To think I still deserve medical attention despite being overweight

[Frequency]

Every time I have a medical issue and seek help for it I get told to lose weight, which is fair enough, I understand that, but that is all the support I get.

For example, I went to the GP recently about crippling pain in my left knee. I can't walk far, I can't sleep, and it often escalates into shooting pains up and down my leg or stabbing pains in the side of my knee which make it really hard to concentrate on anything but the pain.

I was prescribed 3 months of Orlistat. Nothing for the pain in my knee, just three months of weight loss drugs and told to come back after I had lost 5% of my body weight to discuss my knee.

I've been on it for a week now. I still cannot walk or sleep and last night another condition I have had previously flared up which I think is related to the Orlistat/weight loss/diet.

It's something I have had previously, only ever when trying to lose weight. It's like a really sharp, unbearable pain across the top of my stomach. The pain is so bad it causes vomiting and shortness of breath. I would honestly rather spend the rest of my life in labour than to experience that pain again and now it's back. I've only had it once up to now but I know the pattern, it will become more and more frequent until I'm having daily attacks that last hours. If I seek help during an attack, then I know a Dr will take one look at my weight, tell me it is because of all the fatty food I eat, and send me away in tears to buy myself some Gaviscon and lose weight.

It never happens when I eat fatty food it happens when I try to lose weight but they never believe me.

So now I am stuck, I can either be fat and never walk without pain again or I can continue losing weight and have hours of childbirth-like pain every day.

AIBU to think it shouldn't be like this?

If you are carrying excess weight then that’s obviously going to put extra pressure on your joints and losing weight will probably help so no, it’s not unreasonable that the gp suggests that first. Also losing weight will bring other health benefits too. Your sharp pain sounds to me like gallstones but does need investigating.

I am not a MN teeny tiny size 4 weighing 50 kilos wet through, btw.

Document everything, videos, photos, a daily list of symptoms of before and after the meds and what food you are eating. If you're seeing the same doctor then see another. If it is different doctors then go with a list of bullet points of thing you want to say and get across.
I have a knee problem, I am overweight. I have explained that since my knee flared again the 1.5stone I lost is creeping back up. They are helping me with my knee. But I had to be firm, not take no for an answer, and explain that being physical and getting out for walks and doing exercise, although small amounts, is beneficial for my mental and physical health and my knee is really making me suffer.
Also, losing weight is about reducing calories. I know this, can explain the knowledge as I've spent time learning about it but do struggle to maintain applying this knowledge due to the other factors like mental health and my medical health conditions, and now making the time as a single parent hasn't helped. I'm honest and explain this with the doctor. Being honest and explaining might help.
I have shown that I am being proactive, I am trying, but my set backs aren't helping.

I'd go back, agree weight loss is important but you need something for the pain in the meantime.

Get your gallbladder checked. I lost lots of weight fast and developed gallstones as a result, which caused pain like you describe.

I agree losing weight is important and would help, so I understand why they suggest it, but it would also be a lot easier to achieve if I could walk and didn't have debilitating stomach pain every time I try to lose weight.

I get what you're saying OP, really I do. Having been there, your knee problem is most likely due to weight. The immense pressure on your joints will not be helping.

You probably know the only solution is to lose weight naturally. Work out your calorie deficit using a TDEE calculator and try for 4 weeks to stick within that range. Even if you give it 4 weeks, it's a small price to pay for what may be the start of a new you!

The weight loss medication makes you ill? Go it alone and be accountable for yourself. I found a calorie tracker like nutricheck really helpful.

Weight loss drugs work but they need a lot of input from the person taking them, you cannot just take them and expect to lose the weight anyway so take some agency and go it alone.

This is not what you want to hear but I suspect most answers will be of a similar nature.

The pain your experiencing is probably gallstones and is common when losing weight, speak to your doctor and get on the list for removal, meanwhile eat a gallbladder friendly diet.

Knee pain is very common in obese people and your Dr was not being unreasonable to suggest weight loss before treatment that said they should have given you pain relief to help you be able to stay mobile.

Respectfully op are a little overweight or very over weight and obese?

Is the knee pain due to gout perhaps?

It might be that the doctors can do much other manage your pain via painkillers which they are reluctant to do long term? The doctors seem to think that the extra weight is responsible for the symptoms which would not be their attitude if you were say just a stone heavier than you should be..

You went to the Dr to hear what could alleviate your pain. The Dr says weight loss is the solution. He has prescribed drugs to help you lose weight. You would prefer painkillers but presumably weight loss will work better? Sometimes the treatment isn’t fun but that’s what you need to do.

Sadly the reality is that excess weight will cause problems on your joints. I’m not skinny - a long way off and know I need to reduce my calorie intake. As you get older it will only get harder.
I would do as a previous poster suggested and take control - keep a diary of pain, what you’re eating and doing to help yourself. Then the Doctor will be in a better position to support you but I doubt he can do it without a lot of input and determination from you.
Good luck

I don't think the Orlistat is causing the pain, I think it is either weight loss or the type of food I am eating (probably the weight loss itself, as there is no one particular food that sets it off).

I do think it's gallbladder related and have mentioned that to the GP last time but was fobbed off with antacids and told to try them for three months instead. I couldn't stand another 3 months of the pain so stopped the diet instead.

