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?

Try slimming world online. It's a very comprehensive site and interactive I think

I have Asperger's, I tell people I have Asperger's. Who do you think you are to tell others how they should refer to their own conditions?

Your GP sounds quite callous to have said that to you (with hand signals too if I’ve understood correctly) 😔
I saw an NHS dietician as I have bowel disease and tbh they were useless. They suggested calorie counting, whilst that is fine they gave me no information on how to meal plan, the importance of macros, and what %age of carbs, fats and protein I needed to eat to lose fat. However, there is lots of free content for this online. Honestly You Tube and even tiktok has been a wealth of resources that has helped me. This information is out there and whilst your GP is not being helpful, based on my experience, you can find lots of useful stuff yourself.

Sorry about your baby son

Your GP couldn’t have phrased it less sympathetically!

I would guess that either:
he meant that your current traumatic situation doesn’t mean that food choices & comfort eating wot result in weight gain, even though nobody would think you weren’t deserving of whatever comfort you could have.

Or he meant that your awful situation wasn’t enough to mean he could immediately refer you to a dietician, because your current weight isn’t enough to warrant it.

I don’t have the knowledge or expertise to help, as I’m sure “eat vegetables instead of sweeties” isn’t helpful. But hopefully you’ll receive some decent advice on the other thread.

Wow, talk about personal attack on me for what reason exactly?

Not that I need to explain this to you but I read the title and OP and empathised with what she is going through, both for personal but also weight reasons, unless you're overweight with a massive gain quite quickly its difficult to understand

My comments have been factual and to aid the OPs understanding of why and what advice would be given.

Perhaps you're projecting, I havent picked a fight with anyone, Ive simply offered advice and guidance of perspective.

Even if you got a referral, the current wait for a place on a weight management course is 12 months plus. I've already been on the list almost a year and no places in sight, and thats for over zoom, actual in person, the wait is indefinite.

It might be worth contacting your local pharmacy, back in the day about 10 years ago my local one had a free service linked to the GP somehow, you had to be a certain weight for it, they saw me every week

It was very good at the time.

Hi OP, I'm in a similar position, I lost my little boy in January and since then my eating habits have spiralled and weight has gone on quickly.

I'm now losing simply by adding up calories and not eating more than 1,200 a day. 2 slices of toast for breakfast is around 188, etc.

It's simple to do and in many cases I'm just cutting portion sizes, so still eating tomato soup (for example) but not eating the full tin.

But I know how hard it is. Sorry your GP was rude.

Presumably you do get through a week of patients - usually - without weirdly enacting nibbling to them though? As some kind of baseline. “No patronising the patients with mime” kind of rule?

I'm sorry life is so difficult. I've gained weight and I have none of the stress you are under. Your GP is a twat.

Dieticians can barely see the patients who have genuine nutritional and food related issues...my DSD who has severe anorexia doesnt get dietician input on the nhs....we had to pay for private dietician.

I’m not really understanding the logic here because:

a) It is awful that there has been no access to an NHS dietician in this circumstance. There not being access in this circumstance shouldn’t be held up as some kind of benchmark about correct entitlement because this is an example of something gone horribly wrong!

b) I see no distinction here with one issue such as anorexia nervosa being a “genuine” nutritional and food issue and the other not being. They are clearly both genuine, both nutritional and both food related. Furthermore, in case people are not aware, anorexia can often be linked to autism related food issues and anorexia can also accentuate autistic-like traits. Both anorexia and autism have implications for other aspects of health and life expectancy.

At the end of the day, it doesn’t help to not request the services we need. We might not get them but we have to push for better. Staying home and not asking for help will not help the NHS either as we have unfortunately discovered in recent times.

That is a very odd way of wording it.
did the GP suggest any other investigations?

Hi OP. I have ASD (Aspergers) too and I know what you mean about it being overwhelming to start from scratch with something. Do you need some easy rules to follow for healthy eating and quick prep? If you want I can PM you what I usually follow as a guide / can help with allergies (I have some too) / substitutions etc. Food is a bit of a special interest for me, so although I'm not a dietician or nutritionist at all, I have done a lot of reading on healthy eating, how to keep fuller for longer etc.

Something else that might be helpful (to take the stress and thought out of it) is that you can buy portion plates that show you how much to put of each food type on a plate:
Like this one on amazon.

Wishing you all the best.

@bellac11 <sigh> it’s not a personal attack at all.

