An NHS rant

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I’ve always had problems with my left ankle and knee, it stems from a fall on a night out that I never got physio for when I was a lot younger get than I am now.

I’ve always been obese.

But since then whenever it plays up, I always try and see my gp and it’s always the same “just lose weight, we can’t do anything, physio can’t do anything”. It’s Lways been the same despite me saying it was impacting my weight loss.

Two weeks ago on a run, I pinged my knee and since then it’s only got worse. I can’t bend or straighten it, I’m in pain literally every day, I’ve not run for 2 weeks. It’s getting worse.

I put in my form that I’d lost 100lbs in the last year and they’ve given me an immediate appointment. Why am I suddenly more worthy of treatment?

Well done on the weight loss.

If it's your knee it's a new injury. And I don't think you should be surprised they are seeing you - if their advice was to lose weight and you've lost weight, then presumably there is a better chance they can do something for you?

It’s the general attitude.

Your knees and ankle problems were likely to be because those joints were under strain due to obesity. What were you expecting them to do?

Congratulations on losing so much though!

No, I had it confirmed by a private physio that I have long lasting damage to my ankle, which can only be solved by surgery, due to weak ligaments. They confirmed this was not due to my weight, and in any event, you should not be denied medical care due to your weight.

Recovery will be hindered and less successful when the person is overweight

Does that mean I should be denied healthcare? Thus being unable to exercise and hindering weight loss…

There is no point in doing surgery if you are not going to be able to do the rehabilitation due to your weight. I know it’s a vicious circle. But you need to take responsibility for your weight.

It’s a fairly common difficulty in lower limb orthopaedics for patients with obesity - there may well be treatments but those treatments are more likely to fail/make things worse/come with increased risk of severe complications elsewhere and the balance of risk and benefit is often more in favour of conservative management . A new injury , or an exacerbation of an old injury but that’s associated with physiological change (eg. 45kg weight loss) warrants a new assessment. Ankles are particularly ridiculous joints and surgery on ankles in patients with obesity can be much higher risk than people might imagine (skin closure/infection/DVT risk can all be much more difficult to manage).

it may be that it’s not been well explained in the past, but the force that a normal weight person puts through their lower limb joints is impressive (particularly doing sports like running)…the force that a someone who’s carrying a whole extra person of weight is even more so and physios/surgeons are rather limited in what they can do without causing worse damage. Doesn’t mean that conservative treatments shouldn’t be offered (like pain killers), but there are limitations to what the surgeons can do sometimes.

Hopefully if that weight loss has been intentional and healthy rather than due to another illness and that may open up new treatment options. Doing an operation just because you can though isn’t always the right thing for a patient in terms of their longevity and general well being.

General anaesthetic is also far riskier for obese people.

This view is proven to be untrue by countless research studies, when actually followed fat patients do not have worse outcomes. Its a way to gate keep care - reduced cost strains on services (and give voice to fatphobic prejudice we have all come to accept). Look up Atlanta University and TKR study

Well done for losing all that weight!

In terms of exercise impacting weight loss, the thinking is that exercise has very little to do with weight loss. So being unable to exercise shouldn't mean that you can't lose weight.

Which is exactly why I lost 100lbs 👍🏻

It’s almost like exercise is good for more than just weight loss? It’s amazing for your mental health, and when your mental health is better, weight loss is easier.

Take responsibility for your weight? She has she’s lost 100lbs!! It’s not always easy to lose weight, I have no thyroid and liked on weight and now it’s not for shifting! Slowly but surely I hope it’ll come off not eligible for weight loss drugs and have a busy life, Sen child, nurse single parent etc along with my metabolism being slower than a tortoise 🐢 I’m shattered all the time. My knees also suffered and same was put down to weight and basically fobbed off except for one lovely physio who was absolutely wonderful. It’s tough

Good luck getting anywhere! My dad has nerves stuck in his vertebrae and needs lumbar decompression. He’s gone from walking to just about being able to even walk with an aid and he’s on a waiting list for surgery.. when that is we don’t know, he’s classed as “urgent” but could be months! Clap for the NHS.

I’m on weight loss drugs, I was never eligible on the NHS though. But that’s also a problem for one particular person at my surgery!

It’s awful isn’t it? I’m hopeful that seeing someone face to face (as opposed to the video appointments!) will get me somewhere

They won’t waste there time doing a procedure where there’s very limited success due to other factors
that can be corrected and then they will operate once these have been addressed because they have more chance of successful outcome

I didn’t expect a surgery.

But being given physio exercises (which did work, as I paid privately to go!) is the bare minimum.

I had a car accident and it caused significant damage to my shoulder that I had physio for at the time. I am a size 18 and still struggle with my shoulder now. Every time I go I get told to loose weight. Like the OP because of the ongoing issue it is agony if I try and do any exercise for my arms.

Every time I go to the GP I get told to loose weight. I've lost 4 stone and am trying my upmost but not every ailment is due to being overweight. I had a detached retina - the ophthalmologist after my surgery told me I could do with loosing weight - well I'm sorry but I don't think my retina detaching has anything to do with being over weight!

It’s disgusting isn’t it? I’ve been told everything is down to my weight - even the most basic of things like infections!!

It just makes you feel worthless when you try so hard to loose weight, you do loose weight and it is still the same attitude. I live very healthy, I run 3 times a week and try and do cardio twice a week but due to a lot of medication I take I struggle to loose weight. Part of me wanted to shout at the Ophthalmologist and say, right, this is what I do and what I eat, you devise me a meal plan and I'll stick to it and then we will see how I go. I've avoided going to the GP now because of it and just get on with my issues.

I did it before, a few years back. I just snapped at the Physicians associate, and I was referred to bariatrics without being asked.

i ended up on WLI which changed my life, but they’re now judgmental of that too!!

It just makes you want to give up. I have this thought that if I got down to a size 6 they'd then blame my health issues because I was overweight before. I'm fully aware of my need to loose weight and I am trying. But more often then not you just get the impression you're looked at like a slob watching Tv all day eating crisps and chocolate. If only...

Yes that’s the thing isn’t it. Even when you lose the weight you’re judged for doing it the wrong way, for being too slow, for being fat in the first place