brilliant that you're so prolific. But how on earth do you manage it? Well, when you break it down to a 70,000 word novel and divvy it up,

it's actually not as kind of, you know, you never sit down to write 70,000 words. You sit down to write 2,000 words or 1,500 words. And I quite like writing in motion and planes and trains. So when I'm travelling, I find that is quite a nice way of doing it. But, you know, I've been doing this for a long time. And so I kind of know what I'm doing more or less, I think, because I'm on book 41. And then, and I always think this is important that women say this because we don't say it enough. I pay someone to help me out, run the house.

I pay for help. I paid for childcare. you know this idea that kind of you know I'm managing everything brilliantly is kind of very far from the truth so I have people that help me and yeah I think I know I think you're all you type fast yeah I think that's really important to say because otherwise people think what have I been doing with my like why have I not written 41 books because you need support is important 41 books means 41 ideas are you constantly coming up are you in the middle of the height of summer thinking about Christmas

I tend to keep it to Christmas, but also ideas are not the difficulty. You know, the world is full of everybody's family is crazy. Oh, apart from your dad, by the way, who's perfect, of course. But, you know, everybody's family's got a secret or, you know, they went to a funeral and there was a second family. Or, you know, my husband's grandfather faked his own death. You know, there's always more fertile stuff happening than. then you can turn into story. And like a true, brilliant writer,

she's left us with that cliffhanger. What? You can't just drop a little line in like that. He faked his own death. Yeah, there was a big train crash in Australia and he left 10 kids in Australia, went to New Zealand and had another 11, of which my mother-in-law was the very last one.

Okay, you might have to come back when we do the item on second families or, you know, secrets or something. Jenny, thank you so. much and thank you for the joy of this book the secret christmas library something that you can all disappear into thank you happy holiday happy holiday and get well soon um and it is out now and i love that my dad's getting shoutouts by the way at work they started calling him balclooney hilarious um 84844 is the text number now in england almost two thirds of people are

considered obese or overweight an estimated 1.5 million people in the UK are using weight loss injections or gLP ones. But what happens when he decide to stop or have no choice but to come off them? A BBC news documentary on iPlayer, what happens when, asks just that. To find out more, I'm joined now by Emma Anders, who, after a short break, has decided to continue using weight loss jabs. And GP, Dr. Hussain al-Zabedi, welcome both of you. Dr. Al-Zabedi, I'm going to come to you first by giving us a brief overview of these weight loss jabs, please, or GLP ones. Who are using them? How do they work?

And the side effects, please? No problem, yeah. Thank you for having me on. Now, these medications such as some agglutide and dysepididid, sort of trade names being Woghavi and Manjaro, they mimic hormones that we naturally produce in our gut. So, GLP1 and GLP, these are gut hormones that release when we eat food and they do a number of things. increase insulin secretion as well as our body's sensitivity to that insulin. They help to slow down stomach emptying and they act on the brain's appetite centers. They're not the only controls,

but they do influence that. Now they're effective at reducing weight and improving a lot of what we call the surrogate markers for health. So things like blood sugar levels, blood pressure, cholesterol. Now they work predominantly by reducing your appetite to therefore reduce the energy that you're consuming each day. And that energy deficit, is what results in the weight loss that you see. Now, side effects are common, especially early on, the most frequent being nausea, vomiting, diarrhea, constipation, as well as tiredness. Now, women tend to report more gastrointestinal side effects like those than men. Reasons being, we're not entirely sure, but we think difference in our guts motilities, how it moves,

as well as hormone interactions, plays a role. And there are also important concerns around lean muscle mass as well as bone density, which is particularly relevant for women, given the fact that they're approaching the menopause and when muscle and bone loss is already accelerated. 844, we've got a few messages coming in. I'll read some of them out and put them to Dr. Alzabedi in a moment. But first, Emma, I'm going to bring you in to talk to us about your situation. Tell us when and why you decided to start using weight loss injections. So I've always struggled with my weight since before I was a teenager. I have done every diet out there, every diet works, but I feel unwell in a calorie deficit. So I end up eating just to feel normal again. Now, I'm also a GP. I'm actually an NHS and private GP. And I have a clinic now, which I, if you talked to me a few years ago, I would never have believed that I would be helping people with their GLP ones. Because when I first encountered them was actually working as a doctor in A&E, and I was seeing the side effects of the early GLP ones. So even though, What were you seeing?

