GP attitude offended me AIBU

[coffeealldayandnight]

Hi, I'd really like your opinions before I consider writing a formal complaint to my doctor's surgery about something that happened recently. Please do tell me, in all honesty, how much I am valid to feel so offended.

After fluctuating between a size 10 and size 20, between 10 stone and 19 stone and many attempts and 5 successes at losing over 4 stone, I finally have had enough of feeling like utter sh*t when the weight goes back on. I've done every diet out there (WW, SW, Cambridge diet, my fitness pal, just healthy eating, fasting, keto, 101 gym memberships) but simply can't maintain without the constraint drain of self restraint. I eat too much. My appetite is ridiculous. I'm never satisfied etc etc

I decided I needed professional help. Had a phone appointment with the GP who I relayed the above info to interspersed with gulping back tears, apologising for my self loathing and shame. She was clearly in a rush and didn't have time to spend discussing this on the phone - totally understandable, NHS staff are under huge pressure, essentially I am to blame, I've eaten myself to obeseness but there was a distinct air of judgement. She cut me off and said 'ok I think this is because of lockdown, we've all been put on a bit' and said she would refer me to the weight loss nurse at my doctors surgery as well as doing blood tests to check thyroid and a few other bits etc.

I felt a bit like I'd been told off. Was weird, I actually felt mortified like I'd made up that this was a medical issue and I'd wasted her time.

Had blood test. I rang to get the results a week later and the receptionist read the results to me 'all ok except your iron folate which is low, so eat more fruit and veg'!!

I don't know, it just feels wrong? Eat more fruit and veg - it's laughable - I mean, had she checked, she would know that 8 months ago I lost 3 litres of blood from childbirth which would explain the low folate, but instead the assumption that because I'm fat, I definitely need reminding to eat fruit snd veg. Not to mention that there was no follow up call after I had been completely wailing with self pity on the phone.

Saw the 'weight management' nurse too. I expected her to have the backstory (BMI 40 etc) but she asked why I was there and then said 'I'm not sure what I can do, what did the doctor suggest?'

I don't even truly know what I wanted from the initial appointment but quite frankly feel fobbed off. I'm a rough cookie despite sounding like loopy and over emotional, I dread toThink how someone with real mental health issues surrounding weight would respond to such cold and unhelpful treatment.

Anyway, what are your thoughts?

Don’t think the suggestion to eat more fruit and veg has any connection to your weight. It’s just the standard advice when blood results show low iron and folate ( but not low enough to need supplements). Don’t think there’s any problem or issue with that

Sorry so many typos, hopefully it makes some sense. I also didn't write that the receptionist who read the results to me had been given the results and accompanying note from the initial GP.

Folate deficiency wouldn't be explained by blood loss. It's very common but almost always due to a lack of folate in diet which is mainly dark green veg.

Thanks @canary1 ok, thanks, that's helpful, I am probably over sensitive with that connection between lack of veg and weight issues. Thanks so much for your reply

I agree with @canary1. I think you would have been given the same advice whatever your weight was.
Obviously weight is a very sensitive issue for you, but I think it's making you over sensitive on that one.

@Anydream I'm on iron folate tablets due to the blood loss since childbirth 8 months ago so there must be some link?

Thanks @DropYourSword ok thanks so much for your reply - def over sensitive then. This is very helpful

I think the gp sounded like she didnt think it was important enough for her full concentration. Having said that, I think its more the realm of a therapist of some kind to get to the bottom of your relationship with food, rather than a GP, however she could have told you that rather than brushed you off. If losing weight was easy then we'd all be at our ideal weight, so dont feel embarrassed for having what umpteen others have too. Learn to love yourself, the real you, not your physical self, although you need to accept that too. And when you go to over eat or binge, try and pause and see if you can work out what emotion you are subconsciously trying to avoid. It's hard work and takes time, but making peace with food and with yourself is really the only way to stop the dieting cycle

Thanks @Snow1n ❤️

I don’t think you’re being oversensitive at all. I don’t think that it’s acceptable for a receptionist to be telling someone with a binge eating disorder to eat more fruit and veg.

