To think that he practice nurse could have been more helpful?

[curlywurlycremeegg]

Have put on 5 and a half stone on in 6 years, in that time I have also had 3 pregnancies. I am really struggling to loose any weight, have done weight watchers, slimming world, low carbing and after loosing abot 7lbs in the first couple of weeks the weight just goes back on despite me following the diet without "cheating".

Saw my GP about it a couple of weeks ago who took blood for thyroid function, she said if that came back normal I could either try Orlostat or see the practice nurse for weight managment advice. Chose to see the nurse as I really want to try and beat this weight gain without resorting to medication etc.

Saw the nurse yesterday and she has left me deflated and upset. I explained the situation, she weighed me (and had a sharp intake of breath.....not very reassuring!). My BMI is 40, I knew that so it wasn't a shock, in fact that was the reason I felt I really needed to loose weight, it's not about fitting in lovely clothes or looking good, it's about my health, I am very concerend about the impact of being this weight on my life.

She then proceeded to offer loads of excuses such as "are your parents overweight?, It may just be genetic" and "you have had four children".....well yes I know all that, I don't expect a washboard stomach but I really need help with this now. The best she could do was tell me to pick up some leaflets from the waiting room and to watch a programme called "food hospital" or something like that.

I will post in the weight loss section later but just feel really let down, I know there is no magic cure for my problem but she didn't even offer to see me again....not that I am sure it would have been helpful after the lack of advice she gave last night.

AIBU to have expected a bit more from her?

That's ridiculous! Did she not even ask you to keep a food diary and come back?

YANBU at all. She clearly hasn't a clue and the GP should have referred you to a nutritionist. It pisses me off mightily when the NHS makes a big song and dance about people getting healthy then offer no real help at all to do it. You have done absolutely the right thing by seeking help and she just fobbed you off. In your position I would go back to the GP, say you were disappointed with the help you received and you would advise her not to refer anyone else to the nurse in future. Then ask if there's a possibility to see a dietician or nutritionist.

YANBU and tbh when I went to practice nurse about losing weight I found it as useless as you have done. bI did lose weight, but with no help from the NHS. What worked for em was hypnosis which helped me to de emotionalise food. Good luck with it - I know it is really hard.

I am like a broken record I'm afraid and I know you've tried it once already but Slimming World is really very VERY good these days, and the only way to combat your weight is through commitment and hard work - Orlastat, is that the one that makes you poo grease? If so, don't bother, it won't work if you're eating a healthy diet anyway.

The new Extra Easy Plan on Slimming World is fantastically easy! I'm in it for the longhaul and have lost 2 stone since March, the group support is second to none and the Body Magic part of it is achievable.

You have to accept that no one can 'fix' you but yourself, and the least support I ever got was from various GP's who told me what I already knew... to be fair to them, they had to say it! I was referred to nutritionists, dieticians, I got a free pass for the local gym. It didn't work. The Slimming World plan is EASY, both to understand and to follow and you will be surrounded by people who are in it with you, understand, and don't waste time telling you what you already know. Good luck. x

YABU.

You refused the medical help that the NHS can offer, nurses aren't there to hold your hand when you are heathy and already know what you need to do. If you honestly don't know what you need to do, then she pointed you in the right direction so you can find out for yourself like the functional adult that you are.

Really, if you refused to see if there mey be an underlying medical problem, then you are basically saying that you just need/want to lose weight the normal way. And you don't need the nurse to help you do that. Just go and buy a book!

Honestly, I can't believe how some people expect the NHS to wipe their arses for them just because they can't be bothered to do it themsleves.

Cailin I know I should go back to my GP but the whole experience has just left me so demotivated. It is so hard to say to someone that you are aware you have this problem, for them to brush it off without any action plan has really throwm me. It was as if she didn't even see having a BMI of 40 a problem, I personally feel that even if genetics has played a part in my weight gain there is a point when it should still become an issue to be taken seriously.

slaveto I haven't declined any tests to check if there was an underlying problem, I had the TFT, it was normal which is why I chose to see the nurse. I declined Orlostat as all it does is reduces the ammount of fat you absorb by extreating it in fecal matter, this will not help in the long term as it is not a medicaltion that can be taken long term.

I do not expect her to hold my hand, what I do expect is a bit of help and advice if this is a service the surgery state they offer. She basically couldn't do that, for whatever reason, and appeared to make excuses to to my weight gain. With a BMI of 40 there really should be no excuse making, if I can get this problem under control now it will actually save the NHS thousands of pounds in the future.

