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.

Protein protein protein!!!! The moment I started actually eating it (I didn’t believe that it really filled you up) it genuinely changed all my eating habits. I get in my 2g per kg and I’m stuffed. So large chicken breasts, tuna, etc etc. life changer for me! Stopped snacking in the evenings as I felt satiated for the first time.

A kilo a month is perfect- you need to change one small thing a month whether that be reducing something or drinking more water but realise that you have to make changes for life. Invest time and effort into yourself for your children as well. I have lost about a kilo a month for the last 7 months and expect to continue for the foreseeable future even when I get to my goal weight which is still another 9 kg away. No one thing will work for everyone but don’t get hung up about how much you are losing but rather about the better habits you can adopt and live with forever. It might take 1,2 or 5 years until you reach a weight that you are happy with but it is worth doing absolutely no matter how long it takes. Be compassionate with yourself and think what supportive thing you might say t a friend in the same position, then tell that to yourself. Very best of luck to you.

You've lost 5 stone in a month?!

I asked for the injections and my gp refused, saying she had never prescribed them and neither had anyone else in the practise.
She recommended low-carb and portion control.
She knows I can’t exercise, I can hardly walk without painkillers; I loved running but am now mainly house-bound. She doesn’t care.

Hi OP.

Great news you have done the difficult part of losing weight and that is coming to terms with you having to change to make yourself healthier. Everything you do from now on will contribute to your health, even if you fail, its still learning.

Personally I think you can do most of this on your own. You know you best. I have just started using an app called MyNetDiary and it has been fantastic to track and plan meals.

With weight loss people usually leave out the observation part at the beginning. This is where you eat what you would normally eat, and track it. After a week you will start seeing a pattern, and don't forget it can be related to what you are feeling so you can track your mood as well. I find watching re-runs of Secret eaters really helpful to understand all the ways that we are unreliable when monitoring our food.

When you have data you can make small sustainable changes. For example I chose to track protien and fibre as I was missing them rather than kcal. It made it easier to make better choices if I hadn't met my target for the day. For example yesterday I had chicken roast and I had met my protien target but not my fibre, so I reduced the chicken and increased the beans.

The key with behaviour change is small and steady, rather than crash and burn. I have chosen to do 3 weeks of calorie deficit (what I can manage) and then 6 weeks of maintence of the weight I lost. When you do this a few times you learn what the portion sizes are so it becomes easier. As you have a significant amount of weight to lose, make this a 5 year goal rather than a 6 month goal.

You can do this, you are worth the effort XXX

From April 24 to Now I read it as

I’d really recommend Noom. That does address the underlying causes of overeating and gives you the tools to deal with them.

Are you on FB? There's a calorie deficit group that's very friendly and supportive, & the members give lots of great hints and tips. The lady who founded it had lost about 5 stone (possibly more) & has a very positive approach to weight loss.
Search for Calorie Deficit Group - Hints, Tips & Motivation.

Doesnt take much to work out its a typo for 2024

Maybe your expectation of how quickly you will lose weight need resetting. You say you have been dieting and it hasn't worked - but it has, you have lost weight. Putting injections aside, the facts are if you eat less and move more you will lose weight. BUT it doesn't happen overnight, it is a long slog - but worth it the end.

We have tier 3 weight management service in my health board which offers psychological support with psychologists, OTS etc to deal with the emotions and reasons behind the over eating behaviour. You have to be a bmi over 40 I think.

I think some people lose weight faster than others and it can be very disheartening when you feel like every pound you lose, someone else loses half a stone, but having seen 100s of posts about injections, this seems to hold for those as well.

I am doing a combination of intermittent fasting, calorie counting, exercise and hypnotherapy - throwing it all at the wall 😁 I find the days I prioritise protein over carbs I am less hungry and I eat less. I also do better during the week with calorie intake than at the weekends where there always seems to be people eating wherever I go!

I wouldn’t consider pumpkin a carb, I had some lovely carrots today and I was thinking about Atkins where they were a carby no no. A carrot has 30 cals - it’s bullshit and no one on earth became overweight from eating carrots 😁 A kg a month is sustainable, give yourself some time 😊

Hi OP
Trying to lose weight in your 40’s is just awful.
it’s really really tough.

As you said you want the route case of your eating, and it’s not something we can give the answer for.
you may need a lot of soul searching

I struggled for 10 years untill I did one of those food sensitive tests found out in dairy and gluten intolerant
cut it out lost 2 stone

i also eat a lot of protein as in 150grams aday
takes away my hunger and food noise

Go on Mounjaro
Honestly, it's life changing.

It's hard, OP, I empathise. I've failed at every diet for over 30 years. The jabs are helping me so far but not much else has.

I was 15 stone and 5ft tall. I started on mounjaro in June and I’m down to 10st. I have struggled with my weight for 22 years. I have severe endometriosis and adhd so I am a hormonal grazer. The quantity wasn’t bad but the sugar and carb content was high. The injection have cost me a fair bit but it’s been a life changer

The current NHS pathway for this is unfortunately really poor. It is well known that effective intervention would be of immense cost-benefit to the NHS (as well as the main ethical win of actually helping people improve their health!) and yet it hasn't really improved much, with the exception of offering injections.

If you feel you have significant mental issues around food which is causing you distress (the pumpkin story suggests you might) you could self refer for mental health? Expect the waiting time to be long though... You could consider weight loos surgery as well, if you go back to your GP and ask for a referral they can advise on your suitability. If course that wouldn't help with your challenges with food and eating, which is the safest and healthiest option to loose the weight.

In the meantime I would second some other suggestions of finding helpful podcasts, books etc. to rethink how you feel about food. It can be really empowering and you never know when you have that eureka moment which helps you feel like you're in control of your eating.

Good luck!

Mounjaro

Mounjaro

I suspect you’re caught in a cycle of habitual eating. Your portion sizes are too big but as you’ve gotten used to them, your body cries out for more of the same and tells you you’re hungry, even though you’re consuming more than you’d ever burn.

You need to slowly reduce them. Buy smaller plates and bowls. Slowly reduce the proportion of carbs to veg. Swap or reduce toast and sandwiches with egg, roasted veg, hummus. Plant based proteins and lean meats.

But, you have to really want to lose it. It’s going to be hard and you’re going to have to be able to remind yourself why you’re doing it because the temptation of delicious and filling food will come to you regularly. As with anything, no one can make change for you (and I realise that’s not what you’re asking for)

Thats a big weight loss. How do you feel about when you come off it?

Im intrigued to know if people slowly regain, like with most other things. If your appetite recovers, will you be able to resist overeating without an appetite suppressing medication?

Mounjaro has changed so much for me. It’s worth looking into and making an informed decision based on benefits vs risks. For me it became very clear very quickly it was the right option for me.

I knew an overweight woman, unsure of BMI but she was in an unhappy marriage. He was was not abusive she just made a mistake and stuck it out and then was economically dependant on him for 30 years. He died. She lost just over 6 stone over the course of 18 months and went from 16 stone to about 9.5 stone I saw her at a funeral, hadn’t seen her for a couple of years since her DH died. DH didn’t even realise it was her. Hers was emotional eating, I’m pretty convinced that is the major cause and boredom of many peoples weight issues.

She ate her misery.

I self-referred to the dieticians in our health board. I did a 6-month course with them and it was great plus got an exercise referral, so got to go to aquatherapy once a week.

I actually know a lot about nutrition but needed some support (nd, so get distracted) and I was surprised how good their information was, loads better than the previous time I was referred, up in Scotland years ago.

I would have thought with your BMI and you being prediabetuc you would be eligible for the injections?