To think I still deserve medical attention despite being overweight

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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?

Do you know anyone of a "normal" weight who is not allowed painkillers so that they can be more aware of their pain? Not something I've heard of.

OP I'm overweight, nearly obese, I don't eat more (I now eat much less) or do less than when I was a size 12, BMI 22 which I was for virtually all of my adult life. Since menopause my weight has massively increased.
If I had read your post then I would have said a variety of the things people have said here - "you will just have to lose weight...., write down what you eat..., take control....I'm not a size 4 btw".
We know that 1000 calories has a hugely different effect on different people, some people burn it easily, others turn it to fat.
So yes of course you absolutely should get medical treatment, being overweight is not a personal failing.

It sounds very much like a gallbladder issue and some GPs can be really dim about it - I suffered for two years being fobbed off and it was only when it was so bad I went to A&E that they identified the real problem. Even then I ended up paying to have my gallbladder removed privately as the waitlist was so long. Well worth going private to get that diagnosed and sorted if you possibly can. The pain is horrendous and it's a simple operation.

I'm overweight and whenever I'm heavier my knees hurt. When I lose weight, they stop hurting. Obviously can't diagnose your issues but it's a major factor so it's kind of understandable that the weight is the focus for relieving the pain.

The issue appears to be they are overweight and this is putting strain on the joints. I think gps look for the obvious causes first. If op loses weight and it’s still an issue then physio / scan / investigation would be next.

Doctors always recommend RICE ( rest, ice, compression. Elevation) time and otc painkillers for pretty much all joint pain Ime.

I feel for you l really do but you must lose weight.

I say this to you at 18 stone with joint issues.

im swimming every day before work, taking gentle walks in the evening.

im not a fan of the cult of slimming world. I think it encourages really bad habits BUT it will help for those first few stone

ffs

as if weight loss was the only thing affecting knee pain and as if it's an easy thing to fix quickly.

yes, less weight less pressure on joints but that doesn't take away the pain now which would enable the op to take sustainable measures to get healthier.

OP see a physio
specific exercises and stretches will be good to reduce pain and improve mobility.

Why can't the doctor help both issues at the same time, though, @Misthios? I have had exactly the same issue - and I told the doctor that the knee pain was stopping me walking the children to and from school - 80 minutes of exercise every week day - and I was having to drive them instead.

If he had helped with the knee pain, instead of just giving me the standard lecture on weight, I could have gone back to walking, which would have HELPED the weight loss, instead of having to carry on driving, which arguably did not help me lose any weight at all!

And in my experience, doctors do not look past your weight, whatever your issue is. I once went to my GP because I had come off my antidepressants, but this had caused me to become severely depressed again - I was as low as I have ever been. All the doctor wanted to talk about was my weight - he had convinced himself that the only reason I was depressed was that I was overweight - nothing to do with childhood trauma/bullying - and it didn't occur to him that the weight was a symptom of the depression (I eat because I hate myself, and why would I bother to look after someone as worthless as me), not vice versa. And this wasn't ignorance on his part - my history was right there in front of him, but he was so arrogant, he thought he knew me better than I knew myself.

Within a very short time, I was in tears, on my feet, about to leave the surgery, feeling even more depressed than when I arrived. I honestly don't know what would have happened if I had got into my car and driven off, but I suspect I wouldn't be here now. This made the doctor finally agree to stop talking about my weight and start talking about my mental health - but even then, he kept referring to my weight as "The thing I am no longer allowed to mention" - sarcastic bastard.

After I left the appointment - with no practical help from him apart from advice to contact my psychiatrist privately (thank god for dh's work medical insurance), I put in a complaint to the practice. Now there is a note on my records to say that they can only mention my weight if it is medically relevant - and I got an apology from the practice manager and a (very reluctant) apology from the doctor.

Probably a few reasons.

scanners are limited as to the physical size they can scan. Some people simply won’t fit in the scanner.

imaging can be difficult if there is a lot of fat obscuring.

skeletal issues will be exacerbated by weight so it will be impossible to tell what’s caused by weight an impact, and what’s caused by the genuine issue.

if you are that obese even if there is an issue that can’t be resolved by simple physician and analgesia, surgical intervention is too risky.

bottom line is weight does impact significantly on skeletal stress.

yes, less weight less pressure on joints but that doesn't take away the pain now which would enable the op to take sustainable measures to get healthier.

Did you gain the weight since the knee started hurting?

Pineapple is extremely acidic, I wouldn’t touch it if you have stomach pain. You can buy omeprazole over the counter which may reduce stomach pain if you’re having reflux. Gaviscon works for me. How much overweight are you? Can you look at moving GPs? Mine has never mentioned my weight, really.

I have lost weight recently but am still experiencing knee pain following a very nasty horse related accident over 10 years ago, it popped out of place this morning and I’m hobbling. Eventually I’ll probably need a replacement, but I’m too young (!). Haven’t investigated yet, but my patella regularly moves out of place.

It may be still gall bladder if it is bile reflux rather than stomach acid

Different scenario but a friend slipped and fractured two vertebrae, giving themselves a concussion with a brain bleed. This was over a year ago. She had a lot of painkillers and is now off them and just otc stuff for bed, This is because physio wants her to feel pain so she better understand what she should / shouldn’t be doing. Tbh it’s not going well. Her balance is affected too and the Pain makes her dizzy and so she managed to fall breaking an ankle a few weeks ago.

GP has her on a 24 hour heart monitor and writing a pain diary.

Op have you been tested for stomach ulcers? The pain you describe could well be that as well. I had them (from taking painkillers for a knee injury ironically!) and it was waves of agony and nausea only calmed down by eating a bowl of Weetabix every 2 hours.

