Where do I start? Morbidly obese ADHD Help?!

[HydrangeaBush]

Hello,

I'm 21 stone. I think. I'm truly floundering at approaches to lose the weight and feel stuck. I'm also struggling a bit in my work and trying to change direction to something less overwhelming and failing.

I'm also due an ADHD and autism assessment in the new year.

I feel for so many years my life has been truly floundering and each year I try to address it it gets worse.

The mobrid obesity is affecting my mobility now.

We are low income but I was wondering whether it was worth stretching to get
weight loss injections as it would potentially be life changing.

But if they want to prescribe with adhd meds that's going to overlap isn't it.

And my GP just told me to eat less and if I just ate 2, chocolate bars a day I'd lose weight as it was calories in/calories out.

I feel like I want help to gain muscle too and obviously I'll have lots of excess skin.

My whole life is a mess and I don't know who to go to for help. It feels like the adhd dr in Jan can talk to me about adhd. I could go to Asda for mountjuuro and they can talk about that.

But I don't trust my own decision making skills and I have no idea.

I'm scared of spending money we don't have (at a time the kids will need driving lessons etc) just to pile it all back on again too.

I did tier 2 with the local NHS but it wasn't great. Just a chat about trying to eat more veg.

But I feel it's an overall thing I'm struggling with (time/energy to cook and eat well. Executive function to plan meals etc)

Honestly I'm struggling and don't quite know who to go to for help.

I understand that the (likely) adhd is impacting on your ability to make a plan and follow it through.

As an external person, if your kids are 11 and 15 then you can focus on helping yourself before you need to worry about driving lessons.

Your assessment for adhd and autism is in process and there is nothing for you to do about that until Jan.

You could start on mountjaro now and see how that helps with your weight, mobility, energy. Any impact with adhd meds will be taken into account at that time. If the weight is impacting your mobility, mood and energy then doing what you can about that will help with the rest.

If the 15 year old is the one who likes tiktok meals then can she help plan and cook them? Agree with making multiple portions and chilling/freezing so you do not have to cook multiple options daily.

I’ve followed along some of the long running threads on here. I went with MedExpress as they’ll price match any others and credit your account. I have a £40 off code if you do decide to try it ( I’ll message it to you) which also gives me £40 credit :)

Reading the weight loss injection threads it sounds like the effect of mounjaro on food noise is very similar to the effect ritalin has on food noise for me. Though the ritalin also makes it easier to focus and function when I can actually remember to take it, I have currently misplaced it somewhere in the house.

Is your diagnostic appointment with a psychologist? Psychologists can't prescribe medication, I don't know if they can recommend it or if your GP will be happy to prescribe ADHD medication without specialist advice. They may want you to see a psychiatrist, so that may cause a delay. A Psychiatrist or Paediatrician usually makes the treatment plan saying which medication to start with and information on dose. Methylphenidate is the most commonly prescribed ADHD medication. Methylphenidate, Dexamfetamine and Lisdexamfetamine can all cause decreased appetite. NHS doesn't mention decreased food noise, but for me thats how ritalin decreases my appetite, Im just not interested or hungry for food when I take it.

Yes it's an NHS assessment through Right to Choose and they can prescribe. Either they do shared care with the GP or they continue to prescribe with NHS prescriptions. It will be in January so maybe I should be patient and see how that goes.

I sort of want to lose weight first to make sure my blood pressure is low enough but maybe I could sustain some at home changes for a few months just to get to that point.

I really don't know much about the different adhd meds.

I see you say ritalin is good for getting things done and elvanse sounds like it's also prescribed for binge eating.

I don't just want adhd meds for wight loss though I want that for functioning. But obviously I'm looking at both issues and they're intertwined.

Not obese but ADHD / autism. Imagine that you had your diagnosis today - what would you do differently?

You could acknowledge that at least some of your planning / exec functioning/ impulsivity issues are down to how your brain is wired - so change things accordingly. You know this from your own kids most likely. Think about how you would improve things - maybe an online shop once a week so you can plan over a few days or avoid the temptation of sweets etc, or whatever works for you.

Download a gamified exercise app to build a few minutes of movement into your day, or a walking or c25k group for accountability.

Etc

I have diagnosed, medicated ADHD (& undiagnosed autism) & Mounjaro has been amazing for me. 53lbs down so far. Food cravings gone. Alcohol cravings gone. I'm even spending less. It's expensive but has been life changing for me

Wow RuLu that's fantastic.
Do you think you'll have to stay on it forever? Had you already been on adhd medication for a while.

I think to answer a pp I've run out of "things I'd do differently" which is why I am hoping medication can help. I'm just not sure whether to wait til say 3months on adhd medication to start wli or start wli now.

I recognise my impulsive nature that after reading lots I now want to do wli now... Like today.

I'm also not too sure what I'll say to people if the weight does come off.

Normally, as you are close to your assessment, I would suggest completing that process first because a) ADHD meds may reduce your appetite anyway and b) they may help your executive function and allow you to do the boring, sensible but necessary planning stuff that means eating better. Then you can make a decision about GLPs.

