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?

It will be acid as your stomach is likely used to being full and now with change In diet eating less etc its causing trapped wind so yes this is something you can deal with over the counter, pain due to your weight is also something you can sort yourself yes maybe pain killers will help untill you lose some weight but there's nothing a doctor can do for you that you can't do yourself!!

Thank you Dr jelly bean 🙄

Sorry you feel like this. I’ve had the same. My knee pain has gone on for 15 years. I was recent,y referred to a new consultant and my joint is getting replaced in two months. I am doing slimming world and Pilates and losing weight. Something has to change in these situations. I honestly understand you as my situation is the same. I would try to lose some weight. Orlistat made me unwell and I was taken off it. Your gp should refer you to a weight loss group x

But you don’t KNOW that OP’s knee issue is owing to her weight.

I thought my knee pain was a byproduct of being fat. My (brilliant) doctor listened when the pain got too much, examined in and referred me for a scan to discover an injury unrelated to my big fat self.

She’s being denied treatment that she deserves.

Orlistat does nothing anyway. I was prescribed it.

But no, you should be given something for your knee. How are you meant to exercise if in so much pain.

I've only read the OP's posts and a few on the first page so this may have already been mentioned. Co-codamol can irritate your pancreas which sounds like the stabby pain - I can't take it for that reason. Also, do you get pains when you eat after not eating for a while? Eg having a meal later than usual, or skipping lunch as you're going out for dinner? I've found omeprazole helps a lot, and not allowing myself to get hungry which is bloody difficult if you're trying to diet. I also can't eat fruit on it's own.

Hmm, I have had psoriasis for over 50 years so something I should be thinking of. I guess a visit to my GP is long over due!

I’m overweight. Never once had a dr tell me a medical problem I have is due to weight or diet. Which makes me assume they are doing this to see if he weight is causing joint problems.

Not an anecdote a real person who is dead she might have stood a better chance had the dealt with her hip when she was slimmer and it first presented itself they xrayed and said its really bad lose weight that didn't help and it badly damaged the rest of her body while they waited

OP: What prescribed medications are you on?

I walk around 5 miles a day with the dog

But not since the knee pain became bad?… how long ago did the knee pain become so bad that you cut down to barely walking the dog? I wanted to assume it was many weeks ago since it takes many weeks (6?) here to get a non-urgent GP appt. But maybe it was only at weight-loss-appt that OP mentiioned her difficult knee?

The painkillers I took last night were cocodamol. I also take ibuprofen depending on the type of pain in my knee. … I do take ibuprofen for my knee. OTC painkillers do absolutely nothing for the knee pain

I can’t make sense of those contradications: is that prescribed strength ibuprofen that you take? Since OTC meds don’t help knee.

Do any (prescribed or OTC painkillers) seem to reduce the stomach pain? How long have you been dieting (this time)?

I have on-going monthly appointments to monitor my weight loss

How long have you been on that monthly appt regime, is it a weight specialist nurse or a doctor who sees you? Did you tell weight nurse only about the pains, or have you spoken to GP about them?

Also, does the stomach pain happen daily right now?

If you Google anecdote this is literally the definition.

I don't think people get what I mean. I get that I need to lose weight. I was trying to lose weight before I went to the GP about my knee because I had general joint pain that I knew was caused by my weight and an increase in activity because of a new job. This pain is different to that.

I have no issue with the GP telling me I need to lose weight. I'm a little surprised she offered me weight loss drugs given my history with food and dieting but I agreed to take them. I am taking them.

What I wanted was some help managing the pain so I could actually live normally while I lose weight. My life is massively effected by this pain.

I'm not sleeping properly because if I move in bed or turn over I get agonising shooting pains up and down my leg. I can't do my job properly because I am so tired, by 3 pm I'm waiting for bed. I can't walk from job to job. If someone reports a job I need to physically attend just after I've done my floor walk or walked in from the bus top they have to wait an hour while I wait for the pain to settle in my knee before I can walk to them. The dog is not getting anywhere near as much exercise as he needs, some days he is not getting out at all because I physically cannot do it. I'm falling behind on my course because I am so physically shattered by the time I get home from work I can't face doing more than 30 minutes work.

