To complain about my G.P.?

[growinglavender]

Would I be unreasonable to put in a complaint?

I have gained five stone over the last two years, going from a healthy 10 stone to just over 15. I look shocking and it's had a hugely detrimental impact on me.

I went to the G.P. when I was at breaking point with everything and I made it clear my weight gain was very upsetting for me.

She prescribed medication (anti depressants) which is apparently also prescribed for people and animals to GAIN weight!

I am wondering if I should put a complaint in, but I don't know how and would I be the surgery equivalent of "that parent" at school?

One of the reasons some people can weight on antidepressants is they lack appetite when they are depressed and start eating better when the meds kick in (true for me). It's a bit chicken and egg with your mood and your food intake. I've lost quite a lot of weight recently and my mood has improved a lot. That's despite being on antidepressants by the way. I recommend the book Brain over binge by Kathryn Hansen to anyone who binge eats link here It helped me challenge my binge eating habits. I've lost weight before but never confronted my bad habits before. This time I've lost a lot more weight. It's worth a read.

Mirtazapine it is indeed.

Talk to them about this concern

They can probably reassure you that they feel the benefit to your mental health is greater, and that the only way for you to lose weight permanently will be to improve your mental health. So it's like, maybe you'll put on a little bit more, but then you'll actually start getting better

If they can't explain, then you could think about complaining. But you should go back and ask first. A lot of people are just happy to take what they're prescribed, they don't want to read about the medication, they want to leave it to their gp. I'm more like you, which is fine, but you have to tell them about your concerns if you want them to be addressed.

Mirtazapine can be prescribed for weight gain but you must admit it's an antidepressant too. You're overreacting a bit. It's not like it's a prescription for the sole purpose of fattening you up

they must think it's very likely to specifically help you for that to be their first idea. OR they're idiots - go back and talk to them! It's the only way to find out

You could be "lucky" like me and end up having a weird reaction and have to come straight off anyway

I will go back by all means but to be frank I have lost trust that what they prescribe for me will help in any way. That's the problem. If I hadn't made it clear that I was grossly overweight and was very distressed by it in an emotional sense as well as the physical ill-effects associated with weight gain, that would be fine. As it is, I feel I have just been fobbed off with 'depressed patient - anti depressant - off you toddle then.'

I know it would be mirtazapine. That'll be because of the insomnia but yeah it's notorious for weight gain. Don't complain, just go back and discuss.

I think you would be well to go back to your GP and ask HER if this particular AD may cause weight gain.

You say "apparently" it is prescribed to adults who want to gain weight and that "you have been told elsewhere" it can cause weight gain.

However, you'd be better asking a doctor rather than relying on hearsay.

What medication is it, and at what dose? I take ADs. The particular ones I take, at the doseage I take them, don't cause me to gain weight.

Ahh posted too late. I see it was Mirtrazepine. Yes, go back and say it doesn't suit you. FWIW I had a trial of this. Yes, it got me off to sleep ok (well, knocked me right out actually and I felt crap the next day) BUT it increased my appetite off the scale.

I didn't take it for very long!

I can promise doubters the mirtazapine causes carb cravings like you wouldn't believe. I am disciplined about what I eat, lost almost 3 stones when I was diagnosed as t2 and have kept that off for years now. But the constant feeling of hunger and the permanent 'hangry' feelings when I tried to ignore it were untenable.

OP, I wouldn't be making a complaint, but go back to the GP and say you've found these side effects are making your mood even lower and that you will need something different. Did they offer any SSRI meds like citalopram? Going straight for the tri-cyclics is a bit of a jump anyway... You can also have zopiclone for short term use to get your sleep cycle back in line.

What do you think they're going to prescribe you for weight gain? Might be an idea to work out what you actually want from them. TBH if I was a gp and as it sounds you have a type of eating disorder that is usually linked with mood and insomnia I'd prescribe the same. However if it was purely down to regular food intake I would think if using the medication to reduce fats absorption, but linked with past history I'd be concerned it wouldn't be used correctly. Not having a go this is purely my opinion.

They cannot prescribe a pill to magically fight your weight gain. They've offered reasonable support which you have declined. What is it you want them to do?

But the GP is doing bloods, yes? And offered you counselling which you turned down?

Doesn't sound like you've been fobbed off to me. Why don't you make another appointment when you've tried the meds for 3 weeks and can see for yourself whether the side effects are making you gain weight? Then you can say you've given them a fair shot, get your blood results and ask about changing to a different anti depressant if necessary.

I did get given something else to aid sleep - a sleeping tablet - it wasn't temazepam but it sounded a bit like it. They would only prescribe four as they said they were highly addictive. Then they didn't work! How annoying.

I won't complain but I don't feel I've even remotely been listened to and that does both concern and upset me.

I sound like such a drug fiend in my last post! It's the result of many years of clinical depression in myself, sadly passed on to my son, plus dealing with my daughter's severe BPD. I must admit I worry about appearing to be a drug seeker to my GP sometimes but I'm lucky enough to have an excellent surgery with continuity of care.

