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.

I know it's tricky but ignore it if you can. My slim, active and fit sister who eats a really healthy diet with lots of grains and pulses etc took a gut problem to the practice nurse. Cue lecture on fruit, veg. diet etc. 'I do that' she said. Lecture repeated. They have the lecture ready on repeat.

Letsgetouttahere2023, discipline, discipline discipline.

Of course. One thing he advised me on was what time to take my medication and told me to eat a snack with it (and advised exactly what to eat.)

Wand waving dietician? 😂

I think you are proving the point I made about seeing professionals and getting the correct advice. The advice is not the same!

Why do people who need to lose weight get referred to dieticians if actually we could just ask @Janiie or @TeaandScandal and they could say 'eat less, move more!' 😂

I think it is just asking for trouble if you don't listen to your patient. You can't meet them where they are if you have no clue where they are!

You say you’re on medication that interferes with weight loss, @Riversideandrelax ?
Surely you get that that’s not the case for the vast, vast majority of people claiming to be puzzled at not being able to lose weight?

No, I don't believe that at all. It's a very significant group of people.

And just one of many where just parroting 'eat less, move more' is at best unhelpful.

How “significant” are we talking? I’ve never met a single person who can’t lose weight because some medication they’re on prohibits it.

As an overweight person myself, I think we need to stop the excuses. If we're not exercising, it's because we don't want to. If we're not eating properly, it's because we're choosing not to. We need to ask ourselves what we really want. I don't want to die like my mother did when she was in her early 50's. She had an atrocious lifestyle and it very much caught up with her.

I don't want my toddler growing up thinking that junk food is a good, healthy option. I know it's hard especially when there are mental health issues as well. I'm battling those as well. I also have a physical disability which leaves exercising difficult for me but I choose to do it because I want better. No excuses, just honesty.

We know the right things to do, we just have to do them. If we're unsure, there's information out there.

'Of course. One thing he advised me on was what time to take my medication and told me to eat a snack with it (and advised exactly what to eat.)'

What? And this has caused you to loose weight?! We usually get told what time to take meds by the actual prescriber and eating with or without food is on the instructions too.

By parroting this 'only dieticians know how to advise us' you are enabling the myth that it needs constant specific intervention, we'll have loads of people saying 'oh I can't I'm waiting for a dietician referral which will take approx 2yrs'.

Eat less, eat healthily and walk at least 10k steps a day. No it isn't new news but it seems it needs repeating to remove the medicalisation of overeating.

I have lost weight by getting rid of my car in the pandemic and walking everywhere. Not possible for those who don't live in London, of course, but has done me and Dh a world of good. Other solutions are possible for other people. For instance, I don't eat meat or fish, so getting protein can be a challenge.

But I am not waiting around for specialist advice, sympathy or empathy. Would be diabetic by then.

Very significant. It affects a large proportion of people with serious mental illness for a start.

It caused me to lose weight.

But not just that. All the advice and support I was given. That was one part.

I'm afraid you are misunderstanding. A prescriber may say take meds in the morning or at night. They may also advice as to meal timings. That is based on the effect the medication will have on the illness and/or side effects. That is not related to the optimal way for the patient to lose weight.

I saw my dietician within a month not 2 years!

And again why do you think people are referred to dieticians if @Janiie could just advise all their patients? You've already shown your ignorance so I'm pretty confused why you think you know better than the professionals? If you're already eating healthily in quantity and substance and walking a lot more than 10k steps a day I'm afraid your 'advice' is absolutely useless!

Meanwhile, for the rest of us; that’s exactly what works 🤷🏻‍♀️

'And again why do you think people are referred to dieticians if @Janiiecould just advise all their patients'

Dieticians should be used for those who need them, like type 1 diabetics and others with complex medical problems. Imo they should not be used for weightloss advice, as we all know there is plenty available online etc no need for face to face assessments.

Again, it medicalises overeating and enables people's bad habits by thinking it's out of their control as they have a 'condition'. They don't. Again sympathies to anyone struggling but we can all eat healthily and moderately without an appointment with a dietician.

Who's 'the rest of us?' What was the cause of you gaining weight?

I'm sorry but you are so incredibly ignorant. There are many complex reasons people are overweight.

I'm not sure you get to decide what a dietician considers a complex issue. And I'm also pretty sure they're well able to know this themselves.

You do realise a complex cases means that there is not going to be suitable advice online? If a dietician decides they need a face to face consultation then they will do that.

Having to take medication that causes weight gain is not a 'bad habit'. As I have now explained multiple times my dietician did not tell me 'to eat healthily and moderately' as that was not the problem!

I find you so arrogant to think you know better than professionals.

Presumably your weight problem was because you ate too much and not healthily and therefore you didn't need to see a dietician. We are not all the same!

We’ve got the message, @Riversideandrelax
You’re a complex case.
Most people really are not, however much you argue.

I'm not ignorant or arrogant. The NHS just cannot sustain providing healthcare for the ever increasing obese population. Dieticians should indeed be advising those with recognised chronic illnesses and diseases not giving dietary advice to overtreaters. I possibly do know more than some professionals

I'm sorry that the truth stings but until people stop medicalising overeating like you keep doing they'll never take responsibility and realise they are the ones to make changes and they are very able to do so.

I've not said that most people are. But there is a very significant number of people that are. And professionals are quite able to discern that without your help! Your 'advice' is not going to be suitable for those people how ever much you argue. And I think the fact you have no idea about that suggests you are quite naive when it comes to this subject.

Nothing you've said 'stings' as it's not the truth. I'm assuming you've struggled to lose weight and this is why you don't like the thought that there are people with more complex reasons for having gained weight. And I'm sorry if that is the case, I'd tell you to seek advice but no point as you'd think you knew better! Maybe it isn't but often it does seem to be the case.

I'm a nurse so fully aware you really don't know more than professionals. You've been unable to grasp the basics I've attempted to explain to you. You still seem to think I'm talking about 'over eating' when I have made it very clear I'm not.

You show your ignorance in this sentence 'The NHS just cannot sustain providing healthcare for the ever increasing obese population.' Those of us in the NHS know that, that is precisely the reason we need to support people to lose weight (also prevent gaining.) Because as much as you may want us to do it - when someone has a heart attack we don't turn them away because of being obese!

You may wonder why I am so passionate about people getting the right support and advice for weight gain. It's because the research my dietician did had more than the affect of meaning I could get back to a normal weight but I put him in touch with our dietician at the hospital I work with. It's helped many of our patients. I suggest you leave those of us who know what we are doing to deal with our patients

There are meds like steroids that make you really, really hungry. I have a condition that needs steroids and other people with the same condition say they have put on stones of weight. I found the only answer was portion control and will power. Truly dull.

When I needed to lose weight my GP advised me to eat maybe three potatoes instead of four when having my dinner and maybe a takeaway once a month. That was it. Needless to say I didn't listen to him.

Thankfully obesity understanding and management has moved on a bit since the days of 'eat less, move more!'

I can imagine that being really hard. I was given steroids once when very unwell. I'd barely been eating due to my illness and suddenly I found myself sitting there eating my dinner and thinking it was so tasty! (And this was hospital food!) I wondered what on earth was going on then realised...steroids!