I have just received a letter from the hospital detailing my diagnosis, can anyone help me please?

[phipps]

Diagnosis -

Fibromyalgia syndrome
Obesity (BMI 31)
Migraines

and 3 others that I already knew.

Medication -

Duloxetine 60mg once daily instead of citalopram prescribed today.
Amitriptyline 30mg night-time, can be increased to 40-50mg later (not much higher while on SSRI/SNRI)
Citalopram 20mg/day long-standing to be discontinued now (I think this is a possible cause of my weight gain.)

Referred to physiotherapy (not sure why.)

Would my GP refer me to one or would I have to go private?

My go referred me to one. But I live in Holland. Your gp should point you in the right direction at least. I highly recommend it. Mine totally opened my eyes about what exactly our bodies do with what we eat. I now eat very little carbs as I'm not an athlete and don't need a high calorie energy producing diet. What I need is good amounts of protein for cell growth and production, and a shedload of vitamins and minerals too, I take a high dose omega oil supplement and a good quality multi vitamin and mineral supplement too. I try to eat 75% veg to 25% fruit. White meat or fish every day. A handful of Brazil nuts every day. spinach or kale twice a week. Its not complicated really. And I drink a pint of water every couple of hours at least. Since I started being more aware and more careful about all this I swear my pain levels from my endo have gone way down. I'm usually very achy and sore much of my cycle. Since I stopped all processed food I feel pretty good! My skin is a mess but she said that would happen as toxins leave through the skin.

Anyhoo its worth going even only for an hour to get a basic idea of what to do. Once the food side of things is sorted you might find the weight drops off with the exercise you're already doing.

My go referred me to one. But I live in Holland. Your gp should point you in the right direction at least. I highly recommend it. Mine totally opened my eyes about what exactly our bodies do with what we eat. I now eat very little carbs as I'm not an athlete and don't need a high calorie energy producing diet. What I need is good amounts of protein for cell growth and production, and a shedload of vitamins and minerals too, I take a high dose omega oil supplement and a good quality multi vitamin and mineral supplement too. I try to eat 75% veg to 25% fruit. White meat or fish every day. A handful of Brazil nuts every day. spinach or kale twice a week. Its not complicated really. And I drink a pint of water every couple of hours at least. Since I started being more aware and more careful about all this I swear my pain levels from my endo have gone way down. I'm usually very achy and sore much of my cycle. Since I stopped all processed food I feel pretty good! My skin is a mess but she said that would happen as toxins leave through the skin.

Anyhoo its worth going even only for an hour to get a basic idea of what to do. Once the food side of things is sorted you might find the weight drops off with the exercise you're already doing.

get your thyriod checked citalopram may be cause of weight gain.

It has been checked gino and another GP dismissed my concerns about weight gain.

phipps- this might help.

I am trying to lose 3-4lbs. Not a lot but the diffeence between trousers fastening and not fastening!

today for brekkie I had small porridge made with water and soya milk, and a few blackberries.(which I picked with my own hands!!!) Normally I will have a boiled egg and 1 slice toast, but today felt like a change.

Mid morning I had a few nuts.

Lunchtime I havehad a small amount of watercress soup- homemade- and a salad with lettuce, chopped apple, tuna, watercress and a few walnuts.

Mid afternoon I am going to have a small amount of plain yoghurt.

Tonight I am having a grilled salmon fillet cooked with honey and soy sauce, and stir fried veg. rest of family will have rice too but I won't.

You could maybe do an on-line calorie counter, most people on here use food focus (that use them at all I mean, not most out of everybody). I use "my fitness plan" and it is careful about making sure you eat enough as well as not too much. My weight doesn't do exactly what it should because of the steroids I'm on but that only means losing 0.5 lb a week instead of 1 - still losing. If you are completely honest and the numbers really don't add up, you have a better case for seeking help (you wouldn't believe how many people kid themselves).

Yep dont you have to run a marathon or something stupid to use up the calories in a chocolate bar. or something equally daft.

I am definitely not kidding myself. I think I am not eating enough and always eat a lot of veg. I used to have dessert every day and now I don't. I have given up alcohol and coke, don't eat chocolate every day and just feel fed up with it all tbh.

I have tried the food focus but it never seems to have what I have eaten on it.

Thanks for all the meal ideas .

DH and I are having salmon for dinner and he wants mash with it but I will just have veg with my fish.

You can add the meals and foods to it. SO i have ameal that says toast which logs the bread i get, and the spread i use. Also when i log my coffee it is a meal to add and already has the sugar and milk calculated into it.

Phipps- how long have you been trying?
I'd say you have to give it a good month of real effort to see any change.

I think your downfall before was not eating enough protein.

I find what only works for me is to really plan ahead- otherwise I get hungry and nibble.

