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Obese... Sick of it... What help can the NHS provide

212 replies

Platypusdr · 02/02/2025 18:28

I am severly obese. My BMI is 44 and I am pre diabetic. I asked my GP for support and they directed me to their 'wellness coach' who I found not that helpful. The main thing he told me is to use the portion plate and to eat a olate of vegetables /salad first and then go to eat the rest. I found this quite helpful. But things are not moving down (In 2 months I have lost 2 kgs).

However I feel like the meetings arent dealing with the underlying reason as to why I eat. The last meeting was a disaster (me crying all over the appointment around pumpkin and whether it should be a carb or a veg... As he said I should limit it but couldn't really give me the reasons why and where it should be in the 50% veg, 25%carb 25%protein portion plate and seemed to say it is veg out carb and couldn't decide which made it so confusing and so many other things). I then mentioned that I feel the meetings are nice enough but the main message is limit food, but not really dealing with the underlying issues as to why I eat, which I feel is not sustainable.

Anyways... I want to know if there is anything else that I can ask for help from from the NHS, or is this it? I would like to go to the next meeting prepared and know exactly what I can ask for as I know that this would be helpful.

OP posts:
Splattsagain · 02/02/2025 19:04

I was in your position last year - BMI of 44, and never had success losing weight long term. I've been on Mounjaro the end of May last year, and BMI is currently just under 37. My weight loss is slow and it took until August for the injections to be effective for me, but it's SUCH a game changer now in terms of significantly reducing food noise. Just had my annual bloods done and my blood sugar has also gone down.
I found the GP support not remotely helpful tbh, just sending you on courses to tell you what to eat. I already know what to eat, what I needed was a tool to help me implement it, and right now Mounjaro is precisely that tool. The NHS courses tend to assume that fat people have no idea that sugar = bad, movement - good etc, it was all pretty condescending and useless. For me at least.

Angliski · 02/02/2025 19:11

Try Food Addicts in Recovery Annonymous or FA. It’s free. It’s a 12 step group. It works. I lost four stone and kept it off. It has been the only thing that worked. Free meetings all hours of the day on zoom.

here is the website. You are not alone. There is a solution x

www.foodaddicts.org

PrincessChicken · 02/02/2025 19:13

You’ve had some good advice here OP. One important thing is you are supposed to feel a bit hungry even after you’ve eaten your fill for the day. Not starving, of course, but you should feel like it’s possible to eat more. And eat slowly! You’ll feel fuller by the end of the meal.

Agree with other posters that in your position I’d try the injections and see where they get you. Friends have had some fantastic results and they really change the way you approach food.

Interested in this thread?

Then you might like threads about this subject:

PurpleFlower1983 · 02/02/2025 19:14

Pay for the injections if you can.

WhichPage · 02/02/2025 19:14

Slimpod is a great recommendation but is not a quick fix. I truly believe in it (it turns off the food noise honestly). Prior to Slimpod I have lost and regained several stones multiple times over thirty years with other traditional diets. Never before have my habits and lifestyle been improved to this degree. Importantly Slimpod is not a punishing diet and it addresses all the issues gently and requires little from you.All I have done is watch a few videos and listen to the tracks daily.

Weight issues can be very complex and imo more and more so the more diet plans you have tried. 6 months into Slimpod ( including extra @ 9.99 a month). I am three stone down and no longer binging. Not unhappy and not on a diet. I fully expect to loose my remaining spare 5 stones
and when I get there I will have good habits and lifestyle well established.

Forget the &@‘%* food plate!

supercatlady · 02/02/2025 19:14

In my experience you need to be very persistent. NHS weightloss seems to work in tiers. I was also referred to a well-being coach who said at the first appointment there is no medication on NHS. Iknow this isn’t true. My BMI was just below 40. I asked to be referred onto the next tier but would told I’d have to try Goji/Slimming World for a good amount of time first.
im on the verge of trying the jabs privately.

Plantlady3 · 02/02/2025 19:15

Have you heard of ETPHD? https://www.instagram.com/etphd_coaching?igsh=ZjNwbjhhd2kzOWJ6

They have a 1-1 coaching programme but also lots of free advice on their Instagram. They also have a programme called Binge Breakthrough which is about emotional eating and getting to the root cause. I’d recommend following to understand more about why you’re struggling before yo-yo dieting again. I’ve been there.

