to think that if a surgeon refuses to operate until you lose 21/2 stone than you should br offered some support with said weigt loss.

[northernsoul78]

So I need an operation. I am not a fool so know that losing weight makes sense before going under thr knife. So I asked my GP for help. They told me I didn't qualify for help as I don't get free prescriptions. This is a complete turnaround as the surgery used to offer nurse led clinics. It now does Slomming World referrals for people in receipt of free prescriptions.
so whilst waiting to see consultant I managed to lose maybe 10lbs.
I basically saw the Consultant who basically told me to come back in 4 months and they will book op if I have lost the best part of 21/2 stone.
Now I know this is a great incentive to lose weight but they are expecting me to lose more than the recommended 1 to 2lbs per week without support.
yet on the NHs podcast there is a woman on there with a lower BMiI than me who had no major health issues. She didn't want to pay out fow a slimming club so she went to GP and they referred her to dietician and prescribed Orlisat.
So it seems that support is there but not in my case. Obviously I am not asking for medication but I would have hoped they could offer something.
Realise I am probably being unreasonable but just fed up.

I run slimming groups and HO won't confirm slimming stats for the members who get it free and my personal experience is that they are not as successful as paying members. We value things we pay for.

Oo, really? People actually did that?

Imagine being voluntarily incapacitated. Bizarre.

YABU just eat less exercise more and stop moaning it isn't difficult

suzanne sorry, I was sort of pre-empting that being said in a snarky manner, after the lean tissue/fat comment upthread a bit. I hope the smiley face was enough to show I wasn't being pissy!

And yes, strength training is very important. Especially if, like me, you are physiologically incapable of doing much aerobic work. HIIT has had a rebirth over the last few years, which does at least mean I can get to some classes that someone else leads

Ok
Yes lots of people find hiit works

However, as pointed out by pps exercise doesn't always help with the underlying problem, ie that appetite is out of sync with energy expenditure

That is probably down to yet another myth. Exercise DOES NOT help you lose weight!

It helps get you healthier but not skinnier.

Counterintuitive I know. But it is now a widely accepted 'truth' that exercise is great for motivation, feel good factor, health and keeping weight off. But, given the fat mass vs muscle mass factor, the raised kcal needs with increased muscle mass etc etc, it can even be a factor in weight gain!!

Don't believe that at all Blanche!

I see lots of people on "diets" who are overweight.

I see very few people doing say half marathons or long cycling events etc who are overweight.

Plus "losing weight" usually means losing flabby wobbly mass. I doubt anyone would mind if they started exercising, lost a stone in fat and added a stone in muscle, as they look much better for it.

It's just a shorthand.

I see very few people doing say half marathons or long cycling events etc who are overweight

Can't comment on this having never done any such events but I see runners cyclists swimmers and gym goers who are over weight

Well, you don't have to believe it, but it is scientifically accurate, though what I posted is a major simplification of the many, diverse factors,

As shorthand it leads to the kind of confusion we had upthread.

There are lots of studies on it over many years. It is not a new idea at all. It is very complicated though and there is a lot of misuse and misunderstanding, especially in the diet and exercise industry.

I see lots of people on "diets" who are overweight. Why would a normal weighted person be on a diet?

I see very few people doing say half marathons or long cycling events etc who are overweight. Well, it is unlikely that really overweight people would enter such events. But go to your local parkrun club. There are lts of us fatties there. When we are no longer unfit and fat we will probably enter an event!

Its very hard to gain more than a few pounds of muscle and the ceiling for muscle mass is pretty low

Sadly not so with fat

increased bodyweight has a large negative effect on running speed and endurance, much less so with say swimming and cycling

It takes no effort at all to consume a tube of Pringles (900 calories), but it takes serious commitment to burn that much in exercise. You lose weight in the kitchen.

I think it would be nice if there was money spare in the nhs to help out with things like this but I also agree you make more effort if you pay for it. I've got inflammatory arthritis and chronic fatigue and I need to exercise regularly and eat healthily or I start to flare badly. This won't go away once I've been to classes for 3/4 months, it's a lifelong thing and I don't expect anyone else to pick up the tab. It is what it is. I didn't ask for it but there are others out there with far worse. I see it as I have a body that physically won't let me become unfit and unhealthy or I suffer terribly! That's not a bad thing. It's expensive but not bad. I'm only 37 and have had this 3 years.
Good Luck op. See it as a positive thing and a lifelong change.

