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.

That’s because GPs can’t prescribe the injections for weight loss. You would need to pay privately.

Elvanse is amazing for binge eating licenced for adhd and binge eating but not on nice for bknge eating are you adhd?

Pumpkin is a carb as like potatoes it is very starchy, however not all carbs are equal, pumpkin is high in fibre and other goodies so eating 300g of that is no way the same as 300g of chocolate.

Not via the NHS. The rollout of injections isn't starting till the summer and then will be for higher BMI and with two or more co-morbidities. And for people already on the top tier of the weight loss management programmes.

The only realistic option right now is to get a private prescription.

It's really hard when you've a lot of food noise and maybe use food as a comfort.
Pumpkin is a veg but it's too high carb to eat with little restrictions.
Pumpkin, squash, sweetcorn, sweet potatoes are all healthy but more carb dense.
If you're doing VLC you should aim for spinach, asparagus, cabbage, lettuce, cucumber, courgette, cavolo Nero, chicory etc. the greener the better!
Mushrooms are awesome and low calorie/carb too.
Still have the other stuff but only very small portions.
Lots of lean protein, eggs, fish etc. plenty of garlic, herbs and spices.
Don't feel guilty about having a small treat each day either. X

So on the NHS there is actually quite a lot they can offer. The problem is accessing it and as is typical, it is a bit of a postcode lottery.

there are various tiers you have to go through to get to the serious weight loss stuff and it is important that this is all tracked with your go if you don’t do it through them

CBT and wellness coaches should help but they won’t solve the problem. I’m also surprised that they suggested eating veg first when it has been shown that protein will fill you up in a sustainable way, then veg and finally carbs.

Ask for a referral to weight management. It is likely that the first thing they will do is give you a 12 week slimming world course. I’m not a great fan of SW or WW. but alongside CBT it may just be the thing.

injections seem to be the magic solution at the moment but beware, there can be some really serious side effects (a family member has kidney failure from being on it for diabetes), and without getting your head in the right place it may not be sustainable when you come off it - so cbt or a club is a good idea alongside it.

weight loss surgery - I had a gastric bypass, on the NHS nearly 15 years ago. It was the single most scary thing I have ever done but it was also life changing in a positive way. But it is a tool not a solution. Privately it costs a lot because it is a huge op and you need long term support and there are side effects.

if you can try something like the Joe Wicks plan - you need to be dedicated to the food but alongside it are various workouts and with the combination I lost a good deal of weight.

however, get your hormones checked to ensure they are balanced. And sadly (and simply) it is generally a question of less calories in than you need. But you know that, it’s just bloody hard to action. And remember that for most of us who hold significant weight, it is a lifelong struggle so quick fixes won’t work.

sorry that was long!

Ozempic/Wegovy or Mounjaro

Literally the best thing ever for weight loss.

I got a watch that counts steps. My friend and I have lost alot of weight, just by eating healthier and 10,000 steps a day. It's so easy, you should give it a try.

I have gone from 16st 3,5lbs to 12st starting in August last year. I was introduced to the New You Plan, recommended by the NHS, with a supportive Facebook group for customers. Its basically a VLCD with four or 5 sachets daily, these can be savoury meals or sweet desserts, shakes, soups, snack bars and treats. It's incredibly easy to stick too, the food noise vanishes, there's no dithering about wondering what to eat, you order 30 meals at time, and that's your food shop finished.

I'm also obese but I've lost 3.5 stone and I'm still going. I joined a fitness group, do at least 4 classes a week, cut down to 1600 calories a day and do intermittent fasting (8.30pm-11.30am). In theory it's not hard, in reality trying to stay motivated and not give in to bad foods was hard. But it's doable, use MyFitnessPal to track food and weigh yourself every couple of weeks. I was also measured at the beginning and it was the inches that moved the quickest and most.

Do not know if it's been mentioned but I do Noom and I think it's very good. It tries to help you identify and get past any food habits. I paid, it's about £9 a month but there's a free trail and a free version too I think.

My BMI has gone from 44 to 24 taking Mounjaro. Its life changing, I pay privately but worth every penny!

Thanks for this? Hadn't heard of them before

If you’re doing over 10,000 steps a day, you’re already active. Can you build on that and find an additional exercise that you actually look forward to doing?

I started lifting weights in the gym, mainly for bone health but I was also overweight, and I found that I could keep it up because I enjoyed the time to focus on myself and listening to my music without the distractions of family and work. There is also a steam room at the gym which I find really relaxing.

I have my gym program reviewed every few months so I’m getting fitter progressively. It’s a slow burn in terms of weight loss, as muscle is heavier than fat, but ultimately, muscle uses more calories, even at rest. My clothes fit better, I look healthier.

Diet wise, I tracked what I ate with my fitness pal for a time. I realised I was eating too many carbs, and not enough protein. So I’ve now adjusted to focusing on protein and veg. Carbs are meant to be better for you if you cook them, cool and then reheat or eat cold. So I always have cooked potatoes, pasta or other carbs in the fridge ready to eat. Convenient for quick dinners too.