Instagram

https://www.instagram.com/etphd_coaching?igsh=ZjNwbjhhd2kzOWJ6

ColourBlueColourPurple · 02/02/2025 19:18

Could you afford to go private for mounjaro? It may seem expensive initially however you'd make up the cost with buying less food as your appetite reduces, snacking etc.

Beeloux · 02/02/2025 19:18

I used to be obese in my teens. I tried many diets and failed but the only thing that worked for me was a low carb diet and the weight dropped off.

I swapped rice for cauliflower rice and konjac noodles. If I was craving a binge I would have watermelon or sugar free jelly/hot chocolate. Bulk meals up with salads or vegetables.

I lost 25kg in a year following a low carb diet and didn’t exercise once. Weight has stayed off since then. I now eat a lot of carbs but as long as I stay under 1800 calories I don’t gain anything.

TwirlyPineapple · 02/02/2025 19:19

I tried everything to lose weight and the only thing that have worked have been injections.

Someone listed the "causes" of obesity up thread but ignored the most important one: biology.

For too long, I believed the crap about willpower or that I was an emotional eater. The fact that I can take an injection and instantly eat like a normal person and lose significant amounts of weight with relatively little mental strain shows that it was actually a biological issue all along.

I'll be on the injections in some form for life, I imagine. And that's fine, because I've realised my obesity is a lifelong medical condition and this is no different to any other medical condition that requires long term use of medication.

Lobsterteapot · 02/02/2025 19:19

I was referred to NHS tier 3 specialist weight clinic in Nov 2023 and have found them absolutely useless.
They won’t prescribe Mounjaro (they’ve not worked out what the “pathway” and prescribing boundaries are unless you’re diabetic) the only alternative is surgery. I’m in the queue for that (Tier 4) but I’m anticipating another 18 month wait.
I’m paying for Mounjaro privately and it’s a game changer.

What I’ve learned from my NHS experience is - no one is coming to help, I’m on my own so it’s time to rescue myself with the WLI.

You can do this op.

Cornflakes44 · 02/02/2025 19:23

I found slimpod quite helpful. But you have to do it alongside some healthy eating otherwise you won't lose weight. I did it with 8:6 fasting. You can also sometimes get slimming world on the NHS. I lost 2.5 stone on that. The issue with injections is that it works as long as you're taking them so unless you're happy to be on them forever you might want to try some sort of programme to address your relationship with food (both slimpod and slimming world do this). You could always go for a low dose of injections to help with will power/ food noise alongside one of those so you have some tactics to help when you come off them?

Namechanged4obviousreasons · 02/02/2025 19:25

I’d think carefully about the injections as although they may help with the initial weight loss, they can come with side effects (sometimes serious) and it doesn’t address the issues when you eventually come off the jabs. There is a definite chance of relapse long-term, which hasn’t yet been publicised much as jabs are still relatively new. Whilst you obviously want the weight off to help your health, who knows what the longer health implications will be from taking medicine.

Instead of looking to drastically change everything to drop weight quickly, could you look at your calorie allowance and just knock a few hundred off to lose weight slowly? That is far more sustainable, doesn’t involve labelling any foods as bad per-se and hopefully avoids binging.

Eating more veg and low-cal foods will give you the volume of food to fill you and leave less space for the empty calories. Can you focus on finding nutritious meals that are packed with flavour so you don’t feel you’re missing out. There’s no sense in eating 1000 calories of veg if that won’t make you feel satisfied and result in you still eating 1500 calories of rubbish to get that hit.

Could you look at when you’re most likely to want to snack or comfort eat and plan that into your routine, so you leave enough calories for something then but add in something healthier too, to bulk it out. For example, if you like crisps, have less plain nachos and eat with homemade veggie chilli (beans to fill you and for nutrition). Or chocolate but less and crumbled over Greek yogurt and berries, so again it fills you more and packs in the vitamins?

