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.

hey OP, theres lots of practical suggestions above but i would agree, whatever path you go down medically, having some sort of emotional support or therapy at the same time is really important. My friend ended up going down the surgical route with good success but even surgery doesn't work for everyone and i think getting to the route of things is really crucial.

I think when you get into the territory of 5+stone to lose it’s almost more about what goes on in your head than what’s on your plate, so looking for good support is the right thing to do. Be wary of Slimming World, whilst they say it’s all about balance etc, they do nothing to encourage you to look at your behaviour which leads to you being overweight, meetings etc are more about people sharing how they manage to ram a massive amount of “free” food into themselves, which doesn’t set anyone up for a healthy attitude to food.

if SW and it’s ilk was properly long term effective, they’d go out of business!

I had to bite the bullet (it was very tasty😂) and get surgery a couple of years ago-I’m 14.5 stones down, and now at a healthy weight with the healthiest mindset I’ve had in my adult life

My experience is that GPs are not great with understanding and treating obesity despite NICE guidance etc. It's worth reaching out for support, but don't be surprised if it's a version of willpower based support groups in the first instance.

@AustraliaFlights I'm not sure that my personal experience will be of any help to you and you are likely to get lots and lots of diet and lifestyle solutions suggested to you here. However I will add it here in the hope that it's useful to you or somebody else who may read it.

I'd like to add my voice to the recommendation to read Ultra Processed People if you can. I'm 50 and yo yo dieting since I was 12. I've followed every diet regimen known to man (including Ozempic). I've successfully lost hundreds of kilos over that time. And yet, there I was I was 40kg above the max recommended weight for my height and certainly in the qualifying range for surgery. I realised that a huge amount of amount of food I was consuming was specifically designed to be hyper-palatable / moreish / addictive and the disruptive impact it had on my health and ability to lose weight. I'm not even talking about the usual suspects like sweets and fizzy drinks but ordinary foods like sliced bread, yoghurts, baked beans, sauces, spreads etc. It's been transformative. I've lost 20kg so far but my mental and physical health has been transformed. I feel like a whole new person. I've lost that constant gnawing background craving / hunger that sooner or later has always been my undoing.

Whatever your next step on your journey is, remember, it's not your fault, you don't lack will power. A combination of genetics and the formulation of modern processed foods means that for many this is unavoidable. But there is a way out.

Wishing you health and success xx

https://open.spotify.com/episode/24FxMPfyoyOz2o2nJnvcm9

This podcast is a good introduction to some current thinking about ultra processed foods

I would recommend Unwinding Anxiety by Dr J. Brewer book. His methods work for all sorts of bad habits, from panic attacks to procrastination to over eating. I felt bored reading the book. However I tried applying the mindfulness approach in good faith. I have lost 3 in the last 3 weeks and I am not even hungry. I often overeat when I am stressed and tired. With Dr Brewer method no willpower is required (I have none at the end of my work day). I hope it helps

There is a book called The Full Diet by written by Dr Saira Hameed (NHS consultant). It is really really useful and aimed at people with significant amounts of weight to lose. It would be a great place to start to read it.

Simple things like starting a walk every day is good too. If you can afford it, start strength training with a personal trainer.

https://open.spotify.com/episode/5VSvk8JFw0Y15KZdDAupNr

apologies - wrong podcast. This is the ultra processed foods discussion

Speak to your GP. There are several services avaialble from free gym memberships and coaching support to something like TBC healthcare who run a weight management programme that helps you with any aspect you struggle with - you can access counselling for emotional eating etc. This is also the service to access weight loss injections and surgeries.

I'm 46 and have spent 25 years trying every diet, only to put on more weight than I'd lost. I have a non-related heart condition and by the end of last year was just straying into diabetic territory and was struggling to walk very far without getting breathless. I had 10+ stone to lose. I really felt that surgery was the only option to shift the weight and hopefully for good. I had private surgery at the end of march and haven't looked back!

I hope you find something that works for you.

Can I ask those who have braved weight loss surgery (not sure I'm brave enough), how do you manage if you've been left with lots of loose skin?

I worry that even if I could successfully lose a substantial amount of weight, I would just be swapping one set of problems for another as I have wrecked my body by being overweight for so long, so I know I'd end up with so much loose skin.

I know it would be healthier overall, but I'm not sure that day to day living with loose skin would be any better for me than day to day life with obesity.

