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?

This sounds 100% gall stones. Id kick up a fuss if i were you because my gp ignored my symptoms even though he accepted it was gall stones and the stones passed into my pancreas which was agony and i ended up in hospital for ages with pancreatitis

also agree that it sounds like gallstones.
if it’s an option, see a different GP. If you cannot manage the pain with painkillers you need to go to an and e (that is the advice I was told every single time until they whipped the bastard thing out)

Doctors often blame weight first and its so disheartening. Anyone overweight knows what issues it can cause, but it shouldn’t stop us being treated!! A rock climber falling from a cliff shouldn’t be left untreated because he had such a dangerous hobby!!
I recently had replacement knees (luckily privately as the NHS would have insisted on lots of weight-loss first and the only downside of the weight is a slightly trickier surgery and a minuscule increased risk of infection - they don’t wear put quicker which was what i thought was the reason NHS wouldn’t do it!)
As for the pain you’re experiencing, could it be IBS from increased intake of fruit and veg? If so, take a look at FODMAPs and try and reduce those items in your diet

These anecdotes are hyperbolic though. 90 percent of weight loss is diet. Humans are extremely adept at storing fat, it's how we survived before Tesco express. We were built to be creatures capable of long distance running. So unless somebody is literally doing ultra marathons they don't generally need to eat gallons of extra calories. Yes a sedentary life will cause weight gain but eating nothing and gaining weight is impossible. At my thinnest I didn't exercise at all I just skipped meals and ate 'like a bird' I am now gym fit and I don't eat excessive calories even though I workout for hours every day.

The fact is doctors are reluctant to prescribe painkillers because they hide pain. That is a suitable approach for somebody who has pain that can't be treated. Somebody who is very overweight, 5ft 9 at a size 22 would likely weigh double what I weigh at somewhere between 9 and 10 stone. If exercising while carrying the equivalent of an extra person on your back hurts, it's probably because it's doing abornous amounts of damage. Taking painkillers could risk masking severe injury. Doctors are discouraged from saying 'you need to diet to lose weight because exercise is going to cause you injury' so instead it's watered down into saying things like suggesting swimming and other low impact things to protect the joints. I know for a fact my joints would hurt if I attempted to walk 5km carrying an extra 9stone, I know I would be damaging myself. It would have little health benefits but would be me risking injury which may put me out of action even longer or permanently. Diet is far more powerful than exercise in these situations and should be used to get the body to a paint where exercise can be incorporated without risking permanent damage.

Right.

I haven't read the whole thread, so apologies if i'm repeating information.

FTR, i'm 5.3 and a size 26, currently weight 20st.

Next time you go to the dr and they mention your weight, you need to be firm.

I am not here about my weight. I am here about X. I would like you to ignore that i'm overweight and address that problem the same as you would someone who was slim. I have a right to be treated, not dismissed and told to lose weight.

Then, if they still refuse, you pointedly say "I want it entered on my records that you are refusing to treat the issue i came in with because you think i'm Fat, and i want you to put your name on the record entry, that way if this issue gets worse, and i become permanently disabled/injured, i will be able to name you in my complaint to the Practise.

Yes i have done the above. I have degenerative disk disease and had to resort to doing this after being fobbed off for 17 years with 'lose weight'. My crumbling spine has fuck all to do with my weight.

Weight loss isn't easy and society can be very judgemental but as someone who works in healthcare, the effects of obesity on the body present significant risks. Are you getting any support with weight loss?

The doctor doing something about her pain and lack of mobility which is restricting her movement and disrupting her sleep would be really supportive of weight loss.

I don’t know how much OP is sleeping but I was sleeping 3-4 hours during the pandemic and it significantly contributed to my 2 stone weight gain over 18 months which I’ve now lost - partly due to improving my sleep.

I didn’t sleep well last night so I’ve made sure to have a long afternoon nap. There’s a much higher chance of overeating or giving into sugar cravings when you’re sleep deprived.

