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?

You need to eat more but protein and bulky veg. Try cutting out the processed foods (like the muller light and fry light) and have a menu like:

Porridge (overnight oats if you're pushed for time) with nuts and fruit or skyr with nuts and fruit

Portion of fruit for a snack

Large bowl of salad (not just leaves but the tasty bits like cucumber, tomatoes, celery, peppers etc) there are some good salad recipes on BBC good food. Have that with a portion of protein (chicken, fish, cheese) carbs (boiled potatoes, noodles, rice) and some fibre (canned beans, nuts).

Snack

Dinner - go to town with things like veg curries, Mediterranean food, just make sure it's fresh and hasn't got any UPF in it. Make extra portions so you can have it for lunch then following day.

That abdo pain sounds awful!! I was going to suggest doing a food diary to see if anything triggers the pain (but you've already mentioned that). Sounds stupid but how's the bladder and bowels? Any problems with passing stools? What about sleep pattern? Look at your macros (carbs/protein/fat/fibre intake) and water intake. Maybe keep a diary on all that too.

I can see why the GP suggested weight loss, but you're in a bit of a catch 22, aren't you? The joint pain probably prohibits you from exercising as much as you'd like to but not exercising is also not great. Try the food diary, monitor bowels and see where you go from there. If the abdo pain persists, you can at least see the GP again, armed with the diary, and try and work out a plan going forward. Good luck x

The knee pain: they’re trying to fix the actual cause of the pain, not just chuck a load of painkillers at the symptoms (which won’t solve the problem). But I agree you need to go back.

If they say to lose weight say “I’m working on that, I’ve already lost X, what options are there in addition to the weight loss that will help more urgently?”

Your Dr is not being at all reasonable.

I’m very fat. I had awful knee pain and was referred fairly easily for X-ray and ended up with MRI. I have a torn meniscus.

Was referred for physio and given pain meds.

All very straightforward.

I would honestly look for a different surgery. I’m not interested in fighting to be treated decently - it should be the default.

How much weight have you now lost OP? Is it near the 5% of your body weight yet?

Or go to your gp and insist on a referral for a scan, at least you will be on a waiting list and can try different foods in the meantime. Your diet food sounds lacking in carbs and fibre, which are essential to lose weight in a calorie deficit.

You have no idea that her weight is the cause. It might be but absolutely might not.

I understand that it can be frustrating and you feel fobbed off but you need to take personal responsibility for your health. You know eating too much is bad as cholesterol clogs arteries and leads to heart attack, excess weight puts pressure of joints, fat around midriff leads to diabetes etc. That's like a smoker going to Gp with chronic cough, there is only so much a go can do - they would need to stop smoking. In your case, there is only so much Gp can do if your health is bad because of your diet and weight.

The stomach pain sounds like gallstones/gallbladder issues. Mine also got triggered by trying to lose weight. Ended up in hospital jaundiced with a gallbladder infection and eventually had stones removed.

Agree that you’re being fobbed off here. Gallbladder issues don’t resolve by losing weight, often makes them worse. Go back to a different GP and ask to be referred for a scan to see if you have gallstones, can then be put on a waiting list for removal otherwise they will continue to flare up.

The knee pain may be exacerbated by weight but unlikely to be the cause. Either get a second opinion or if you can pay to see a physio to get advice on best stretches/exercises to do to relieve it.

Nothing wrong with eating healthily but I’d be avoiding weight loss tablets as it’s only muddying the waters for you as to which are side effects from those etc.

Gp not go!

I think you should change GP. Lots of doctors are fat phobic unfortunately.

Yes weight loss would probably help your knee, but they are not giving you a good standard of care in general, you deserve much better.

but if your obesity is causing the issue, then there is the solution. What have you tried to get your weight down?

a lot of conditions are caused by poor lifestyle choices and if that is the cause, rhen you annot expect the GP to fix it.

What painkillers are you taking? If Ibuprofen or another NSAID, they will irritate the stomach. You should probably stick to paracetamol or similar.

I remember listening to Dr van Tulleken (can't remember which brother) and he was explaining that obese people are treated poorly in NHS. The suggestion being the focus is always on the weight. Like as if the GP sees nothing else. Have a friend who I am pretty sure was being ignored because of their weight but they pushed and pushed and eventually saw a different doctor who was more reasonable and did a few tests and sure enough found something. Took about 8 months.

Anyway in your case I would email GP and explain everything. Accept that weight loss would be beneficial but explain that such extreme pain impacts your attempts to lose weight. Push them in writing. It usually makes people sit up and take notice. Also, are there other weighhtloss drugs that could be offered?

I've had awful knee pain. I'm 5 stones overweight. I went to a physio and she said that whilst weight was important the main thing was my knee muscles weren't strong enough to carry the weight so she put me on a program to build these up and my knee pain has nearly gone. I can leg press 52kg with each leg so I can support my weight better. I have lost 8 pounds too.

