Is my GP being fair?

[Losingmyboy]

-I am a wheelchair user following an accident. I can't use my legs.
-I had sepsis which gave me an underachieve thyroid.
-I now have type 2 diabetes due to weight gain caused by the above.
-I have to use my arms for cardio, but my breasts prevent me being able to do this long enough to get the cardio my heart (and my weight loss!) needs to be healthy. I often can't exercise due to the pain caused by my breasts rubbing and bras digging in.
-I have been professionally fitted for bras, they are just too large and get in my way.
-I eat less than 1200 a day, low GI, however due to my medication, I am sometimes forced to eat more in order to bring my blood sugars back up. I am often sick and the medications I take also cause weight gain or water.

I have lost the 2 stone I put on after being in the wheelchair, but now I have hit a brick wall and I am not losing anymore.

I went to the doctors with this dilemma - Pain, Breasts, Mobility, Underactive Thryoid all causing issues with me losing weight, which need to do to help with my diabetes.

His answer - lose weight.

I asked for better pain management, he said he didn't want me to get addicted.

I asked for a breast reduction, he said I would need to lose weight first.

My whole aim in life is to lose weight, I feel like he hasn't listened to me at all! I am dieting as recommended to me by the NHS dietician, the GP told me to "diet harder" and exercise more.

I am now feeling extremely low and found myself googling extreme diets, which I know I really shouldn't. But I am desperate.

Any safe recommendations for diets lower than 1200 for a diabetic?

[Losingmyboy]

underactive not underachieve!

[PopWentTheWeasel]

Go and ask him to be referred to a dietician to help you lose weight with your health issues. It's fine for him to say you need to lose weight, but not for that to be the end of the conversation. Are there any other GPs in your practice you could swap to?

[FixTheBone]

You need to research what your local CCG guidelines are for referral for bariatric weight loss surgery, but they will inevitably require going through a deitetics referral etc etc.

If what you say is correct though, your type of diabetes is potentially curable by returning to a normal metabolic and bmi state.

As for the breast reductions - look again at your CCG guidelines for referral, but even if you fall outside of this, your circumstances must be fairly exceptional, if not unique - see if an exceptional circumstances appeal can be made.

[Losingmyboy]

Thank you PopWentTheWeasel, I am already under a dietician for my diabetes. There are other doctors, however he is the head doctor and all other doctors put difficult cases through him, leaving me with not much hope, but I have to

[Losingmyboy]

Thank you FixTheBone. I am not large enough for weight loss surgery, not even close :-( I carry most of my weight on my abdomen which causes the diabetes and fatty liver disease.

I can absolutely reverse my diabetes if I lose that abdominal weight, which is what I am trying to achieve. My thyroid is back under control and I am no longer gaining weight, just struggling to lose the rest.

[LIZS]

Do you have access to physio or a wellbeing advisor? They may find exercise programs to help you feel fitter and start to lose weight. Is your diabetes well controlled? Chances are you would be too high bmi to risk elective surgery at the moment.

[bellinisurge]

I was "prescribed " a course of mindfulness run by local NHS for pain management. I was very sceptical but it really helps.

[Pipandmum]

What about the 800 calorie diet by Dr Mosley? It has had success in reversing type 2 diabetes.

[Losingmyboy]

Lizs, Thank You - I have a physio trainer whom I see twice a week (paid for by myself) we do what I can, but it is not enough.

Bellinisurge Thank You - I use mindfulness a lot, I am a parent so I cannot take my pain relief all the time, mindfulness helps me cope but it doesn't take away the pain sadly.

Pipandmum Thank You - I am not allowed to do the 800 diet due to a combination of low blood sugar and other medications I am on.

[Namenic]

Perhaps see if your dietician could work with a diabetes specialist nurse. Certain diabetes meds are better for weight loss (though may have higher risk of urine infection etc). Not all diabetes meds will cause low blood sugar. Some of the issues may be to do with the timing of food and meds and exercise as well as they quantity.

[Losingmyboy]

Namenic Thank You - We have done this, we went through a lot of different medications to get one that didn't make me constantly sick (though I was losing weight that way, so may just go back to that!) The diabetic nurse and dietician had to work together to stop me being ill.

