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.

@ScaredSceptic re loose skin…I have a lot of loose skin and I deal with it by ignoring it as for me it’s a vast improvement on the alternative, which is that it was all lovely and smooth because it was filled with an extra 14.5 stone of fat! It’s only visible when I don’t have clothes on, but it doesn’t stop me wearing a bikini on holiday.

Yes surgery is available and I’ve seen many many good results, but for me it’s too risky. Surgery wise it’s actually more risky than the original surgery was. For me, the weight loss surgery was about my health which has vastly improved, and skin removal feels like a huge risk for the sake of vanity.

I’m in my early 50s and I’d maybe feel differently about it if I was 10/15 years younger. I’d need a full tummy lift, boob job, thigh lift and arm lift, and for me, once you get into that territory where do you stop? I could have the body of a 30 year old but I’d still have the face of a 53 year old, so do I get a facelift too?

I’m a million times happier than I was when overweight and that balances out the skin issue for me

Ozempic is the drug designed for Diabetics that diabetic people can't currently get because too many people are ordering it for weight loss @Butterflytattoo

Wegovy is different, (even if it is basically the same drug). Diabetic people shouldn't be affected by overweight people buying Wegovy via private clinics because it isn't prescribed for Diabetics as far as I am aware. It is labelled as a weight loss drug, not a Diabetes drug.

Though hopefully @AustraliaFlights would be able to get Wegovy prescribed on the NHS in her area anyway - something to ask her doctor

It's fine to ask.
As I said it's not available in my area.
But it is the reason that ozempic is unavailable because it is the same drug.
I'm not complaining about people using it privately for weight loss. It's clearly an excellent method and, if it was available more widely on the NHS, would probably be a cheaper method than surgery (although obviously long term data is lacking).
But it is (another) example of crap central planning. NHSE etc have announced that these things are available on the NHS when they aren't in very many places (and guess who gets the complaints?) plus it's not available anyway, even if we could prescribe it (on the NHS it would be prescribed generically so the brand name is not relevant).

@AustraliaFlights - calorie counting makes me obsessed too. And yes it can definitely lead to disordered eating for some people. Diets in general can. I used to have days where I would have various diets literally swirling around in my head trying to decide on which to do. And the feeling of panic and failure and just generally feeling crap and useless was horrible. Ozempic has changed my life.

If you could get approved for Wegovy you could lose a significant amount of what you need to lose which would bring so many health benefits with it and would make it easier to maintain a loss and be more active. Wegovy and Ozempic (semaglutide) switch off that food chatter in your head. They help with inclusion resistance which a lot of obese people have issues with even if they are not (yet) type 2 diabetic.

@Butterflytattoo - let’s just hope that with these new drugs making such a difference for people who suffer from obesity the NHS will make them easier to prescribe. Ultimately the money the NHS will save in the long term with less obese and type 2 diabetes needing medication and other medical interventions must be considered. The current weight loss/management offerings must cost a lot for not much return.

@AustraliaFlights - a good read about obesity is “Why We Eat (Too Much) by Dr Andrew Jenkinson who is a bariatric surgeon. And it is about what he now knows about obesity and why it is so hard to tackle. It was a bit of a lightbulb for me.

Yes I totally take your point about crap central planning @Butterflytattoo

Sorry you're getting stuck with complaints about it when it very clearly is out of your control.

Saxenda? I have 4 stone to lose. I've been on Sax for 2 weeks and dropped half a stone all ready. Yes okay probably water.

Diet has been mainly low carb. No sugar, protein, greens and medium fat. Hunger has gone as has the 'food chat' in my head.

OP I needed to lose 9 stone. I was so ashamed I went to my GP and she put me on Ozempic. In 14 weeks I lost almost 3 stone. That enabled me to start going for little walks and be just a bit more active. The weight loss slowed but I'm still losing weight. I've now lost over 3 1/2 stone. It works because you don't feel as hungry. Some people do get side effects but I haven't. I just ensure I eat fruit, veg and have a glass of fresh orange to keep away constipation and it's fine. My DH started taking it after I lost weight. Now in 3 months he's lost 2 1/2 stone too. We both have more energy.

@caringcarer you were so lucky to have it prescribed weren’t you? It’s so unfair that the system means that some GPs can and will prescribe and some won’t.

Yes I was lucky to get it prescribed by my GP. DH paid because his go refused to prescribe. Now Wegovy is available it will be interesting to see if GP's will prescribe. In the long run it will be cost effective. Already I only need 1 blood pressure tablet and 1 cholesterol tablet instead of 2 of each and my asthma is so much better do I'm not needing to take so much reliever. So using less other drugs. Plus as my weight goes down I'm less at risk of a heart attack or stroke so GP's should factor that in before refusing people help.

