GP - Unrealistic expections re. weight loss help?

[DoTheChickensHaveLargeTalons]

I've been overweight all my adult life. Lots of denial, yo-yo dieting, etc. The weight is now affecting my health - had enormously swollen feet for a month now, breathless even though not smoked for a year now, and generally knackered for no good reason.

After months of psyching myself up, as I hate asking for help, I went to the GP today and finally admitted I need help to get my weight sorted. I was really upset and burst into tears as soon as I said it. She was very sympathetic, but all she had to say was eat less, exercise more, don't do faddy diets. Said all my health problems were down to the weight, and I needed to get on with doing something. She told me to come back in 4 weeks to get weighed again, and that was that.

I'm not stupid, I know HOW to lose weight, but if it was that easy, I wouldn't be so bloody fat in the first place! I'm not sure what I expected, but I thought she might have some supportive suggestions or ideas? I'm very near the tipping point where if I put on more weight, I will be unable to get about and burn calories, and will turn into someone who will end up costing the NHS a fortune. On the other hand, I suppose she is right, calories in needs to be less than calories burned to equal weight loss and only I can make that happen.

I don't know, I'm still tearful 7 hours on and just don't know what to do. What is the NHS supposed to do with someone like me? Or should I just get a grip?

[CombineArvester]

Hmm I would have thought they might've referred you to a dietician or something especially if you are getting to the point of not being able to get out and about...

What sort of thing have you tried? Have you tried Weight Witches / SW and all that? Hypnosis? What about counselling, are you a comfort eater?

Perhaps she was trying to give you a short sharp shock - I mean the reality is to lose weight you need to use more calories than you consume, but I guess what you were looking for is more practical / specific help in achieving this.

[Birdsnotbees]

First up, well done for facing up to what sounds like a really difficult issue for you - you deserve credit for that and I'm sorry your GP couldn't give you more support.

Sadly, in many ways your GP is right. There is no magic cure, just hard work ahead. And she's also right in that the key to weight loss is simple: exercise more and cut out/down on high fat/high sugar foods.

What she seems to have missed is the emotional angle. That until you break the cycle of essentially destructive behaviour (ie overeating), you will always struggle. Counselling should be available on the NHS but it's likely to have a very long waiting list. Worth asking for, though.

Cognitive Behaviour Therapy (CBT) can be really helpful in situations like yours and there are lots of self-help books on the subject in the meantime. I used them and it helped me address my own eating disorder - plus I did pay for private therapy for another issue, which as it turns out had a massive impact on my body image/eating - BUT I now rarely think about my body/weight, haven't dieted for 5 years and am slimmer now than I was in my 20s (and I've got a 5 month old baby).

The key for me was breaking the cycle and changing my mental approach. I don't eat crap now because I don't want to. I do do a lot of exercise, however, and will put on a few pounds now and again - the difference being it's no biggie if I do, and it's easy enough to drop the weight again.

Are there any support groups in your area? For eating disorders rather than slimming world or whatever - just as you say you know how to lose the weight but can't seem to do it. Sorry if I'm reading too much into your post, btw - if I'm way off the mark ignore me!

I hope that helps. I do feel for you. It's a long journey but you've made a start - I wish you all the best along the way.

[KilledBill]

Its possible she reacted this way as she thought you were after a free gastric band or weight loss surgery on the NHS. Maybe go back in the four weeks and ask to see a dietician.

[CrossWhy]

Doctors will often do this as they want to see what you can achieve by yourself. Ideally in 4 weeks your doctor is looking for you to lose 7lbs or just over 1.5 lbs a week. The doctor will then be able to see how comitted you are to losing weight before making a judgement on the best approach be it dietician, Orlistat or continue as you are if you are doing well. Some Lloyds pharmacies (depends on pharmacist more than anything else) run a free weight less clinic which will measure your weight and body fat content on a weekly basis as you work towards a goal (they will no doubt offer you some weight loss products along with the advice).

[AngryFeet]

You need to use a website like food focus or weight loss resources to keep a food diary. These will also tell you how many cals a day you need to maintain your weight. To lose weight you need to eat 500 cals a day less than this amount to lose 1lb a week. So if you need 2300 cals a day to maintain your weight you should eat 1300 cals a day to lose 2lb a week.

The first week you will lose more due to water weight and if you are very heavy you may lose quite fast to start with. Also your cals to maintain will be higher so it is not too hard to cut down to a reasonable level (i.e. you don't need to starve yourself). Can you give us an idea of what you eat on the average day (being honest, no need to be embarassed). It is honestly easy to eat well and lose weight you just need to make better choices :)

For example I am losing weight and currently my BMI is 32 (5ft 3 and 13st 3). I could eat the following in a day and still lose weight:-

B: 2 scrambled eggs with 2 slices toast and spread
L: Smoked salmon and cream cheese sarnie and bag crisps/jacket potato with cheese and tuna mayo/soup and a bread roll
D: Chicken/beef/lamb with mash, lots and lots of veg and gravy
S: Homous and carrot sticks

If you weigh more than this you can eat more than this to start with - obviously as you lose you are able to eat less.

Exercise helps a lot even if it is walking. You can start small like walking for 10 mins and build up. I tended to do aerobics DVDs at home as I hate the gym and was embarassed to wobble around in front of other people. I am basing a lot of this when I lost 4 stone a few years ago. Sadly babies meant I put it back on but I am working on it again.

YOU CAN DO IT! Honest :)