I'm so huge and fat, I'll be dead in five years

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In my early 30s, 5ft4 and last time I got on the scales, I weighed 26 and a half stone. Currently on the antipsychotic Aripiprazole (15mg daily) and Fluoxetine (20mg daily). Before that, I was on Olanzapine and Paroxetine. Before that I was on Sertraline. Before that I was on Mirtazapine. Before that I was on Citalopram. Got a parent who has hypothyroidism. At the beginning of the year, I had blood tests after a stomach bug and got told I am deficient in Vitamin D and B12. I was prescribed some Vitamin D to take twice a week, but I have not been taking it consistently. My face is puffy and I get hairs on my chin and a few on my chest. Periods are irregular and when I do get them, they get quite heavy. I'm tired all the time and the house is a mess, but I just have no energy to do anything. I barely manage to get up for work. Got left pelvic pain and left hip hurts when walking. Ankles seem swollen and feel sore when I lie down in bed at night. Get out of breath going up the stairs and too fat to reach my toenails to cut them. I want to lose weight, but just feel hopeless.

Sounds like it's all got a bit on top of you. BUT, the first step is reaching out to try and have some help to think things through.

You need to do this in the following order:

Speak to your GP surgery and ask to see someone to talk about weight loss and a different person to talk about possible PCOS.

Keep those appointments.

Self refer yourself for therapy. It might be a long wait but you can at least start the ball rolling.

Drink at least 2 litres of plain water a day.

It's a journey.

It isn't enough. The guidelines say other factors are needed such as BP, heart issues, and diabetes.

I am so sorry to read this op. You sound really distressed.

If WLIs are not doable in your budget (they wouldn't be in mine either), and you cannot get them on the NHS, would you consider another weight loss treatment, like surgery? Afaik, that is available on the NHS

Vitamin d deficiency is really easy to address with a loading dose...don't feel bad go back to doctor and ask them to re test and represcribe a loading dose.
I had vit d deficiency and it makes you feel utterly crap

My heart goes out to you, please don't give up on yourself, get GPs help

Yes she is at risk of those without doubt but my understanding is that unless you have diagnosed conditions and they are the comorbidities that the GP/NHS requires to meet the criteria you wont get offered the WLI on the NHS

People seem very certain that because OPs BMI is so high it would automatically qualify her but Im not so sure. The NHS is way behind on this and gatekeeping a revolutionary and life changing drug here. Very difficult to get it on the NHS

I had a sleeve gastrectomy last June. I was a size 28. I'm not a small 14, and really enjoying exercise and meal planning. Can no longer tolerate crap food or fried junk and honestly feel like I have a life now.

im not pre diabetic and my sleep apnoea gone.

highly recommend it.

good luck OP x

You can be prescribed it for Type 2 diabetes on the NHS without the comorbidities, just not for weightloss. How are your blood sugars, OP?

There's some terrible advice on this thread (e.g. come off your meds ASAP, give up your job etc) but the overall jist about seeing your GP is sound. You may not qualify for WLI on the NHS, in order for GPs to prescribe you need to have four or of the five specified co-morbidities (type 2 diabetes, raised blood pressure, raised cholesterol, heart disease, sleep apnoea), but your GP can refer you to the weight management service and you may be able to access bariatric surgery via them. Best of luck.

You need to do everything you can to get Mounjaro, save every way possible to be able to afford it.

Sounds overwhelming OP, as if there are so many issues/symptoms that you can't get started. Can you either get a double appointment with your GP, or perhaps a long appointment with the nurse. Write down everything that you are dealing with - just list them, and take it to show them. My sister was in a similar spiral, someone suggested this and it really helped. The nurse spent 45 minutes with her, she was then booked in with the doctor and they had a plan for everything - in her case her weight turned out to be the least of her problems and as the other issues were addressed, she started to lose weight naturally. I can't remember everything but she was definitely referred for physio, blood tests which picked up hormonal issues, counselling, chiropody as her toe nails and feet were in a state. I'm not saying these all apply to you, but sounds like you need a full assessment, and all of the issues worked on together.

I'm so sorry you're going though so many health issues. I know a lot of antipsychotics can make people put on a lot of weight.

Wli are really expensive. I don't see why someone like you can't get them on the NHS?

If you were offered bariatric surgery do you think you'd be able to lose a bit in preparation for that?

I hope things improve for you x

I think they might be rqually terrible, but in a different way so having both... No wonder Op feels crap.

It’s not hopeless . You’re trapped in a circle of medication making your weight worse and your weight making your need for medication higher .

Please try Mounjaro it will be life changing . Your BMI should be high enough to qualify but you also have other factors …… depression, probably PCOS , joint pain, fatigue and possibly endocrine and gynaecological issues . Do you have sleep apnoea ? It’s common with obesity. Is your cholesterol or blood pressure high? Those are also relevant qualifying conditions .

