To expect some help from my GP in losing weight?

[Chubbychubchub]

I am a fatty. Properly overweight. About 8 stone over normal weight range (about 19st, I should be 11st at most according to BMI).

Last year I had some health issues. My GP said I'd benefit from losing weight. Just eat less and move more were her words.

I have tried. However I struggle to control what I eat, and have zero willpower.

I did go to a well known slimming group previously. It made me ill, though I did get down to 13st. But it wasn't sustainable.

I asked my GP for help. I was told 'all they could do was refer me to the nurse, but she would tell me the same. That was all they could do and there was no other help available.

I have heard of people locally being referred to a dietician, or sent to slimming group for free etc. Aibu to expect something similar, or certainly some kind of help beyond trite advice?

Diet is much more important than exercise in terms of weight loss.
You don't have to eat food you don't like. But you do need to make changes to lose weight. What can you change?

Chubby, I was 19st 1lb at my biggest in Feb last year and I've been morbidly obese since I was 11 years old, obese since I was 7

I know where you're coming from and trust me, I've been there but with the greatest of respect, YAB MASSIVELY U!!

I got down to 14st in November last year and was super proud of myself (I'm 5ft 5 so I was still obese) but because I took my eye off the ball, I re-gained 3.5 stone in 4 months.

That's not the NHS's fault or the fault of my GP, that's all on me. It's SO easy to re-gain the weight and I didn't realise just how quickly it could come back. All I did was return to my previous way of eating which wasn't even that horrendous or so I thought..

Anyway, I got back on my diet now that things in my life have settled down and the 3.5 stone I re-gained is shifting gradually. It should be gone by mid-June at this rate and at least now I know I actually can't ever relax around food. This bit is really really important:

You and I are not in the same groups of people as those who find it easy to maintain a healthy weight. I split it into 2 groups: the usually-slim and the usually-fat. For whatever reason (and your reason will be different to mine), we're usually-fat. Because of this, if we want to be a healthy weight we need to remain vigilant and can never relax our attitudes to food. This isn't to say that the usually-slim can't ever get fat, they absolutely can and in the same way, the usually-fat can also get slim.. however, once you're out of your bracket it's almost impossible to stay there without conscious and constant effort. Eventually that effort becomes habitual but it will never be natural, hence why you need to keep on top of it.

Which bit of this do you think the NHS can help you with?

Your GP isn't responsible for your health, you are.

But you already went to slimming group, which by your own admission didn't work. I don't think a free group works better.

OP, can you maybe book a nurse appointment and ask whether your surgery is part of a scheme that prescribes exercise, rather than prescribing diet?

I have been given slimming world on prescription , gp told me i was fat but not so fat nothing could be done and to eat more veg and chicken , i needed a blood test off the nurse and told her i had been trying really hard to eat well but weight was not really coming off very quickly it was the nurse who referred me to slimming world but really its not anything you couldnt do at home its basically a low fat low sugar diet im doing quite well with it and once my 12 weeks free is up i will pay to keep going

I don't think you'd get much out of a dietician appt, my ds has two dietary issues, one being recurrent low blood sugars and one is dairy allergy and they've never been very helpful for us in terms of recommending foods/meal plans etc. The main reason I go is for the emergency regime if he gets a hypo. You might get more out of seeing a nutritionist, I'm pretty sure they don't work in the NHS. Or how about a fitness instructor who has knowledge in nutrition?

Keep on trying and looking into new ways that could work for you.

Our surgery has a practice nurse who is trained in the Counterweight programme, it's basically portion control. It's a bit of a faff due to lots of weighing and measuring but it works for me even though I cant eat wheat or dairy.
If your surgery doesn't do the plan this is based on Counterweight. (Tip 25g dried weight of rice and pasta and 100g of raw potato are each one portion.)
I have massively cut the amount of processed foods and sugar from my diet losing 4 1/2 stone, and kept it off, since I started nearly 6 years ago.
Diets don't work and you have to revamp your whole way of eating and exercising for the better to achieve any long term changes.

I don't have diabetes, in fact for some reason I am now where near it. I think if diabetes prevention was an issue I would potentially be getting more help.

I am aware nhs resources are limited. But i thought that help to assist me in losing weight now before I am a drain on resources would be preferable.

I ran because I enjoyed it. At 13st I could do 15 miles a week (3 sessions). I probably could still walk that far just about. But I haven't been to the gym for a while as I feel so huge I struggle to exercise.

I drive to work, then walk half a mile. I don't have time to walk further at present but I will try.

I do try to eat less. But I never feel full. And eat when I'm sad, bored, as a reward, etc.

Eating food you don't like is pointless. You need to do this in a way that is a change for life, not a quick fix. What healthy food do you like? What exercise do you enjoy or think you could do regularly? Walking is great, or swimming if you have time & resources. Also what unhealthy things could you cut out without feeling restricted? Fizzy drinks or sweet snacks perhaps? If you start small and lose a bit it may spur you on to do more, but only if you're doing it in a way that is manageable and sustainable. Slimming clubs work for some but personally it would make me miserable.

What 'help' do you expect because it sounds like you're thinking in terms of freebies.

Slimming World will enable you to eat enough to feel full. It’s helped me relearn good eating habits. No medical help can sort out a lack of willpower.

I suspect the help you need OP is psychological / CBT rather than a diet plan or slimming club. I am also overweight and I know that my lack of willpower is linked to using food as a comfort and reward rather than just liking eating. I probably need to unpick my relationship to food in order to lose weight in the long term.