I am actually a nurse and have a strong educational basis in nutriition, I don't need to pick a book up off the shelf, it will offer me no more information that I already have access to at home. What I need is anothe professional, who is not so emotionally involved with this situation to provide support.

Do you also feel that smokers should not be entitled to attend smoking ceasation groups? I would suggest that anyone who is trying to make a postitve improvment in their health should be provided with the support needed by the NHS as in the long term it makes economical sense not to mention being a humanistic approach to health care.

It does sound like you need to use slimming world/WW or similar, as what you need is support from others doing the same thing (IMO as you are a nurse and you know the practicalities). If you didn't want to go to a group there are online forums for the same, just to give that encouragement and support that the nurse couldn't be bothered with.

I also use foodfocus.co.uk to help me log what I am eating as I find if I don't I eat way more (healthy though) than I should without realising, it also gives me the flexibility to eat what I fancy while still controlling the calorie intake, it's free too. I have just lost 2 stone btw through changing my diet and exercise lifestyle as a permanent measure, not a "diet".

Do you really think she was trying to make excuses for your weight gain? Could it be that she was trying to find a reason instead, which could be something that needs to be dealt with separately?

I wasn't there, so I can't say if she had a bad attitude or not, but I'm sorry that you had to leave your appointment feeling bad.

I misread the bit where you siad that you did have the test, but if it came back normal then my comment about you needing to lose weight the normal way still stands.

While I see that you getting the problem under control will save the NHS money, I think that is your responsibility to do, not the surgery's. If you already have the information you need then you should be using it, and getting support from your friends and family. I realise friends and family don't always give good support, but that's what weight watchers, slimming world or online support groups are for. There are loads of them out there, and I don't think that nurses doing that for you for free is a good use of their time and resources.

Somking ceasation groups should be provided, but I don't think they should be free, nor should all the patches, gum etc that they hand out. If people can afford to smoke, they can afford what they need to help them stop. There is no reason why people shouldn't pay to attend those groups. They would happily pay if they were committed to stopping smoking, and if they are not fully committed, the group won't work anyway. I am a smoker btw.

It would be great if everyone that wanted help to be heathier could get it on the NHS, but the NHS doesn't have enough money to do that for everyone. And people should be responsible for their own health anyway.

YANBU She could have offered to see you again in a fortnight for a weigh in & follow up chat about maintaining motivation. This has the potential to be a good use on NHS resources in that you are actually asking for help and could avert early heart disease, diabetes etc.

However, recent research said the NHS was worse than useless at helping achieve weight loss and that commercial companies get better results. I would go to one of those. I would also see if a friend would become my exercise buddy. Brisk walking regularly can help.

Hi Curly, don't post much, but wanted to recommend something called zest for life if there's one in your area. It has the group format, but aims for optimum health through nurtrition with weight loss as a side effect, it's run by qualified nutritionists focussing on low GI foods and increasing your metabolic rate (eg exercise that builds muscle instead of burning fat) No dramatic results but v good to keep on long term and also for the whole family.

Good luck. That nurse sounds hopeless.

YABU. You complain the nurse tried to make excuses for you, but it sounds like you are making excuses for yourself:

"after loosing abot 7lbs in the first couple of weeks the weight just goes back on despite me following the diet without "cheating""

Well this is just biologically impossible unless you have an underlying medical problem, in which case you need to have tests to investigate what that might be.

I can't see a nutritionist or dietician making a blind bit of difference. I've certainly never had a patient lose weight after seeing one. You need be honest with your self about how much you eat (so a food diary is a good idea) and why, then tackle those behaviours. No one else can do this for you, though groups like Slimming World can help.

I know how you feel! I had to keep a food diary for 2 weeks. All I had was 3 slices of bread at lunchtime with filling, plus a small dinner. However, one day I had 2 very small pieces of lardy cake. And, of course, she picked on that only. "How fat is that?" she said. I didn't go back.

Rabbit, don't be so smug. It is not biologically impossible at all. With the wrong diet eg low calorie, your weight loss can plateau and then will regain as your body gets used to starvation mode and better at storing fat. There is increasing research that weight gain is due to unbalanced blood sugar levels leading to insulin release which then dumps excess blood sugar as fat and eventually leads to diabetes. The equation is not a simple calories in must equal calories spent as we have all like to believe...