If you need to lose a large amount of weight like that its easy to get overwhelmed and disheartened and repeatedly give up.
So I personally think its really helpful to make small interim goals and small lifestyle changes that you are likely to be able to stick to long term.
I lost 6 stone for my wedding. My big thing was walking. Doing a little more each day. Easy to incorporate. I got a step counter and it was like playing a game seeing if I could get my average up a little bit each week. I ended up doing the 3 peaks challenge which is 3 mountains and 28 miles in a 10 hour period. I never in my life thought I'd be able to achieve that. And I did it by walking more and more and up steeper and steeper paths a little bit each day over a year. (It took me longer than a year to loose 6 stone)
Do not try and go on a fad or crash diet. They get quick results but after a few weeks slow down and you are so depleted in energy and miserable that you will end up binge eating the weight back on.
Losing 10 stone will take a long time and a large part of doing that is accepting its going to be slow. But keeping at it in a way that you can manage long term. Do not starve yourself just make sure you are filling up on healthier foods and filling foods that are naturally lower in calories. You are less likely to binge eat crap if you are full.

I think and hope that more GPs will prescribe Wegovy for people with a BMI of over 35 (when there is more stock) than were prepared to prescribe for Ozempic, because it is labelled as a weight loss drug.

I'm sure GPs don't enjoy refusing people drugs that they are asking for but I did agree with their decision to prioritise Diabetic people for Ozempic while stocks have been so low.

Are wegovy and ozempic the same.

Thankyou to the GP who commented. I really appreciate hearing what they might say. I am really worried that bariatric surgery might be the only option though. I've heard/read others say similar things about losing so much weight being near impossible.

I really really want to do it myself. And I don't mind paying someone to support me. But I am anxious that the body will just sabotage attempts. I feel I want a psychologist who knows about eating!!
(And a chef... and and...)

It does make me wish people in the general public say "it's their fault /they're fattthey can sort it" when we have GPs saying actually that's near impossible..

It feels we're condemned on all sides with no route out!

There's some really good advice on here, OP. I really hope you can do this without needing to resort to surgery. Have faith that you can do this. It isn't insurmountable.

I second listening to the Zoe podcasts, and also recommend Intermittent Fasting Stories podcast with Gin Stephens. She lost loads of weight doing IF and talks to people about their inspirational weight loss journeys too.

Intermittent Fasting Stories

Wegovy & Ozempic are the same but Ozempic is licensed as a treatment for Diabetes in the U.K. whereas Wegovy is licenced as a treatment for Obesity. Wegovy goes up to bigger doses of the drug so you can increase the dose if you start finding after a few months that it’s not working as well at reducing your appetite.

@AustraliaFlights - yes Wegovy and Ozempic are both the same drug. They are both semaglutide. You could get Wegovy privately. Boots and Superdrug are both doing it but are currently prioritising current clients who were using Saxenda which is another similar drug - Liraglutide. It’s a daily injection as opposed to weekly but otherwise works similarly. (No idea why some of this is underlined.)

If you can afford to pay for psychological support instead maybe you could try to get an appointment with an endocrinologist privately. You could try the Spire in Southampton. I know of someone on the Ozempic threads who did that and the endocrinologist prescribed Ozempic. I am thinking of doing the same. For me mainly as I feel I know a bit more now about obesity and diabetes and causes and I would like the medical support going forward especially as more of these drugs are launched. We are currently in a bit of a Wild West situation where people are sourcing these medicines without really doing any research and not understanding how they work and why and they mess with dosages and timing etc. which is pretty dangerous.

These drugs are game changers though.

Read the Andrew Jenkinson book. I can’t tell you how much better it made me feel about it all.

Research the medications so you understand a bit about how they work.
Stop blaming yourself. You are not a failure.
Make one small change from Monday. Something you can stick with. What do you normally have for breakfast? Switching breakfast to something easy and healthy and protein based can be an easy win which will keep you full all morning.

You are not doing it to lose weight - you are doing it as part of eating healthy filling nourishing tasty food.

And feel free to keep posting here. There will always be the people who say just eat less and move more but as we know it’s not that simple for everyone so just ignore that type of comment.

Thanks peridot. I really appreciate the kind support so much.

I had Porridge today.

Rich tea mid morning

Lunch I had a peanut butter sandwhich, satsuma and a naked bar (I know they're upf but they're easy to eat at work)

I've come home and this is when I'd often want toast/crisps. Crisps are my downfall.

I've made a bowl of mixed nuts, 2 dried apricots and a few dark chocolate drops.

So it feels I've had something snacks but has some real food too.

