TO BE REALLY P*SS*D OFF!!

[joash]

Three months ago, I approached my GP about having a gastric band fitted. He did say that I woule probably be turned down as I am to young (I am 44); I don't weigh enough (I weigh 27 stones) and I do not have any illness of informity to do with my weight. He said that he would be willing to 'fight my corner' and back me all the way as I have tried every single way imaginable to lose weight.

Got a call from a friend of mine yesterday (she weighs less than I do, is 27 years old and has a major heart complaint) - her GP has offered her obesity surgery they are not even supposed to consider it if the patient has heart problems.

Anyway, I went to see my GP today to ask if he had heard back from whomever he wrote to and he admitted that he hadn't even bothered to recommend me as he felt that I should persevere with the diet etc. I have been on orlistat and weightwatchers (again) since feb/mar and have not lost one pound!!
I am totally pissed off and very angry.

Does anyone know if there i anyway of going over his head or would I be better changing GP's and finding one who is likely to keep his/her word?

bigcar - the thought of changing to her GP did cross my mind briefly, but it's about 15 miles away, I have no transport and there are only two buses a day that go anywhere near her village - none accessible for me.

There is something else wrong with you that a gastric band will not fix - if you eat 1000 calories a day and burn up 2000 you WILL lose weight - it is as simple as that - and you must never not eat or go without food or your body will think it is starving and stop burning off calories.

bottom page 49/50I knew It was right!

NICE guidlines....seems like your doc was wrong

Although I don't know your BMI, so sorry if I have insulted you! But that aside you seem to fit all the rest of criteria. I think you should take a copy of this little document to your doccy's and stand your ground.

Twinkie1 - If you read the thread you will see that I have been on numerous calorie controlled diet plans - even one managed by medical staff (in hospital) for two weeks consuming 500 calories a day, I did not lose one pound!!! GOD - SOMEONE FIND ME A BRICK WALL!!!!!!!!!!!!

I think the problem isn't that simple Twinkie. I think Joash has tried all the obvious things and is now resorting to some left field thinking in the hope that it will help.

Joash can you self refer to a surgeon?

do you think the pill could have affected you? (you mention further down the weightloss starting after taking the pill)

6 stone in 6 months is a lot after starting the pill, could it be hormone related?

fizzbuzz - thank you, I've been searching for info all morning. No you didn't insult me, as I said, my BMI is 65!!!

sorry, weightgain, not weightloss after pill

Oliveoil - I definately see the pill as having kicked something off (but haven't been on it now for over 20 years). Apparently I have no hormone problems at all.

wandering trolley - I wouldn't know where to start. I have emailed someone at the NHS for advice on going over the GP's head straight to a surgeon, so now have to wait to see if I get a reply.

who says you don't have any problems though? your 'helpful' GP?

your G P should have at least referred you to an obesity clinic.

it must be very , very frustrating, at what point will you be heavy enough for him to take seriously.. surely 27 stone is morbidly obese?

and you are at risk of more health issues

i do agree with carmenere, taht the gastric band might well be pointless if you already restrict your diet. as that is all that the band does.

if you can afford to see someone privately then try that

otherwise push for a second opinion

your gp sounds very lax

Six stone in six months?

Sorry, but there is SOMETHING wrong with that and a band isn't going to fix it.

I would ask for a new endocrinologist to get to the bottom of it.

That is not normal.

Joash, there must be something else going on if you are eating and exercising the way you say you are. A band seems like the last hope but it won't work.

You need either a new GP or referring onto a specialist for further tests.

I do understand and to some extent agree with what various posters keep repeating abotu a gastric band not helping - ut I have nothing else left to try.

Apparently if I weighed over 30 stones, was aged over 64 and had some illness associated with my weight, I could have the band. According to the GP, those are the guidelines that our local PCT use. If that is the case, why offer it to someone who weighs considerably less than I do and is 27 years old. Someone who openly admits to having four breadcake bacon sandwiches for her breakfast every morning. Eats sweets, cakes and biscuits all day, everyday, has lost most of her teeth due to heavy consumption of fizzy drinks and admits to never, EVER buying fruit or vegetables apart from potatoes to make her daily favourite chips and cheese.

I do not have any money to go privately - otherwise I wouldn't have even considered the NHS.

Oliveoil - i have had numerous tests across the past couple of decades, nothing abnormal whatsoever. Even repeats of tests - I am just FAT!!

because it will probably help your friend because she's stuffing her face and the band will prevent her from doing so.

According to you, you do not stuff the food down so how can it help?

joash,

In answer to your first question, I think you should look into getting another opinion from another GP.