Hi @ScaredSceptic I still have a way to go, but do have some loose skin on my thighs, arms and tummy. However I'll take that over finding walking hard and not wanting to do anything. It's hidden under clothes mostly and for me there are far more benefits to being slimmer and healthier.

I think the weight loss drug Wegovy could be something for you to consider, maybe talk to your doctor about it to see if you could it prescribed on the NHS. You fit the criteria as far as I can tell.

Do a lot of research into it first, it's not an easy fix. But to my mind, it's a less drastic solution than surgery.

https://healthmedia.blog.gov.uk/2023/09/04/accessing-wegovy-for-weight-loss-everything-you-need-to-know/

Thanks everyone. So many posts- which is wonderful! Just taking time to read them all.

I really would like to avoid surgery if at all possible. I feel like help really should be available before it gets to that point but not sure if it is.

To answer a pp I was googlefuing and found my county's pathway for tier 3 support and they'd only accept if Dr's have had 2 yrs of intervention first.

The phone appointment is with a "tell it how it is straight talking" older woman who I'm sure would be great at more medical things but I am a bit scared of talking to on the phone. I know I'm life limiting if I'm this big. I just need more help than "eat less" as its obviously more complex than that.

To answer another pp I have really limited mobility currently. I have had ME/cfs for 16 years (which partly led to weight gain as I because much less active so presumably needed less energy.)

In those 16 yrs I have realised I am.likely neurodiverse but again haven't yet got onto the waiting.lists as scared of going to Dr's with too many things so living with that for now.

I also have childhood trauma which resurfaced with having my kids - I had counselling for that which finished early his year and was truly life changing.

So although life has been pretty shit (and still have a lot of family issues, autistic child(possibly 2) it is now slightly calmer and I'm in a better position to "do something."

But last year I had repeated covid/chest infections and I'm now struggling walking, which prompted the dr visit. They've given me a physio app for that bit - of course it's probably size related but a year ago I was walking and now I'm not. So exercise is truly limited.

I dont want to calorie count. I have tried it before and got obsessive. I would really like to develop a healthy relationship with food. I think from googling those with adhd struggle more with impulse and its almost like a food "high" . And we miss the "I'm full" signals you'd hope would stop you.

I think we need to meal plan better. I struggle with this. Often after work I am completely exhausted (mix of ME and weight probably) and so instead of cooking (I struggle standing) we go for whatever is easy. Asking kids to make cheesy chips is easy for example. (Don't do that everyday but explaining what's happening!)

I want to increase fruit and veg.
I've started having nuts out so more tempted to snack on those than toast.

I am worried though at this weight I really need someone holding my hand. More of a positive reassurance and help than someone with a stick.

That's why I wondered about the Southampton thing (assume they do remote I'm not that close but our county outsources tier 3 to them)

I dont have a good income but would rather pay for help if it works.

I would try injections I think. But would be anxious about side effects. From what I've read you need to stay on them for life so what happens after the 2 yrs funded by the NHS? If our Dr's even does that?

I do feel a bit hopeless. I'd love to be able.to sort myself out. I've tried so many times so it isn't lack of trying its just each time I put more weight on...

Thankyou all again.

Just looked at wegovy. I'd easily qualify (sadly) .I suspect my bmi is around 50....

But I wish I could just sort it. Its taken 10 yrs of nearly a stone a year going on. So I imagine it won't go quickly. But every year I've tried something. And failed... its so disheartening.

I am scared.

You say you don't want to calorie count but that is likely going to be a significant part of any weight loss plan if you are over eating. Can you go into more detail about why that hasn't previously worked out for you?

I tried Ozempic which is the same thing as Wegovy but licenced differently. I will be very honest with you and say that I had to stop taking it because I suffered bad nausea and vomiting.

BUT I think I was quite unusual to get such bad side effects, most people on the Ozempic threads on Mumsnet seemed to cope with it much better than me. Some people have lost several stones on it as it really reduces your appetite severely - you just don't have much interest in food anymore.

It sounds to me like it could be worth a try for you, especially since you could get it on the NHS and benefit from their advice and support also while taking it. Even if you did get bad side effects (which most people don't) you could just stop taking it, like I did. The side effects stopped within days of my last injection.

I would also think you would qualify for Wegovy. And it could be life changing for you.

you are quite right in that people with ADHD struggle more with impulsive eating for the dopamine hit. I would hope that your GP would be aware of that but sadly they may not be.