Once the weight starts to come off you will stay to feel more positive and can look into what’s causing these issues . Your body is your worst enemy at the moment but it really isn’t hopeless . Just take one step at a time .

I am in similar position but Weigh more than you. I also have pcos and the only way I can lose weight is with metformin. I am not eligible for weight loss injections as don't have 4 additional factors only one. My doctor wont prescribe metformin for pcos anymore as against nice guidelines. Hoping that will change with the renaming. I agree it feels hopeless x

My best advice to OP is to choose one thing each day that you think you can do that would improve your life. Just focus on that one thing for that day. This can be very small or simple, like go for a half hour walk or make an appointment to sort out your toenails. As long as it feels possible but not easy for you & you'd like it to happen, that's a good goal.

Next day in the morning, you can choose a different thing as your daily improvement goal. It doesn't matter if you fail on any previous day's goal. Just work on one day at a time.

.....

OP: what are your current medical diagnoses?
Do you have high blood pressure or high cholesterol?

The meds you list, they are typically used to treat

psychosis: Aripiprazole, Olanzapine
depression : Fluoxetine, Sertraline, Citalopram, Mirtazapine

Are you taking any other prescipription meds?

OP, at this point you can’t afford not to do something. So if you can’t get WLIs/bariatric surgery on the NHS, I would do whatever you can to fund this yourself. £200 a month is a lot, but when it’s your health and your life at stake, it’s worth finding however you can.

Have you thought of volunteering in Africa or south east Asia - have a complete change of scene and do some good.

How is your diet?

No sarcasm, just general day to day, what do you eat?

Healthy or junk?

Is your job a desk job?

We can give advice for little tweaks you may not hate so much, but it's never going to be a fast thing to change your life. You could look at 'this time next year I wanna be 20 stone, and the house half organized'

It doesn't have to be all at once. Don't be sad. You can live a good life as you are right now if you wanted too, but we need to change that mind set a little bit. Nothing will change if your sitting there thinking your too fat to clean or too exhausted to meal plan etc.

Sending lots of love.

Slimming world. Look for a group on their website see if any close by. You can do this just by changing mindset and eating habits, sometimes the eating habits being forced to change are the catalyst for mindset improvement.

NO, slimming world 6.95 a week, support group, eat nice food. With pcos its important to balance blood sugar and so eating lower g.i carbs are important. Get rid of the white bread, anything made with white flour and sugar is a good place to start with this. Eat fruit to get by the sugar cravings if they are a thing.

Hi, please sign up for a free Boditrax evaluation through your local council library or leisure centre. That will give you an accurate assessment of your current situation. They will also check for cholestrol, bp etc. Based on those results you can see your GP and ask for help. You really need to lose weight and it is easier in your 30’s than in your 40’s. Look at your diet and try making small steps to eat healthier, drink more water, cut out all processed food and sugar and the weight will slowly fall off. Also try to do some small bits of exercise, start with walking and slowly build up to doing more!

Being obese is a massive vicious cycle.
You likely have insulin resistance and a whole host of other problems which means losing weight is extra difficult.

If WL surgery or WLIs are not suitable for you right now then perhaps focus on losing a couple of stone naturally.

Your previous attempts have probably consisted of restricting yourself too much and then not being able to last on it.

Everyone is different and the key is finding what works for you.
Not just what helps you lose weight but something that you can see yourself doing for the next 12 months at least.
If it’s a struggle to just get through a week, it’s never going to be sustainable.

What worked for me was reducing my carbs and upping my protein and veg.

Carbs are not the devil and I didn’t cut them out completely, but if you don’t immediately use it then it gets stored as fat really easily.

Whereas protein is much less likely to be stored as fat - it is literally used in your body for everything else first.

Veg has hardly any calories and is full of minerals and vitamins.

I didn’t even worry about counting calories at first but it is a good idea to track your food, just as it’s easier to not overeat then.

A weekend would be:
morning - scrambled eggs on toast
lunch - stir fry (no noodles) or tuna salad
dinner - chicken & veg
snacks - eg sugar free jelly, fruit, protein yoghurt, kitkat, crisps, ice poles etc - just be careful you don’t overeat on these but I have to have a sweet treat and so I chose a couple a day and stuck to it.

Going to bed early and going for a walk really helped too, mentally and also it’s easier to not snack if you are physically busy.

If you end up having a binge - so what. You just carry on the next day.
Overall you’ll still be eating less calories.

It sounds as though you have a bit of depression which does not help if you’re an emotional eater.

This. It's easier to qualify for than mounjaro.

OP I was similar and lost five stone with WLI over 2 years, also weight gain from olanzapine. I paid for it privately.

I have recently had metformin prescribed (extended release) due to being on antipsychotics if that helps in any way. (NHS) via the GP