My spare tyre is a result of nibbling.

Your G.P. can refer you to a dietician.

It may also help to start a food diary, both in preparation for that appt. and for your own benefit.

I have been trying for a few months but really trying for a month.

Today I have had 2 scrambled eggs on soya and linseed toast for breakfast. Humous and crackers for lunch. Expecting that to be a bad choice but I really wanted it and hate throwing food out. I have had 1 chocolate eclair sweet and dinner will be salmon and lots of green veg.

It depends on how much humuus and how many crackers- it is very high in fat so you might like to check the container /carton and see how many calories you ate.
If I was having it- which I do quite a lot- I'd have something like 2-3 heaped teaspoons ad 2 crackers, but then I'd be starving 2 hrs later and nibbling.
You could have swapped the crackers for celery or carrot sticks- or red/green peppers.

I still think that it's too little for a lunch. you could probably add a tub of low fat sugar free yoghurt to that to get more protein.

I probably had 3 tbsp and about 6 crackers. I love humous but would rather have none than a tiny amount and be hungry later.

I think I need to learn what counts as protein, carbs, etc. I would happily live on cereal, soup and veg but that won't help me lose the weight.

If your body holds on to fat if you don't eat what it needs how come we have the sad situation with people having anoerexia and dying?

3 tbs hummous is prob a load of calories.

anorexia- well there is a limit!

if you only eat an apple a day then you will lose weight! It might be muscle first, then fat.

why don't you try calorie counting?

If you have one portion of protein at every meal such as chicken, fish, eggs, cottage cheese, beans, lentils, and fruit and veg that would work.

for example, soup alone has no protein unless it has something like lentils or beans in it ( or chicken of course- big lumps, not cream of chicken rubbish.)

I make my own chicken soup with 4 drumsticks, carrots, leek, swede, peas, a few red lentils, and it's very filling. One pan lasts 3 meals for a lunch.

you see- going back to the humous you prob had as many cals there or more, than a small chicken breast, or portion of prawns, or small tin of tuna and a salad. Not criticising but just pointing out that what doesn't look like much can be very high in cals.

I am having salmon for dinner, what would be the best things to have with it so I don't eat the pringles that are in the cupboard later? I used to be able to eat anything and my weight stayed the same give or take a few pounds .

I have bought a soup cook book and definitely want to start making my own.

well i am having salmon tonight too- once Dh gets himself here.
I am having broccoli and if I had any carrots I'd have those too but haven't. I might do a quick veg stir fry with peppers and broccoli.

what veg have you got at home now? peas? green beans? carrots?

I have just checked the cals in my new tub of humuus- brace yourself.

In a 200 gm pot- that's a small size- there are 625 cals.

so 3 tbs is prob half a tub at least, or maybe a whole tub.

For that value, when you include the crackers, you could have a roast dinner without the roast spuds- just meat and veg.

You need to think of having 3 meals a day with 300-400 cals each meal and maybe another 50-100 as healthy snacks in between- so your total is 1200 ish.

Just so disappointing.

I have done peas, corn, carrots and cauliflower. DH is having mash with his.

I have seriously considered a meal delivery service but I would be pretty upset if I still didn't lose weight having forked out hundreds of pounds.

What purplepeony said about nutritionists. If you go to Ben Goldacre's Bad Science website, it has a picture of a rubber duck with the word nutritionist underneath. And since it's not a regulated job title, there's no reason why it couldn't be. If you're prepared to spend money on this, it would be better aimed at Weightwatchers or similar.

When you say your GP says it's not a thyroid problem, has s/he actually tested for one?

I do believe you are eating what you say you are, but saw a documentary on obesity with doctors saying everyone who's overweight swears they eat virtually nothing. So I think you need to keep a detailed food diary, including every drink, every sweet, everything that passes your lips for a month, and your weight at the start and end. That may help him/her take you seriously.

Agree with LTS.

My brother had a girlfriend ( short term) who was a nutritionist/dietician. she had amasters degree in food science and dietics and worked in the NHS working out what diabetics needed etc.

There was a TV prog a while back about food values. what is showed was that people often think they are not eating much but they are- due to portion size, or just not being honest/knowing cals contents of food.

The used an example of which has the most cals- a sandwich, a roast chicken dinner and something else. everyone got it wrong- the roast dinner had the least as the sarnie had mayo, butter, etc etc.

it was also about portion size- one person said she could not believe how she did not lose weight and on;y had fruit for breakfast- when they looked at it, she had a huge bowl of fruit salad with loads of grapes etc and the whole thing was about 400 cals.

He has done the tests mentioned above and going solely by them. Isn't interested in me telling him I have symptoms.

I will start writing down everything I eat. I am trying to drink more and think twice before eating. DH came home with some G&B chocolate. Lovely thought.