I'm making stupid mistakes at work and college because of how tired I am. It took me 20 minutes to work out the speaker I'd just given someone was turned off and that is why it was not working. It took an hour for me to work out that the HTML form I built for college was not working properly because it didn't have an end tag and I know how to build a HTML form. I've known that for years.

My house and garden are a mess because I can't manage them. By the time I get home from work, I physically cannot move, so nothing gets done during the week, and on a weekend I can only manage a few short tasks before I need to rest my knee for a couple of hours. I can't socialise. It is affecting my mental health.

Yes, I need to lose weight, but surely I deserve decent pain management while I'm doing it so that I have quality of life? Even if they only offered me 3 months of pain management and then took it away if I didn't lose weight I would be happy.

The knee pain started around 2 weeks ago. It took a week to get a GP appointment. The appointment was for my knee not my weight but we barely discussed my knee. I kept trying to talk about my knee but she kept dismissing me and going back to my weight.

OTC ibuprofen doesn't work but I take it anyway out of desperation. The only prescribed meds I am on are the weight loss drugs, I am not allowed anything for the pain and I did ask. I got told they wouldn't work because of my weight and to use ibuprofen. I did tell her several times that ibuprofen doesn't touch the pain nor does OTC codeine or pain gels.

I only started the weight loss meds last week so I have not had my second appointment yet but I will be mentioning the pain in my knee when I do have it.

The stomach pain has only happened once up to now but I know from experience that this is how it starts. It gets more and more frequent as time goes on until it is happening nightly for hours at a time. It usually takes a few months of continued weight loss for it to escalate to that point. It doesn't usually start less than 2 weeks in. I can normally diet for a good couple of months before it starts.

@Frequency

You need to

a) ask your Gp for more pain relief, something like tramadol or maxitram which you can take with paracetamol.

(bear in mind this is opioid medication, addictive so they are loathe to hand it out and you are going to get side effects like sleepiness so could be in the same position with tiredness or worse)

b) get your Gp to refer you to a gastroenterologist to assess for gallstones. Research managing gallbladder pain yourself.

(again not an easy road, you will be waiting a while and the procedures to rectify it ERCP and cholecystectomy aren’t pleasant. If you can afford it or have health insurance ask for a referral letter for private and book yourself in next week to see a consultant, NHS you are talking a year wait minimum)

c) ask for referral to physio for the knee, physio will work with you for a number of weeks and can then refer you on to free gym membership with personal trainer for people with disability - they will work around the knee.

(again private if you can afford it)

I am not allowed anything for the pain and I did ask. I got told they wouldn't work because of my weight ...

I appreciate you don't wish to know what you weigh, but depending on how much it is I'm told they may be correct - or at least that you'd need much higher doses which carry their own risks

I went through some of this myself and understand how horrible it is to live with, but came to understand that I was paying the price of my own choices and that the only real solution to any of it was to lose the weight

What is most disheartening about these threads is the sheer ignorance of much of the public on how complex weight management is.

Many years ago people who were depressed were told to simply “look on the bright side” “be more positive”. Luckily such attitudes are changing and it’s hoped fewer and fewer people subscribe to such naive views.

Similarly weight management for many is a complete. Interplay of genetics/physiology , life experience and mental health. All of these factors need addressing in order to successfully loss and maintain this weight loss. A doctor telling someone they need to lose weight before they will treAt knee pain is like telling someone with depression they just need to go away and cheer themselves up before they help them with chronic stomach pain which might or might not be related. Doctors are extraordinarily lazy with this sort of thing.

Tips for sleeping with knee pain:

If you are a side sleeper, put a cushion between your knees.
If you are a back sleeper, put a pillow or rolled small blanket under your knees.
If you are a front sleeper, stop.

Try and get referred to a physiotherapist.

The right sort of knee brace, in the right size can help when you are walking the dog. But, ultimately a knee brace weakens your knee if you wear it for long periods.

Weight management is complex because it's a lifestyle shift. You need to treat the person holistically - what is going on in their life that is triggering the poor (over or under) eating habits? Low level therapy plus guided exercise and dietary advice are all needed, so that's 3 teams to treat one person effectively and that's without advice on stopping smoking, physio for injuries etc.