If you have an ulcer, for some people the pain comes whenever the stomach is empty as stomach acid then comes into contact with the damaged area, which would fit with this happening when you diet.

Ulcers can also be caused by bacteria, which you may have an infection of as well as taking things like ibuprofen and naproxen. You need to convince the doctor to at least test you for the presence of the bacteria as they will reoccur unless treated, and make dieting very hard and taking painkillers for your knee actually dangerous.

Worth checking imo.

The issue isn't solely that the pain may improve with weight loss - it's that doing a major operation with a general anaesthetic on a very obese person is much higher risk, plus you are at much higher risk of post-op complications. At 17 stone overweight they would not want to do a knee replacement. Harder to intubate, ventilate, harder to do the surgery, more likely to die, more likely to have blood clots, poor wound healing and more likely to have a poor outcome due to excess weight on the post-op joint.

People forget there are 3 possible outcomes from an operation: better, worse or the same. Surgeons need to look at the likely benefit vs complications. Being morbidly obese means the risk/benefit of an elective joint replacement tips towards being more risk, less benefit.

Your NHS trust will have a BMI cut off for joint replacements and if you are too overweight then you need to lose weight in order to get on the waiting list.

The stomach pain is only when I diet, not when I eat "normally", although I don't really have a normal. I have a lot of issues around weight and eating that go back to childhood. I was anorexic as a young teen. I bounce between eating nothing but chicken nuggets with mayo, cheese garlic bread, and sausage rolls or what I am eating now.

The knee pain has been sporadic since I injured it at 21. It's only in the last few weeks it's become permanent and debilitating.

My BMI is very high. I have no idea how much I weigh. I asked the GP not to tell me. They will weigh me again in 3 weeks to check how I am doing on the Orlistat. I'm 5ft8 and a size 22, if that helps.

I walk around 5 miles a day with the dog (although since the knee pain started this has been cut down to 1-2 miles as I physically cannot manage any more than this). I also walk a lot in my job.

The painkillers I took last night were cocodamol. I also take ibuprofen depending on the type of pain in my knee. If it is normal joint pain I take ibuprofen as advised by the GP (even though I told her it doesn't touch the pain) but for the stabbing and shooting pains I take co-codamol. The pain started about half an hour after I took them. I do sometimes get stomach aches if I take them on an empty stomach and eating a banana or some toast makes it stop but last night the banana made things ten times worse.

Just to say OP I never had gall stone pain when I ate fatty food, only when I lost weight. (Eventually bad enough to have my gall bladder removed)

Its not unreasonable to tell someone the truth. Guy at work was obese and has huge issues with his knees. They wouldnt even consider him for the op until he lost weight. His weight meant he was never going to get much benefit from any operations to fix his knees and if they did risk the op there was a good chance of complications during and after the op due to his weight.

He has made a real effort to lose weight. Reached their targets and is now waiting for the op. He is healthier, his mobility has improved even without the operation and he is giving himself the best chance of success.

They are looking after you even if you dont think they are.

Couldn’t you lose weight without the Orlistat? By reducing calories?

How about some strengthening exercises for your knee? Whole body? These will help the knee pain and building more muscle will help the weight come off too. Has your gp referred to physio? Swimming/cycling/ static bike can be good ways to get moving without direct impact on the knee.

Ibuprofen on an empty stomach is never good.

Why don’t they help her lose weight by helping with the knee pain, though, @Tessasanderson? As I said earlier, I had the same issue, and it was preventing me from taking my normal exercise (walking the kids to and from school, 80 minutes a day on weekdays). I needed that exercise to help me lose weight, but the doctor completely ignored this.

A lot of the comments here are beside the point. Yes, quite likely the ultimate cause of the knee problem is weight and OP would be better off without it but that still leaves her in need of treatment. Not just pain management but ideally targeted physiotherapy to build up the leg musculature. Piss-poor medical practice not to look into specific treatment - especially if the knee problem is keeping OP from being more physically active and thus helps perpetuate her weight issues.

Looking after should entail pain relief in a case like this. Denying it almost feels like saying 'you made your bed, now lie in it' imo.

I haven't been referred to a physio. She did mention it as a possibility after I lose 5% of my body weight, depending on if the pain is getting better or not.

I have dieted in the past without Orlistat and still had stomach pain. The stomach pain is usually what ends the diet, it gets that bad and I get no help or support that I just give up. I have been to the GP, urgent care, and even A&E by ambulance once after work called 999 due to the pain and vomiting, and still get no help other than to be told to take Gaviscon and stop eating fatty food. Gaviscon literally does nothing. I have Omazaprole which helps a little but doesn't take the pain away completely. It does make it slightly more bearable. It stops the vomiting and shaking with pain but the pain is still at a level that makes it impossible to do anything other than curl in a ball and wait for it to stop.

I am determined not to give up losing weight this time because I cannot not walk, I need to be able to move, but I honestly cannot face months of this stomach pain again.

I also need to be able to walk. I need to do my job, clean the house, cut the grass, walk the dog, sleep, and concentrate all of which I am finding very difficult at the moment. The dog probably won't get walked today because I had a driving lesson earlier, practicing maneuvers (so lots of on and off the clutch) which triggered the shooting pains up and down my leg. Once they go off and I can hobble again I need to cut the grass which will cause more pain.

Again, I agree I need to lose weight but I'd also like to be able to walk and sleep and generally live my life while I am doing so. I'm very heavy, it will take months if not years to get to a healthy weight (especially since I can't walk) I can't live like this for months or years.

So you aren’t bothered enough or committed enough to lose weight to solve your issues, but you want a doctor to magically fix it for you? 🤔