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?

Where have I said this?

Your diet food sounds lacking in carbs

the dietary example she gave was mostly carbs!

This is the problem with posting on here, you'll get as many suggestions and as many different pieces of advice as there are people posting. Some are well intentioned but misguided and some is just plain nonsense.

I understand you want help with the pain. They are trying to address the underlying cause but the pain should also be addressed.

If you fancy another piece of advice (don't know if it's already been suggested) but I'd look up Dr Jason Fung - the obesity code. It's available free as a podcast on Spotify.

There are so many things going on here, this is why you need someone to listen and holistically put things together, you're never going to get that from a GP

Gall bladder issues are more complicated than 'dont eat a fatty diet'. I now know I have gallstones, had a scan after pain which confirmed it. Ive lost a huge amount of weight. Did I have stones before the weight loss (fat women are more prone to stones) or did the stones develop due to the weight loss (this can also happen).

Are the stones the cause of my acid reflux or is the acid a side effect of me eating much much less?

Ive also read that some people, when they're on a low fat diet, their gall bladders play up. I admit, I do not pay attention to how much fat I eat, at the moment, touch lots of wood, I dont have pain but am on a long waiting list to be seen about the stone to discuss whether they'll remove it.
On the other hand some people can eat barely anything due to the pain

I dont believe in a 'low fat diet' as a way to lose weight and so I think Orlistat is not a good idea personally but it depends on your view and what suits you

There is no way that your weight is not affecting your joints, it will be hard for the doctor to treat this effectively without you losing weight, hence the suggestion of a percentage weight loss. Are over the counter painkillers enough at the moment while you get some weight off?

@Frequency hon, is the GP aware you have an eating disorder? I get worried when a gp prescribes weight loss meds and sends a patient off with instructions to lose weight as we know what that can trigger psychologically. I think there needs to be a separation out of your knee and your digestive issues - for the former having physio might help, the second needs a better medical approach that gets to the route of the cause so you understand what foods you can eat without triggering pain. ultimately you may benefit from trying exclusion of or limiting certain food stuffs but again if you have an eating disorder then this should come with psychological support.

It is exhausting sometimes with doctors
I'm allergic to exercise (it's more complex but that's the easiest way to put it) so I physically couldn't exercise
Now they have me on a drug that works, and after I listed all the exercise I do (spin, weights, netball) they nodded and said "gentle walking is good if you struggle with your mobility"

then they estimated my BMI without bloody weighing me as 40, when it's 34!

Pain exists as a warning to your body that something is wrong. It's to get you to stop doing something to avoid causing further damage.

If the doctor had just given pain relief medication without addressing the cause, then it could exacerbate whatever injury was causing the pain in the first place.

The gp doesn't just want the OP to mask her knee pain.

Can you self refer for physio at your GP - Most GP's do this now?? No need for GP input at all, GP's are generally not good at muscular/skeletal issues. Physio can refer you for scans if required, as well as giving you specific exercises to help with your knee pain.

For the stomach issues, it could be so many things, all of which need some investigation. It could be as simple as your diet or medication you are taking, it could be gallstones, it could be H Pylori, or a Hiatus Hernia (if you are very overweight, also very possible). But these need to be tested for and diagnosed. Painkillers will irritate all of these issues.

Have you tried anything to improve your gut bacteria. Don't dismiss it. It works for many people. Supplements, or Kefir, or Symprove etc can help.

In any event you should push for a gastro consult, regardless, as all the medications you are taking will irritate your gut, and you may need to tackle other issues at the same time.

IDK if the GP knew about my eating disorder specifically but we did discuss calorie counting and why it doesn't work for me (I take it way too far and end up deficient in pretty much everything) and she did say she noticed I was directed to A&E by another GP in the surgery last year with heart palpitations and shortness of breath which turned out to be caused by extreme dieting, so I assume she had some idea.

That was why she prescribed the Orlistat. She doesn't want me to count anything. She wants me to eat 3 healthy, low-fat meals a day and snack on fruit only if I really need to. I wasn't offered any counselling or support other than the Orlistat.

