Morbidly Obese - help?!

[OneMoreStepAlongTheRoadIGo]

I'd really love some support from anyone who has been here or who has knowledge in this area.

I am very overweight and really need to get a handle on it.

I would really like to try to avoid surgery although I suspect I would qualify.

Is there any help I can access?

Or what has helped people? its so different tryong to lose10 stone to 2! I am so ashamed its got this bad but I want to change.

Can you access any weight management services through either your local authority or GP? I think some proper support might be beneficial to help you lose the weight and then keep it off afterwards

I have booked a drs appointment but I'm not really sure - in the dark ages they just offered free Slimming world/weight watchers which I honestly think has not helped in my case.

But yes I would really like "Proper Support" just don't know what that looks like or how to access it.

I think the GP they've appointed for the phone appointment also isn't the most sympathetic. 🙄

Can you afford bariatric surgery ? My sister had it 18 months ago and has lost 9 stone .

It has changed her life . She had it at bupa and it was £10k but it includes so much pre and aftercare .

I approached my dr for help.
apparently I didn’t qualify for weight management via the hospital as my BMI is under 40 so was prescribed orlistat and told good luck.

It’s so backwards because surely prevention is better before it gets that bad.

ask for a referral to a dietitian

Yes I'm not too sure what to ask for. No I can't afford surgery but expect I'd get that on the NHS. Wow at 9 stone. That would sort me out but really not sure about surgery.

Orlistat - I don't really want to do that as am not sure super low fat will help right now. I'd rather get help with eating real food that includes avocado/fatty foods. Just the right ones.

And yes prevention would have been a. Fab thing as I've asked before and just got slimming world.

My bmi is over 40

Just not sure what to ask for or who can help.

Or even if I could pay for help but not just some random pt it would need to be someone who understands morbid obesity...

I also suspect I have adhd/ I've wanted to try drugs for adhd for ages but haven't go around to referring and I know the waiting list is long.

I have also asked for help with mobility and they did book me a physio for that.

You may be able to get it on the nhs but the waiting will take forever .

Maybe I should ask for it and then try and lose while on the waiting list...

I have a phonecard to speak to a Dr I just don't know what to say.

So the spire Southampton do a package for just under 500 which includes a dietitian and food related counselling for 12 weeks.

Now we don't really have 500 but if it means getting help I wonder if that's worth a go. I might contact then.

Try the NHS first. Availability is low in a lot of areas, and not all docs are helpful, but if you will struggle to afford private it is worth trying the free options first.

Read up on the NICE guidelines before your appointment (there are several, and they are in the middle of updating them at the moment so there will be a more up to date version out next year, but https://www.nice.org.uk/guidance/cg189 is probably the one you need). That will give you an idea of the options available and which ones you qualify for - surgery, drugs (there are newer and better ones than orlistat now), and referral to specialist diet and weight management programmes. There may even be funding available to cover the cost of a Slimming World type programme or meal replacement diet.

I would suggest looking at the new generation of weight loss drugs (Ozempic etc. yes, I know they are meant to be for diabetes) before considering surgery. I don’t know if you can access them on the NHS, you might have to go private.

I did wonder about ozempic.

It does look like you have to engaged for 2 yrs with the dr/tier 2 before they refer you for tier 3 help (which looks more helpful and isn't diety based)

But tier 2 includes slimming world.

So they want you to try something that doesn't work before giving you something that does. Arggg.

I'm terrified of surgery and it's long term implications. But also aware this is affecting my mobility so need to do.something soon!!!

I think I have the wrong dr booked for my call as I think she will just tell.me to eat less...

https://www.mumsnet.com/talk/weight_loss_chat/4683388-10st-plus-to-lose-part-2

Really great supportive thread right here on MN 😀

Slimming world does work especially if you currently eat alot .

You know you don't need to eat 1200 cals a day to lose worthy . At your weight you only need to reduce your cals by a few hundred and it will drop off because your body uses so many cals to survive and carry you around .

I'll try and find a link to the info

Where are you getting the '2 years at tier 2' from? I can't see that in the NICE guide (but only skimmed quickly, I may have missed it).

If you're morbidly obese it's likely you also have weight-related comorbities and would qualify for semaglutide - there's a table in the guide showing BMI thresholds for NHS prescribing.

I would go on the weight loss threads on here but also access appropriate hypnosis tapes on YouTube relevant to your situation. Suzanne Robichaud has stopped me eating junk entirely and the difference to my health has been astonishing.

Ozempic is for diabetes but the sister drug Wegovy which is for weight loss (same medication) is now available in the UK and on the NHS. So if you can get a sympathetic GP you may be able to access that.

If you think you may have the wrong GP for your appointment maybe try to change it.

In the meantime - if they offer Slimming World it might be worth trying. Concentrating on whole foods, lots of fruit and veg and whole grains and protein. Cut way back on any processed foods. Ignore the Muller Light and other low cal processed rubbish.

Try to reframe it in your head. It’s not a diet with an end in sight. It’s a way of eating healthy food for life as you deserve healthy nourishing foods. They will make you feel better. Cutting processed foods can help with inflammation and will help with general aches and pains as well as contributing to weight loss. It’s not a punishment regime. It has to be foods you like. Foods you can make easily. Foods that fit into your lifestyle.

MellyMays Weight loss on Instagram she has lost 10 stone through calorie counting.