It is not NHS policy to refer automatically to a nutritionist. For one thing it would cost a fortune given the number of overweight and obese patients! Also, there is little evidence that for most people a nutritionist is beneficial.

www.nice.org.uk/nicemedia/live/11000/30366/30366.pdf

It sounds as if you would really appreciate the sort of support and comraderie available at a group like WW or SW.

Weight doesn't plateau after a few weeks! Maybe a few months, but not a few weeks.

If the OP has gained 5 stone in 6 years, she either has a medical problem or she is eating too much / the wrong foods. There's no point pretending she's eating carrot sticks and has mysteriously gained 5 stone - it isn't going to help her to lose weight, and I don't know what the OP wanted the nurse to say - eat more healthily perhaps?

Hi,

OH needed to lose a bit of weight and did go on Orlostat OTC. I was a bit [hmmm] as I believed that we did eat a healthy diet. But it did surprise both of us [him a bit more] and retrained his thinking. He had tried a food diary but could not get along with it at all.
Might be worth having a go, it can really concentrate the mind.

He only did it for 3 months, and it did help and he still has the mind-set of If I eat this would I have needed to take a pill? If yes then he doesn?t

Plus the OP said she put the weight back on after a few weeks, not that she just stopped losing weight, so it sounds like she is eating too much / the wrong foods in order to lose weight.

OldGreyWassel - you say all you ate was three pieces of toast with filling, but what kind of toast? What was the filling? How many calories?!

Curley - I used orlistat and was amazed at the things I thought were okay that were in fact full of fat. Even stealing a few of the kids chips at supper made me feel the effects. I found that initially in conjunction with a low carb WW programme it worked, it made me think very very carefully about what I put in my mouth and has totally changed the way I eat. I am nearly 2 stone down in 12 weeks and still have a 1.5 stone to go. My BMI is now out of the obese section and into overweight.

I'm in roughly the same boat as the OP.

I've cut out fizzy drinks, alcohol, chocolate, biscuits, crisps, ready-meals and pretty much everything that could even be construed as unhealthy. I only drink water or sugar-free squash, I have halved my portions, I've stopped deep-frying my chips and gone for oven-cooked healthier ones instead, I have a stepping machine that I use daily whenever I'm watching TV, I go out for long walks with the pushchair, I actively play with my DS and the only snacks I have are carrotsticks or celery.

I've lost the grand total of 1lb :(

I have no idea what I'm doing wrong, but because my BMI isn't quite as high as the OP's my GP doesn't seem to think it's that big an issue!

OP, barring a medical problem the answer is move more and eat less. There is no magic other way. Portion control, regular meals, regular exercise, yada yada. you really don't need a nurse or anyone else to tell you this. In fact I would bet you know than many people about diets, nutrition etc. given your history.

You may benefit from hyponotherapy which can help you address unconscious motives for overeating. It can also help you to build good habits that will be easier to stick to as they become unconsciously part of your behaviour.

Having said that, and I do not mean this harshly, some people go the rounds of seeking help for a problem in order to find all the remedies fail, and then use that as an "excuse" to maintain the problem. I am not saying that you are doing this, but you may wish to consider the possibility.

Good luck. Hope you manage to help yourself achieve what you want.

rabbit
""after loosing abot 7lbs in the first couple of weeks the weight just goes back on despite me following the diet without "cheating""

Well this is just biologically impossible unless you have an underlying medical problem, in which case you need to have tests to investigate what that might be."

I would have to say I think you are correct with this, which is why I really wanted some advice from her and why I am so concerned about it. When I have been on WW I have followed my points rigidly, even though sometimes it has been difficult as you actually need to eat quite a lot of food for the point allowance of my weight band. I haven't just given up if I haven't lost after one week, however if after a three of months I haven't seen any result I do go back to our standard family way of eating. This isn't full of refined carbs however, we tend to eat low or wholegrain carbs, little meat and lots of veg, no snacking etc, we want the children to have a healthy attitude towards food, it is not used a reward and therefore we try to lead by example. This is why I feel so disillisioned about the whole issue now, I want to make the change, I have tried WW and SW and I am honest about my food intake but now feel stuck as to who to turn to.

Rainy thank you for that recommendation, I will look them up and look into the blood sugar information, I know I little about it from reading about GI but it is something that I could do with reviewing.

Thank you everyone for your messages, I am feeling a bit down about it today and people are making a lot of sense :)

Have you kept an honest food diary for yourself, including portion size?

it would come in useful when talking to doctors anyway and may shed some light on what's going on.