Pancreatitis, nausea, abdominal pain. That was my first experience with the early JLP one. So Saxenda, this was nearly 10 years ago now. So I've always struggled, though. I'm super active. I was on the England karate team. I'm a competitive weightlifter. I do all sorts of sport,

but I just can't manage my food. And I've turned to everyone. I've joined Weight Watchers more times than I have years of life. I've done everything, because I've always thought, I'm just doing the wrong diet. I've not found something that works for me. So when GLP ones first came out, I thought, well, they're all well and good, but I don't think they're going to address the underlying cause of obesity. So I didn't even consider them. I had private

clinics where they asked me to prescribe them. I said no. But then a few years ago, I started working at a different private clinic. And by this point, a Zempic had come out, which is one of the newer GLP ones. And I said, I'm not going to prescribe them, but I'll speak to patients who are on them, because I'm very open-minded, and it was very different to what I expected. I thought patients would be telling me how skinny they felt and how much better they looked, but they were talking about how they felt. And actually, as somebody who this has always been my area of interest, I've studied eating disorders into the ground.

I've studied eating behaviours. I've worked as a GP in the clinics I've been at. I've often spoken to the people with binge eating who struggle and given them techniques for those sorts of things. People weren't talking about how they looked. They were talking about things like that. and I was fascinated. So I looked into it and thought, still,

I've spent 30 years trying to diet. I'm not just going to take the easy way out and go on a quick win. So I spent one year doing everything. I saw every private doctor about my underlying health issues. I thought I'm going to attack this from every angle. And a year later, I was nearly morbidly obese.

So at that point, I thought, even with all the exercise that you were doing and you just... I do tons. I've always done loads. Can I ask you what weight you were at? I don't like to give numbers because I don't want people to compare

but my BMI was approaching 40 I was very big and I was finding it difficult to do the exercise that I enjoyed I found it difficult to get up the stairs I looked physically very and well but I still was exercising I still was trying

I was taking off on average three to four stone every year and then regaining it with more it was a constant battle So how quickly did you start losing weight when you started taking the weight loss drugs and what did you, did you have any side effects yourself? Well, that was, I got to October of last year and I thought,

I'm heavier than ever, I'm just going to do it. I'm going to close my eyes and give it a go. And I was terrified at the side effects because I've seen them. And I took, Mungaro was the one I took, on the 12th of October. And within 48 hours, I know, I know as a doctor, this is not what we're supposed to say, but I felt like a completely different person. And I can't tell you why, because it didn't affect my appetite at all in that first week. But within two to three weeks, I've had acne rosation for 10 years.

was completely gone. I had energy levels that I've never had before. And by the third week, if I eat a very big meal, and I could still eat everything because it wasn't affecting my appetite, I could feel full. And I didn't realize before that third week that I have never felt full. And I thought, oh, this is why people say dieting is easy, because they get this when they eat. And so I never used to eat meals because a meal made me feel no more full than a snack. So I'd just constantly snack to try and keep my hunger at bay as best I could. So as someone who is a medical professional, then, did you have an exit strategy? So obviously you know what this is, no.

I didn't think it was going to work. I just went on it because I was desperate and I tried everything else. And I thought, I have to give it a go. I've tried everything. I saw myself in a future where I was one of these people you see on TV who can't get out of a room because they're so big. And I didn't know who I could turn to because I know what education doctors have. I've spoken to thousands of colleagues over the years. And all of them tell me, I had one take me to the gym.

and when I deadlifted 120 kilos, they didn't know what to do because clearly I'm used to being in the gym. I had people who just couldn't see past my weight to understand that I really was trying. And I think sometimes in medicine, when we don't understand something, we dismiss it or we don't believe the person. And so that was personally why I set up my clinic, because I know people really are working hard and I actually listen and we work with people in different ways with JLP ones. Because what I've realized is that for me, I feel so healthy on a JLP one that it's easy to lose weight. And my weight loss, again, I don't really like to be that specific, but I lost a huge amount very quickly on the lowest dose. And my body felt great. I've never had

a single side effect. I didn't lose any hair despite rapid weight loss. And I wasn't doing anything dramatic. I was actually eating probably in the best balance I've ever had because I felt so good. And now that you have lost the weight, just tell me where you are at now and then we're going to bring Dr. Els Bailey back in. So I lost the way. weight within three months, I lost 56 pounds. And then after that, I actually, to show my defects as much as the things that have gone well, I actually got pregnant very quickly on a JLP one. And I share this because you should never get pregnant on a JLP one. I've never been able to get pregnant in over 10 years. And when I joked around with my friends who were obstetricians,