I have a right to be treated, not dismissed and told to lose weight

edited to add : @Foxxo has the right approach. Whether OP wants to lose weight or not she has a right to be treated beyond just being told to lose weight.

Climbing cliffs doesn't increase your risk of type 2 diabetes, various cancers, strokes, heart attacks etc...

Hormone changes and rapid weigh loss are both associated with gallstones. I also found the pain of gallstones attacks similar to labour, and the location you are describing is about right. It’s hard to get it taken seriously @Frequency but it’s absolutely awful. You have my sympathy.

If I take regular ibuprofen, I get terrible stomach pains and the GP said it's gastritis. So I buy the meltlet ones that dissolve on your tongue and problem solved. If you're taking a lot of painkillers, it could be that rather than your gallbladder. https://www.nhs.uk/conditions/gastritis/

It increases your chances of falling off a cliff 🤦

They wear ropes and harnesses 😂

Obviously, I haven't said it won't. I agree with the doctor that weight needs to be lost, I've said with my own knee problem I have made changes to try and lose weight. What I have also said is that there are other factors that impact weight loss. Being in constant pain isn't going to help anyone be in the right frame of mind to lose weight and make the necessary and permanent lifestyle changes needed.

Everyone who is saying she can’t get the weight off because she can’t exercise is wrong. Research has shown that it is not exercise that reduces your weight, putting less food in your mouth does. Exercising just allows you to eat a little more-you could run 5 miles and that is equivalent to three chicken nuggets.

Being overweight impacts on your joints; another proven fact. Being overweight also makes undertaking surgery very risky. It also reduces the outcomes of any surgery and increases risk such as infection. This is why you need to lose weight.

return to your GP and talk about your stomach pain. Take the omeprazole for a time before you do that so you can say that you have tried them. Get fully on board with losing weight; maybe a dietician referral and some psychotherapy to address your eating issues.

And yet still get injured and treated!
the point is that dangerous behaviour (being overweight/rock climbing) should not negate being offered treatment

Hi OP. It sounds to me like the food you're eating when dieting is the issue, not the weight loss itself. I could be wrong, but perhaps the high amount of fruits and salad (very high acidity) is irritating your stomach? I have "functional dyspepsia" which is basically stomach pain with no ulcers, there are certain foods I have to be very careful with. I can't eat anything too acidic. Also my mother struggles a lot with eggs, they give her stomach issues. Everyone has different triggers.

Your stomach is very likely used to a low acidity diet of gentle, carb-heavy foods. To make a sudden change is obviously causing issues. If omeprazole helps a little, this (to me) indicates it's a stomach issue, as omeprazole works on stomach acid.

Perhaps you could try more gently transitioning to new foods? Eat your normal diet whilst adding in healthier things, and slowly increase them and see if the pain starts? It might be easier to work out what the culprit is then.

One thing I'd also suggest is asking the doctor for lansoprazole. It's a very similar drug to omeprazole but it works better! I was given omeprazole for months, it did nothing. I then saw a different GP who said "I'm going to prescribe lansoprazole, it works better and it's my favourite of these drugs, it's more expensive though so we always give omeprazole first". Well lansoprazole works like a dream for me. Also you have to take it long term, it won't work if you only take it when you get the pain. Same for omeprazole really.

Good luck OP, I'm so sorry doctors aren't taking you seriously. Even if you weight is the cause of your issues, you can't be expected to suffer for months/years whilst trying to lose weight. It's very unfair and unreasonable.

No, but it does increase your risk of arthritis, “climbers back”, long term hand and wrist injuries, lung cancer, heart disease, and HBV (hepatitis B). Not to mention injury from falls.

To be fair, lung cancer, heart disease and HBV are risks of climbing walls rather than cliffs, but most of us do practice indoors over the winter.

A blood test (with special focus on liver functions) might help. Gallbladder problems are tied up with liver enzymes and albumin levels. If (heaven forbid) anything is off, that just might just persuade your doctors that you need more help than the "lose weight" line.

Good luck OP - you have my every sympathy.

