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?

In my experience when you go to the GP it’s best to know what you want that visit. Is it medication, a referral somewhere or just advice and support. It sounds like you don’t know what you want so they are struggling to help you. I don’t think it’s anyone fault. It’s a complex issue and you would probably be better off seeking help via paid methods like therapy.

From my reading, as an outsider, this sounds more like an overworked healthcare system meeting someone who is looking for validation and support for what is in reality quite a complicated situation, and finding that those things are thin on the ground, than any particular sort of judgement. Your self loathing and shame stands out and I think that it's important that you address those things alongside whatever steps you decide to take regarding your physical health.

You gave birth 8 months ago. You are already a heroine! (I like this , I'm not sure if it speaks to you.)

As someone who has had many weight fluctuations over the years I two medical conditions where weight gain is almost inevitable, I know exactly where you are coming from. You were very brave to ask for help and were definitely treated very shabbily. Please read a book called Why We Eat (Too Much) by Dr. Andrew Jenkinson. I read it last year and cannot recommend it enough. He is a bariatric surgeon who has listened to his patients and has the science behind the obesity epidemic and how many of us lose weight only to gain more than we started with. We blame ourselves and start another diet only for the pattern to be repeated over and over again. We start by just losing that stubborn stone and over time find we need to lose a stubborn five stones. The most shocking fact to me that I found out from this book is that in their seven years’ training, doctors spend less than a week learning about obesity, in spite of it being such a danger for so many diseases. This is why their only advice is to eat less and move more, of which we are already very well aware. If this truly were the magical long-term solution, no-one would ever be overweight again. Psychological solutions are rarely advised but there is a strong link between obesity and mental health problems. Finally, far too many doctors do judge overweight people, particularly women, differently from those who are not and blame for their problems, whether weight related or not:
Tonsillitis? “Perhaps you could lose some weight.”
Migraines? “You would feel better if you lost some weight?”
Ingrowing toenail? “Time to lose some weight.”
Pneumonia? “You really need to lose some weight. Eat less and move more.”

@Snow1n pernicious anaemia is a form of Vit B12 deficiency not folate deficiency

[quote LowlyTheWorm]@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…[/quote]
What exactly what do you think the average practice nurse is going to achieve here?
She said she has no specialist training in weight management and Op has already got cross that she was told to eat more fruit and veg!

Is it possible this frustration at the GP lack of empathy could be turned into determination to succeed OP ?

Could you try the things again that have worked for you in the past - like Slimming World / Weight Watchers/ IF etc and show that GP that you don't need her help ?

As in a kind of " fuck you !"
🤭

Totally agree with @erinaceus

Sometimes when we feel shame it can include blaming others .
The receptionist wouldnt have any idea of your size and would not be allowed to check your notes.She was simply passing on a message.
Its your judgement of yourself talking here.

Blood tests etc particularly thyroid is a good start.
I also agree with the poster who suggested thinking about your emotions when eating, a diary can be good.
Are your relationships healthy Op?

Can I say I think that I agree with the pp, you were wanting much more time and a level of therapy amd real answers you were never going to get from a gp in a couple of mins video call.

I don’t really understand why you felt told off. And the fruit and veg was just a general comment.

The nurse for me was the one who fell down on the job.

I think it was a bit shit OP.

It's really hard being a patient these days.

Gone are the days that you could pour your heart out to get some direction with your problems.

I think you need to do your research first. "I'm calling about X. I have already tried A B C without success. According to the guidelines, having already tried these things but still (e.g. having a BMI of xzy) it would be possible for me to try (e.g. saxenda) at this point. I'm wondering what you advise?"

I realise this is hugely unfair and means certain people get a better service, but being an educated and assertive patient, with a specific question in mind, seems necessary at the moment.

It's also worth checking if what you are hoping for is available from another source e.g. a pharmacy service. Or self referral to community dietician etc.

Sometimes you have to doctor-hop until you find one who will listen. So many seem to just fob you off. A doc who will listen seems a rare find these days. And sometimes you have to tell them what you want-- if it is surgery then they will be able to put you on the steps needed, like a PP described. I went years with the symptoms of underactive thyroid and it wasnt until I went in there and asked for a test, that my underactive thyroid was discovered.

Sorry you had a bad experience OP!

It does sound like you're sensitive about this issue.

Practice nurses get everything sent their way and it's a bit unfair of the dr to claim this nurse was a specialist in weight loss when she was no such thing.

There are a couple of things I've found helpful with this issue so I'll leave them here in case they speak to you.

Personally I have no willpower so I know I can't rely on that.

I have done hypnosis (via a recording) which you have to listen to so many times (you can put it on at night if you don't have time in the day). There are apps.

A book called atomic habits was life changing for me. In it the man talks about how a tiny bit every day adds up to a lot and you get a compound effect. That shifted my perspective from thinking about being 'bad' vs 'good' (a common trope in disordered eating').

Not sure if you get this but I have a thing like oh I've ordered a dominos for dinner so I may as well just write this day off and also have ice cream or whatever. But actually any small difference is a difference.

Or another example, I've got some dumbbells and whenever I walk past them I do 5 reps of an exercise. It's not hard work and it's takes no time but I swear it has made a huge difference.