This ^^

My bil is overweight but he’s treated with respect and taken seriously by his gp for his many health issues.

Also I’m underweight due to a health issue and still suffer from reflux and indigestion. And back pain, you wouldn’t believe how many people say my back pain may be helped if I lose weight. My dh usually steps in and tells them not to be ridiculous.

Sympathies with your knee pain. This is what helped me:
Wearing a knee brace (the basic tube of elastic type). Wearing a tight one of these during the day did more to reduce my knee pain than anything else. Just watch out for circulation problems if it is too tight.
Other things I have tried thay may have contributed to improvement over time:
Pain relief gels such as ibuprofen gel, or voltarol.
Swimming.
Exercise pedaller (that can be used while sitting watching TV etc).
Muscle strengthening exercises to strengthen muscles around joint (look up on internet for ideas). It might be worth trying private physio for a few sessions to get specific advice on exercises.
Personally I have not found that tablet painkillers like paracetamol, ibuprofen, codeine etc did much to help.
I would also suggest joining a weight loss class that meets in person, not so much for the diet advice, but to help motivation and meet people on a similar journey.
Good luck.

OP you poor thing, the abdominal pain sounds horrendous. I have experienced a lot of abdominal pain & it really is the worst. It feels to me that weight is an easy thing for GP’s to latch on to & fob people off and avoid investigating the issue further. Even if your weight is the issue they should understand that losing weight takes time & is difficult given your knee pain. You should absolutely not be left in this level of discomfort & your abdominal pain needs to be investigated.

I don’t think doctors prescribe pain killer now - you need to buy them over the counter.

A friend had this, his weight gain was mainly due to heart failure, when he was finally treated after ending up in hospital he lost almost five stone in excess fluid.

While being overweight won’t help with joint pain, it doesn’t excuse not seeking to find the cause of the problem, be it an x-ray, physio referral etc.

The stomach pain could be painkiller related, I get awful awful pains if I take ibuprofen, these can last quite a while, not just the day I take it.

You can specifically ask your GP to make a referral, so if you are worried about gallstones you can ask for a referral, if they say no remind them you have a right to ask, and they must provide an appropriate reason to refuse and allow you to seek a second opinion.

Christ some of the self righteous replies to this make me angry on your behalf @Frequency.

News flash to the sanctimonious- overweight people can have health issues that are not weight related.

It sounds as though your old injury is flaring up and may be exacerbated by but not solely caused by excess weight. You should have been prescribed pain relief.

Sudden calorie restriction can trigger gall stone and pancreas issues. The pain is excruciating so I’m sorry that your twat of a dr seems to be one who deems suffering the price of being overweight.

If you can, look at building more protein and volume eating in to your daily diet. The orlistat doesn’t sound like a good fit.

Try a knee brace for support and ice / heat therapy.

Anti inflammatory gels would be better than tablets given your stomach issues.

Could you afford a session with a private physio to get a proper review of your knee?

I’m sorry you’ve been treated like this and hope the pain lessens for you.

Your weight won’t be helping (I know first hand) but it may not be the cause of the pain, particularly as you think it is an old injury playing you up.

I usually just go straight to a physio for this type of thing, they’ll do a more detailed assessment than the GP can in a 10 minute slot and be able to treat you better. Some physios prescribe too so they’ll be able to treat the problem holistically.

Sounds awful 😞 sorry my egg suggestion wasn't a good one! Hope you're able to get help to get it sorted.

So this pain is only when you diet? Not when you eat “normally”?

that would suggest to me it is an acid problem as you’ve reduced the food for acid to work on, leaving excess to damage your stomach. If it were something like gallbladder the pain would still be there when you increase your eating.

Painkillers like ibuprofen also increase stomach acid.

when you get the pain do you take an antacid? What happens when you do? If you eat a bulky meal like salad or veg do you get the same pain? Or is it only with smaller meals?

sadly o/p your posts read like a series of reasons why you can’t lose weight. If you have a BMI over 30 then yes joint problems are to be expected, whether new or exacerbating old ones.

you need to sort this stomach issue first. Step one is to take antacids whenever you get the pain. If it helps, it’s acid. Second is do bulk up and increase your fibre. If that helps, it’s constipation/wind.

if neither helps, get a referral to a dietician.

lastly, find a non weight bearing exercise program that doesn’t exacerbate the knee. Swimming- even if it’s walking up and down the pool. Upper body strength, seated exercise etc.

the GP is right that you need to sort your general health first. Once that’s done you know what issues are due to weight, and which need to be sorted by other means.

How long after you took the painkillers did the stomach pain start and what type of painkillers were they? Some painkillers can directly cause stomach pain if for example you have an ulcer. Ibuprofen and other anti inflammatories tend to be worse than paracetamol. I have to take Omeprazole along with eating 20 minutes beforehand.