But - if you have raised BP you may need to reduce it in order to take the ADHD meds. In this case it might be beneficial to start with the GLPs. You need to talk to a health professional who will give you objective advice so that you can make the right decision for you. I would suggest starting with your GP or someone who is not going to make a profit from weight loss injections to make your plan even if you have to go to a private provider to get the actual injections. That way you can be confident that you are on the right path.

To add to what others have said, try to stretch to Monjaro or similar if you can.
I'm also awaiting an ADHD assessment and you sound very much like me, overwhelmed with choices and unsure what to do first.
I've lost 1.5 stone since August on it, it's not cheap and I get nausea and fatigue as a side affect but its worth every penny.
As an aside, I think SW has a very distorted view on what 'healthy eating' is. I lost 2 stone in a year on it, then put it back on. I bet the whole diet club industry are frantic about these weight loss drugs!

You also need to factor in the timing for starting ADHD meds - perhaps others on here who went through the NHS can advise.

Ie you currently don't have an appointment but think it'll be in Jan (?).
Appointment + x weeks - report and diagnosis
Appointment + y weeks - referral to psychiatrist (?)
Appointment + z weeks - psychiatrist appointment, start titrating medication.

I'd be very surprised if come 30 January you've got a diagnosis and a bag of dexamphetamine in your hands.

I was on evlanse and that really reduced my appetite. I had to come off them as it was taking the ADHD meds that made my asd unmask! ( diagnosed ADHD in 2023 and diagnosed with ASD 4 months ago )

So the referal has gone through and I believe that this provider is quick to prescribe if you are deemed as needing medication (I know one of the others puts you on a new list).

It feels like I've been on the adhd/autism journey for years and it's now getting towards the end. I kind of wish I'd started wli a few months ago!

But yes I guess it may be my asd assessment first. I don't know which order they do it in.

I'm itching to start wli butrealistically on our income it makes sense to try the adhd meds and stabilise first.

It would be great to know they're in sight and to have A Plan though even if it's a good while away.

Same. It was terrible. And a cracking headache to boot and incredibly dry mouth, even if I mainlined water.

If you look on Reddit and elsewhere you'll see plenty of "AuDHD" people who didn't get on with stimulant meds. My experience was awful and I'm too scared to try second-line/non-stimulant meds now.

Yes me too I am not medicated for the ADHD at all as life was much harder when the autistic traits came up stronger 😅 but knowing that I am AUHD has helped in general as I'm no longer pushing myself to do things, I just take everyday as it comes now and it's a lot easier mentally

I've saved so much money since I've been on Mounjaro. I don't buy or eat/drink alcohol or anything fizzy, crisps, nuts etc, chocolate or takeaways. It makes such a difference to my finances.

Oh gosh I was hoping adhd meds would help not make it worse!

I noticed there's a thing that MJ might affect mood. I really need not to have lower mood.

But then adhd meds could affect sleep and anxiety... Grrr.

I wish I could afford a private specialist!

I miscounted the weeks so it's probably 3 months til my adhd assessment. But I feel I ought to try that first.

Hi, sorry to hear you are struggling. I don't have a diagnosis or anything but I do have some similar traits especially executive dysfunction. Anyway if you are an "all or nothing" person like me then you might get on well with a total food replacement plan (I am on New You Plan and they do meals, soups, shakes and bars) and I love it because it takes away all the thinking, meal planning etc. I know at some point I will have to eat "normal" food again but for just getting the weight off it is fab. It's not easy, especially at first, but if you're struggling with meal planning and calorie counting it just takes that away.

I'm ND and obese so fully understand the struggle. The two definitely feed into one another. I'm in hospital having taken just one 2.5mg of Mounjaro so biased in saying definitely don't go there!

Omg what happened?

I'm currently thinking get settled with adhd meds as I will want that long term and then try MJ as it seems that lots of people have had success and long term morbid obesity will kill me...

But hospital???m Sorry to hear that. What happened? Are you okay now? Did yiu know it was the drug straight away? I'd have to start a day I could easily go to hospital 😬

@HydrangeaBush I'm in a similar position to you. I weigh more than you do currently and also have ADHD.
I'm now almost 2 stone down after starting Slimming World at the end of August.
Going to group each week keeps me accountable and helps maintain the motivation to keep going.
I have a few meals which I batch meal prep and always have either in the fridge or freezer ready to go. So if I'm hungry I have something available fairly quickly.
I find the weekly support from the group is fantastic too. It's an hour a week where I can concentrate on it. I know there is lots of people who criticise SW on here but in my experience most of them have never been to group or properly follow the plan.

Yes definitely an adverse reaction. I have acute pancreatitis. It is extremely painful.

Gosh that's scary. My mums got pancreatitis. Can they treat it? Will you be in hospital long? Was it after the first shot?

I have ADHD and have lost a lot of weight.
What helped was working on my relationship to food. I saw a therapist about food issues through tier 3.
Working out why I overeat and my feelings towards food.
I tried stimulant ADHD meds and didn't get on with them. In terms of appetite they do reduce it and make food seem more repellent but I don't think that's a long term fix personally.