I wouldn’t worry about what would happen after two years on Wegovy. I’m taking Ozempic (buying it privately) and have lost three stone. I have two more to go. My thinking was that losing a large amount of weight is so overwhelming and difficult that I would try the Ozempic to help me lose the weight and in that time change my eating and up my exercise and if I have to stop taking it I would still be in a hugely better position than I was and would find it easier to maintain. It will still take work to maintain but less than the mountain of losing a large amount of weight.

For your GP appointment I wonder if you would be able to email the GP first with a list of your issues and what you have tried already so they are informed before they speak to you. If not have a bullet list of things you want to say in front of you so you are controlling the narrative a bit. Rather than just say I need help to lose weight if you see what I mean.

Hi @Twiglets1!

@AustraliaFlights - @Twiglets1 is right. Some people get quite bad side effects but others don’t. My only side effect was constipation. Occasional nausea but nothing too bad.

Proud - yes lots i could say about this and I've done this before. In my case it led to quite disordered eating. Not eating things like avocados and eating lots of processed food as it was easier to "count" than working it out for a salad for example. Also trying to game it with "free food" rather than looking st the food itself. Low calorie yoghurts/etc often aren't healthier. I do get this works for a lot of normal people though!

What the tier 3 eduction looks like is a move away from focus on calories more to the type of food that is on your plate. Alongside triggers, recognising full signals etc. More the psychological side which I imagine is important at my stage. But I don't know if I can access this.

I can read this and it makes sense. I am not stupid. However I am struggling to just do it. I guess I. The same way we cna read self help books but counselling works better. Even if you have the theory.

I kind of know what I could do with but no idea if I can access it.

Wegovy looks fab. I think people tend to put it back on don't they but if the NHS does it alongside support it would be fab.

Hi @Peridot1 😀

You are one of the very best people that could possibly advise @AustraliaFlights on Ozempic/Wegovy because you are so well informed and give sensible advice.

As you say, many people only have constipation as a minor side effect and there are simple remedies for that.

And yes thankyou Peridot.

If it got me started so I was more mobile that would help!

My sister did this, she said one day a switch just flicked in her head, the only thing I can control is my weight.

she was late 50s, heading into all sorts of health issues. Lost 9 stone. Over 24 months. Started by tracking all her food, she used to eat a lot of pizza, pastry, garlic bread, red meat. Walks for an hour every night after work, without fail. She now does hill walking every weekend. Kept the weight off for a decade so far.

Calorie counting doesn't work for everyone @AustraliaFlights

You don't need to calorie count on Wegovy as you won't have the urge to eat much anyway, even snack food.

I think with any weight loss plan, people tend to put on weight afterwards unless they stick to the healthier way of eating they have got used to on the diet. I hoped Ozempic would kick start life style changes for me which it did to an extent even though I was only on it for a couple of months. Your appetite does return as soon as you stop taking it, that's true. But you will hopefully have lost a few stone if you can stay on it for 2 years which will make it easier for you to exercise and maintain a healthier diet as you will feel better about yourself.

I had gastric sleeve surgery which is amazing. Joined vitality health insurance for a year and then you get the surgery for 25% of the cost so I paid £2600 for it. Highly recommend

It very much depends on your area.
If you were speaking to me as a GP I'd be empathetic but there's not a lot I can offer you.
You can't see a dietician in my area as you wouldn't meet their criteria (they don't see overweight people).
You can't get access to a medical slimming programme eg ozempic or wegovy etc because there isn't a pathway in my area. It's literally not available on the NHS in my area (and we can't even get it for our diabetic patients who have been on it for years because there's a national shortage on the NHS as so many people are paying private clinics for it).
You can't get free slimming world (or equivalent) as that doesn't exist in my area.
If you're not one of the first people asking for help in April you won't get a referral to the "weight management service" because it's capped (and also crap) in my area.
I can give you orlistat which is of questionable value really.
But honestly bariatric surgery is going to be your best option.
Losing that much weight is hard but possible as an adult. Keeping it off is almost impossible. There are people who do it and do it very well. It's very very very hard. Weight loss as an adult is so much more than calories in/out and getting the right balance/ratio.
Bariatric surgery is not easy but it's by far the best option for maintaining significant weight loss. The waiting time in my area is around 12 months which is bad but not as bad as the waiting time to see, for example, a dermatologist or a neurologist.
I'd ask for a referral.