How do you respond when medics dismiss significant weight loss?

[JohnTheRevelator]

When a medical professional tells them they should lose weight when they have already lost a substantial amount? I have lost 104 lbs (7 stone 4 lbs) over the last 3 years,was nearly 21 stone at my heaviest,I'm now 13 stone 7 lbs. Which I know is still overweight for my 5 ft 6 in! I had an orthopaedic consultation yesterday (bad osteoarthritis in one of my hips). Practically the first thing the consultant said to me was 'Have you tried to lose some weight?'. I've also had it said to me at a nurses appointment a few months ago. She asked me to stand on the scales then said 'You could do with losing some weight'. When I told her I'd already lost just over 7 stone,she said in a sniffy tone 'Well,you need to lose at least another 3 stone'. Sometimes I wonder why I bother! Seriously though,it is really discouraging. And I'm not sure of either of them actually believed me when I told them how much I'd already lost.

Out of interest, where do you view those complaint outcomes?

To answer OP's post, they should be encouraging you in your weight loss, so once you'd explained how much you'd lost, they should have said something to the effect that you are obviously doing well and to keep doing what you're doing.

Congratulations on your loss so far! Not long to go now at all compared to how far you've come before you'll be in a healthy BMI. Your rate of loss might slow as you near the healthy range, but don't give up, you can and will go all the way!

For me, it's when you go in for something else completely and they decide to focus on that

This has happened to me with repeated ear infections and a range of other stuff that led to me being tested for Epstein Barr and various other things.

They knew they had put me on medication that caused weight gain, they knew there wasn't a choice about me taking it - though they did spend a long time asking me to basically starve myself in order to avoid the weight gain.

So when I came in with something completely unrelated, they should not start the conversation with "can I put you on the scales?"

and then the spiel about how weight to affect your health. Oh my God, how many times have I heard that? I literally had to tell one nurse "yes but I'm still alive" in order to get her to drop it. Otherwise it was a long list of "have you tried…?"

I don't know if they get some sort of financial incentive for patients losing weight

I'm quite terrified what happens now these bloody injections are available

Honestly, I just don't know what to say about the NHS these days. I have managed to avoid them for about three years, had one interaction which I really regret and posted on here

Fortunately, it was a telephone appointment so nobody asked me about my weight!

sorry @JohnTheRevelator not trying to detract from your thread - I just so know what you mean

I get this. Whatever I go to the GP with, the first thing they say is ‘you’re overweight’. It’s depressing and worries me as they might be missing something serious.

Then surely the obvious answer is to react positively when patients tell you they have lost a significant amount of weight?

It doesn't take a genius to figure out that saying "well done, your weight loss will already be having a positive effect on your bones/heart/whatever. If you keep going until you've lost X you'll be in an even better position" is more likely to spur their patient on than if they are negative about their current weight.

Ok, you've made your point about a million times but missed mine, entirely.

The point was, medical professionals don't always meet the standards their profession should demand of them and so, are arrogant about their own flaws (including lack of courtesy) when talking to lay people.

I don't care about what they should be telling other people. It was about how they tell other people and why they think they can talk down to others.

I'm exhausted by this exchange.

Totally agree with this. Imagine losing 7 stone and STILL having pain and other issues caused by osteoarthritis and being told you need to do more. Not to mention the fact that when you have a painful condition like that, being active is really, really difficult.

It’s true that a lot of doctors are fat phobic and lazy in respect of actually treating people. When I was larger (I’ve lost some weight in recent years through meds changes and healthy eating) I learned to ask what they would prescribe to a thin/slim person who presented with the same symptoms and then asked if I could be treated the same.

I don’t drink alcohol or smoke. Literally no one congratulates me! I wish they would. 😂 They barely even ask about it.

Thank you for your kind words. Regarding being lectured by an overweight nurse about your weight,it reminded me of an incident years ago when I was in my early teens (when my weight problems all started). My GP sent me to see a dietician. I'm not kidding you,the dietician must have weighed at least 20 stone. We came out of the consulting room and my DM said to me 'I hardly think she's on a position to lecture anyone about their weight!'.

https://www.hcpts-uk.org/

But the dietician advice is likely still correct and relevant, and you don't know the dietician medical history (steriods, hypothyroidism, pituitary disease etc).

All HCPs should give the correct advice in a professional and supportive way that is all.

Emerald Roulette I totally get what you mean. I can't help feeling that the outcome of my orthopaedic appointment on Saturday was affected by the weight issue. I was really hoping to be put on the waiting list for a hip replacement operation but the consultant seemed determined to paint a grim picture of the outcome (risk of infection, scarring,blood clots etc). Everything I have read about hip replacement surgery is that it has one of the best outcomes of remedial surgeries (even with people with much higher BMIs than mine!). Plus he told me that the pain in the front of my thigh and lower back was absolutely not caused by the arthritis iny hip. Only the pain in my groin would be caused by that. He said Iust have a trapped nerve in my lower back. I know he's the expert,but I beg to differ. The pain in my thigh and lower back has only started since the osteoarthritis in my hip has got really bad! I've had a trapped nerve in my back before, and no way does this feel anything like that felt. So now I've got to wait goodness knows how long for an MRI scan to rule that out before I can even contemplate being put on the waiting list! Anyway,I'm going off the point here!

The 'grim picture' and the advice is likely evidence based. The reality is that outcomes and recovery are poorer from obese orthopedic and anaesthetic risks are higher. Unfortunately this is just how it is and prior to the last few years and WLI there was a limited amount they could do beyond just telling you to loose weight. However now there should be a push towards more holistic and integrated healthcare and more liberal prescribing of WLI to help you get to the weight you need to benefit from the surgery.

But this doesn't change the basic facts of surgical and anesthetic risks.

I do feel medical people dismiss women who are overweight. I have ongoing health issues. Possiblely something like you OP something going on with my nerves. I was something like BMI 18 or 19 when it started very slim 6 years of being referred between departments with my mobility decreasing as my pain increases. Numbness weakness falls inconenance then inability to pee without using a catheter. The last couple drs I saw said it’s normal for women over 40 to have many of my symptoms (I’m 30s and was early 30 when this started) and told me to loose some weight because I’m now overweight. I can’t fucking exercise is why I’m overweight but as soon as I they can fob me off with that that’s what has happened.

@JohnTheRevelator horrible people! I would have said well done, you've done much better than I have and you've taken so much strain off your joints by doing so! I've got to lose 5stones and need some inspiration.

Exhausted?

Blimey, maybe you should see a doctor.

As long as they're not overweight 😜