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

[Platypusdr]

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.

I follow a low carb diet and fast 16:8 - I’m rarely hungry and treat myself if there’s an occasion I want to to celebrate with food.

I’m not one of those fast losers but it feels sustainable - I’ve lost 4 stone in 8 months and am really pleased with the results. Aiming for another 4 stone this year.

Can i ask which one you went for? I am looking at mounjaro at the moment.

@Horserider5678 that's an issue with any weight loss approach and something that is not a surprise to anyone who is obese, as they have likely been yo-yo-ing for years. I'd rather be dealing with that issue at a healthy weight than not! And after a year (for me) of eating a lot les than I have previously, I stand a better chance of maintaining the new normal. Plus, if I ever end up with a BMI over 27 (over 30 in genera) I can restart the injections. I need never reach a BMI of 35, 40 or 50 ever again.

Calorie counting. Try and see it though as just treating your body kindly and make it a life style change. Volume eat with greens. Get into cooking and make it fun. I made it my goal to pick a random country every 2 weeks, and eat one of their native dishes. Also the good thing about calorie counting, is that if you really want to as a one off treat, you could save them all up for a takeaway!

I lost 3.5 stone calorie counting and finally went from obese to only overweight lol.

I boredom eat and eat crap when I'm emotional. My therapist told me to pause and take stock if I'm about to binge on biscuits, and really question the underlying feelings e.g sadness. Also do something that keeps your mind busy, like a new hobby, to stop you thinking about food. I find painting very mindful.

I still calorie count and really don't find it restrictive. I still eat plenty of pasta/rice (bulked up with veg) and usually have calories spare for a sweet snack like a couple of Oreos or small bag of crisps.

Just get Mounjaro. I know people are so sceptical but you can stay on a maintenance dose long term and it’s been life changing for so many people. You can do it under supervision of a dietician for careful monitoring if you like. It’s worth the cost.

What you have been told is correct I’m a registered nurse in NHS bariatric clinic. You need a BMI of over 40 with co morbidities, need to have something like SW, meal replacement. Medication is currently limited on the NHS and bariatric surgery is not a cure for obesity! Your stomach is a muscle so can be stretched overtime and after 5 years many patients have regained the weight!

Hi Op,
you seem to be well aware that there is an underlying issue (emotional eating) that is preventing you from losing weight. Until you are able to deal with this issue, you will probable continue to struggle.

I am a therapist who sees lots of people like you who cannot lose weight and it's never just about the food - there is always, always, some reason why you self sabbotage.
I know that once you can identify the underlying issue, address this issue, you will find that your relationship with food changes.
Please feel free to message me if you want to 🙂

get yourself a prescription for mounjaro and maybe some therapy if you’re so keen to find the real cause

I’m all for it but what happens to the poor souls who can’t afford mounjaro ? So essentially the people more likely to end up dependent on NHS services with obesity related health issues will generally be the poor who can’t finance the injections.

One of the most successful diets my DP has been on was calorie counting. There are apps where you can scan barcodes of things to make it easier to log them. If you do cook from scratch you do need to weigh things.

It's the use of oil to fry things that really pushes it as well. We found those 1kcal per pump frying sprays helped with that.

That way he ate what he wanted, as often as he wanted, as long as he didn't go past the calorie deficit he set himself.

I’m all for it but what happens to the poor souls who can’t afford mounjaro ?

They could work on it themselves through diet/counselling/exercise?

If you have emotional eating, I think is best to address that first. The NHS doesn't provide much support for obesity, however if you have a binge pattern disorder, they may be able to help.

Anyone who gets to a BMI of 44 is spending at least 100 a month on extra food. Put that towards the cost of jabs.
I have found the jabs stop me drinking too and reckon I am saving around 100 a month.

I just don’t believe that talking therapy can fix a hormonal/endocrinal issue. Obesity may start with emotional overeating, but it doesn’t end there. Once you’ve gained the weight, it becomes a medical condition. Fixing the underlying issues first is like saying oh, you have lung cancer caused by smoking. Let’s spend the first 6 months on giving up smoking before we address the cancer.

I listen to the podcast https://pca.st/podcast/ff4de3a0-1403-0135-52f8-452518e2d253

Losing 100 pounds (a bit American) but very interesting, more of the why we overeat etc.