I have a few questions:
How much/ what type of things/when do you eat?
Do you have family (partner, kids) in the house with you?
Who does the shopping & cooking?
The reason I ask is that I had a DH and child who I felt I 'had' to buy treats/certain foods for - which of course I also ate, which led to me getting fat. I was also unhappy at work and depressed which further led to me comfort eating.
Could it be worth exploring WHY you eat what you eat?
Whatever you choose to do, I wish you all the best. You've taken the first step of realising you need to do something - that alone makes you AWESOME in my eyes xx

Hello OP, everyone has their own way that works but I would highly recommend reading the Fast 800 as it talks about delay not deny and it follows a higher fat, higher protein Mediterranean diet to give satiety and avoid cravings.

As a previous lifelong dieter it's completely transformed my approach to food and I view it as something to nourish my body and don't really want to overeat or eat rubbish as I can immediately feel the difference.

I'd also recommend Ultra Processed People which is an eye opener and makes you realise that a lot of this is not your fault, it's an incredibly poor quality food chain that exacerbates a lot of weight problems but it's hard to avoid unless you know how.
I lost 3 stone which I know isn't the same as you but you will be able to do it, you just need to find your rhythm.

Slimming World/Weight Watchers do work if you stick to the plan as they plan is worked so you eat less calories but I get plan does not fit with everyone's life style.
I am currently doing Noom which I find really helps as there are daily lessons to read about the reasons we over eat and how to change bad habits, you enter all food/drink and it works out calories and gives you a realistic calorie range for your weight/height you can also earn more calories by logging exercise. But again like any thing you have to be honest with what you log for it to work.
Also you have to realise nothing is a quick simple fix it takes time and consistency to loose weight.

My best advice would be to chat to doctor but look at calorie controlled apps such as Noom try give them a good try and be honest on them. Look at current diet and see if any easy swops you can make for a healthier version (IE baked crisps instead of high fat ones or a smaller portion) try to stick to 3 sensible meals a day, 2 snacks if really needed (but try to make fruit or high protein). Try to move a bit more yes exercise only does not help you loose weight but I find if I exercise my mind is in a better place and I therefore dont crave eating rubbish the same. Try just going for a 10 minute walk to begin with and each week make walk slightly longer.

There is no magic bullet and whatever advice/help you get you need to listen and follow consistently for a long time to get results.

I second @hobbledyhoy’s recommendation. I lost 6.5 stone in 18 months. I started with a 3 month course of Saxenda and that really helped kickstart me. I do 16:8 fasting (usually I just have fruit and Greek yoghurt at 1pm then my main meal in the evening) and cook weeknight meals from The Fast 800 recipe books which are really great. Depending on what else I’ve eaten that day I will increase the portion but I always stick to low carb, high protein and under 1200 calories a day. From Friday evening to Sunday evening I still do 16:8 but I relax what I eat so I always know if I fancy something I can have it at the weekend. It has changed my life.

I relaxed over the summer and put on a stone which horrified me. My body just cannot eat what normal people eat – probably because I’ve fucked it up through decades of yo-yo dieting. It has taught me that I have to commit to a way of eating for the rest of my life, and this works for me.

I still have about 3 stone to lose.

I don't know if this applies to you OP, but I find the problem with the "help" available on the NHS is that it just assumes you are uneducated about what healthy food is. The number of times I've wanted to say "I'm fat, not stupid".

Now for some people that help will be useful, but I suspect for many, like me, it's as useful as telling a drug addict that drugs are bad for you.

I know it's not technically an addiction, but that's how it feels to me - that I am addicted to food. It's 100 per cent a psychological issue for me which goes back to my teenage years and comfort eating. In my experience there is no useful help on the NHS for that, but it may be region dependent.

I wish you luck. I know exactly how it feels to want so much to change, and yet constantly failing to do it. Feeling as though you are trapped in a prison of your own making. It's an ever present cause of shame, embarrassment and self loathing for me, not helped by how society judges the severely overweight. I wouldn't wish it on my worst enemy.

I'm not familiar with Spire Southampton, but I would check it out, read reviews etc. If you can get a quality package for just under 500 which includes a dietitian and food related counselling for 12 weeks this may be a good deal.

I agree with @Peridot1 , especially with regard to Concentrating on whole foods, lots of fruit and veg and whole grains and protein. Cut way back on any processed foods. Ignore the Muller Light and other low cal processed rubbish.

When I was on a diet, I aimed to eat 1300-1400 calories between 10 am and 6 pm (intermittent fast) and I cut out all refined carbs, sugar, alcohol and UPF. Eating mostly the following I was never hungry:

Brunch: 2 egg omelette with vegetables or mixed salad with 2 boiled eggs or a tin of tuna
Snack: 2 tablespoons of yoghurt or cottage cheese plus a cup of berries or a handful of nuts
Dinner: LOTS of vegetables plus c. 100-120g of lean protein (chicken or salmon mostly) and half a cup of lentils or quinoa.

I would make up a batch of salad dressing consisting of lemon juice, a bit of a balsamic, EVOO, mustard, salt pepper, so I could be sure to add only a teaspoon or so to my salads. I'd also make various marinades to flavour the chicken.

There's an excellent book by Dr Mark Hyman called The Sugar Solution which was a total eye opener to me. I also find Dr Becky Gillaspy on YouTube very good at explaining healthy dietary choices.

Can you also consider exercise? Walking is always good, but Lucy Wyndham on YouTube has lots of short and not very challenging workouts that are perfect for beginners. She is very calm and gentle - not at all shouty like some online trainers.