they said there's three reasons that women get pregnant on a JLP one. One is because they lose the weight. Do is because it regulates their blood sugar. And three, because they ophulate when they haven't ovulated before. But I've been lean for good periods when I've been dieting. I ovulate every month. I've been through IVF multiple times. I ovulate all the time. And my blood sugar, despite being fat, has always been very good. So I thought the rules don't apply to me. Why would I use contraception? And anyone who's been through infertility will tell you, you can be quite illogical when it comes to it. So I got pregnant within a few weeks before I'd lost weight, before I'd had any significant change in my body. So I have a big warning to all patients to make sure you're on

contraception before you start the medication because we don't know the effect it could have on a fetus but I got pregnant and so I had to stop the medication and then unfortunately I lost the pregnancy so I had a few weeks off it because I just I honestly wasn't thinking about my weight and it was strange because in that fifth week I carried on losing weight I was still eating the same way but in the fifth week my energy level dropped through the floor my acne came back and it's the only time it's been back in the last 14 months. And I just couldn't function the same way. I couldn't get full when I ate. So I went back on it. And within two to three weeks, I was back to where I am now. And I've just continued. And to be honest, I don't know if I've lost weight, because I don't weigh myself,

because I'm not interested. It's never been about being slim. For me, it's always been about having the best quality of life. And now, because I'm in a lean, a fitter body, I love exercise even more. But I don't do exercise to try and be thin. I do it to have a great life. So I've really got into running, which I've always wanted to do. Well, you sound like somebody who's already sort of exercised as well before anyway, but I mean, Dr. Al-Zabody, I want to bring you in because actually what we want to talk about here is exit strategy. And you say that people really need to think about this from the outset.

Can you explain and give us a bit more information? Yeah, definitely. And I think those points were really good there from Emma. And I think what we need to start to realise as society is that, you know, obesity is not a choice. It is a chronic condition and one that is relapsing. And so we know there are a number of genetic components that influences people's appetite control. And there have been various different studies over the years that have demonstrated that. And given the environment shifts that we've seen over the decades,

that combination of genetics in an environment now where we've engineered movement out and we've changed the food landscape vastly, it means that it can be very, very challenging for people to be able to maintain. weight through lifestyle alone in environments like ours. And the exit strategy is really important because for some, they won't want to be on the medication for long because they have different experiences. It's great to hear that Emma hasn't experienced any side effects, but many other patients do. And in fact, somewhere between 60 to 80 percent will experience a side effects of some kind. However, the vast majority can be worked through as long as they are talking and

engaging with their healthcare team to work through them. Now, the exit strategy is for, or those that have reached the target weight that they want to do and they feel that that is their focus. Now, bear in mind if they have type 2 diabetes, then in reality, we're going to be continuing this longer term. These medications are providing far more than just appetite control, as we've touched on. But where weight is being managed,

we need to understand that the injection doesn't leave a lasting legacy in terms of improving that weight balance. We need to think about what other measures we do alongside. Yeah, because I mean last week... Yeah, no, just last week we had doctors. Sarah Jarvis on talking about weight, the importance of actually strengthening the body and muscles and muscle tone. And it's not just as simple as kind of taking the jabs and just letting your body to kind of figure it all out. I'm really keen to bring in a couple of messages from our

listeners. Got a couple here. One says I had lost three and a half stone on weight loss jabs this year. I came off it in September as I wanted to break from the side effects and have already gained back two stone in three months. I completely understand. the reason for the weight gain is my diet. I found myself so hungry since stopping. My willpower seems non-existent. But it did surprise me how quickly the weight back went back on. I'm planning to restart the drugs in the new year

with the understanding that I'll probably need to remain on them permanently. If I'd like to keep the weight off, you're nodding, Dr. Elzebady. Yeah, like the experience there, first day, I totally understand. And it's very traumatic to have to go through that weight regain so quickly. And I think there's key measures. we know that there's emerging evidence to try to understand why we see weight regain so quickly afterwards and one component is the muscle mass component because when we do lose weight rapidly the quicker we lose the weight the more we lose from our fat-free mass that's like our muscle

our bone etc and the muscle is so much more important than just giving you strength and allowing you to move things because our muscles are one of our primary storage areas for energy so if you lack the same muscle composition that you had at the beginning of your treatment, then when you do consume meals, you have less of a storage capacity. And instead, it's going to be stored more increasingly as fat. And so when we look at the weight regain composition between fat and muscle, it's far more leaning towards the fat component. And women are particularly at risk of this, because although not old, there are plenty of women with a very high muscle mass composition, but generally they'll have lower muscle mass composition compared to men. And they do

