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?

OP - it sounds like you are going through a really hard time. And some of the posts on here are appalling - completely lacking in any empathy (there is so much ableism and ignorance around Asperger’s here that it doesn’t surprise me sadly).

I think you did the right thing going to your GP and he was not helpful at all. His response to you also shows his lack of understanding of how autism affects people. You are not a “picky eater” - you have sensory issues and that is totally different (I have Asperger’s too and mine mostly relate to sound, light and smell)

If you want a slightly friendlier and potentially more helpful audience - head over to the nuerodiverse mumsnetters section (in special needs). You may get some support there (though it’s a little quiet at times). Even if we just sympathise/empathise - just to know you are not alone.

Anyway, ignore all the crap responses here - focus on the many positive ones - and don’t doubt yourself - you did the right thing and with the right support you will be able to make changes.

Well, he could have tried giving a shit? Or perhaps tried to answer without being a patronising arsehole? Or maybe asked a few questions to find out why she might be putting on weight? (I'd have thought that was a basic requirement for a doctor when a patient turns up with a problem)
Compassion fatigue? Poor doctors, it must be exhausting not seeing patients and being expected to try and solve the occasional medical issue if a pesky patient does sneak into your office.

Does your doctor know you have Asperger’s? If he didn’t it probably explains his response. If he did he’s not doing his job properly and should have spoken to you in more specific terms. I don’t think you can be referred to a dietician on NHS unless you have a serious weight problem which as a size 16 you really don’t though you may not be happy with it.
Is you mum still around? If so could she help teach you to cook some basic dishes. If you can learn how to prepare a few basic vegetables and learn some basic herb and spice combinations you should be ok to stir fry, make casseroles or tray bakes. My son is an autistic adult and during lockdown I taught him how to prepare veg, and we cooked from an Indian cookbook which just uses a few basic ingredients for each dish and he quickly learned and is now much more confident in preparing and cooking food

I can't eat almonds unfortunately. I love them but they bring me out in hives (as do peanuts). See also most fruit, of which I love

Thank you for your suggestions x

Is every dietician trained well enough to know how to help people with Aspergers or autism with dietary choices? Impression I get from OP is that OP needs very simple diet plans and no other discussions or choices to make.

Also am not sure OP told GP that OP has autism. Would OP need a referral to any dietician or to a dietician with the specialist training to help people like OP?

No need for the faux outrage, its clear what Im talking about, she has maintained healthy eating habits for longer than she has been overweight, so therefore she has the knowledge and skills and habits within her, she has done it before.

What healthy eating habits of before? I use to eat just once a day - usually a pizza with ketchup. And that was it. Nothing else really at all. Nothing healthy about it

In a lot of areas there is strict rules about who can be referred to dietician often depending on medical conditions/ BMI - often your local council may have a link to healthy eating support on there website or your GP may have a social prescriber with an interest in diet - there is some great resources on line too - wanting to make a change is a great start.

pubmed.ncbi.nlm.nih.gov/34682735/

I have every sympathy, OP. I'm not diagnosed with anything, but I have awful issues with food; mostly texture, and I have a limited diet as a consequence. Healthy eating blogs are useless to me. I'm so sorry that the GP was dismissive of you. I hope you'll speak to another GP about a referral and about how you were left feeling after your last appointment.

The GP sounds clumsy at best, and unsympathetic.

My DS has ARFID as well as ASD, so we see a dietician who specialises in children with additional needs. My DS is extremely underweight though, and has to have extra calories in the way of drinks like Fortisip. However when we go to clinic there are some children there who fall into the overweight catagory, so there are services out there, but it may just be for children.

Sorry just seen you can't eat almonds ☹️

I think there is some poor advice on here

OP can ask and has asked for a referral to a dietician but if the GP doesnt see the need then thats that, she doesnt meet the criteria.

Posters on here are winding her up, telling her to go back and ask for a referral, talking about being 'entitled to ask'. Yes she is entiteld to ask, which is what she did but that doesnt translate to following through with a referral if its not needed

The language of the GP seems straight forward enough to me, it makes me wonder if he specifically chose to be blunt and very basic and clear because he knows that she has Aspergers.