Some years ago my Mum broke her femur and had a 1/2 hip replacement i.e. the cup was hers but the ball was prosthetic. After a couple of years she started to get hip pain and was referred for physio. This made it worse and I said she needed an X-ray. This showed that there was no cartilage and it was prosthetic rubbing on bone, so no amount of physio was going to help. She ended up with a full replacement and everything was great.

Ask GP for X-ray and if it is a similar problem nothing will resolve it except a replacement. One thing that can help is taking collagen which is very good for joint problems as it helps with connective tissue (no good if you are veggie or vegan, although there is a vegan alternative called vollagen).

You said the knee was damaged during a youthful, drunken night out so it is likely that the weight you have gained since then is exacerbating the problem.

I would imagine given your food/eating problems that a lot of it is psychological so sorting that out is paramount because no amount of binge eating/crash dieting is going to help you lose weight. You will just keep yoyoing in weight and get even more despondent.

Most diets don't help you to lose weight in the long term. The only way is slow and steady and changing your relationship with food. You talk about "safe" food as if some is dangerous and then go back to chicken nuggets - these are no good for anyone.

I know next to nothing about gallstones, but reading posts from those who do, it sounds like this is a separate problem which needs sorting out by your GP. Next time you go for an appointment ask to see a different GP for a second opinion.

Exactly, and I think much more than a life style switch, it is often also related to deep seated(often unrecognised) trauma as well as genetics.

talking therapy, somatic therapy, therapy such as hypnosis to reach the sub conscious, adjustments to work life balance and reduction of stress to lower cortisol (inc proper meditation technics) basically the whole of body and brain needs to be rewired. This is why even seemingly great diets often have short lived effects. We’re treating the symptom not the cause.

The medical profession simply washes their hands of obesity with a subscription to weight watchers (who make lots of money from yo-yo dieting).

We are an obese society because society creates obesity. Society needs to change beyond recognition to combat this. We need to be seeing people in a more holistic way. Ironically as we solely concentrate on the physical it is our very physical beings which suffer

Yes, as others suggest take notes of when/what happened before/after. Ask for testing to rule out things. Talk about the good lifestyle things you do.

I read an article in the last couple years from a very respected source that talked about overweight women's health conditions being ignored and how often their cancers are caught much later than women with BMI's that are not in the overweight category. Signs of cervical, endometrial, ovarian and other cancers completely ignored and being told to lose weight. This is a problem in health care that women should be aware of and medical professionals should address in themselves and others in their practice/clinics etc.

Ah, that all sounds so tricky and painful.
I hope you can get taken seriously and soon.
I had gallbladder 'attacks' and it is so freaking painful.
Weight loss - if too quick - is know to make this worse. It even says it on the NHS website
"avoid low-calorie, rapid weight loss diets. There's evidence they can disrupt your bile chemistry and increase your risk of developing gallstones.
A more gradual weight loss plan is recommended."
Maybe you need to loose weight more slowly? Maybe in conjunction with professional support? Do you have health trainer service in your area?
Even so your knee pain is pain! You are so right that you should not be denied pain relief! Or tests to see if anything else is underpinning it.
It is crazy, you have knee pain - advice says loose weight or we won't help - loosing weight too quickly makes you have extreme gastric pain - and you still have knee pain. It's bonkers!
Pain relief for the knee and proper steps being taken to look after you making sure there isn't anything dangerous going on with your gastric pain, or exacerbating your gastric pain seems to be a proper way forward?
Can you get an advocate? Or speak to PALS? To help move things forward more positively for you?
All the best x

Change your GP OP because that's not acceptable.

What would you like them to do for your knee? I think you need to be blunt and advocate for yourself. If your knee hurts from an old injury ask them for a referral for an MRI on it to assess the damage. Just explain you want to become more active to aid the weight loss, but you are scared to damage your knee further. As you’ve said you know the weight won’t help, but let them know what you want.

I think the thing is, in their text books and teaching so many conditions are caused or aggravated by weight. When they need to be mindful of the cost to the NHS it might be harsh, but they really do see it as simple as that, ‘just lose the weight’.

I injured my knee two years ago, it’s miserable so you have my sympathy. I hope you get some a some & relief soon.

I am much too heavy, and recently experienced knee pain.
First thing I did was to put myself on a strict diet. I didn't bother troubling the GP, as I knew what they say!
Sorry OP, I can obviously empathise, but there comes a point where we have to take personal responsibility.