Okay then, let me put it another way.

I know a large number of people who are overweight, constantly on a diet, some yo-yo, some just stayed the same, some get bigger.

The ones who decided to get fit, as in properly fit - those army boot camp sessions in the park in the middle of the Scottish winter, or started training to run a half marathon, or started cycling 45minutes to work and back each day, they are the only ones who have lost weight and kept it off. And now look and feel fantastic.

It's not what overweight people want to hear, but it's the reality.

By 'Support' you mean money - ie a subscription to SW.
The NHS is strapped for cash.

It's not what overweight people want to hear, but it's the reality.

Well, it's an opinion. An opinion based on some truth. But it is not the only truth.

Weight loss really isn't that simple. If it was there would be no fat or unfit people.

The ones who decided to get fit, as in properly fit....are the only ones who have lost weight and kept it off. And now look and feel fantastic

people vary in their baseline untrained state as well as in how quickly and strongly they respond to exercise training, some can run a decent 5k straight from the couch, others struggle for ages to run for a few minutes at a time.

Some put muscle on easily, VO2 max shoots up, they get stronger/faster, other peoples bodies respond minimally and they see very little change.

It may not be just willpower, people who are naturally good at exercise tend to be the ones who are attracted to it and who stick at it, just as those who are naturally flexible are attracted to yoga.

make no mistake, I am a huge advocate of exercise if you do not exercise your body will wither and your organs will malfunction, yes that happens eventually anyway but it happens far more quickly if you are sedentary.

it's not so much that exercising makes you lean, more that having an affinity for exercise makes you exercise and that tends to make you lean, provided you can get on top of your eating.

very probably ability to control food intake causes exercising, rather than exercising leading to control of food intake

people vary in their baseline untrained state as well as in how quickly and strongly they respond to exercise training, some can run a decent 5k straight from the couch, others struggle for ages to run for a few minutes at a time.

And some of us start out as the former and, through a mix of lifestyle choices and physiology, become the latter, all of a sudden. When you add iin the psychology of exercise and health you really start to find confounding factors that astound even the most motivated!

And some of us start out as the former and, through a mix of lifestyle choices and physiology, become the latter

I'm not sure about that, you cant train yourself into being athletically gifted, you can only work with what you've got

we all have a certain potential for muscularity or for aerobic capacity beyond which we cannot go no matter how hard or smart we train.

yes we can all improve but some can improve much more than others.

or maybe I misunderstood you Ourblanch?

I think we are in agreement, certainly I agree with this Weight loss really isn't that simple. If it was there would be no fat or unfit people :o

These people haven't become athletically gifted. They aren't "good" at their activity, they just keep trying, trying to better themselves a little bit at a time. They put in the effort and it pays off for them in terms of their fitness, whatever their baseline is.

Anyway, sometimes hard work beats talent when talent doesn't work hard.

I think you might have, suzanne but I wasn't clear.

I used to be very sporty, track and field pentathlon, all sorts of team sports, carried on into adulthood. Then I got cfs and that stopped me in my tracks. I got back a bit, became a group fitness instructor. Then pernicious anaemia hit. The combination of the two make me physiologically incapable of doing much/any exercise whatsoever.

I did not adjust my food intake quickly enough and got fat. Being fat has reduced the amount of exercise I can do even further. I should have known better, I am/was an health and exercise physiologist!

Whilst I appreciate that I am in minority, being physiologically incapable, I know that there are many other factors involved that make it far more complicated that 'get off your arse and exercise. Now stop shoving food in your mouth. Ta da, all fixed!"

Oddly, I do have one friend who runs, works out, does exercise classes etc, all quite seriously (she runs half marathons, for example - no slouch) and she's overweight. Not massively so, but certainly noticeably. It always makes me wonder why because she must work off an awful lot of calories, and she's not the sort of person you always see with an ice-cream or bag of crisps on the go.

Anyway, that is one single data point. Generally, though, I think you have to do an awful lot of exercise to lose weight.

An hour of running is 5-600 cals for most people
Walking maybe half that?

What counts as a lot though?