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.

Well have you quit upfs? It's not a 'diet' to abandon, it's just eating normal natural foods. It doesn't take long before you lose interest in upfs completely.

Sorry, but you are completely unreasonable.
You wouldn't be unreasonable to say that as a society we should look at the root causes and determine if we wish to do something about the obesity problem on a holistic front, however you can't expect a doctor to go into that much depth. The effects are damaging to your health, but the cause isn't generally a health issue, rather a "coping with modern life"issue.

Statistically it wouldn't be worth it because the time spent would be considerable, would take away from treating people he/she could actually help, and the chances that you would succeed are minimal.

If you have the time watch Nina Teichholz on YouTube, she is an American investigative journalist who took a look at the healthy eating guidelines, the eat more plants less fat guidelines, and revealed the absolute lack of evidence for them,
It is very interesting, basically suggesting that our current health eating guidelines coincide suspiciously with the obesity epidemic. Correlation is not causation, but if the eat less/ move more is clearly not the answer.

Actually he could have used motivational interviewing and empathy. It wouldn’t have been a quick fix but much better than trotting out advice unnecessarily so you can tick the box. I don’t blame the doctor but these are skills they should be taught. The reasons for living with overweight are very complex.

I'm not sure what other advice he could have given you? He's told you the things that need to happen for you to be a healthy weight physically, presumably he was not a psychiatrist so isn't qualified to unpick your complex issues surrounding food. The advice he gave was correct, if you chose to follow it you would lose weight so he has done his job.

Yes. I overheard an obese colleague say they were having a Chinese takeaway for tea as it's healthy.

*because of the veg apparently.

'What I was thinking was more along the lines of 'FFS do you honestly think I don't know that!'

Well tbf on the very recent 'How dare a hcp give me weight advice' thread someone did say that fruit juice and nuts were just the same health wise as Coke and a Mars bar so we cannot presume everyone is as informed as you.

It's very boring but obese people do need constant reminders that their health will suffer at some point very soon and all the defensiveness and enabling their overeating won't change that.

It sounds like he was polite and kind though so that's good.

I am sorry but this was not patronising...

The basic advice you get is the right one: eat a healthier diet and do more exercise/be more active.

What else would you expect?

This person is not a dietitian and there is no magic way to lose weight.

Unless of course the weight is linked to taking a specific kind of medication and is one of the side effects, I think you need accept that this is something where personal responsibility comes in.

If there is a psychological aspect to your struggle then again you can seek support from a counsellor or a support group to try to address that.

Sometimes GPs have agreements to refer to local gyms to help people with certain health conditions. I had a referral like this a few years back to help me recover from a major operation. The gym gave me a low cost subscription, a personal trainer who created an exercise plan for me and then saw me every month to check progress for the first 3 months. Maybe see with your GP if there is a scheme like this where you live.

I think I have a different post code lottery to some posters. I can barely get my GP to even call me back, let alone see me. I have been on a waitlist for some surgery for two years ( not weight related).

Motivational interviewing to help me lose weight seems very distant to me.

The doctors just say the general, 3 meals a day, no snacking. A lot of people are on medication and PUT UP weight by eating 3 meals a day.

Once someone said to me'no treats'. I had to ask them what a treat was, as I eat healthily and didn't eat takeaways etc

I think they should be trained more on telling people to avoid prepacked food, more protein, veg, with meal plans for quick healthy dinners. They should focus on getting people to build muscle to raise metabolism.

A diet full of saturated fat and animal products is not the answer either. She is a dubious mouthpiece for the beef and dairy industry in America, not a scientist or a doctor, and not well-regarded by actual researchers in the field.

There is over 50 years of evidence showing a plant-based, Mediterranean-style diet is the healthiest diet for general health and also for longevity. People are obese for many reasons - it's not because of the healthy eating guidelines, which most don't follow anyway.

To be fair, what else can they do?
We all know how to lose weight, but no one can provide the motivation for us (sadly).

It takes four years to train a dietitian (UK sp.). Doctors are lucky if they have a one-semester course throughout their entire degree, on health behaviours. Of course they can't counsel effectively on weight management.

In the UK, all GP practices are now part of groups called Primary Care networks. Many of them now employ dietitians, and Health and Wellness workers. Sadly, not all other clinical staff in the GP surgeries remember to refer people with weight management issues, so contact your GP surgery, ask if they have a dietitian, and ask for a referral if they do.

Also, the NHS has an online weight management programme for people who have been diagnosed with both obesity, and diabetes or hypertension. You can be referred by a GP OR a pharmacist.

There's a very inciteful documentary on Netflix about obesity. It describes how a huge number of overweight people literally have different body chemistry. They process food differently to thin people, and fat isn't burned off. Instead their bodies just immediately store it.

In other words, they literally can't help putting on weight, their body just doesn't work properly.

The solution identified was a "Poo Transplant". Where fecal material from a "normal" person was literally inserted into the nether regions of a "fat" person. This process changed the body chemistry of the obese person and reset their system, allowing diets to work for them.

It demonstrated fairly convincingly that for a huge number of people, obesity is actually a "medical" issue. They could eat like a rabbit and still gain weight.

Nope, sorry, I don't believe that the vast majority of British people are overweight or obese because they can't help it or they eat too many vegetables. Individual cases aside, on a population level it's because we eat rubbish
and too much of it.

YANBU, but I suspect they are required to tell you that information.

There's a very inciteful documentary on Netflix about obesity. It describes how a huge number of overweight people literally have different body chemistry.

It's not body chemistry! It was about the gut microbiome - which is changing on a day to day basis, and can be vastly improved with, guess what? More vegetables.

'In other words, they literally can't help putting on weight, their body just doesn't work properly.'

I guarantee if they controlled the amount they ate and did even a minimum of physical activity their bodies would indeed work properly and pounds would start to drop off

This 'it isn't my fault' narrative doesn't help anyone.

If doctors stopped telling people to lose weight, can you imagine how many overweight people would say, "Well it can't be that much of a problem, otherwise the doctor would've mentioned it".

Then when they get weight related medical issues, it'll be all the doctor's fault for not saying anything about their weight.

Rock meets hard place.

You forgot to mention that people's guts got into such a horrible state in the first place from not eating enough plants.

Or if they stopped telling people their BMIs. Blunt tool though it is.

Microbiome, that's the word I couldn't remember.

Right, but as mentioned above, shit diet caused the microbiome problems. Poor gut health isn't the excuse we all need to shrug our shoulders and say - meh, I'm just built this way. We (or our parents) caused it, and we can fix it.

Poo transplants proved the theory by showing immediate improvement, but it's easy to rehabilitate one's own microbiome with diet.

This is absolutely horrific. I'm so sorry you were treated in this way. A different subject, but very similar theme - the recent maternity services report (which was horrendous) had a very common theme from all the patients - they felt like they weren't listened to. And that appears to be a similar problem across all HCPs.