They think I might be 2.5 (type 2 now but developing into 1)

[MrsBosh]

I know all practices work differently but surely you can request to see another GP? Yours sounds a bit like they're not thinking very holistically. If he is the Senior Partber that's just a managerial thing. All the GPs (obv unless registrars) are qualified and shouldn't be passing difficult cases onto him!

[Qwertypop]

I've heard some really good things about whole food plant based eating and controlling/reversing Type 2 diabetes. Have a look at the Clean Food Dirty Girl group on Facebook, loads of people there have come to that way of eating to try and reverse similar issues.

(PS I am not at all giving medical advice and I'm also not very good at following this way of eating but I do aspire to it!)

[Losingmyboy]

Mrs Bosh - Thank You. I think seeing another GP or even changing practises might be my next move.

Qwertypop - Thank You. I think I have heard of that girl. We do eat very well indeed, though we do eat meat. We have a Mediterranean diet mostly, lots of salad, meats, olives etc. No ready meals, no nasties. Low GI on the advice of the dietician and personally I prefer a low carb diet as lots of carbs make me feel ill.

I also have nutritionally balanced freeze dried meals I eat which make limiting my calorie intake - I use these when I am not at home. They are 400-500Kcal each meal and extremely filling. On the days I have those I am eating 800-1000kcal a day (excluding few cups of tea or coffee and sweetener)

My dietician has stated my diet isn't the problem, they cannot cut out anymore without making me ill. I need to find a way to exercise.

I feel like I am stuck in a rut I cannot get out of :-(

[lyrebird1]

Hi, I really feel for you. It is awful to be trying your hardest and still be struggling.

I have 2 suggestions. Firstly, ask for a referral to a pain management consultant (or see one privately if you prefer). They have access to lots of treatments besides addictive medications, depending on what and where your pain is (for example, they have given me lidocaine infusions, steroid injections and a combination of nerve painkillers).

Secondly, regarding the exercise, have you considered using a passive exercise machine at home for your legs? I don't know if they would be suitable for you, but your physio might be able to advise. They look like pedal exercisers but they are motorised so they move your legs for you.

I would also recommend using resistance bands to build some muscle in your arms/chest/back. I found that even though I didn't lose weight doing this, I lost inches from my stomach, and my metabolism is faster than it was before.

Apologies if you are already doing these things. Just a thought regarding breasts: Do you wear a sports bra? I swear by M&S extra high impact non padded, non wired ones. They come in front and back fastening styles (though come up a bit small!)

[trinity0097]

Low carb high fat is the way forward. Diet doctor website explains it all. I reversed by type 2 diabetes in 3 months on it and have lost almost 8 stone with virtually no exercise.

[trinity0097]

And you might not be eating enough to lose weight currently!

[Namechangeishard]

My dietician has stated my diet isn't the problem, they cannot cut out anymore without making me ill. I need to find a way to exercise.

You need to see a new dietician because something clearly isn’t right. It is possible to lose weight without exercising at all. The problem is not being in a calorie deficit.

Work out your TDEE here then reduce calories by 20% and you will lose weight. Log & weigh EVERYTHING you eat in my fitness pal (including cups of tea) It is amazing how quickly it all adds up.A Banana can be well over 100 cals, as can an apple, nearly 200 cals in a small amount of coleslaw - It all adds up! A sandwich can have more calories than a roast dinner.

My TDEE is 1550 cals per day just to stay the exact same weight. It’s hard

tdeecalculator.net

[Yorkshiremum17]

I second the Michael Moseley fast 800 diet. Basically cut bread, pasta, rice, sugar, wheat, absolutely no snacks 2 -3 meals a day follow a Mediterranean diet high in fat low in carbs and drink at least 2-3 litres of water a day. Intermittent fasting is also a useful tool when trying to lose weight so fast for 16 hours and eat in an 8 hour window. I stop eating by 8pm and don't eat anything until at least 12pm the following day, you're asleep for most of it so I find it really easy!
I know you are a wheelchair user, but are you able to go swimming? Great for cardio exercise whilst supporting your whole body and a final thought is there any way you could bind your boobs whilst you exercise to try and keep them out of the way?