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'm the mum of the obese 12 year old. He is disabled, autistic, suffers from hypotonia & dyspraxia. He is 20 now, he isn't a greedy person, eats 3 meals a day, does a minimum of 10k steps a day, has been a young carer since he was 8. He's the person who both exh & I rely on if we have a fall, exh carers just stand there staring & do nothing other than ring ds while he can get his dad up off the floor using his weight to his advantage to heft him back into his wheelchair, he's picked me up a fair few times when I have fallen. Ds has clearly marked on his records that he is a young carer. Imagine if one of your children was suicidal, a HCP called them fat & it tipped them over the top to attempt suicide. I know which I would prefer, a ds who is alive.

'He's the person who both exh & I rely on if we have a fall, exh carers just stand there staring & do nothing other than ring ds '

I'm so sorry for what you endure. Please please get in touch with whoever organises your care. If carers cannot manually handle you and your dh safely then you need adaptations such as a hoist to make sure this can be done. I've every sympathy for your situation and of course i wouldn't tell an autistic 20yr they 'were fat' but a healthy diet would surely mean he was in a better physical state to assist you but do chase up hoists and adaptations .

Some people take medication that causes weight gain.

These people are not a tiny minority

This is interesting.

What are the statistics please? Out of the roughly 63% of overweight adults in the UK, how many take medication that causes their weight gain?

I would've thought it was a minority, but I can't find any stats?

Yes, it is definitely a minority. If you were to purely look at people with a serious mental illness who are pretty much all going to be on medication with a side effect of weight gain (if compliant) then it's about 1% or 500000 people. But if you look at more minor mental illnesses of course they affect far more people. 25% of people experience a mental health problem every year. Many of those will take medication that causes weight gain. So I believe it is a significant issue.

Can you link to any statistics or is this just what you think?

Millions of people take prescribed medicines. All of them come with a leaflet about side effects.

Not everyone who takes medication suffers from those side effects.

I'm on 3 different types of meds for life and suffer no side effects at all.

I've not time to look up statistics but I have experience as a nurse. Certain psychiatric medications have a very, very common side effect of weight gain. On my ward currently we have 2 that are not obese and that is because of anorexia - they're probably borderline over weight. So, no, it's not the case of only a few will have that side effect. Within mental health weight gain is a very significant issue. It contributes to the reason why people with serious mental illness die so much younger than those without.

'Many of those will take medication that causes weight gain. So I believe it is a significant issue'

Many of these meds may increase appetite rather than cause weight, or if depressed people are less likely to be up and about doing physical activity (which is a shame as endorphins etc released would be beneficial) they will gain weight. Or, some meds may slow metabolism in some cases but so does such naturally occuring body changes like menopause and if you eat less it balances out.

'Meds cause weight gain' is not always accurate or actually even helpful. If you still pay attention to what you consume it can be managed. We must empower people to feel in control rather than have this defeatist attitude.

It's actually much more complex what they do to cause weight gain. Everyone on my ward is well aware the meds cause weight gain. They come in underweight and can end up doubling their weight! Even though they are not over eating. So no them just paying attention to what they consume doesn't help. We do empower them - do you know how? You're not going to like this - but they see the dietician to get support to work against the medication. It's tricky work as very complex. But they finally feel in control of their weight and most are able to lose a significant amount with massive knock on effects to their physical health meaning they will be much less of a burden to the NHS.

I still don't understand how you can state with such certainty that the people gaining weight through medication, are not a minority, yet you can't back it up with anything other than anecdotes?