10k steps is about 5 miles

I dont walk that far a day and I concentrate on making sure I walk 3 miles at least (not always successful)

I was accessing the tier 3 weight management program with the NHS..I found it really unhelpful personally but through this I did get referred to psychology service .This was incredibly helpful for me giving me some tools to start addressing my issues with overeating.
I can't recommend this service enough .It really isn't just enough to be told to eat more fruit and veg well for me certainly. I have list and gained so much wright throughout my life but getting fatter every Yr .
Good luck

@AIBot i love swimming so might get back to it. I am also interested in the weight lifting. I have a gym membership. But I don't know where to start/who asked you what to do. Any advice? Not like there is a weight lifting class? +

I've lost 9 stone so far, and I've still got another 6ish to go.

What I've discovered is that there wasn't any one thing that was making me that fat, it was a collection of things. So my solution had to be a collection of things.

I started by changing one big thing (stopping full sugar drinks) and once I achieved that, something I thought I could never achieve, the successes snowballed.

I can't say it's been a smooth journey, there are times that it has taken over a bit too much and other times where I've given up a bit and started to relapse towards old habits one by one.

In terms of the mental side of it, I've done a lot of work in reducing my stress and taking up hobbies that bring me real joy. This has been life changing in ways that go far beyond weight. But it's helped fill the void that food was being used to fill. It's also been a lot about putting myself first, enjoying my own company, reducing my dependence on relationships that were leaving me feeling wounded which I was soothing with food.

In terms of practical habits - you will know all of these already - Sugary drinks, sauces, butter and oils, eating enough vitamins, minerals, protein, fibre, meal planning, having healthy snacks within grabbing distance, limiting empty kcal snacks etc etc. But the big work is in the mental side which has mainly come from self help and I see my (private) counsellor every couple of months for a catch up - but previously I did have a couple of years of seeing her fortnightly which helped me to ditch a toxic relationship, deal with some of my issues and get into the headspace to make the mental changes.

I have done mine without any injections or drugs (if I could afford it, I would and it's taken 18 months so far. I do get frustrated with how slow it feels but that's mainly because I have compared my journey to too many people's online journeys and remember it's always the most extreme (fastest, most lb lost etc) that get the most views and so these are not typical results.

Mostly it is down to a lot of self reflection, being honest with yourself, sitting with uncomfortable feelings and working out what you need to change, making changes beyond diet to help fill needs that you might be meeting with food, having a cast iron organisation system for meal plans and food prep, and having a lot of self compassion.

I don’t say this lightly but Mounjaro has changed my life and I would highly recommend to anyone in a similar situation if medically allowed. I started in September with a BMI of 44.5 and it’s now 39. This was after years of struggling with PCOS, trying to work out at the gym, calorie controlled diets, seeing a PT & a nutritionist with almost no success. I tried so hard in 2024 and lost 4lbs; it’s so disheartening. The NHS probably won’t help with weightloss injections (I was told I could be on a waiting list for years) so it’s a big choice to make and you need to be able to commit to following the guidelines properly for it to make a long term change. It isn’t cheap as I’m funding it myself but it has changed my life, my wellbeing, my fitness levels have improved etc.

The NHS is absolutely useless when it comes to losing weight, I've done all the weight loss tiers over the years, right up to tier 4 for weight loss surgery, which is a joke, jumping through hoops and would have been waiting years.I took the decision to have weight loss surgery, here in the UK, best decision I've ever made.If I'd waited for the NHS to help me, I wouldn't have survived.

I was just like this OP but I've lost 4 1/2 stone in about 21 months with Ozempic and I'm losing it slowly so as not to be left with baggy skin. I'm so lucky my GP prescribed it for me as pre diabetic and other health issues. My DH went to his GP for help but as LL he got was come in for a weigh in once a fortnight.

They should be able to give you advice at the gym if you book in a session, thats what a friend of mine did.

Please just ignore anyone saying don’t do the WLI. Try them. Start at a low dose. See how you feel. I had some nausea to start with but it passed.

I feel like I have got my life back. And I’m nowhere near my goal weight and probably never will be! But I’m so much happier.

Definitely do what you love, and try to fit it into your week at a time when it is less likely to be derailed by other things.

The staff at my gym will go around the gym with you and make a programme for £10, but if your gym doesn’t offer this you may need the services of a personal trainer. A weekly session with a PT might be worth a try if you can afford it and you think it will help establish a healthy habit.

You might enjoy Ben Carpenter’s fat loss book also. I hate diet stuff generally, and had already got my routine going when I came across him, but he speaks a lot of sense around establishing good habits that will stick.

i was the same as you before Xmas and was determined to go on weight loss injections. However I thought I’d give a diet one last chance. I found the zig zag diet and it’s working great so far. 5 days a week I eat 1600 cals and 2 days I eat 2300. On the 2300 days I can eat what I like to a degree and it feels less restrictive. I’ve lost 14 pounds in 4 weeks. I’m also doing growwithjo workouts on YouTube 3 times a week.