FWIW I was so sad to have to stop the mirtazapine! After the initial sleepiness and detachment it worked so well- can honestly say it's the best I've felt in years. But it just wasn't possible to keep piling on the weight and feeling obsessed with food.

I wouldn't complain - I don't think you're at that point. I would go back and explain the issue all over again. Maybe to a different doctor.

Can anyone on here advise what medication/help might be available to the OP to help her? It can be useful to ask for specific treatments/remedies - even if they don't turn out to be right for you, they can help nudge the conversation in the right direction.

I can promise doubters the mirtazapine causes carb cravings like you wouldn't believe

No, you can't, You can say that for you it did. It doesn't for everyone, by any means.

Scooby, you've misunderstood me a bit but it's my fault for not explaining.

I didn't go with weight gain. I went with insomnia (which isn't helping the weight gain as I'm so exhausted all the time) and general low mood/tearfulness which again wasn't helped by insomnia!

It took a lot for me to go. Initially I saw a nurse practitioner who was lovely but couldn't prescribe what I needed - she was the one who prescribed the sleepers - and made an appointment to see the G.P.

There was a huge contrast between the two. The nurse practitioner let me talk. The G.P. just kept interrupting me and talking over me. But I know I made the point re weight gain. She was insistent it was my thyroid hence the bloody blood tests and I have to drive miles to get them done and I didn't feel she listened to me. But she did prescribe mirtazepine.

I haven't found I've had carb cravings although I'm not sure I know what I want any more food wise. But it does seem strange that you'd prescribe something for weight gain to an obese patient.

Your gp is maybe treating the underlying issue that causes the binge eating - I don't know what your personal circumstances are but tackling the cause of the binge eating seems sensible. ADs are often used for this I believe. There will be a long wait for counselling on the NHS I would expect so if you are able maybe gave some privately. YWBU to complain, go back and discuss further.
Hope you feel better soon.

if the weight gain is caused by bingeing which is caused by depression, then she is right to tackle the depression. There are two ways of doing this. Medication and counselling. You refused one of the two. if you stop being depressed you will be much less likely to binge eat, which will stop you putting on weight. Then you will need to go on a diet to lose weight.

The impact of weight gain caused by medication is negligible compared to the impact of you binge eating, so it seems to me you need to stop binge eating first, and it sounds like you might be able stop bingeing if you stop being depressed.

i think he diagnosis is entirely reasonable and you are being irrational and lashing out. there is no magic unicorn cure for either for depression or for being fat - both take work from you I'm afraid but anti-depressants and counselling help.

I very much doubt your G.P. would prescribe something specifically to make you gain weight.

It is far more likely to be a side effect of the medication. Many of them have potential weight-gain lusted as a side-effect.

Lavender, you're right to be concerned and upset. There can be quite a strong culture of defending the NHS at all costs on AIBU and sometimes that makes people uncomfortable about suggesting doctors can be wrong. I'm perfectly happy to say that doctors, nurses, all HCPs can be wrong sometimes just like the rest of us. There will be reasons for your GP trying to get you out of the room asap, mostly to do with huge workload and tight budgets rather than anything personal! If you can't change surgeries or see a different GP in yours, research is the way forward. Go in and say 'I have this problem, I feel these meds will potentially make it a lot worse, what do you think about trying y or z instead?' I have found this approach very useful for my daughter's GP (not at my surgery) who really doesn't have much idea or interest in mental illness. Although it feels very cheeky initially, doctors often much prefer to treat patients who have engaged with their condition and are able to put forward ideas for treatment (as long as those ideas are sensible and grounded and not too expensive).

I do understand that kimmy but it doesn't explain why out of the many ADs available the one she decided to prescribe was one that causes weight GAIN.

I don't think she listened to me at all and it's that which is concerning me.

I think probably the most sensible thing to do if people feel complaining isn't appropriate is to cancel the follow up appointment and try to get a grip on this myself.

I understand a bit more, however if you feel that the gp didn't listen. Make an appointment with another in the practice.

I've been on nearly every ssri antidepressant including mirtazipene and the only one that caused food issues was citalopram. This is because they're side effects, all meds have them. If mirtazipine was used as you say it is every anorexic would prescribed it and they'd be cured as long as they took it.

Feather I doubt it too.

I don't think the G.P. is malicious. However I do not feel she listened to me, read my notes or really tried to help in any way that was really meaningful.

Silver, thanks. I think the problem is people understandably look at the support you have and G.P. is one of those forms of support but actually nowadays it probably isn't because as you rightly say the cuts and all the rest of it ... but in fact I do think there's an element of you being on your own with most stuff!

I think the best thing might be to give the medication a go for three months then book a review. It often takes a good deal of time to get the treatment right for depression.

Well, I don't have enough for three months so I'd have to go back anyway for a repeat prescription but I definitely don't want to stay on weight inducing medication. I know that much. If I am to stand even a chance at sorting my life out I can't do it at over fifteen stone.