Also, look at fats that you consume with those carbs. Carbs have been demonised but in reality, who eats plain rice or boiled potatoes without butter, jacket potatoes without butter and cheese, mash without butter/milk/cream. If you could cut the fat down, I don’t see anything wrong with moderate amounts of carbs. I whack fage yogurt in my mash (as an example) and plenty of seasoning, or cook a veggie curry (using yogurt instead of cream) and have that on a jacket potato as I don’t need the butter then for moisture. I avoid toast as I can’t have that without lots of butter, but you could spread runny eggs over toast or beans. It takes time for our palettes to adjust but I just think carbs in their natural state are not an issue as no one eats them without being paired with fats and sugar. It’s the combo which is calorific and doesn’t fill you. You could eat 500 calories of plain potatoes and be very full - far less full with 500 cals of chips though or potatoes laced with butter.

Sorry it’s a long post but hope some of this is helpful. Diet is such a tricky thing and there’s conflicting info everywhere but I really believe that trying to have moderation and some of what you enjoy (but tweaked) is the best way for long-term success. Pinch of nom cookbooks are pretty good for fakeaways.

SuchiRolls · 02/02/2025 19:27

You are in a similar boat to where I was 5 months ago. I have been on mounjaro and it’s honestly changed my life. My issue is also food noise and I am neurodivergent. Food has been my emotional crutch for so long, particularly sugar and high carb foods in general. I’ve lost and gained so many times. This is the first time in my life (I am 44F) that I feel in control. The first time in my life that I understand what it feels like to not be full but know I’ve eaten enough, and leave food on my plate with zero issues about it.

I take no joy in eating sugar any more. I pass the aisles full of junk at the supermarket and no longer have the pull of ‘go on. It’ll make you feel better!” I did eat some sugar over the Christmas period, but no where near the quantities I had been eating, and have pretty much stopped again now. I literally got to the point that sugary foods were about 80% of my caloric intake! 🫣 I now am in a deficit and eat about 1500 a day sometimes a bit less or a bit more. I eat lots more veg than I ever did and rarely have potatoes/chips/pasta and if I do it’s about 1/4 of the amount I did have. I have lost 4 1/2 stones and have about the same to go again. So yeah, I had gotten in a ridiculous state. The money I’ve saved in food has pretty much paid for the injections tbh as I was spending a silly amount a week on crap I didn’t even need. I was totally controlled. I have so much more energy, I can run and keep up with my youngest who is an eloped (one of my biggest issues as I was limiting what he could do as I couldn’t keep him safe).

The injections aren’t for everyone but they’ve saved my life! I have 3 boys (age16, 12,9) and all three are autistic. I have the same thoughts that I was going to die if I didn’t do something about it. I’m so glad I did! I pay privately for mounjaro. I did research and it seemed to be the best one for me.

Whatever you do OP, good luck. Take back that control 💪

rainythursdayontheavenue · 02/02/2025 19:30

Please don't go down the injections route - it's a quick fix, doesn't fix your underlying food addiction and could be doing all sorts of unwanted things to your body. And if you're pre-diabetic, you have to use it under medical supervision and not some random pharmacy online.

I'm type 2 diabetic and found that removing carbs from my diet has been the way forward. I have cauliflower rice instead of rice, have celeriac mash instead of potato mash, and roast cubes of butternut squash to satiate that carb fix. Once you stop your body from going on a sugar high/sugar low action from simple carbs, the "food noise" bullshit that people mutter about the injections getting rid of disappears without you spending ££££s. Protein makes you feel fuller for longer; and I stop eating at 6pm every evening which cuts out hundreds of snacking calories. The Freshwell App is brilliant as is the Low Carb Program. There's lots of support if you join - think it's about £65 a year and it's well worth it.

babyproblems · 02/02/2025 19:30

Can you find a nutritionist?
if I was you and saw no way out and had no spare money, I would ask chat gpt to make me a meal plan for weight loss; and then I would start walking - a lot. Like 3/4/5km a day every day. You’re not a human anomaly- you will be able to lose weight by less calories in and more calories out. Keep going. 2 months is not a long time. You might find change begins slow and then speeds up. Don’t give up xxx

soupyspoon · 02/02/2025 19:30

I'll be honest, all the therapy and mithering about apparent 'emotional eating' never solved any of it for me, I just needed to eat less and have a mechanism that allowed this and for me that was surgery

I couldnt get on with the injections but if I could I would just have taken those, I think they are game changers for the likes of us