OTC painkillers do absolutely nothing for the knee pain and it is stopping me from living a normal life. I understand I need to lose weight to help it but in the meantime, I have very low quality of life. I can't walk, clean the house, take the dog out, or sleep and it is effecting my ability to do my job.

It doesn’t really make any logical sense that losing weight gives you crippling stomach pains op. Unless it is an anxiety and hunger thing. Or you’re eating/taking something you’re allergic to. The simple act of eating less calories than you expend will not give you pain.

the knee pain could absolutely be weight related I’m afraid, the joints and muscles struggling. A friend of mine had this. She was on morphine at one point and pain patches,her legs and ankles swelling, and she went to slimming world, and even just losing a couple of stone eased it, she’s now a size 16 (5 ft) and is totally off the painkillers and is fine. Simoly her body couldn’t cope with the excess weight. I’m not saying it’s the same for your but the doctor clearly thinks there is a chance. However you should be given medication to see you through.

@Frequency I know it can be really hard work trying to lose weight and I struggled doing it alone. I found the group support of joining slimming world really helpful and having the consultant to chat things through with was great. It became a real social occasion too as I made lots of friends and looked forward to going each week. Would this help you?

I was directed to A&E by another GP in the surgery last year with heart palpitations and shortness of breath which turned out to be caused by extreme dieting, so I assume she had some idea

op, could there in addition also be an element of anxiety, have you discussed this with them,?

In your shoes I would stop taking the medicine.
And try and do strenghening exercises for your knee. Go swimming to take the weight off ... Core strenghening...
I do believe there is an underlying issue, but any intervention will involve physio and exercise, so it's better to go into it with more muscle strength.

Change diet more slowly. A sudden change in diet can be troublesome for a delicate stomach.

Keep a food & pain diary that you can present to your GP when the stomach pain flares up again. Again, there is probably more to it, but it's sadly up to you to prove that.

I know how it feels when you just get stereotypical suggestions in relation to your health. It's incredibly patronising and frustrating.

I wouldn’t ever presume the gp does know, I’ve been amazed by what GP’s don’t know about me that’s been highly relevant even though it’s all in my notes…they don’t always seem to have the time to read up on their patients . Have you ever sought support independently yourself ? It’s 1 part of the picture that may be worth tackling if you feel up to it.

I don't think I have anxiety. It was discussed when I was sent to A&E but blood tests showed that I had imbalanced electrolytes and was deficient in pretty much everything except vitamin C, so they think that is what caused it rather than anxiety. I was given supplements and a diet sheet to follow and told to stop being so bloody stupid and start eating properly

Although, in fairness to that A&E Dr I deliberately did not tell him about my history of disordered eating and anorexia.

I have severe arthritis and a chronic illness that affects my joints. I have also been almost every size. When I was at my largest, I was maybe a uk size 18, and the drs always mentioned me losing weight as a result to ‘help’ my arthritic pain. I’m now a uk size 6 and the difference in the way they treat you based on size is if you’re not ‘overweight’ they actually take your issues seriously and look into the issue rather than blaming your weight for the issue.

My bmi was 29.3 on 30 April and a friend introduced me to the Nutracheck app. My last weigh in on bank holiday Monday just gone showed my bmi was 27.7, I've lost 8 pounds.

I realised my portions were too big. I know weighing foods is tedious, I've got a short attention span and have the ability to give up easily but I've never dieted before but since being told I have a fatty liver and gallstones I needed to do something.

I don't go running, swimming, the gym or long distance walking but just keep active.

According to the app I should reach my goal of 9 stone and my bmi should be 24.7 by 13 September this year.

I can't calorie count. I appreciate the suggestions (I've used Nutracheck before) and I know it is the best way for most people but I really want to avoid that this time if I can because I know it will trigger downward spiral into utter stupidity and make the stomach pain worse which will then lead to me "having a week off" to get a break from the pain and trigger a bout of binge eating chicken nuggets and Gregg's sausage rolls.

