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.

But unfortunately some people will always think they know better than the professionals!

Have you lost weight in another way?

The having a takeaway once a month reminds me of someone telling me how they asked their GP how often they should eat chocolate as they were trying to lose weight. The GP said 'try to limit it to once a day.' They were overjoyed as they only had it once at the weekend. It's always dangerous not to know where someone is before giving advice!

'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.'

Not at all, I'm a fit and healthy size 12. What did happen was after years of eating what i liked when I liked it changed < as it does whe you get older > and I started put pounds on so guess what I did.. I ate less and it worked! As i keep saying I get cravings like everyone else but the days of gorging on chocolate every evening have gone I have to have a bit of self control. It's common sense tbh.

It isn't easy but it doesn't need medical intervention. I maybe have a chip on my shoulder as I had a serious diagnosis (not lifestyle related) that required surgery and further treatment and if I could have fixed myself by self control I'd have done it.

So you were eating too much, then you stopped that and you lost the weight. That's wonderful that, that was the case and you were able to deal with it. But that really is a very simple case.

What you don't seem to understand is that not everyone has spent evenings gorging themselves on chocolate. So it not such an easy fix to just have a bit of self control. You didn't need medical intervention, no. But very many people are not so lucky in that regard. Some people have very complex cases. And yes, they do need medical intervention.

And those people just like you would fix themselves by self control if they could. Insisting that they don't need medical intervention because you are upset about your own illness is really very unfair. Let the health professionals decide who needs medical intervention. Imagine how you would have felt if people had been telling you, you didn't need medical intervention for your illness?

'Imagine how you would have felt if people had been telling you, you didn't need medical intervention for your illness?'

How I'd have felt if someone told me I didn't need surgery I could cut down on what i ate and I'd be fixed? Well I'd have been overjoyed and relieved. Seriously please don't equate a serious diagnosis with unhealthy lifestyles.

You sound very proactive in your medicalising overeating campaign but I don't think it helps. We've said yes meds can increase appetite but being hungry won't kill you whereas being obese might. We need to reduce the amount of diet induced diabetics currently putting great strain on nhs services not excuse and say they can't help it.

Goodness you're hard work!

I'm not talking about 'an unhealthy lifestyle.' You had an unhealthy lifestyle. I never have. I've always been really into nutrition and health. We are not all the same!

Imagine if ignorant people told you that, despite medical professionals telling you that you needed medical care, actually they didn't believe you did. You shouldn't be getting that medical care.

There are many people that do not have an unhealthy lifestyle. But they are unfortunate to become seriously unwell. So unwell they have to start taking medication. And one of the side effects of this medication is that they will gain weight. Those people need medical care for their weight. They are not less deserving because they have a different illness to you.

I'm not talking about being hungry or over eating. Yes, it is complex and perhaps this is why you don't understand. You are not more deserving of NHS care because you happened to get one illness over someone else getting something else.

I had weight loss surgery 11 years ago, a mini gastric bypass. Lost 11 stone in 10 months and continued to lose. I became very unwell. I had it reversed after 15 months. Kept the weight of for around 5 years but started to gain during Covid and got a PCOS diagnosis. I've now been on Ozempic for two years and I love it.

'And one of the side effects of this medication is that they will gain weight. Those people need medical care for their weight.'

The vast majority of overweight people overeat. I'm not saying this to be goady it is true. A tiny percentage may be on meds that may increase appetite but that doesn't mean they cause weight gain. Stop enabling and excusing poor eating habits.

I'm not more deserving of nhs care specifically but people who become unwell through no fault of their own, not through poor lifestyle choices should not have to wait longer for services and treatment because overweight people are using resources.

YANBU I’ve been grossly overweight since aged 6 and diagnosed with T2 diabetes 25 years ago. I’ve seen GPs for over 50 years none of whom gave me nor parents any decent advice other than generic leaflets and a couple of dieticians and several diabetic specialist nurses were no better. They all just parrot the basic genetic info from nhs leaflets which I can read myself! I’ve Lost count of the number of times I’ve been told to eat fewer mangoes despite never eating them - what a surprise mangoes are mentioned in the nhs leaflets!

Are you honestly not able to understand this?

I am not talking about medication that increases appetite

I am not talking about people with poor eating habits

Some people take medication that causes weight gain.

