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 is a good point. And so true! I would say I put on 15kg after each child, and there are 3 years between them - so even slower than 1 kg a month.

Another handy number to keep in mind is that 1kg of fat is 9000 calories. So to lose 1kg in a month you have to eat 300 calories less than you use/burn each day. If you were actually eating 200 calories per day more than you needed before you started to do something about it, that means you have to cut 500 calories from your diet. That's already quite a change.

Animals evolved to lay down fat in anticipation of famine. The human body treats "hard" dieting as famine occurring, so when the "famine" ends, it makes sure that it can deal with the next famine, and lays down more fat (hence "yo-yo" dieting). So the slower you can bear to lose the weight, the less likely your body will think that something drastic needs to be done, and the greater your chances of keeping it off. Good luck! 🙏

You need support to lose weight OP. Either from a slimming group or from a friend who can be your weight loss/accountability buddy and keep you on track. Doing it by yourself is tough.

From what I've read WLI sound like the most effective for this

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.
@PrincessChicken you’re not supposed to feel hungry after a meal. You’re supposed to feel satisfied but not over full. Have you ever struggled with your weight?

At least get this book. I can vouch it works. I had an autoimmune issue that had me packing on weight despite eating "healthy". Easy to understand. Educational. And transformative - not some faddy diet. The NHS know zitch about nutrition or are very, very behind the curve with it.

Why do you tell the OP to not bother with things that help many people?
They might not help you, but OP is desperate for help.

Clear Minds Hypnotherapy has solved my poor relationship with food. I'm 62!
It's cheaper than slimming clubs (which work for many people) and really easy to use.
It's turned off the food noise for me, without injections or any medications. It may be worth a look?

It’s going to be harder to get weigh loss injections
https://www.dailymail.co.uk/health/article-14356525/Major-crackdown-buying-weight-loss-jabs-online.html

Not harder for those that qualify, and for pharmacies that already do sufficient to meet the checks required. So there will still be plenty of options for the OP, who does qualify and isn't on the borderline of doing so.

@StMarie4me
I'm afraid slimming clubs and VLCDs simply don't work for "many people" long term.

I do slimming world for this and even though often I maintain at least I'm not gaining. I find you have to choose a good class leader who really wants to get in to the whys with you otherwise all the psychology bits are missed and it ends up being a club for the eternally hungry. Also perhaps try therapy? I've come to the conclusion I have undiagnosed ADHD and it doesn't help with impulse control around food. I can not stick to strict regimes, be bothered to count anything and eat so much when I'm bored. I have no way of planning meals ahead so will eat massive meals at every sitting if that's what's available so now I try to serve myself less massive portions. Just knowing these things helps answer some of my weight questions and the whys of my behaviour.

I am pretty sure I have undiagnosed neurodiversity.

What therapy have you used? How have you accessed it?

I say this as an overweight person (man)

Eat less and move more. Easier said than done, I know, but that's the crux of it, really.

FFS 🙄

I'm only surprised it's taken 8 pages until someone came out with this old chestnut.

Would you try hypnotherapy??

I mean, it is science, but okay—when I lose weight, it's because I consume less than I need. Exercise will help with this.

I've been out for three days, eating out each meal and drinking a few pints along the way while not doing anything manual. Guess what? I'm three pounds heavier.

I'm not saying people don't have issues with their relationship with food, but the simple fact is that in 99.9% (made up figure) of cases, people eat less, move more, and lose weight.

Weight-loss drugs don't 'melt' fat; they make you feel full, so you eat less. It's like a temporary stapled stomach. or like drinking plenty of water so you feel full.

The problem with temporary solutions like this is once you lose your weight many people start back on their normal lifestyle and put the weight back on, starting the cycle again.

When people (and I'm not picking anyone out who has posted here as I've skimmed the posts) can point out their issues with weight gain but then seem to want it validated by a condition or excuse for being overweight, then that's fine. Feed yourself that information if it makes you feel better, but unless you have a medical reason, such as an underactive thyroid or Cushing's syndrome, then it's likely down to diet and exercise.

Like many things in life, it's easier said than done; we all have our hang-ups. And I speak from experience as someone in the obese category at the moment, but also someone who has run a marathon and been 25kg less than I am today.

@40YearOldDad thank you for that lengthy post. It's a good job a man came along to explain all that to us, we'd have had no idea otherwise.

Ahh - the old mansplained comment when you can't offer anything constructive.

Just for a laugh, I may not be a man 😂, but it is nice to see how women treat who they perceive as men with utter shite comments like yours.

*edit - I am a man, or say I am - who knows?

@40YearOldDad if you are a man then it is easier to lose weight. Women have the added complications of less muscle and hormonal variations at different life stages.

So no, not quite 'eat less, move more.'

Does your local area give free or discounted gym memberships to the local gyms? Ours does through the council/nhs.
Join a walking group.
You could lift small weights at home.
Use a child’s plate to be careful of portion control, I don’t think you need to obsess over if a pumpkin is a carb or not!
If you have underlying emotional issues ask to be referred to Talking therapies.
Try to do 10k steps a day but start at 1/2/3k to build up.

@40YearOldDad your comment was spectacularly unhelpful. Repeating content that is well known and well understood, whilst waving your apparent additional expertise (marathons! 25kg weight loss!) as somehow important or relevant. What you wrote was patronising. You self identified as a man, when it wasn't asked for or relevant. Patronising + "man here!" Is the very definition of mansplaining.

What people like the OP are looking for is ideas and support to help them address why they find it harder than you to stick to a long term calorie restricted diet. Repeating at length "just eat less, move more, it's simple!" Is to misunderstand what's being asked for and to be unsupportive. It's comments like that which can lead to the desperation and feelings of shame and deep inadequacy which are so often apparent in people who are significantly overweight.

The OP is morbidly obese and pre-diabetic. Short term weight loss is appropriate and necessary, longer term solutions can then be addressed when the urgency of weight loss is relieved somewhat.

But it is the same, essentially. We'll all have different tolerances, but that's just life. We can all work out our BMR or a guide to what it should be.

BMI Calculator

@40YearOldDad you seriously bothered to link to a BMI calculator? like no-one has ever heard of it?

@40YearOldDad until you've experienced periods/pregnancy/menopause don't bother posting on a predominantly women's website about weight loss. Until then your views are irrelevant.