The risks are incredibly low though with just a smaller percentage of climbers ever having these issues when compared with the chance of having obesity related health conditions which are almost gaurenteed.

There is also a risk vs reward equation which is true of all sports, generally speaking though being active and engaging in physical activity has such great health benefits it negates the small percentage who have a sports related injury and is overall good for body conditioning. Being overweight or obese has no upsides, it doesn't protect against a myriad of other health problems.

To add to my last post, sports and physical activity is also really good for mental health. It encourages socialising as well and being outdoors which also improve depression.

Being overweight is terrible for many people's mental health.

oh no ! What painkillers are you taking ?
being doubled up with stomach pain sounds absolutely awful.
sounds like an ulcer to me ! Or gallstones .
i can’t eat certain foods or take NSAIDS like ibuprofen or I will have awful stomach ache .

I have lost 3st. My bad knee has disappeared- I damaged it 3 years ago and it has been a really painful bind. It now appears to be normal again since losing weight.

Your stomach pain sounds like gallstones, even possibly pancreatitis caused by gallstones- another very common side effect of excessive weight and high fat in diet. I had those too - the pain is terrible. I was in hospital for 10 days in agony, on morphine and other painkillers.

Weight and bad eating habits affect our bodies and our health. I know.

Weight stigma is a real problem in the NHS and needs to be sorted because it ultimately affects people getting the care they need and / or seeking medical care. Regardless of size. Most people know the size they are without a doctor pointing it out!! I would like to see a more supportive approach and less shaming! Small lifestyle changes can make a big impact! You might need further tests and investigations for your knee and possibly gall bladder, see if you can get seen again, they can only point out your weight once after all!! Poor you, I know the NHS are meant to be waking up to avoiding weight stigma, but like anything... it's going to take a looooong time 😕

Another vote for gallstones.
OP there was never much of a pattern to my pain when I had a gallstones, but I did have a few attacks when I'd actually not eaten anything for a while, and it seemed to ease shortly after if I then ate a small amount of something plain. I'm sure I read up on why and there was an answer, but it was 100% gallstones.
There is also a complication of gall bladder issues that gives rise to pain when you take certain opiates such as codeine - is the painkiller you take anything like that?

Re you knee. Physio here and 100% losing weight would help, however with no symptom relief to allow you to exercise pain free, and a potential gallbladder issue preventing proper dieting it's not straightforward. I would be pursuing the weight loss as best you can (could you do water based exercise to take the pressure off?) AND also pursue / nag the GP for adequate pain relief to allow you to do this and for some weight loss advice / dietician referral to take into consideration your other health issues.

Good luck xx

@Frequency

Your doctor is right to tell you to lose weight to try and resolve the knee pain as this is the most likely thing causing it and it needs to be ruled out first.

Besides, if you do need to have surgery for the knee they will tell you to lose weight anyway and to get fitter to prevent you dying on the table and for a better recovery.

The pain you are describing sounds like gallstones which can be caused by poor diet but are also more likely to form with quick weight loss.

You can raise this with your Gp, there is medication that can prevent it (see link), ask for stronger painkillers, and referral for assessment to see how bad it is with a view to cholecystectomy or ERCP.

https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/dieting

I was morbidly obese and am now down to "merely" overweight. The GPs at my current surgery took any health concerns I had seriously, in spite of my weight. Perhaps helped by my acknowledging up front that I wanted to lose weight, but still it was never really focused on.

At my surgery you can self refer for physio. I did so more than once while morbidly obese, and was given exercises to help with the problems I had. I don't see quite why you couldn't be advised to lose weight (and supported doing so) AND referred to a physio to get exercises. After all, movement is vital for good health, so perhaps it's especially important that obese people can keep moving.

Can you afford to pay for a one-off private physio appointment? And are you in a position to take up nature walks or wild swimming or some of the other activities which so many people find good for alleviating pain, for gently losing weight, and for generally improved physical and mental health?

And if you've met each of the GPs at your current surgery and found them to be unsupportive, is there a possibility of moving to a new surgery?

Very much hoping things improve for you.