You are repeatedly saying that the GP has behaved correctly. You are also not taking into account the impact of autism. If you said it once then I’d have left it, but you are coming back - rather aggressively - with ableist overtones, impractical advice and I just don’t see how you think you are helping.

As I said before, maybe a dietician can’t help (though maybe they can, I don’t know) but a GP should certainly be able to help someone who is clearly on their knees. So I do not think this GP did respond appropriately at all.

In a world designed for neurotypical people, life is stressful and difficult enough for autistic people. I cannot imagine being able to cope with all the OP has on her plate. I would need additional support - there is no way I could cope. But attitudes like yours - asking an autistic person to do what worked for you - is why life is so much harder for us - we are constantly having to explain (and that can be v v hard in itself). All I was asking for is a little compassion/understanding in your posts.

@Theredjellybean Whilst I do appreciate that GPs are under enormous pressure, there is never justification to patronise/minimise or be rude. Also I would hope that any GP would take the OP’s diagnosis of Asperger’s into account when giving her advice - it really doesn’t sound like the GP did. I have completely sympathy for GPs who have to deal with unreasonable patients every day (every hour?) but surely, with the background the OP has given, you can understand that she is looking for support in very desperate times? Fortunately I have a lovely GP - gruff-ish manner - but he listens, helps and explains in a compassionate way.

Some harsh comments, maybe because the OP could be understood as the GP saying she wasn’t entitled to extra help vs what he really meant: she wasn’t entitled to extra food.
How rude if him! OP I can definitely see how even one appointment with a dietician could help especially as I see how your Asperger’s (even if we aren’t supposed to call it that) could be part of the cause.

Practically, could you describe your « barriers » to preparing food? Maybe people will
give you ideas. Is it about using the oven/pan? Or anything that would be messy like slicing tomatoes or peeling an egg?

Could you ask for an occupational therapy referral? They are more geared to the practical side of preparing food and are very good at sensory needs. If that GP was a locum I would try and see somebody else.

It sound like you have been through a lot.

Could you start by having quick but healthy food in the fridge? I'd start by having some full fat (10% fat) Greek yoghurt for breakfast every day, with some raspberries. That takes less than 5 minutes to prepare and eat, even on the go, and it's filling. Don't worry about the other meals being 'healthy' until having breakfast is ingrained into your routine. Once that's done, you can think about lunch.

We've been told not to refer to dietitians anymore. Even newly diagnosed diabetics. A two year wait apparently.

The dieticians association has posted advice about autism and diet.
I guess you are thinking your child had access to a service that you thought maybe you would have access to too. Makes sense. But I am guessing kids have different medical extras to adults.
hope you get sorted.
I have ceoliacs and don’t normally have access to nhs dietician but they asked me to go when pregnant with twins. I think I switched off when she started insisting I add two pieces of white gluten free bread to my diet.
www.bda.uk.com/resource/autism-diet.html

I feel that when he spoke of 'extras' and 'deserve something else', he was referring to junk food. I get that. I ofter think after a hard day, I deserve an icecream! But I'm a bit fat right now, and know that I should not think like that!

That’s absolutely appalling. Even if you don’t meet the dietitian referral (which I imagine you probably do) there are definitely other referrals he could have offered for you. Like most areas have a weight management referral which is usually a course of sessions - and also have you accessed bereavement counselling for the loss of your son?

Please complain to the practice manager about the despicable way you were spoken to. He clearly needs some education about bereavement and autism.

OP I am so sorry you a have had such a devastating time of late. I think the GP wasn't considering your whole situation - much like many of the posters here. The GP knows they cannot refer everyone to a dietician who needs to lose weight as the dietetics service simply could not cope with that. However your situation is clearly complex. Have you had any sort of bereavement counselling? There might be a bereavement midwife you can link in with or you could try the nearest children's hospice maybe. I suspect you need much more than a dietician can offer, but unfortunately as you know it is really hard to access anything on the NHS. I assume that you cannot get anymore respite? 10 hours seems ridiculous given you are on your own! I really feel for you op

What kind of foods do you eat? What kind of foods are you able to eat and so you enjoy eating? What kind of prep do you feel able to do and how much time do you have? Maybe if you post some of your requirements on mumsnet (although I’d probably start another thread) some posters here will be able to help with some meal planning or recipe advice.

I recently had a nhs dietician appointment and I was so disappointed, she most talked St me, telling me bland obvious things I knew and there seemed little depth or robustness to her knowledge when I asked direct questions. Honestly it was a, waste of time. I wouldn't pin hopes on it