To think that most health care professionals are hopeless at advising on weight

[Hellostrawberries]

I had a hospital appointment today and the doctor, as expected, advised me to lose some weight. (My BMI is 39). He then spent around 30 seconds explaining how to do it, basically by eating less processed foods and more fruit and veg, lean protein, whole grains etc.

I couldn't be bothered to say what I was thinking so I just thanked him, assured him I'd try and went on my way. What I was thinking was more along the lines of 'FFS do you honestly think I don't know that! I've spent the last 30 years trying to do just that. I succeed for a few weeks and then the hunger and cravings overwhelm me and I abandon the diet yet again. Each time it happens I hate myself a bit more. I've also got a history of ED and had a year of therapy for bulimia in my teens. My weight and my disordered eating are the biggest struggle of my life. And you reckon you can wipe it all out by trotting out a line about how I should eat more vegetables and less cake! Fuck off!'

So AIBU to think that HCPs are hopeless at advising on weight? I'm happy for it to be mentioned. I'd just like it to come from a place of understanding, of assuming my weight history is long and complex, of crediting me with knowing what healthy eating is.

Exactly. What did you expect him to do - wave a wand, or give you a magic potion? If it was that easy no-one would be overweight. If you can't be bothered actually talking to them they can't help. Maybe visit a dietician?

He advised OP to lose weight? What more did you expect him to do? I'm overweight, I know how to lose weight, when I make the effort it happens. I don't need a doctor to provide some magic cure. People need to take some sort of responsibilty for their own health when they can do so.

Obviously there are some exceptions, but for most people there is only one way to lose weight - but people seem to think they shouldn't need to put in the work and want an instant quick fix.

Oh, I thought it was just me who thought like that.

Taking responsibility for your own life seems to be an old fashioned concept that no-one understands any more.

I was at the GP for another reason but I mentioned how much my weight was distressing me. Hitting 50 with 40 years of being overweight behind me, peri menopausal, ND teenagers, challenging job, depressed husband, widowed mother, feeling at breaking point. She told me it took three weeks to form new habits so I would get used to not eating biscuits. After I told her I had disordered eating due to anxiety for 40 years.

Anyway she wasn’t remotely concerned about my health (I am very fit and healthy) and I’m not fat enough for any intervention other than a health trainer teaching me how to make salad. I’ve spent a fortune on therapy.

Now back at SW until my clothes fit again feeling hungry and miserable, until the cycle begins again.

But I am just lacking will power.

As a smoker I think YABU, healthcare professionals often tell me to stop smoking, hand me some leaflets, signpost me to smoking cessation, etc etc.

But ultimately, it's up to me to do the work, it's my job to get my head round giving up smoking (which I love and am quite emotionally attached to).

I'm fully aware of the potential consequences of not giving up smoking. I know.

What should they be advising me to do?

What do you want that you don't already know?

Re smoking, that's pretty much what they do tell you!

Yes, nicotine replacement therapies are available, but if you don't stop putting a cigarette in your mouth and lighting it, you're not going to give up smoking, are you?

Also, I see you were seeing a Dr for a non-weight related issue.

It's standard.

My smoking is yet to impact my health, so it's standard when I see a health professional and they ask if I smoke, when I say yes, they give the usual spiel about smoking cessation.

Likewise, if you go and see a health professional, they will give you the weight talk.

If I went the GP and because I wanted to and was struggling to give up smoking they would offer much more in depth and specific help.

If you went to the GP to address your weight I'm sure you would be directed and referred in a more appropriate way.

Ultimately, it's up to us though to address our bad habits. Should we chose.

Offering to signpost her to the relevant services, she would probably benefit from more specific advice from a dietician/physio/mental health professional.
Asking OP if she agreed to be referred would take less than 30 seconds.

There are so many women on mumsnet with weight trauma issues that I wonder why they don’t band together and form some sort of private weight therapy group ? Genuine suggestion. The constant slagging off of healthcare professionals who are only trying to do their jobs is getting tiresome.

What do you want them to say? Take responsibility for your own choices.

I think you are being unreasonable. Losing weight is a matter of numbers, calories in vs. calories out. unless there are other issues at stake (hormones, medication etc.). If you're having issues because of disordered eating then it's more likely that you need therapy not dietary advice.

