Referred but GP says not in our area

[Bluntedscissors]

Had this message from GP “The xxxxxxxx team have written to ask us to refer you to the weight loss clinic to consider injections. Unfortunately we do not have access to this service in xxxxxxxxx so we will not be able to refer you.”

Anyone else had this response or know how long before it becomes available in all areas? Referral has to be from a GP. I’m in London.

My understanding is you can be referred to weight loss services for support in dieting/surgery/WLI but not specifically for WLI.

Weight loss services may determine (after you follow their usual support groups/healthily eating plans etc you are eligible for WLI, but last I saw they are still priortising those with BMI>45 with at least 4 specific weight related co-morbidities so you may not be eligible yet.

If you are diabetic there are different guidelines.

It sounds like they are saying there are no weight loss clinics though. I’m now pre-diabetic. My body basically does its own thing since I’ve had long covid so I’m already on a low calorie, but hoped might help me feel less hungry and maybe reduce calories further to slow the (what seems to be inevitable) weight gain. Covid triggered a number of new conditions, but don’t think they’re specifically weight-related.

Locally there are no teams.

Despite all the fanfare it isn't available in our local area and will take months to years before the services are set up.

This doesn't stop specialist teams based in hospitals building up their patients hopes and asking the GP to sort it out.

Locally we have the weight loss surgery pathway.

Basically the person has to go to the dietician and see them for over a year and follow all the advice.

Then depending if they meet the criteria they can refer for surgery.

People generally decline this.

The mounjaro clinics are not yet set up. But will likely follow a similar pathway. Follow advice from dietician for a few months before anything else.

Sounds like no services. NHS criteria for Mounjaro is currently very narrow

Even if there were the new weight loss clinics in your area that were supposed to be planned and rolled out by the end of June, I don't think you'd qualify for the first tranche anyway. Your BMI would need to be 40 or over, and you'd need to have 4 out of 5 specific weight related health issues.

Any chance you can self fund Mounjaro or Wegovy privately?

I asked to be referred to a dietician a couple of years ago when there seemed to be no logic to the amount of weight gain. Some weeks I was putting on a few kilos, despite eating the same as a week where I might lose a kilo. I used to exercise a lot and can now not even manage the stairs some days, so I know that will have an impact.

Financially I’m screwed - I can no longer work and am now supported by partner. Our outgoings were set up for both of us working and we were fortunate to have savings, but these have now run out too.

I finally got to see the dietician recently - I thought they’d be able to give some pointers, or say or what should be a sustainable calorie level, or at least help me manage mix of dietary requirements (low iron, high cholesterol, pre-diabetes, need high sodium for POTS). He said he couldn’t help as I didn’t have set eating times from day to day, don’t have a regular sleep pattern etc - these are things I can’t help. I’m sometimes too dizzy to be upright for long, I sometimes vomit a few times a day, a doctor’s appointment can leave me bedbound for a few days. I asked for guidance over a week so it might even out on better days. I asked if my calorie intake was too low (about 900). I asked for recipe ideas that are quick and easy, but which could address dietary requirements sufficiently. He couldn’t seem to fathom that I might not eat three meals a day, even on days where I’m asleep for 18 hours. I said fruit is obviously a quick, easy snack but I need to be careful as pre-diabetic. I gave him examples of what I ate for each meal. The only advice he gave was to maybe eat a smaller banana. I still don’t understand why I’m putting on so much weight though. I’ve been pretty disciplined as far as I can be.

I’d also secretly hoped the injections might help with reducing inflammation or mysteriously helping another symptom (there was a thread on surprising side effects).

Any chance you can afford it privately? If you shop around it's about £100 a month for lower doses. Do you receive PIP or similar?

Dieticians on the NHS are beyond useless. I have a family member who has several chronic illnesses and they just kept throwing at him leaflets for each one individually what they can't eat for that condition and it essentially left him with nothing much left to eat. When he asked them to give him what he could eat they just repeated the leaflets what he couldn't.

When you went to the dietician recently did you go prepared with a food log over a sustained period of time to show them the issue? Do you have a follow up appointment? I would start logging calories/marcro in an app and honestly logging/weighing everything you eat and drink for at least a month including oils, sauces, etc and daily logging of weight. Then take it back so you have proof to actually show them.

You could try putting your conditions/needs into ChatGPT and asking for a suitable diet plan and the calories you want to try. Ask it to give you a high protein diet. Then if the plan makes sense with what you already know try to stick to it for a month to also show the dietician/GP facts and data that are indisputable.