The more you procrastinate and try again or try this book, that book, this pod cast, that pod cast, try low carbing, try fasting blah blh blah, more and more time slips by because you need medical intervention just like you would for any other disorder that you cant change by yourself

Thats my advice. I spent decades more obese than I should have because of 'needing to know the underlying reasons'

In the end there werent any, I just like my food and given opportunity, I will eat too much. I too home cook and scratch cooked everything, unfortunately I love my own food too much and we love eating out and have lots of holidays. I dont have a natural off switch and the injections will fix that. That is the underlying reason

SuchiRolls · 02/02/2025 19:31

I just wanted to add also, or more address things raised by previous posters, yes the research is limited because of the recent boom. But personally I’ve tried everything going…it cutting calories/fasting/exercising worked, I’d be slim and healthy by now. My issue isn’t knowing what to do, it’s stopping the food noise in order to implement these things long enough for them to work! This has done that. I’ve not wasted any of the time I’ve been lucky enough to do this. I’ve researched and found things that work for me, goods that I can have and put things in place so I don’t slide. I couldn’t ever do that for a long enough period before. I was stuck in a cycle of feeling completely controlled. Please feel free to PM me if you need any support. You have to do what’s right for you though.

Horserider5678 · 02/02/2025 19:33

My friend is a research nurse and has just finished a clinical trial with weight loss medication, most of the participants are gaining weight again. To use these you have got to be committed to lifestyle changes which sounds like even with a wellness coach you’re not. It’s very easy to say I want to do it for my family and not follow it through.

Id suggest asking your GP to refer you to a dietitian rather than a wellness coach. You also meet the criteria for bariatric surgery as your BMI is greater than 39, but they will expect commitment from you as even with a gastric sleeve you can pile the weight back on.

I’ve struggle with my weight for about 20 years and I’ve found the best approach is a high protein diet so look for a GLP-1 diet. You need to aim for 0.8gms of protein per 1kg of body weight. So if you weigh 15.7 you need to aim for 80gms of protein per day. To date I have lost 33lbs

Juststoppo · 02/02/2025 19:34

Fasting solved my weight issues. There is a reason so many spiritual practices involve fasting of some form.

Hwi · 02/02/2025 19:34

Whatever you do, please do not go for surgery - my relative works in one of the private hospitals, she is a medical secretary, all she is doing now is typing recall letters that run somewhat like

Mrs X had a band placed in 2009 under Mr Y. I explained the reasons for the recall to her, that a few bands had been found to be malpositioned around the aorta....

RudbekiasAreSun · 02/02/2025 19:35

Get rid of all bread, cakes, buiscuits, rice and massive pasta portions, potato portions and so on
eat all the rest with a lot of fruit and veg
you can have custards and trifles for pudding

Merryoldgoat · 02/02/2025 19:35

I have had weight issues all my life.

I am on Mounjaro and would recommend anyone try it if they are obese and want to lose weight.

My BMI was 53 and it’s now 44.

My doctor recommended I try it - I was actually approved for surgery but I never wanted it and I’m so glad as this is much better. I feel better than I have in years.

I’ve had minimal side effects and I’m able to eat sensibly.

Being so fat it’s taken 4 stone for people to start to notice and it’s really nice feeling being able to wear better clothes.

Horserider5678 · 02/02/2025 19:36

TwirlyPineapple · 02/02/2025 19:19

I tried everything to lose weight and the only thing that have worked have been injections.

Someone listed the "causes" of obesity up thread but ignored the most important one: biology.

For too long, I believed the crap about willpower or that I was an emotional eater. The fact that I can take an injection and instantly eat like a normal person and lose significant amounts of weight with relatively little mental strain shows that it was actually a biological issue all along.

I'll be on the injections in some form for life, I imagine. And that's fine, because I've realised my obesity is a lifelong medical condition and this is no different to any other medical condition that requires long term use of medication.

But you’re not dealing with how much you eat! Once you stop the injections research shows the weight goes back on! There is no such thing as eating like a normal person!

TroysMammy · 02/02/2025 19:37

Have a look at Nutracheck. It helped me massively with portion control. The first week is free and afterwards around £25 for 12 months. I lost 13.2kg in 7 months just by weighing my food. I didn't cut out "naughty" foods like chocolate, biscuits and pizza but ate smaller amounts although I wasn't eating them on a daily basis.