In most areas, gastric bypass or banding will be considered for funding on a case-by-case basis by the PCT, so if you don't want to change GP, you could try contacting your local PCT directly and asking to speak to whoever chairs the 'individual treatment panel' or deals with requests for out-of-contract treatments, as some PCTs (though not many) will accept requests from patients without going through a clinician. It may also be worth looking up the NICE guidance on bariatric surgery if you haven't done that already.

I don't know why your GP isn't asking for a referral for you - directly or via the PCT. A final decision on whether you are going to be helped by surgery would be by the specialist after referral, no-one here can say whether you would or not, you need the referral, and it doesn't sound like your GP should be stopping the process before it even starts.

I've quickly looked up the guidance, and you are not too young (you're over 18!), and if your BMI is over 40, you also weigh enough.

because that 27 year old woman's obesity is the result of eating too much/portion control issues that a band can fix, as she won't be able to eat like that and keep it down after banding.

but you have already restricted your diet, which is the pupose of having a band fitted.

if you're 'just fat' despite such diet restriction and exercise then a band isn't going to change that.

perhaps the fact that your friend has admitted to overeating is the reason she's being considered for the band.
you, on the other hand, are doing your best and watching what you eat, but to no avail.
Maybe start looking at some of the more unusual causes...like cushing's, which has been mentioned.

You wouldnt lose any weight being on a diet that restrits you to 500 calories a day - your body would go into starvation mode and not burn anything worrying that this was going to be a long term thing. I cant understand the mentality of a health professional doing this at all.

You body is a machine - you put fuel in and it uses it to do the things you have to each day - if it doesn't have enough fuel and works hard it will lose some weight unless there is something wrong with one of the components, if there is restricting the calories you are eating will not fix the problem ergo a gastric band will not help you.

CaptainKarvol - thanks for the info on 'individual treatment panel' - I had no idea where to start. I will do just what you have suggested.

I did read the NICE guideleines and did a lot of research prior to approaching my GP - however, he claims that the guidelines are just that 'guidelines' and that the local PCT have their own criteria on top of those.

How horrific to put yourself through a dangerous and painful surgery for it not to work? how hideous would that be?

Also, if you develop some medical conditions, you have to have the band deflated.

FFS - anyone got that brick wall yet?

Twinkie1 - it was a hospital based programme wich down intake and upped energy use. There are a number of VLC options that hospitals use when patients have to lose weight quickly prior to operations etc. Anyone of my size who reduces their intake should loose weight immediatey before the body begins to manage on less. This is why, in general, people who diet, usually lose more weight during their first few days and then it slows down. At the levels I was ebing supervised on (weighning less than I do now) they should have seen weight loss of at least 7lb a day during the first 2 or 3 days.

You cannot tell me anything about intake v energy use - I'm practically a bloody expert after studying and researching it constantly for the past 26 years.

Shall I just scream?

OTHER REASONS WHY YOU MIGHT BE HEAVY:-

Several genes influence weight. One gene that has been identified?the ob gene?controls the production of leptin. Leptin is a protein made by fat cells. Leptin travels to the brain and acts on receptors in the hypothalamus (the part of the brain that helps regulate appetite). The message carried by leptin is to decrease food intake and increase the amount of calories (energy) burned. Researchers discovered that mutations in the ob gene prevent leptin production and result in severe obesity in mice and in a very small number of children. In these cases, administration of leptin effectively reduces weight to a normal amount. However, most experts think that in most people, many genes influence weight, and each has a very small effect. These genes have not been identified. Thus, genetic treatment of obesity is unlikely in the near future.

People who were obese as children are more likely to be obese as adults, largely because when weight is gained during infancy and early childhood, new fat cells form. People who become obese during childhood may have up to 5 times more fat cells than people who maintained a normal weight. Because the number of cells cannot be decreased, weight can be lost only by markedly decreasing the amount of fat in each cell. This fact may limit how much weight can be lost and make maintaining a normal body weight more difficult.

Hormonal disorders rarely cause obesity. Excess production of cortisol by the adrenal glands (Cushing's syndrome) causes an unusual type of obesity in which fat accumulates only in the trunk while the arms and legs remain thin. Polycystic ovary syndrome may be associated with obesity. Occasionally, an increased level of insulin in the blood (hyperinsulinemia) causes obesity.

Many drugs used for common disorders promote weight gain. Examples are drugs used to treat psychologic and neurologic disorders (including many antidepressants and antipsychotics), some antihypertensives (such as beta-blockers), corticosteroids, and some drugs used to treat diabetes (such as insulin).

expatinscotland and Carmenere I really have considered all the implications, but the potential benefits far outway what is goidn to happen if I continue to balloon.