These people are not a tiny minority

These people became unwell through no fault of their own

Health care professionals know what they are doing. Your ideas are pure ignorance. Including that you believe you know better than HCPs! 🥺 I feel sorry for any HCP working with you, goodness me!

I'm just not agreeing with you, most people simply eat too much of the wrong stuff. You must know this if you are a nurse?

Stop enabling and excusing, it doesn't help with the massive and ever increasing obesity problem. I'm not suggesting insults and sneers just stop medicalising it.

Not sure why you'd feel sorry for any hcps I encounter? I obviously respect their role unless they give me reason not to.

Thank you, I'm glad it helped you, not gonna lie though I was hoping for a magic bullet for my own weight problems

You clearly don't! You think you know better. You think you know better than me about my own patients for a start! I'm not talking about 'most people' as I have made abundantly clear!

Well, I've tried my best to help you understand. But sometimes I guess there's no arguing with ignorance.

Oh gosh, sorry! 😄 No, his advice pertained to a quite specific but complex issue. He did lots of research and was able to crack it! But good luck with your own journey! I hope you find the thing to crack it for you too.

'Well, I've tried my best to help you understand. But sometimes I guess there's no arguing with ignorance.'

It isn't 'ignorance', it's a different opinion. Try to debate without being rude. I understand it is an emotional issue for those struggling with their weight and of course defensiveness will be a natural reaction but we are allowed to, politely, challenge your views.

No, it's not a different opinion because you've not given an opinion on what I've actually said. You've misunderstood or ignored most of what I've said and just kept going on about 'medicalising over eating' and everyone just needs to eat less. It's a shame you are so completely unable to be able to learn anything that challenges your narrative that everyone is an unhealthy, chocolate binging, over eater as you've said you are. There is no debate with you as you don't respond to anything I've said.

I'm not struggling with my weight so have no defensiveness on that part. I just find ignorance so frustrating.

If you really want to debate:
Explain why dieticians should not see complex cases of obesity where over eating is not the issue? I get you find it to hard to understand that, that is the case and you find it hard to understand what input a dietician can give. (And as you think you know better than HCPs you can't accept they know) But putting that aside for a moment. Let's say theoretically that is the case. The person is not over eating so can't lose weight by reducing what they eat. If helped by a dietician they can get to a healthy weight and therefore put less strain on the NHS. Is that a suitable person for the dietician to see in your opinion?

' should not see complex cases of obesity where over eating is notthe issue? I get you find it to hard to understand that, that is the case and you find it hard to understand what input a dietician can give'

Your dietician said take meds at a specific time and have a snack with them! I mean I'm sorry but that isn't the wondrous advice you seem to think it is. Maybe it's the placebo effect someone is 'treating' you so it gives you motivation and incentive?

I won't insult you by saying 'you're ignorant ' etc etc. We all know obesity isn't caused by complex medical conditions. It is basic physiology that calories in must match energy used. If you take meds that increase appetite you have to find strategies to cope with hunger pangs and an opa at a hospital to tell you that is absolutely unnecessary.

We all know obesity isn't caused by complex medical conditions. It is basic physiology that calories in must match energy used.

Why do you think this? It’s been proven over and over that this isn’t the case.

And I'm really interested @Janiie as to why you think GPs/nurses etc are making all these, what you consider to be inappropriate referrals? And why dieticians are accepting them?

'I'm sorry you may not like it but you are extremely ignorant. You can't say it to me because it's not true!'

No, I won't say it to you because I'm not rude. We disagree, you mustn't take that so personally.

I've lots of experience regarding the nhs on both sides and as I keep on having to tell you services are absolutely snowed under with diseases that aren't all directly lifestyle related. Overweight people of course need motivation and support but this could be done by attending a weight loss club that they access independently.

Oh. I can imagine that. All drunk men and beaten men send off home as due to their poor choices they do not deserve to be treated, all with stab wounds as their poor lifestyle choices...then it would be all men with football, rugby and cycling injures. Then all who fallen from the horse, all drowning etc. We just can close NHS really.

I guess you are drinking or at least you drank in the past. Alcohol is one of the worst drugs know to humans. Caffeine is not that healthy either.
Really, I do not understand why we have to pay for people who cheerfully drank wine and coffee.

Weight loss club?! Dear god - the naivety! 😂 Sorry have to laugh or I'll cry.