GP says I have no entitlement to have anything 'extra'

[lockedonyou]

I've had so much going on it's just been so hard, I know it's no excuse.

I went to my Gp today to discuss a dietician referral. I have Asperger's (unknown to anyone apart from my mum), and I'm not great with making food, I struggle - plus I am a picky eater.

Anyway, I was hoping to see a dietician for advice and maybe ways I hadn't thought of for healthier eating

In 7 months, I've gone from a Size 10 to a Size 16. I look so big. I looked in the mirror last week, and saw I have no waist anymore I felt fine really until that moment. I knew I put on quite a bit but didn't think it was that bad

GP listened to me and then said 'you know Polly, you aren't entitled to extras. I know that's hard to hear. It must be very difficult caring full time on no sleep. And I suppose that makes you feel like you deserve something else'

He told me to come back in 6 weeks if his suggestions of simple meal prep etc don't work. I didn't know what to say, I felt so sad

I lost my baby son recently, coupled with caring for my disabled DC 24/7 and providing all the care. It's so tough. I know it's no excuse but was it really necessary to phrase it like this?

I am just utterly surprised you got a face to face appointment for a dietry issue. they are like gold dust here, you have to be literally dying and even then they send you to A&E.

Surely there is loads of info online about this stuff?

Why are people telling OP that he is right and she isn't entitled to extra food?!

OP doesn't want extra food, she wants dietary advice.

I'm no doctor and I don't have your experiences but on the face of it, what is a dietician going to do? Presumably you already know or GP told you, some changes to make? How will a dietician help you do that?

How are you eating now that is different to seven months ago? It doesn’t need an expensive dieticians appointment for you to work that out.

Someone asked what I ate or how I ate before I became fat.

I ate badly. I didn't eat all day, then quickly had a cheese pizza with ketchup in the evening when DC was asleep. Maybe the odd bit of fruit throughout the day. Occasionally a soup for lunch if I was lucky to get the time

So essentially if we're looking at calories alone, about 1400 tops a day and no more.

Now I'm going things like eating here and then when I can get DC in his restraint care seat before a journey, eating in the car to places. That type of thing

The things I eat are all the same but the difference is it's more of it

I wanted a dietician referral because I have Asperger's and severe problems around food itself and cooking food. It's hard and I've never before had help.

In addition to that, I'm allergic to most fruit (anaphylactic allergy to some).

I am so, so sorry for your loss. Are you getting any support or counselling around that? Or any support and help caring for your disabled child? Anyone with a brain cell would realise that all these things are linked and this is NOT just about eating less.
I don't know if you post anywhere else on MN, but there is a lot of support on the bereavement board and on the special needs board.
You can't address your eating without some help and understanding of your grief, stress and exhaustion.

It's similar to why people have personal trainers, even though they could just use the gym.

What type of treatments do [dieticians] offer?

Dietitians interpret the science of nutrition to improve health and treat diseases and conditions by educating and giving practical advice to clients, patients, carers and colleagues. They advise and help to maintain nutritional status when individuals want to trial dietary interventions such as exclusion diets, nutritional supplementation or dietary interventions in areas such as autism for which evidence is still emerging.

Dietitians are legally able to supply and administer some prescription only medicines e.g. insulin, phosphate binders and pancreatic enzymes, through Trusts/Health Boards. They can also adjust this medication. Much of their work is spent advising/counselling other medical staff as to the best course of action in regard to an individual’s nutritional status.

It does because they help with ideas around food. They have extensive knowledge regarding this type of thing (my DC has seen them in the past and our local team is both adult and paeds, especially for special needs)

Slimming world is to healthy eating like bargain booze is to sobriety
Amazed people still suggest this.
The op sounds like she would benefit from some psychological support rather than the standard one size fits all nhs 'measure your potato, a fist size portion of meet, snack on yoghurt' advice

^This. There’s so much at your fingertips with the internet, I would start from there and see what you can put into practice yourself before pushing for a dietitian referral - which will take ages anyway if you’re lucky enough to get one, given how stretched NHS resources are.

Sorry for your loss, it sounds full-on. Do you have a support network that can help you? Talking therapy (on the NHS) might also be an avenue to consider.

Are there any autism support services close to you? They may be able to help you access support tailored to your needs. They may have access to funding for this that the GP isn't aware of.

I'm so sorry for your loss op.

I would make an appointment with a different GP and try again. The way he spoke to you was unacceptable.

Food can be a big issue for people with ASD and the GP should be aware of that. I have ASD/ADHD and huge issues with impulse control around food. My ASD teenager never feels hunger so has to be reminded to eat. It's a minefield.

So basically he suggested that you are indulging in emotional eating because you are struggling with your responsibilities and grief? That's how I read it, sorry if I misinterpreted it.

This is a perfectly reasonable suggestion on his part, especially since you put weight on in a very short period of time (whilst your Aspergers, picky eating and inability to cook are life-long). He could have put it differently, but I don't think he was rude, he acknowledged your difficulties and suggested some simple meals. I don't know what the criteria are for a referral to a dietitian and if he could have offered more help.

Well he was very unclearly worded for a GP. I wouldn't even have got what he meant.

I dont understand why people are saying op doesn't need a dietician as she can just google... This applies to everything so maybe dieticians should become obsolete and lose their jobs as they are now considered pointless as you can just google a diet for every condition.

But the internet can be bewildering.

I have a first in English lit but I still wouldn't have googled how to lose weight.

I think it IS extremely important rude to mime nibbling gestures at a patient while shooting down a belief they had not expressed.

Extremely rude^

Sorry for your loss OP.

Does the GP know that you are autistic and require extra help?

I think that a dietician alone will not work. You need more support in the house. If you don't have time to prepare food or eat, due to your caring commitments, a dieticians advice will not change that. Maybe they could some suggest some healthy snacks that you could grab on the go.

I'm sorry that everything is so tough for you right now 💐

Did you tell the doctor all that you have said here? If you did, he is an absolute bastard.

Please go back and see another doctor. Is there a more sympathetic one at the surgery?

Explain all this to them, write all the issues you have down first if that helps and take notes with you. Emphasise that you are really struggling. I really hope you get help. It sounds like you just need help organising your food around your busy life and suggestions of things that you can actually make. Food doesn’t have to be complicated to be healthy but it does need to be doable and you deserve some help.

What suggestions did he make? Are you more able to follow video recipes rather than written?

@lockedonyou I'm sorry you were spoken to like that, that doesn't sound in any way helpful!

I struggle with executive function and am terrible at planning (or sticking to) meal plans and making healthy decisions - I know the theory but the reality is overwhelming!

I wonder whether you might find more constructive support by posting on the Neurodiverse Mumsnetters board instead? There may be people there who experience the same difficulties you do and can share tips they've found worked for them?

He doesn’t sound very helpful. You have a lot going on and I’m really sorry for your loss.

Do you have any support for yourself and for your dc?

I’d assume extra resources/referral too tbh.
They are constantly getting new guidelines re referrals to various resources/departments.

She hasn’t got learning difficulties, she’s autistic.

If she’s feeling overwhelmed, I will take a guess that video recipes would feel like even more “noise”.