To think that most health care professionals are hopeless at advising on weight

So why do dieticians have to study then? I mean after all all they need to know is 'eat and drink less crap'??

Do you not understand there are many reasons people are overweight? For example due to medication?

And clearly you have no clue about being preventative? Then we have less people to scan etc.

@Hellostrawberries What do you think the HCP could have said in this situation? I mean this as I’m genuinely interested.

also to add, I think you get this nonsense obvious advice in loads of context, my friend has chronic insomnia and the doctor asked if she had considered lavender pillow spray. I had chronic back pain for years, and repeatedly was asked by Doctors if I tried Pilates, I had done it for absolutely years and could plank for minutes... It's just autopilot I think.

I just think it's a checklist they run through, eat well, less alcohol, no smoking, more sleep.... Etc there isn't much more they can say in a short amount of time. I do wonder sometimes if things are missed in patients over a certain bmi as any symptoms are attributed to weight but I'm just spectating.

Errr this.

Your BMI is 39 so that is a risk factor and he had a duty of care to mention it. There are some procedures that they won’t do over a certain BMI e.g. IVF is 30

@Riversideandrelax ...there are HCPs appropriately trained to help people with complex obesity, however it's unreasonable to expect a doctor from a different specialty to have this in depth knowledge.
If you are going to argue that being overweight is a complex medical issue then surely you want people being seen by the doctors and nurses who are specialist in that field ?
Because if you think every doctor should be able to give "better" advice despite that not being their speciality then we are effectively saying it's not complex or a medically complex problem because any doctor can dish out the right advice

@Riversideandrelax what would you have liked the HCP to say in this situation?

I agree with this. There is nothing he can say is there? You know you need to lose weight and how to do it, he knows you need to lose weight and know how to do it but don't. It had to be said though because your weight is impacting your health. As far as he is concerned now he has told you what to do and it's up to you whether or not you do it. He can't really do much else, lifestyle choices are something that HCPs can't change for you.

Even after 2.5 years of waiting for tier 3 support I’ve been told there’s actually nothing they can really offer me as the local icb won’t fund certain medications and I don’t want a gastric band 🙃

No, you can't say it about anything.

You can't take your own appendix out, CT your own brain, fix your own broken leg.

You CAN eat and drink less crap, move your body more

It rather depends on what the speciality of the doctor was...so if you'd been referred to bariatric service id expect a bit more as it's their speciality, however if you were seeing an orthopaedic surgeon about your dodgy knee for example, NO it's not reasonable to expect them to have a deeper understanding of disordered eating and obesity and weight loss...
As said up thread at some point self responsibility needs to kick in and we cannot expect our HCPs to omnipotently knowledgeable in everything. If you think you need tier three help ask your GP to refer you to the appropriate doctor/team..

You could say that about anything. You have any health condition whatsoever - you have to take responsibility yourself. But if you need the professional advice of a dietician, 'taking responsibility for yourself' isn't going to cut it.

And the other reason your advice is crazy is being overweight means you will need more help from the 'overstretched health system' so what we really can't afford to do is not help those who are overweight.

This is a fair point but it is likely to be cheaper to provide effective support than to deal with the health costs associated with obesity

Yes, we are just saying they need to be clairvoyant.

No one is saying it’s their fault.

At a certain point in a nation's overstretched health system, you have to take responsibility for yourself. We are at that point. Not the HCPs fault.

I have found our local services useless. At my request, I was referred to a weight loss service only to find that it only operated Mon-Fri 9-4 (so not something you can access regularly if you work). A year later, again at my request, I was offered an online appointment which my GP inferred was with a dietician. The person definitely had not had any in depth training and the advice offered over the two 30 minute. appointments was eat fewer snacks. She was a complete waste of my time and of NHS resources. I have now requested a referral to the specialist weight loss service. I wasn't referred and instead have been sent for a blood test. This seems to be a thyroid check (I have hashimotos) and doesn't include a check for diabetes. I am trying to help myself and have had a PT for 2 hours a week since December. I am definitely fitter but have only lost 4kg in weight.

I have gained weight due to medication I have to take. I kept asking for help with my weight and was referred to a 'health coach'. She was dreadful. Had no idea about the medication I was taking. So vague. Told me to eat more and 'healthy' food and that was it really.

However, I then managed to get a referral to a dietician. He was great as he really looked at my case on an individual level and gave me some specific things to try, then at my second appointment really listened to what worked and what didn't and made changes. Unfortunately, I'm only going to see him once more as he has no capacity to provide ongoing support.

Agree completely OP.

I’m obese (very obese) for a variety of complicated reasons. If losing weight actually was straightforward there’d be no fucking fat people.

What could he really have said though?! What did you want him to say? If he had the magic answer that would stop your years of disordered eating I’m sure he would have given it to you!

I find that a lot of health care professionals are overweight themselves. It’s the blind leading the blind.

He knows you won't listen to him, but yes, he has to mention it.

A BMI of 39 is relevant to your health and your appointment. He needs to make sure you understand that. There is also some evidence that a HCP mentioning it can make a difference.

He knows you know. You know he knows you know.

At least he mentioned avoiding UPF which is better than recommending low calorie chemistry experiments. If and when you are in the right headspace, I recommend Andrew Jenkinson's why we eat to much. Amongst other things It explains why diets don't work.

What do you want them.to say?

Those are the facts

Fair point. If there is relevant research that shows that, then they should be made aware of it in their training. A question along the lines of 'do you feel you need any support to reduce weight' might be better. Although if people say yes, I don't suppose there is any. So maybe not.

So in the (30 seconds? 1 minute?) he had to discuss your weight, what should he have said? What would have been helpful?