lose more during rapid weight loss in comparison to men. And so it's important that we look to see how can we prioritize strengthening in a way that works for people because for many, they will find it difficult to suddenly take on strength training from the outset. And the symptoms during treatment can be difficult for some. So engaging in these kind of activities are challenging. Is it safe to take them long term? Do you know what? We have reassuring medium term data, predominantly for those with type 2 diabetes, where we're using the same medications. Now, to give you the kind of complete answer for long term, we don't have that yet. But I think what we need to start to understand is that obesity is a chronic condition.

It sadly won't go away unless we look to think what tools we can do alongside and embed important lifestyle measures. And Emma mentioned numerous things that she'd been doing. And these are all probably what gave her the best results while taking these injections. And then what can we do on a societal level? at the end of the day, there's a lot that government can do in policy to change the landscape to ensure that it isn't such a difficult place to maintain weight, because all of our weight as a population is increasing. It's not just a few.

Can I also just add... Yes, please do, Emma, quickly. Just that everyone who struggles with obesity is different as well. If you actually speak to people about their experience of why they struggle, they're going to need slightly different help. So one thing I commonly manage is people with ADHD and obesity, because actually there's certain habits and behaviours that the medication can absolutely help and support, but it's not the answer, it's not the fix. And so for them, it's actually about addressing these other

things. And everyone's going to be slightly different. So we can't predict at the moment when you go on it, what's going to happen when you stop it. So we actually don't know what we're addressing. And that's ever more important to address as we're increasingly looking at giving these medications younger. We need to know how to target them for the right people, so we're not over-prescribing them. And their lifestyle. Yes. Thank you both, Dr. Hussain. Al Zabedi and Emma Sanders. Thank you for now. And you can see the documentary

What Happens When, it's on BBC News and IPlayer, and if you have concerns about any of what's being discussed, you should speak to your GP, of course. Now, Amara O'Kareke has been taking the musical theatre world by storm with roles, including Cosette in Les Miserables, Eliza Doolittle, in My Fair Lady, and she's currently singing and dancing across the stage as American model Dale Tremont in the Irving Berlin's

1930s musical Top Hat at London's South Bank Centre. Amara, welcome to Women's Hours. Welcome back, I should say. Thank you for having me back. It's lovely to have you here. Now, Top Hat. It's a story of lovers, interwoven, with mistaken identity and has come, has some of the best songs in it, putting on the rits. Let's Face the Music and Dance, cheek to cheek. What's it been like singing these old classics? It's a real joy to be able to sing of in Berlin. He's, you know, we always say he's the true American songbook and he's one of those writers that even if you don't think you know any of the songs you've definitely heard them before

they exist somewhere in the back of your mind and that's just because they are some of the greatest songs ever written so I feel very lucky to be able to sing them it was originally a film from 1935 I'm sure lots of our listeners will know this with Fred Astaire and Ginger Rogers and you take on the Ginger Rogers role how do you think it speaks to a modern audience

What is it about this that people keep coming back to? Well, our director, Kathleen Marshall, she always says that this is just an old-fashioned rom-com, essentially. And, you know, it's the same old story two people meet. There's a bit of a mistaken identity situation, a bit of a farce, but eventually, you know, two people who were meant to fall in love, end up falling in love. It's feel good, it's joy, it's all these feelings that, you know,

you never get tired of. And no matter what's going on in the world, everybody needs a bit of permission to laugh and to smile and to feel good about themselves and that's what this show really provides. We as the audience love it and it's this time of year which particularly for me I love going out

and seeing shows at Christmas but what do you feel the same energy when you're on stage? Are you enjoying it just as much as us? Oh yeah, absolutely. The word of the show is joy. It just you feel it emanating coming off of us and coming off of the audience and it's just this back and forth of smiles. It's wonderful. I was reading that when you were younger, you watched singing in the rain every day. I did.

Every day? Amara? I mean, why not? So your love of musical theatre started young? Absolutely, yeah. I loved those movies. That golden age of Hollywood was just, it meant the world to me. How worn out was that VHS? Oh, yeah. There was a point where it stopped working. What's the appeal? I think it's just the ability for these performers to do every.