Tonight we're having salmon, green beans and potatoes as that's my favourite "healthy" meal. We often ate pizzas Friday so the kids might still have pizza.

The difficult bit is not eating after or eating cheese...

I have the book Ultra processed people/food whichever one it is by the tv dr. But struggle to read /concentrate at the moment.

I'll order the other one too.

I really do want to make changes without surgery.

I dont really have "spare money" by mn standards... we live month to month and down have proper pensions etc.

BUT the 500 I wondered if they had a plan etc would be worth it if it works as at this rate I won't live to retire anyway.

No idea about medical support costs though.

I have the Ultra Processed book too. Scary isn’t it? Just read bits as and when you can.

Porridge can be a great breakfast for some but for others it can spike their blood sugars and leave them hungry mid morning. Could you switch the porridge for eggs or Greek yoghurt and berries?

All the posts and advice on here must be overwhelming.

How about giving yourself a week to have a good think about how you are going to do it. Don't diet but think about what you are eating. I'd weigh myself too. Some people don't like too but it motivates me.

I think logging all your food is essential. You don't need to calorie count it but you should still log everything. It sounds like you already know what foods are better to eat and if you have already done 'obsessive' calorie counting then you will already have a good grasp of portions etc.

You said earlier that it's not as simple as eating too much, I understand what you mean but in some ways it really is as simple as eating too much. I think it's easier to deal with if you keep things really simple. Involving too many people and too many avenues of help is going to make it too complicated. You need to keep,reminding yourself that you are doing this for you and no one else. You have all the control.

You've not been putting weight on crazily quickly so it's not as though you have to slash the amount of food you are eating. You are in the habit of eating a little bit too much and you have to change that habit. Slowly and steadily. Don't do anything drastic.

Can your partner help out? You mention crisps and similar? Are you sure you need to even have them in the house? Can your partner do the shopping?

The best book l have ever read on this subject is Why We Eat (Too Much) by Dr. Andrew Jenkinson. He is a bariatric surgeon who has listened to his patients and conducted his own research into the obesity epidemic and how people can be helped. He is particularly sceptical about Slimming World and Weight Watchers. His very compelling argument is that while they work in the short term, they do not want you to succeed in the long term because they are businesses and want your repeat custom. I think you are very wise to avoid Slimming World. I can’t recommend this book highly enough and I think it is very helpful for someone such as yourself who is serious about losing weight.

Thanks violin- yes I've read enough to know slimming clubs aren't really a long term solution. I've just ordered that book as a pp mentioned it.

Curious he's a bariatric surgeon. Presumably he thinks surgery is ultimately the answer but be so good to avoid that.

I'd like someone to look at what I'm eating with me (food diaries) and help me improve. And yes I agree about all the competing info! It's like I need a coach I can trust.

I rang Southampton and can't get through to anyone. One person thought I wanted bariatric surgery and started giving me consultants numbers. The other link got me to physios who put me through to the nhs "weigh ahead" programme they run (but is gp referal after 2 yrs here).
Their answerphone says they ahve a long wait but also that wl injections are not yet available on nhs. So that's my answer about that.

I have no idea about spiking blood sugars with Porridge. I quite like it. Sometimes I have toast and marmalade and sometimes coral so Porridge seems best of the 3. I'm not great with yoghurt or eggs in the morning. Love It other times though.

Zoe had a thing where they got you to wear a blood sugar monitor didn't they but again didn't start down that track either!!

I so wish I had private health care and could go all guns blazing!

I am also morbidly obese, and short of surgery I don't know if that will ever change... But I train 4 times a week swim once and walk 10-15k steps a day and so am moderately fit - that is the one thing that has made me feel so much better! have you had a look at rebel fit on facebook? you dont need a PT to be an expert on obesity - I hit the jackpot with my trainer - never once has weight loss as a goal been mentioned - all about what your body can do rather than what it looks like - honestly once you change your mind set to that mentally helps so much - good luck with everything xx

As far as I remember, Dr. Jenkinson would rather avoid surgery if at all possible but he does think that it can help many people.

@AustraliaFlights - we have private healthcare and it’s still not easy! The insurance companies don’t tend to cover weight loss.

The book I recommended and also @Violinist64 is by a bariatric surgeon yes but it’s more about why obesity is so hard to treat and what he has learned in treating obese patients. He doesn’t try to push surgery at all.

The Zoe thing with the glucose monitor can be interesting I think but there are a few threads on here about it and some people are a bit disappointed in it. About porridge - Tim Spector of Zoe found porridge spiked his blood sugars.

I wouldn’t go down that route really. Certainly yet. It’s also really expensive.

Concentrate on protein, fibre, whole foods and lots of water. Just do that for now. Don’t try to do too much at once.