I do understand OP. My BMI is around 30. I also have a disability that means I'm in constant pain. I've been on countless diets and schemes. However, I now go to the gym multiple times a week. I do a mixture of weights and cardio and I'm seeing a massive difference already. As a result, my eating has improved. I have a long way to go and I'm sure there will be hiccups along the way but it is about taking personal responsibility. I also refuse to weigh myself and I don't calorie count. My aim is to be stronger and fitter, it's not about my weight. Maybe shifting your focus might help?

Don't get me wrong, it's hard. My illness is flaring up and I've been left so tired but it is worth it.

I think you missed an opportunity to actually respond to the Dr's comment with some information about your history. That could have prompted the Dr to offer support tailored to you.

you would be surprised at how many people have absolutely NO clue about nutrition

I think the problem is docs don't have enough time to really have a proper chat with patients so end up giving rushed advice as even though being overweight is serious often HCPs are focused on solving more immediate and pressing problems

Every year when I have my medication review & annual health check I end up getting the same doctor who is obsessed with getting patients to lose weight. He never realises that I'm housebound, virtually unable to walk, am on several medications that a major side effect is weight gain. I once went to see him with ds who at the time was maybe 12 or 13, we had gone because both of us had chest infections, his opening words were "I'm going to refer you both to the weight loss service, you are both fat" No good morning or what can I do for you. I told him straight off that we went to slimming world every week, I had lost 2 stone & ds 1.5 stone in 3 months, his next words were "It obviously isn't working for you, are you even following the eating plan?" If we didn't already feel crap, we definitely did then. I had already been to the weight loss service, it consisted of being weighed & then lectured by 2 women who made a pencil look fat who spent the entire meeting telling us we were abusing our bodies & would probably drop dead if we didn't lose weight then told us everything we couldn't eat but not actually what we could. After the first month I never went back because they made me feel like crap.

It is frustrating. I told a doctor the exercise I do and he said "have you tried some gentle walking, that can be good to start with if you're overweight and struggle with mobility"

My sentence before that was I do regular spin classes, lift weights, occasional aerial fitness and taken up netball
What part of that sounds like I struggle with mobility or need to start with walking?!

Your weight isn't impacting your health, currently. Give it a few years and it will impact, at the very least, your knees, and maybe also your hips and feet.

I agree, it is insulting hearing this basic stuff - as if one has never heard of it - when you have a long history of dieting and also ED history. But there really isn't anything else he could say, because it's the truth. At least he didn't throw in a side portion of shaming.

Also, 5 portions a day is really the minimum. If you up (as he suggested!) your vegetable and decent whole grains, nuts and fruit (fibre, basically) there is less room for discretionary foods, and over time you do lose weight.

@queenparrot I guess it's so individual though

Like you mentioned nuts, I don't even buy them because I would just eat too many of them. Plus you've got costs involved. Yes I can eat bananas and apples but I absolutely love mango, pineapple, melon and fancy vegetables but I can't afford them
Time wise preparing food especially with other health conditions where you just want to eat a bowl of cereal and go to bed

Not excuses just saying that everyone is so different with food and weight

Well, no-one has to eat nuts. They are just good sources of protein, healthy fats, minerals, vitamins, and plant fibre.

Have you been to a toilet without the patronising sign of how to wash your hands!

The doctor's just doing their job in the tiny time frame that the appointment allows. You say you're healthy so why are you bothered by the generic advice?

At a bmi of 39 you must be consuming a serious amounting calories to sustain that weight.

The statin may have been offered as your Q risk was high. Even if your lipids were normal.

I was super lucky that I went in for a blood pressure check one day and the nurse I was supposed to see was off, so my check was taken by the locum dietician instead.

She asked why I was having checks and I explained that it was for anxiety and burnout from stress. I'd simultaneously piled on the pounds as well as having no appetite somehow.

She referred me to an app based live support program where I was coached through the nutrition I needed in serious detail, and taught about Leaky Gut syndrome, and the role of leptin and ghrelin in weight management.

(Turns out that when you're stressed and having a high intake of toxins, your body can lay down fat in order to store them safely - lose the weight and the fuckers are let free again!)

It was complete coincidence that I got proper holistic support and could work back towards health again.

What did you want him to say?
People need to start taking personal responsibility for their own health.
Losing weight isn’t complicated, if your energy expenditure if greater then your intake, you will lose weight.