I am eating better, currently. You can't eat fat with Orlistat so it leaves me no choice but to diet. I'm not calorie counting but I am making sensible choices. My diet tends to be very "samey" when I'm trying to lose weight but I don't think any of the foods I go to would cause the type of pain I get. I tend to stick to fruit and yogurt for breakfast, tuna salad for lunch, and veg omelet (fried with low cal spray oil) or jacket potato with salad for dinner.

What do you think is causing the knee pain?

Do you honestly think it's just due to your weight. And if you are very overweight that will put immense pressure on your joints. Or something else?

What would you like the gp to do?

If the weight loss medication doesn't agree with you, then you are going to need to lose weight the traditional way.

Another thing to consider is stomach ulcer, especially if this was your previous diagnosis as your Dr recommended Gaviscon.

I'd check with a pharmacy if you can take Esomeprazole with the Orlistat. This will reduce the acid and the pain.. I personally hated Gaviscon liquid and the tablets stuck to my teeth, but have found Tums are perfectly pleasant to chew on, so highly recommend them to help.

Edited to add that I get pain high up when fasting/ losing weight, and it is an ulcer. The antacids do work.

I'm guessing you're female? If so this is absolutely par for the course.
There are absolutely massive problems in Western medicine with women being taken seriously and when they do its usually pinned as being our own fault.

I say this as someone who works in the field.

And if the gp is prescribing weight loss drugs then you must have at least a BMI of 30, which is very overweight.

And for gallbladder pain the first line treatment is diet not anything else.

Have you tried eating a gallbladder friendly diet and seen if there is any improvement

Eg recommended to avoid eggs with gallbladder problems

I think the knee pain is related to an old injury. I've always had issues with this knee since falling on it when I was a drunk, stupid (and underweight) 21-year-old. I accept that my weight is making it worse but I don't think it is entirely caused by my weight.

And the stomach pain I get when I try to lose weight with or without Orlistat.

I expected to be told to lose weight. I don't think it was unreasonable of them to suggest that but some help with managing the pain while I was trying to lose weight would have been nice. Not sleeping and not being able to walk is not conducive to healthy weight loss.

I'd also like to be taken seriously when I ask for help with the stomach pain instead of them assuming I've been eating gallons of fatty curry which is what I had the last time 111 directed me to urgent care because I'd been vomiting with the pain for four hours without relief. I'd eaten a small mushroom omelet. I don't even like curry.

Whilst being heavier is not going to help joint pain there is nothing to say this isn’t caused by something else.
News flash - us fat people do get non weight related injuries and illnesses too.
Don’t be fobbed off OP. Get a second opinion.

It doesn't have to be either/or.

Being able to do lots of brisk and uphill walking would be highly beneficial to OP.

I get awful upper GI pain when I eat omelette or scrambled eggs i.e. eggs at the more lightly cooked end. No such trouble with hard boiled eggs - could you swap for hard boiled or temporarily cut out eggs altogether to see if that helps?

You acknowledge you need to lose weight, and it probably would help with the knee pain but you should have been given something for the pain in the interim. Have they actually examined your knee? Can you try a different gp? Or go to a walk in centre when you are having an attack?

I hear you OP, I was once told to lose weight when I went in with a frozen shoulder / RSI 🤷‍♀️ it seems to be the default advice, above and beyond treating the actual problem (and I got the same frozen shoulder / RSI pain even when I was significantly lighter and younger so fairly certain my weight had no impact on it!)

Push for a second opinion/different GP and ask specifically about pain relief - you shouldn't have to suffer while trying to make changes. Might also be worth speaking to your pharmacist as they can prescribe certain things now I think.

It sounds like the weight loss programme they are suggesting isn't the right one for you. So either you need to go to the GP again and say yes I'm happy to lose weight but I need am alternative to how as this causes pain. Or you need to research yourself on alternatives.
There is definitely a view now that cals alone are not the cause of long term weight issues and that you need to look at everything in the round. So how is your sleep? How about your guts? Have you got hormonal imbalances? Can you incorporate gym and strength training into your life?
You can look at improving some of these things and maybe review other measures like intermittent fasting (look at Fast like a girl by Mindy Petz for example). The long and short of it is that it's not as simple as just reduce cals and clearly you are not over eating on this diet and you shouldn't be in Such pain !

I might try a food diary to see if I can work out what is triggering the stomach pain. I didn't eat any eggs yesterday when the pain flared up again. I had a yoghurt and banana for breakfast, a grilled chicken and salad wrap and small portion of fresh pineapple for lunch and a small jacket potato with low fat cottage cheese and salad, 5 strawberries, and a muller light for dinner.

The pain started approximately 2 hours after eating dinner shortly after I took some painkillers for the pain in my knee. I assumed it was due to taking painkillers without enough food so I ate a banana when it started but that made it ten times worse. I ended up in the garden double over, vomitting and sweating for an hour.

My bmi is 34, I'm at least 4st overweight. I also have knee and hip pain due to osteoarthritis, which the doctor assures me is not caused by my weight but definitely not helped by it.
If I went to the doctor with knee pain he would treat my knee pain.
We have an understanding, I'm not gaining weight, I bike 45 miles a week and walk 20 miles. My blood pressure is fine and I'm not taking up smoking.
As long as I'm sticking to this and active and 'healthy' neither the doctor or nurse bring my weight into it.
Disclaimer-I'm under no illusions as to the consequences of a bmi of 34.

Weightloss aside, are you active? And how's your blood pressure? Do you smoke? That's what I'm asked.