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?

@Higgeldypiggeldy35 you are advising someone who has several times now stated they have a history of very disordered eating to the point of being hospitalised, to listen to podcasts on weight loss, intermittent fast - a shiny new way to excuse disordered eating / orthodoxia - and are promising her, a stranger you know nothing about except she is overweight, following you advice will change her life.

It is gobsmacking to me that being fat is seen as a moral failing, but being mentally ill when it comes to food is perfectly acceptable as long as you’re thin.

Rapid weight loss. As the body metabolizes fat during rapid weight loss, it causes the liver to secrete extra cholesterol into bile, which can cause gallstones

sound like this is your problem, what you need to know is how to stop the pain

eating citrus fruit may well help

I get it my friend has history of food issues and I get how had she tries to be sensible and not let the old thoughts creep back, Personally I had to change from omep to emeprozole as omep stopped work for me. I have GERD and it is random foods that trigger me but it hurts like hell when my stomach is triggered. I am not allowed ibroprophen as I have previously had a ulcer. Perhaps somthing to consider when keeping a diary to include pain relief

It does sound like it could be some kind of allergy or intolerance. I'd persist with the food diary, and research common allergens, also "fodmaps" (which commonly cause intolerance) and "oral allergy syndrome". Try to experiment and work out a pattern.

I haven't RTFT yet but a few things jumped out at me about your stomach pain.

You mention taking painkillers, forgive me if you've already answered this but are they an NSAID? I have finally overcome gastritis after 4 years of intermittent flair ups. During an acute flair up I felt exactly how you described. I remember sitting in bed rocking back and forth with pain as bad as labour. I ended up at the hospital thinking it was my gallbladder. I believe it was long term ibuprofen use that did it to me but it can also be caused by H.pylori bacteria, in which case it's targeted antibiotics you need.

Your GP is unlikely to refer you for a scan until you've ruled out gastritis if they suspect it, I asked. I didn't need one in the end as it is now gone.

What helped me was long term omeprazole (sp?) and I'm talking about months of taking it, not just a couple of weeks. I had a few periods of short term use over the years which helped slightly at the time but it always came back.

It wouldn't exactly have crippled the NHS for the doctor to supply OP with much-needed pain relief.

You sound like you're of the view that if a person's condition is anything that could be pigeonholed as self-inflicted they're entitled to no help. Although I agree the NHS is on its knees, OP is just as entitled to treatment as she would be for any other condition.

If its gastritis you need to steer clear of acidic foods and drink.

Fruit was the worst thing for me when I had It, even fruit smoothies would set the pain off. If I had an orange or some Pineapple I would be paying for it for days.

Not eating enough is also a trigger, when the stomach is empty the acid is worse. So if I didn't eat little and often my stomach would hurt badly.

Chocolate (I know you said you're not eating that but I used to eat lots of it) is also a bugger for it.

If you think its possible look up a gastritis diet and it'll tell you what to avoid, there's a lot.

I've noticed a change in attitude recently because I am now retired. I can't help wondering if certain groups eg obese retired are treated differently .

There's no rush to get me back into the workplace.

OP, I just want to say I think you're doing great! You know you need to lose weight; you're trying hard. You're trying despite so many things that make that challenging. You know your own limitations and are sticking within them. You're walking the dog, mowing the lawn, staying on top of work and god knows how much else you haven't mentioned! All whilst your GP is being a bit crap (not wrong necessarily, but still not the sort of help and encouragement that would be ideal here). I'm normally more of a lurker than a poster, but wanted to take a moment to tell you you're awesome and I am definitely rooting for you to succeed here!!

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

I don't pretend to know either way, but let's not forget that unlike us the GP will have OP's history to hand and may have insight into whether an exercise regime is likely to be stuck to or if it'll be one more thing the patient "can't do"

Unfortunately, too often folk expect some kind of magic wand - we're seeing it ATM with the common conviction that "slimming pills" will sort it all out - but unless sustainable changes are made the weight just goes straight back on and it's rinse and repeat

I have not read everything but do you think you could have a stomach ulcer?

To add to the side effects I was having (I can't believe I forgot this one...)
Pain in my shoulder and going down my arm so excruciatingly painful that I was collected by ambulance and carted up to a&e, blue lights flashing, because it was thought I was having a heart attack - twice!

It took ages to get diagnosed because the separate medical issues overlapped. Initially, after an endoscopy confirmed the sliding hiatal hernia, I was told to eat lots of dairy, drink milk, even to eat melted dairy ice cream. Imagine the effect on my gall bladder from eating all that dairy based fat - I was in absolute agony.

One thing that did slightly help the acid reflux caused by the hernia was an old wives remedy of warm water, bicarb of soda and dark brown sugar. Took the edge off before the codeine could kick in.

One additional minor thing that might help - could you get some hiking poles? I found them incredibly helpful for my knees when hiking with a heavy rucksack, they take a surprising amount of the weight and also prevent accidental twisting.