I don't think YABU - it would be in their interest to help you now rather than have you suffer health complications. It might be worth going back and asking more directly if they can set you up with an appointment with a dietician. Some GPs also fund gym memberships which might help you as you could get advice from a PT on how to exercise without injuring yourself.

You have recognised that you want to change OP and that's the first step - hold on to that and keep looking for a solution that works for you! Hopefully with more direct questioning your GP can help.

Counselling may help.

I get the impression you want to fix this now. You just can't do it on your own. You've just maybe phrased it incorrectly. You need some form of support.

I'm not sure the issue is you have no willpower. More maybe it's understanding why you over eat and how to prevent it.

Many things cause us to over eat. Be it boredom, habit, stress, unhappiness. Whichever way you look at it it's disordered eating

In addition, 19 stone is big. So something mentally let's you get to that size, like you're missing a mental break to stop well before you hit that.

I'd maybe speak to the gp again. Tell them you want to lose this and can't do it on your own and need support to stop over eating and see if there is some counselling you can be referred to.

However, as everyone is saying, it doesn't remove the element of personal responsibility. So in thr meantime attempt to do exactly what the gp said. Eat less and move more.

Not really understanding why the slimming group route is not compatible with OP but it suddenly would be if it were paid for by the NHS and not out of OP's own pocket?!

Perhaps you need to look at your relationship with food before trying again. Eat less move more is 100% right but it obviously doesn’t take into account why you’re eating.

If you’re relationship with food is messed up it will make things a lot tougher.

Could be a lot of things sabotaging your diet, boredom, comfort eating, binge eating. NHS does have nutritional psychologists perhaps asking to see one of them.

I've lost 7 stone on Weight Watchers, I eat what I like as long as it's within points or zero points on the no count plan. I don't use any WW products, IMO they are over priced and taste like shite and I never struggle for things to eat. I'm never hungry, always have decent sized meals and plenty of healthy snacks if required. It can be done

Also, just re your point about never feeling full - people who are overweight (and that is me too! I started this year with about 5 stone to lose and I've lost 15.5lb since the start of Jan) have often learned to ignore our bodies' satiety cues. That means it's really hard to recognise when we are full. The good news is you can relearn this and lots of things help (eating slowly, not eating in front of the TV, putting your fork down between bites, using smaller plates etc). You can teach your body to know when you're full, and yourself to recognise how that feels. I know this doesn't help you much now but just wanted to reassure you that in the long term that is a problem that can be addressed x

You really shouldn't have continued to put on weight if you were running 15 miles a week. Something's wrong there. Were you over-compensating for the calories used up exercising?

Help - something that would assist me in changing how I eat and also maybe understanding my emotional response to food. The pp who said sbput talking to her nurse, that would be nice but apparently the nurse in my GP is too busy.

I don't really have money to pay for therapists etc which I think are £50+ a session. My food bill (for whoever said if I ate less I could pay for therapy) is £80 a week for 4 of us. If anything if I buy loads of veg and fruit it would be more or the same not less.

Chubby I'm sorry to see that you're getting such horrid and rude replies including a lot of fat shaming. Losing weight by eating less and moving more does take willpower which is why it's often not the best way to lose weight.

Since you weigh 19 stone then it's extremely likely that you are insulin-resistant which will make conventional calorie-controlled dieting next to impossible for you. I suggest you look into a method of weight loss that works by lowering insulin levels. I favour a low carb approach because you don't have to restrict calories, only reduce your carb intake. That means cutting out all grains (bread, cereals, pasta, pizza), rice, sugar, and some higher carb fruits and vegetables. You can freely eat meat, fish, eggs, lower carb vegetables and fruits, and full-fat dairy. You can also eat nuts and dark chocolate in small quantities.

If those types of foods don't appeal to you then you might consider an intermittent fasting approach instead. On the 5:2 diet you eat normally five days a week and have two non-consecutive 500 calories days per week. On the 16:8 diet you eat all your food within an 8-hour window and fast for 16-hours. Usually this means skipping breakfast and having lunch and dinner within eight hours of each other. The blood sugar diet allows you to combine reducing calories, eating low carb and intermittent fasting in the manner that suits you best.

There are support groups on Mumsnet where you can get more information about eating low carb or intermittent fasting. Alternatively, feel free to PM me (I'm a healthy eating diet coach.)

Depending where you live there could be help. Three years ago my GP sent me to a Emotional Eating workshop, but you are the one who has to want to change.

That worked for a bit for me, but it then spiralled up again as I had stress and anxiety issues but I am seeking help again and doing the workshop again soon. I now also have prediabetes, so this was a kick up the arse to get my eating in gear and stop the sugary cereals and tons of cakes and chocolates and stuff...

And i have lost 2kg in 2 to 3 weeks and hope this will be more sustainable...

When you say you never feel full. Are you eating a lot off carby sugary crap?

How do you think slimming world or a dietitian would help you if you have no willpower?
It’s your health, it’s your body, it’s your life, it’s your choices, yet you still want to pass the blame to your GP!
Don’t buy crap foodstuff, if you don’t have biscuits, crisps, chocolate or whatever your downfall is in the house, you can’t gorge on them. Buy meat, fruit, veggies and cook from scratch. Don’t say you’re short on time. Beans on wholemeal toast with no butter on is filling, fast and fat free. As is an omelette with spring onion, red pepper and a smattering of strong cheese.
Try to go for a twenty minute walk everyday. Ten minutes walking, then turn round and came back, it’s not far.
Only drink tea, coffee, water and occasionally a fruit juice, so no pop or booze and watch the weight melt away. But stop blaming everyone and everything else for your shortcomings.