And I think it’s very shabby that two medical professionals - a GP and a nurse - did not offer more robust advice.

Low folate is actually much more commonly due to pernicious anaemia rather than due to a lack of it in the diet

@Anydream meant to tag you in my last comment

I'd be requesting a dietician appointment, and also counselling. Also finding out what the remit of the nurse is- do they have any training with weight management? What makes her someone to be referred to? GP isn't going to help- this isn't something they can fix. I'd say the same probably for the nurse. It probably needs to be done out of the practice. I get you're frustrated, but I do think you're being a wee bit sensitive.

Not more commonly.
Pernicious anaemia should be checked for but low folate on its own is far more likely to be dietary.

I've been in your position, and had a lovely telephone appointment with a GP who took me seriously. I was requesting referral for bariatric surgery. He explained that the first step was slimming world classes. I went, and lost some weight, but got to a plateau and really struggled. I spoke to a different GP who was again very sympathetic and prescribed orlistat.

I don't think your complaint is really about what was said and done, but the lack of understanding of your longer term position which is that you have a chronic obesity problem and you need help.

I had two health professionals on the trot who paid attention and took me seriously.

I have had years of patronising and dismissive HCPs, so was hugely moved and grateful to finally get two who took me seriously.

I must say, OP, I've lost 5 and a half stone doing slimming world. I'm maintaining the loss at the moment. I'm not saying it's easy. It isn't. Like you I struggle with having to maintain discipline for ever. I'm coming to terms with that now. That's my current task, recognising and working on that.

I'm a practice nurse and we have a GP that often refers patients to us for diet and lifestyle advice. I have no particular training in such that enables me to give you any more info than ten minutes on Google will tell you. I'm not any kind of specialist in this. I do smears, baby vaccinations, dressings. They're passing the buck.

Leaflets in the waiting room show local weight management services to which you can self refer. No need to see a nurse for that.
FWIW, there's approx a three month waiting list to see a dietitian in our area for diabetics alone, for a one off appointment.

Unfortunately, rightly or wrongly we just don't have the expertise or resources (or time) in house for personalised weight management.

This is rubbish for you OP - you asked the GP for help, they referred you to a weight loss nurse and the weight loss nurse just asked what the GP said to do. This is a failure in your GP practice - can you email the practice manager and ask what you're meant to do now given neither the GP or weight management nurse can help you? Or can you see a different, hopefully better GP?

Have you checked out Overeaters Anonymous?

I would ask for a referral to the hospital. They can discuss your options including weight loss meds. Some people are genetically predisposed to be hungry and eat more and can spend all their lives battling their appetite. There is no shame in that so do not apologise!! It is no different to being predisposed to Asthma or Arthritis.

I can guarantee the 'weight loss nurse' will just be the general practice nurse who hasn't a clue what the GP is talking about.

Id ask for the gp to do further tests to see if you have pernicious anaemia as it is actually very common, and much more common that low folate from diet

GPs are not trained in helping people with this. The whole NHS approach is woefully inadequate (there was a great documentary on this by a professor of obesity, called Obesity: How prejudiced is the NHS? It was an amazing program. So, I think that the nurse and GP really let you down. I would email the practice manager as mentioned above and see what they suggest now. Sorry this happened to you. I am in a similar boat, really struggle but fortunately found a GP who was a bit more helpful.

@cptartapp it’s disappointing you don’t feel as a nurse that part of your role is health promotion, including healthy weight loss. And suggesting leaflets from the waiting room sounds remarkably like “passing the buck” in a similar manner to that which you criticise the GP for doing…

Google the referral criteria for the “weight management service” of your NHS local hospital trust. If you meet the criteria, email the survey asking for a referral.

As you said you weren’t sure what you wanted to get out of this. I’m not sure of what magic bullet they can offer? Sadly it’s eat less, move more which you know. And it’s bloody hard, otherwise we’d all do it.
If you think you are an over eater then maybe join an over eaters anonymous group? If you think you need counselling over your relationship won’t food then pursue that?