I don't know anything about the stomach pains but I can tell you from experience that GPs are very good at fobbing off physical injuries. If you can afford it I'd recommend finding a good physiotherapist (ask for recommendations locally) and pay. In my experience the NHS will fob you off with pain killers for months on end before they refer then you're on a waiting list, next there's only a very limited number of physio sessions allowed.

Could you maybe look into loosing weight without the tablets? Ngl I don’t really have a lot of experience with weight loss except with after my DD when I went up 3 dress sizes after birth and was back to my size at 9months pp which was hard. Just thinking as you’re able to diet with the pills but have all these side effects maybe dieting without them and see how you go?

@Frequency your stomach pain sounds exactly like gallstones, I've had numerous attacks, the last one I had landed me in hospital. I'd irritated my stomach because I was taking naproxen for joint pain, was given codeine for the stomach pain and this made it worse. A GP later told me that if your gallbladder is already inflamed or contracted around stones, codeine can cause it to contract more. You can also make gallstones worse by skipping meals or trying to lose weight rapidly. Please go and see a different gp, you need to have ultrasound to check your gallbladder and insist on a x-ray for your knee. It can cause serious problems if you are having so many gallbladder attacks.

Yes you do deserve help. Doctors are largely a waste of space - they don’t give a shit.

it sounds like gallstones - a well known side effect of v low calories diets. Try an anti spasmodic like buscopen and pain killers.

sounds like the pain is potentially your IT band get a yoga strap/belt lie on your back stick the leg into the air but yoga step round bottom of foot and swing over to opposite side of body whilst gently pulling on strap to bring leg closer to top of body.

Go to A&E. Whatever you weigh, you should not be denied pain relief.

"Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.
This medicine may increase your risk of having kidney stones. ". This is the advice for the side effects you are sharing with the specific drug, so worth you raising it if it reoccurs

I'm not though am I.

If somebody who drank a lot developed liver disease. I'd agree they should be treated by the doctor. I'd also agree when the doctor told them they needed to stop drinking. If they continued to drink despite being told what it was doing to them, and knowing it was the cause of their health issues, I would agree that is their decision to continue, but the GP can't magically fix ailments that the person is inflicting on themselves. If they don't want the disease to progress and further complications to develop they have to have some of their own accountability. This isn't comparable to a sports injury where the recovery is usually a few weeks. It is a sustained lifestyle choice that is causing detriment to their health, that they can predict will happen. Nobody falls while skiing and breaks their leg expecting it to happen, it can't be predicted. The outcome for people who are overweight can be and they do have the power to prevent and safeguard their own well being.

Recently had my knee properly looked at as was lucky enough to have Bupa cover. Had a scan of it and turns out all the cartilage is worn away behind my kneecap. I also had a fall which caused a lot of pain around 4 years ago. I have always been heavy but gained another 2 stone during covid. The knee was getting unbearable. I did physio and the consultant gave me some surgical options that were highly experimental but ultimately he said, weight loss will really help. He said for every lb you lose its equivalent to 13lb less weight through your knee joint when you step on it. I don't know how that works!

I started Wegovy recently. Lost two stone and the knee pain is gone. I wasn't able to walk up or downstairs a few months ago.

So the doc is probably right on the knee, and if you have cartilage damage there ate likely limited options. Depends where it is. Hope you can lose that % so doc will refer you. How cruel. If it does feel better don't tell him - get the referral either way.

Can't help with the stomach ache but it sounds really serious. Gallstones? Go gluten free for a bit see if it helps? Or try coeliac diet. Might be a reaction. My sister had some funny issues with that and had to highly restrict types of food until she could get surgery.

If you have any savings and can afford a private consultation and tests then I'd be going that route to be honest. Check fees for your local private hospitals :(

It could be gall stones. I had bad attacks when losing weight. It seems to stir them up. Had to have it removed eventually.

Tbh I don’t think that most Drs try to fat shame people but its a very difficult conversation to have when you know that losing weight would benefit the patient considerably. Yes, i know that some are terrible but most are doing their best. People don’t want to hear that though. They want that magic wand-don’t we all?! But there is no surgery that will be done on an obese person that isn’t an emergency. The risks would far outweigh any benefit and no one wants to take risks to life.

Go back, talk it through some more. Get some decent insoles in your shoes, have a google of knee exercises to try and strengthen your muscles to support your knee more. Ask for a physio referral and a dietician to sort your disordered eating. And yes, all of the above about gall bladder, as it sounds like many on here have had similar experiences with rapid weight loss, so ask about that too.

It's cos of momentum I think, your knee is not just supporting your stationary weight, but having to dissipate all your downwards momentum each time you take a step. Like trying to stop and start a full shopping trolley. (Disclaimer I'm not a knee expert!)

Depending on where you live you may be able to self-refer to an NHS physiotherapist.