Desperate to lose weight!

[StrawberryShortbread2001]

donning my hard hat

I reached out to my GP again for support as ever since I was put on certain medication I have gained twice my body weight. I never had any issues before.

My GP said they would refer me to a 'diet and lifestyle coach' to review dietary advice. I don't need dietary advice, I need someone who understands what is happening with this medication. I've already seen the 'diet and lifestyle coaches.' The last one's advice was to eat more and do less exercise than I'm already doing. It's not helped in the slightest! If in 6 years I've only put on weight, how is being referred to one of these 'coaches' again likely to help?

AIBU to ask to be referred to a specialist weight loss service? It's been 6 years and my self esteem is so low due to this weight gain. I'm even considering just stopping the medication as I can't go on like this. My heart rate and BP are high. I'm so worried what this is doing to my health.

Anyone?

Can I ask what medication you’re on? Are there alternatives with a different side effect profile?

Yes, I take quetiapine (which I think is a big contributor), but I always have other meds that have weight gain in the side effects - venlafaxine, mirtazipine and pregabalin. They are all for my mental health and ime, psychiatrists aren't willing to talk about weight gain, they just want you taking the drugs.

I was sold these drugs as a temporary fix while I had therapy. I'm still waiting for that therapy. I was told after I had it they could look at reducing my medications.

@StrawberryShortbread2001 that’s so difficult. I’m a mental health nurse prescriber and you’re right that these drugs will be a big contributor. It’s not my place to comment on your treatment regime of course but I would ask to meet with your psychiatrist to discuss any potential there may be to switch to medications within the same class of drugs where weight gain is less problematic. This may not be a possibility of course but warrants a conversation surely?

Thank you, that's a good idea. I have found in the past, though that psychiatrists deny that these medications cause weight gain. Funny how when I was on a ward most came in slim or underweight and pretty much all left obese.

How much weight OP? I'm on quetiapine and Venlafaxine and have also gained weight, despite eating far less and doing much more exercise.

In my experience of asking for help for TEN YEARS the NHS have been no help at all with the weight. It seems to either be stay on the drugs and be fat, or come off them and be thin and mentally fucked.

I've now massively reduced dosages and it's a bit more manageable. I'm still overweight but only about 2 stone now.

In reality I need to do at least 12,000 steps a day and under 1400 calories to stay under 10 stone ☹️

I hear you. But your mental well-being is also vital to your overall health.

The truth is I don’t think there is any other meds that don’t cause the weight gain.

Im not a MH professional but have personal experience and know others who have gained weight.

There is not an easy solution. But at least with being overweight you are mentally stable.

And yes it is true they fob you off or say ‘there’s no evidence of that’ arggghhhh

A cousin of mine ballooned on a similar package and it took years for him to find something that let him bring his weight down and it was intermittent fasting that solved it.

He's intermittent fasting and low carb and has lost loads of weight and looks better than he has in years. He isn't, and I don't think he will, ever be back to pre-drugs shape, but he's not a proper chunky monkey anymore either. He doesn't do much exercise, just walking so I guess it's mostly the diet change.

YMMV

I went into hospital at 7st. I came out 3 years later at 14st and then over the last 4 years I've lost and gained so another 2 stone has gone on.

I go to the gym 4 times a week doing classes, gym, badminton, swimming. I walk lots too and find I can only lose weight if I cut down to 800kcals. But I've been unable to sustain that to get more than 2st off which I've then put back on.

I agree with you about no help with weight gain due to psychiatric medications. This is why people who have a mental illness die 10 years younger than the general population. I don't want that to be me!!

You see these 'coaches' and they just parrot out that you should gradually increase your exercise so you are walking 30 mins per day. When I explain I already walk an hour 20 minutes on the school run, plus gym/pool/classes/badminton they just ignore you. Apparently I need to eat more despite the only way I have lost weight is by cutting down to 800 kcals! And when you explain about your medication they just look blank.

I'm sorry you've struggled too 🌺

@TinglyandCurious I did wonder if the GLP-1 injections might counteract some of what the medications do? My GP said they aren't available on the NHS, though.

You’ve really reminded me of the number Mirtazapine did to me. I’d had an ED for years. Recovered. Got put on it and I ballooned. Yes, it made me more stable for one thing, but it then destroyed me mentally again very quickly with the weight gain. I joked at the time I could eat a salad and gain half a stone.

They don’t understand. As you say, it’s be referred to someone who tells you to eat less and move more. Well, whoopee. No. The meds completely screw your metabolism.

I ended up refusing to take it and saying I would rather be slimmer and less stable as I was heading straight back to bulimic territory. Sending love.

I'm so sorry you experienced this too. But very validating that you understand where I'm coming from!

Oh, I do! You always get told it’s your diet and you won’t gain on these meds if you’re not eating too much.

Bull.

Side effects happen, but why do no meds give glossy hair, glowing skin and a cup size increase? 😂

Well, exactly! Haha.

To my mind psychiatrists play down the weight gain as they know that will put people off taking these drugs. But that's hardly informed consent!

The GP's referred me for an online 12 week programme. He says if that doesn't help the next step is surgery!!

Ask your psychiatrist for alternatives
There are lower weight gain alternatives to most of these drugs: aripiprazole for an antipsychotic and lamotrigine for a mood stabiliser but of course I have no idea if those are suitable for you.
For many diagnoses drugs are overprescribed. NICE doesn't recommend any medications for personality disorder but a lot of people get it anyway. If that's the case for you then risks might outweigh benefits and you could just try gradually reducing it as long as you discuss it with your psych.
The GP neither could nor should change meds for someone whose been in hospital for 3 years
Your GP can't do anything other than what they have done. You can't get the injections on the NHS unless you fit the BMI criteria AND you complete the lifestyle programme whether you think it's bullshit or not.

They are not compatible with so many other medicines though. My friend was on pregbalin and another everyday med and was rejected

There is no availability through NHS.

My GP said I already fulfil the criteria to be referred for the injections but he's unable to refer anyone right now.

I'm not saying this 12 week online course will be bullshit, I'm keeping an open mind.

But the 'health coach' and their eat more and exercise less message is absolute bullshit!

Oh, really? That's rubbish.