I mean, it's just pure entertainment. I think the choreography, the music, you know, you can't go wrong with something like that. Now, I need to celebrate you because you are remarkable, not only because you're from Yorkshire. You won best actress in a musical at the stage debut awards in 2018 for your portrayal of cassette in Les Miserables. You were the first black actress to be cast professionally in that role. Well done. Thank you. Where were you of the significance of that?

I was very aware because, you know, I obviously grew up watching musical theatre and looking out for people that looked like me doing these types of roles. So it really meant the world and, you know, it was a dream role and it was something that I didn't expect to, you know, come across, especially so early in my career, but I was absolutely thrilled. You were still at drama school when you got offered the part. And that speaks volumes about your talent. Oh, well, thank you.

I appreciate that. But you had to switch off your social media after that. I did, yeah. I mean, it was just a choice that I made for my own well-being. I think social media can be a very useful tool, but at times it can be a lot of noise. And sometimes it's a lot of opinions that are, frankly, none of my business, to be honest.

And I think I just didn't need to hear everything all the time. No, I completely agree with you. But why do you think that it caused that reaction? I think it's just, you know, it's always going to be controversial when something new comes along or something that people aren't used to seeing all the time. Anything that seems different to people can seem like a big deal even when it's not. And I think people are open to their opinions

and they are very happy to share them and that's completely fine. But ultimately, my job is just to get on stage and do what I do. And yeah, I think that's why I didn't need to. hear the rest of it. Yes. And your talent is your talent. Thank you. I have got to mention you're the daughter of Nigerian doctors. Yes. As a daughter of Indian parents, how did your Nigerian doctor parents respond to you wanting to go into theatre? Well they've both been incredibly supportive and very kind about it and patient with me and my mum has always been a big fan of theatre. She's the reason that I love musical theatre. She really introduced it to me very

young and I think over the years she sort of saw me fall more and more in love with it and so when I did eventually approach her and say this is something that I think I want to do she was sort of waiting for me to come to her with that and she was like I was ready for you to say that and my dad on the other hand bless him he he it was for him it was a bit more of a shock because this is an industry that he doesn't know anything about of course so he was a bit nervous about me going into something that he doesn't know anything about but I think once I'd got my first job he was sort of like oh okay you can survive off this so I can I can relax a little bit but they've both been wonderfully supportive and secretly hoping that if you could always go back

and study medicine you've been described as a new face of British theatre I have yeah how does that feel it's it's interesting yeah I mean I'll take it but I think the face of British theatre changes all the time I think that's what's great about British theatre is it's so diverse and so full of different kinds of talent and yeah I feel I feel great to represent that and you are still so young and doing so many amazing things like can you share a dream with us like where do you see yourself I think um I think over over the years for me it's just been I would just like to work consistently just keep doing great shows and great projects and um continue to live like that that's all I really want and we we hope the same as Well, it is delightful that you're back with us and you are going to sing for us. I am, yeah. Tell us what you're going to sing. I'm going to sing a song called Better Look Next Time from Top Pat.

If you take your position at the microphone, so Amara is singing Better Look next time and accompanying her on the piano is the show's musical director, Stephen Ridley. Wonderful. Amara O'Karek. What a voice, what a talent, the face of British theatre. Wonderful. Thank you so much for coming in again and speaking to us. And thanks to you, Stephen.

Brilliantly played on the piano there. Stephen Ridley is the musical director. And Top Hat is on at the South Bank Centre until the 17th of January and then touring around the country so you can catch it where you are. I'm going to end with a couple of your messages. Someone saying they're listening with their 14-year-old son and saying what the government is proposing. This is about the violence against women and girls strategy

is like giving a paracetamol for the symptom as opposed to treating the root cause. And a message from Anna about weight loss jabs. She says I've been on weight last jobs for 18 months. I was very obese and tried everything. I'm 53, so menopause made it harder. I'm fitter, healthier and happier. It's a total lifesaver for me. Join me tomorrow on the program. I'll be talking to Hollywood actor Kate Hudson. That's all for today's woman's hour. Join us again next time. Hello, I'm Nula McGarverin and I want to tell you about a BBC podcast called Send in the Spotlight. The number of children with special educational needs is increasing.

Too many parents are having to fight to get those needs met and councils are spending money that they do not have. Against a backdrop of government reform, I bring together families, teachers, experts and decision makers to reimagine the system. Listen to Send in the Spotlight on BBC Sounds. Thank you. Thank you.

Thank you. Thank you. Thank you. That's all for today's woman's Join us again next time.