She had a business (of course) but does free courses as well.

https://nobsweightloss.com/

You didn’t read my post properly, I assume. I don’t intend to stop the injections.

And I don’t believe that “dealing with how much you eat” is relevant for people with chronic obesity. The issue to be “dealt with” isn’t how much we eat in itself, the issue is “the biological reasons why we eat more than others”. No amount of lifestyle changes or therapy or any other intervention will change how much I eat, when the reasons I eat too much are to do with biological processes I can’t control without medication. The fact that these injections have stopped my overeating entirely proves that it isn’t something mental or emotional causing the issues.

Saying I “haven’t dealt with how much I eat” is like telling an asthmatic they “haven’t dealt with why they don’t breathe properly” or a diabetic that they “haven’t dealt with why they don’t process glucose correctly”. I will “deal with” how I eat in the same way they deal with their conditions- by taking the medication which stops the physical effects from causing health issues.

The NHS will fund it in the end. They’re currently struggling with the sheer number (and therefore cost) of people who want to try it. I’m paying for Mounjaro privately. Everyone doing that is making it easier for the NHS to fund it for people who can’t afford it.

I haven’t read the whole thread so I’m sorry if this has been suggested. If there is an underlying issue around mental health then no amount of diets etc will keep the weight off forever.

I have not had the same experience but I do have underlying anxiety issues that cause me various symptoms. I’ve been trying to treat the symptoms for years and not the underlying issue. Then I came across hypnotherapy. This worked for a while - there is a Paul McKenna book and audio called ‘I can make you thin’ that deals with the mental side of things that may be of interest. Paul McKennas book on stress helped me massively in the past.

I’ve also just been through the Thrive programme, with a coach, for emetophobia. Like obesity (in my opinion) emetophobia was a symptom of a bigger underlying mental health problem and the Thrive programme helps you confront and overcome the core issue, the idea being that if you can solve the underlying problem, the symptom (being overeating, OCD, phobias etc) will disappear. Just thought I’d mention it as it has really changed how I think about myself - it deals with your sense of power and control over your environment and your self esteem including limiting beliefs you might have (one of which is explicitly, ‘I am unable to filo diets successfully and lose weight’). Look for Thrive programme by Rob Kelly and you’ll find it

*follow diets - gah, toddler climbing on me

You don't need to stop. She says she will be on them for life. As will I

This

My GP always said I just needed a mechanism to eat less, theres no more or less to it.

Little did I know that he had personal experience of WLS in his family

I’m ND and in my late fifties. I have tried to lose weight using every system available for the past forty years. All failed.

Now I know why. My hormones are out of whack. Taking Mounjaro has rectified those levels and I’m losing weight at a steady pace without any associated pain or deprivation. Once I reach a healthy BMI I will take a very small dose to maintain that weight.

People take all kinds of medication for life; statins, beta blockers, asthma meds. Why not a medication that enables me to maintain a healthy weight?

I went to my GP in April 24 because I was at the end of my tether. For about 12 years I tried to lose weight, I did weigh watchers, slimming world (which worked for about 3 years but I put all the weight I lost back on pretty much straight away), Noom, fitness pal, slimfast, atkins, interval fasting - and more. I was very overweight, my BMI was 41, I had joint pain and numerous other health issues directly linked to my weight. Food noise was constant, and despite cooking from scratch, having healthy snacks etc etc nothing worked long term. After basically crying in my GP’s face, I was referred to a ‘weight loss’ clinic. They told me all they could offer was online access to weight watchers. Discharged. I decided to start wegovy and as of New Year 2025, I have lost over 5 stone - and I have my life back. This isn’t an advert, it’s real. I was a size 20 and now I’m nearly a 12. Nearly all my pains and medical conditions have pretty much gone or much improved. This is just my experience - but I genuinely would recommend researching it at the very least.

I would read ultra processed people OP. I think a lot of the reason we have so much food noise is because of the highly addictive processed food we are surrounded by. Literally designed to make you overeat and totally break the link between eating and feeling full or satisfied.

Definitely ask for the weight loss injections. I know someone who was referred to oviva for weight loss management however they did have to do the gruelling tier 2 weight loss plan for almost a year, show some weight loss and commitment and it not be too substantial that the weightloss injections were no longer needed.

However as you have a comorbidity you may bypass this. I don't know for sure.

I pay privately and they're revolutionary.