My GP told me once to carefully cook my dinner, lay it out on the plate and then sweep half of it in the bin (along with some hand gestures!)

I dont do that because Im too greedy but essentially that is the correct advice. Eat less. Difficult to do.

Agree that this is one of the most ignorant and patronising statements around ASD and Asperger’s that I’ve seen on here for a while.

But it should be left for all to see the lack of understanding we face on a daily basis.

Handhold OP, see your regular GP

Your OP cited that you were upset that you have put on weight.

If a pizza and tomato sauce was maintaining a good weight for you, that is healthier than being overweight.

The bottom line is that people with a healthy weight are healthier than those who are overweight, no matter their diet. All sorts of risks present once that weight creeps up.

Yeah maybe make another appointment when your normal GP is back.

Like a PP said what do you like etc and maybe we can help come up with some ideas. Unfortunately weight loss food is very boring, went back to my old logs and I was eating a chicken breast and some veg etc. Birdseye do a really nice selection of microwave rice and veg etc that’s so easy to prepare.

M&S also do such nice little side/ rice salads and pasta. Could you go back to eating one meal a day, I know that is a thing (OMAD) xxx

Do you have a Healthy Lifestyles service where you are? Where I live you can ask for a referral to a health trainer who can support you for weight loss and other lifestyle services. Unfortunately you wouldn't hit criteria for dietetic referral based on having Asperger's and moderate weight gain here

NHS resources are all extremely stretched right now and with all kindness and respect, there is so much information online about eating and so many recipes, this is really the kind of thing you may be able to take responsibility for yourself rather than see an NHS dietician (as previous posters have said, they are of limited use in any case and not likely to be trained as a comprehensive resource for people with very specialised sensory dietary requirements in any case).

Can you post on here what your issues or requirements are? If not here, a relevant forum board on MN?

I am sorry for your loss and your struggles.

i don’t really see what your GP can do. NHS dieticians, even if you got a referral, would not have the capacity to untangle sensory food difficulties with adults at the moment, or if they did- quickly.

Find out how many calories you should be eating.
make a list of foods that you like.
eat within those calories and track on my fitness pal.

You can scan barcodes, buy pre-prepared foods and ready meals which takes the stress out of tracking. I know you

That's a horrible way for then to talk to you!
Don't be cruel to yourself by saying 'it's no excuse', because you're having a rough ride that many, including myself couldn't manage. It's understandable that your healthy eating and weight are taking the back burner.

OP I am so sorry for your loss. This may already have been discussed, but check your local council's webpages in case they have weight loss services that might help you and that the locum GP was not aware of.

I am having some success with limiting my eating window to 8 hours.

I hope you are getting any bereavement support you need too 💐

I think he was clumsy in his delivery but I don't think the message he gave was wrong. If you've gone up a lot of dress sizes, it's due to eating to much of the wrong thing. That's all he said to you.

Why is it an unreasonable request to ask to see a dietician when people are referred to the slimming world ? I would see another GP.

• you have said that you find tracking overwhelming, but this + consistency is the key to weight loss. It’s really hard to lose weight without it.

I know your 1 cheese pizza a day wasn’t the picture of health, but I imagine it was better than your current diet if you have put on weight.

Eat whatever you like and are able to. incorporate a multi vitamin too and some fruit. But just eat less and according to your calorie goals.

you are just going to put on more weight if you wait for a dietician referral as you won’t meet the criteria for it as it stands.

I hope the neurodiverse board can give you some more support and ideas.

@bellac11 I’m not really sure why you are posting here. You seem determined to minimise what the OP is going through and disregard how a combination of relentless 24/7 caring, horrific bereavement as well as being autistic is having on her.

Whilst it may not be possible for the GP to refer her to a dietician, surely he should be able to understand how overwhelming life is for her, which may suggest some kind of intervention is needed - especially when she is a career and someone is relying on her.

Also - why do you think that people with Asperger like to be spoken to in a blunt way. Is it because you think we have no feelings? Because we only deal in black and white logic? Personally I really really benefit when I deal with a compassionate HCP who is able to set out clearly, but kindly, what the options are.

You many think you are just “telling it like it is” but a little empathy would be appropriate here. And if you can’t do that - perhaps find another AIBU where you can pick a fight.