Or ten star jumps whenever I go for a wee. It seems like nothing hit just small hits of movement have changed my body.

Don't feel pressured to make it all or nothing. It has to be sustainable. Tiny changes are worthwhile.

@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?

There does seem to be a "what do you expect me to do about it" attitude prevailing at the moment, personally I don't think you should be made to feel bad about needing help we all do at times. For me water is the key, lots of it

Honestly, this is usual in my experience. I don’t think complaining will change anything. I have never had any sort of follow up from GPs about anything. They do a test and you get told all fine, no further action, despite the fact that you still have the problem. Had much better response and follow up and even being listened to properly by private GPs, but unfortunately they are quite expensive, as are any private tests.

Please consider self-referral for counselling:

www.nhs.uk/service-search/mental-health/find-a-psychological-therapies-service/

Having lived with an eating disorder for most of my adult life, at the age of 51, I couldn’t live with it any longer. I’ve been receiving weekly counselling (NLP) since 7th December last year and I’m absolutely amazed at the different, more relaxed, attitude I now have towards food.

Good luck 🤞🏻

@Violinist64, does that book also give helpful information on how to lose weight for good as well as explaining why things go wrong?

lowly the GP can send whoever they like to me for weight loss. The problem is I have no training any more than you do in the matter. Hasn't been part of my remit in twelve years.
I can advise low carb, portion control, a balanced diet, exercise etc. Which probably isn't telling her anything she doesn't already know. It's like sending someone into a butchers for a dozen donuts! Wrong person.

I think the point of fruit and veg was standard advice for low folate and clumsy in the circumstances if not actively unhelpful in isolation. The key point for me was the poor advice for your circumstances. I would try and speak to a different GP, tell them the nurse didn't know what to advise and the first GP wasn't fully engaged. Is your BP raised or other adverse results of your weight that might trigger more sustained or active intervention such as Semaglutide, OP?

It is hard but try not to take your self-judgement and read into HCPs communications a tone of judgement if you are not reasonably certain it is there. Some HCPs are judgemental though patients are often looking for judgement and hear it when it isn't intended. Weight gain does happen but obesity is rife and the UK environment is obesogenic.

Good luck.

I too have doubled my body weight. Can I recommend googling inattentive ADHD and see if this applies to you?

I’m in a similar position, my weight goes up and down, I have two Heath conditions that make me gain weight really really easy and I hate myself for gaining so much back.
I’ve gone back on slimming world and it is working I’m loosing weight but I’ve realised that I’m probably going to be on some sort of restrictive diet for the rest of my life. I can have a treat occasionally but not every night like I was before.
I’ve got to stop looking at food as a reward.

Well done for bring brave enough to ask for help op. The disappointment of not getting those answers or support must be huge. I think it's terrible we don't have more support from the nhs (GPs, dieticians, nurses whoever) to support healthy lifestyles and attitudes towards food. Surely it would save the nhs so much money in the long term?! (This is coming from someone who is lucky to have a healthy lifestyle and not need that help, I just wish everyone could feel happier about food) Good luck in your journey.

@MirrorSignal1

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.

Scientists are finding that gut bacteria are the cause of additive eating patterns and weight gain. Gut bacteria are also implicated in cancer so I’m glad they’re finally being studied.

@Pinkbendyman

Please consider self-referral for counselling:

www.nhs.uk/service-search/mental-health/find-a-psychological-therapies-service/

Having lived with an eating disorder for most of my adult life, at the age of 51, I couldn’t live with it any longer. I’ve been receiving weekly counselling (NLP) since 7th December last year and I’m absolutely amazed at the different, more relaxed, attitude I now have towards food.

Good luck 🤞🏻

Oh wow, thank you most kindly for this link, I haven’t been able to access help for cPTSD (abuse in foster care) and chronic suicidal ideation from the nhs, why didn’t I know about this 😭

I think you may well be a candidate for bariatric surgery - but after you’ve been through the rigorous prep and assessment. I think counselling would be great for you.

Sorry that was your experience, it's always been mine too. Doctors are crap at weight loss advice.
To be fair, there's not actually that much they can do really is there?
I'm in the same boat as you and am waiting on an appointment for a weight loss clinic.
Which, it turns out, will actually just be a phone call. Presumably with somebody telling me to eat more fruit and veg
They're not wrong are they? But they don't help you with how to stay motivated.

Check out Georgie Beames on YouTube, podcast and Facebook.
She works mainly with people who have had weight loss surgery and still struggling and has lots of insight into why that is and how to overcome it.

Wow, I've just checked back and am overwhelmed with the responses! Thanks so much, some of them made me laugh and done are really insightful, also a lot of moral support in there, thank you. I think I may go back and perhaps have a direct approach of what I want from them as suggested by so many of you. Just need to work out what that is exactly... I've been reading about a new weight loss injection, maybe I need to look at asking questions about that and whether I am a candidate as it sounds like alongside diet and exercise its like a kind of 'hand hold' which would be very reassuring and encouraging. Also, these binge eating anonymous type groups I didn't know existed so thank you 🙏🏼🙏🏼