At the moment, with regards to weightloss I feel like I've found a good balance with the Orlistat and 3 healthy meals a day. I don't need to worry about calories because the Orlistat will take care of that for me if I go too far so I am "allowed" things that would previously have been off-limits on a diet such as wholegrain bread and chia seeds. I'm not eating silly things like half a boiled egg and a tomato and calling it a meal nor am I tempted to, so in that respect I am in a good place.

The knee pain and this stomach thing starting up again is a problem.

It's because you're restricting your food too much and eating shit still, just less of it. You can do this but weight management is a lifestyle overhaul (I have been 16 stone and lost 4 which I currently maintain). You can't eat as restrictive a diet as you currently are giving yourself or you will, and are, making yourself ill. Focus on one thing at a time, if it's cutting out sugar then focus on that if it's cutting out UPFs then focus on that if it's hitting your 5 a day then focus on that. Once the habit is in place (around 3 weeks) then move onto another aspect of your diet to change. You need to eat a surprisingly large amount of food to lose weight, including healthy fats like avocados and nuts.

But doctors use a process of elimination, don’t they. So the obvious thing to try first is to see the effect of weight loss before they go on with other investigations.

Also op has not revealed if she is obese morbidly obese or overweight because these things definitely have an impact on joints.

I was just into the obesity range until recently and am now over the moon that I am now merely overweight. I can feel the impact of the weight loss already - especially when I exercise.

I have never heard of weight loss causing stomach pain and wonder what that could be.

Big sympathy from me. I have bone on bone osteoarthritis in both knees and have had periods of extreme pain but also very long periods of it being ok. I really recommend getting a very good quality knee brace to help with all the active stuff you can’t avoid.

When the pain has settled a bit do try to build up your muscles. Obviously physio would be great but even doing the stairs frequently will help, especially if you try not to use the rail. And also I find using good quality shoe inserts which push my feet into a better position ( they tend to roll in on my arches which is very common) makes a huge difference.

The stomach issues need to be investigated by your GP and I’d also suggest asking for a dietitian referral as the traditional low fat approach seems to be quite outdated now. GPs are absolutely not experts in weight loss unless they have a specific interest.

Best wishes. You are right that overweight people are absolutely treated differently by the medical profession even if it isn’t a conscious bias.

I hear you OP .I am similar have a sore knee , which keep being told to lose weight as well . They have said I am eligible for an injection though ,maybe knee surgery .This has all been put on hold as unwell due to different reason.I would ask for a different GP if possible . If you are ok with codeine, Paramol is a good effective over the counter painkiller.Weight loss is not as simple as "eat less walk more"!I read recently that our bodies have a set weight and return to this weight whenever possible! Do press to see someone else OP.I refuse to see one GP because he is just like this!

When your GP says try some thing eg gall bladder and your knee and it doesn’t work do you make another appointment to speak to them?

My knee is a new thing but I have on-going monthly appointments to monitor my weight loss so I will mention it again at my next one.

The stomach pain I do follow up on when their suggestions don't work. I am usually told to give it time (if I follow up a week or two later) and then I give up and go back to my diet of chicken nuggets and sausage rolls and the pain stops so I stop seeking help for it.

I always mention that it's a previous issue when it starts up again and I'm usually told to give it more time on the gaviscon/cutting out fatty food before giving up and going back to a diet that I know helps.

I suppose what I need to do is try to live with the pain long enough that someone eventually helps but when you're in agony comparable to childbirth every night for hours at a time, that is easier said than done. Oddly, it is usually early evening or nighttime that it gets so bad I literally can't do anything except vomit or curl in a ball.

I have started a food/pain diary now so I will take that with me next time it happens.

The pain you’re describing sounds like gall bladder pain which is caused by obesity.

Both the conditions you’re describing are weight related which is why they’re attributed to your weight.

I see what you mean but the excess weight is likely to be the cause and is the easiest to treat. If it still persists once you are down to a 'non load bearing' weight for your knee then that's another avenue to explore. They should send you for xrays etc as well though. If they haven't insist!