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?

And also reassuring to hear that doctors often seem to fail on supporting weight issues. It baffles me as so many potential complications arise as a result from being overweight or obese! As a teacher, I can't imagine sending a child away because they are unsure how to learn or turning them away when they ask for help to be a better learner, to me, being unsure how to maintain a healthy body is what the doctor is there for?

And yes I'm super sensitive about it to those suggesting that too 😬😬

@Staffy1yes it does.

@coffeealldayandnight

And also reassuring to hear that doctors often seem to fail on supporting weight issues. It baffles me as so many potential complications arise as a result from being overweight or obese! As a teacher, I can't imagine sending a child away because they are unsure how to learn or turning them away when they ask for help to be a better learner, to me, being unsure how to maintain a healthy body is what the doctor is there for?

I think that overeating/ obesity is so incredibly complex that its really impossible for GPs to be able to provide adequate support. Its 10 minutes per patient. Its a huge multifactoral issue in society including predisposition, family attitudes, societal attitudes, easy availability of high calorie, highly palatable, cheap foods, lack of MH support, pressures on women both in the home and workplace, transport. I could go on ! I really dont think its down to not knowing that fruit and veg etc is better for you/ eat less which is what the GP will tell you.

I agree that you’ve been a bit over sensitive about the blood results, and also that you need to be more direct about what you want/ would like to happen. I don’t think a complaint is valid at this stage, although they could have been more sympathetic.

Perhaps GPs aren't great at weight loss support because it is a complex and difficult area in which there are no easy solutions and the issues are often based deeply in patients' history and psychology so the tiers of interventions are probably the least-worst approach. The UK has an incredibly obesogenic environment. MH doesn't have parity of resources and solutions are often long-term. If there were easy solutions then patients would probably get there themselves and the world would be full of thin people until fashions changed. Patients gut biome and physiological responses to food are fundamentally individual so rigorous diet advice is difficult and expensive beyond 'this is in general what a healthy meal looks like and what gradiated exercises would involve'. If you see an online miracle diet then almost always it is talking rubbish where the seller goes beyond 'this works for me'. Unlike drug and alcohol dependency, abstinence won't work and even meal substitutes don't easily admit to establishing long term healthy eating patterns. It is a difficult area though patients expectations can be unrealistic for what a HCP can achieve for them when the patients do the eating and the exercise. Patients have emotive responses to what is an incredibly emotive subject in this society. Have seem some great responses to injectables though, to be fair, have seen some great long term responses to diet and exercises when the patient is able to fully engage , for example as a result of a diagnosis of obesity-related 'secondary' conditions.

No quick fix but I would also really recommend the 'why we eat (too much)' book.

It's not really a a medical issue in the GP sense though is it? Unless you want some kind of pill or therapy if you overeat die to some type of trauma. It's just you eat too much- you said so in your OP.

What do you want a dr to do?

@MirrorSignal1 your point was really amazing and stuck out to me and sums up why exactly @JustWonderingIfYou I went to the doctor in the first place, I guess I assumed they would have some medication or referral to where I might get the support or medication to help suppprt me to lose weight and MAINTAIN it forever. I've no issue or struggles to lose weight, it's the forever battling the appetite and fighting the willpower

[quote coffeealldayandnight]**@MirrorSignal1* your point was really amazing and stuck out to me and sums up why exactly @JustWonderingIfYou* I went to the doctor in the first place, I guess I assumed they would have some medication or referral to where I might get the support or medication to help suppprt me to lose weight and MAINTAIN it forever. I've no issue or struggles to lose weight, it's the forever battling the appetite and fighting the willpower [/quote]
So the challenge is accepting that in order to stay slim you need to change the way you eat for ever. You can't diet and then return to unhealthy eating it won't work.

This is why healthy eating programmes now come with maintenance plans.

When you reach a weigh5 you want to stay at then keep to the healthy eating you've used to lose weight but add in an extra 100 cal per day for a couple of weeks. If your still losing add in another 100 cals per day etc. until you identify the appropriate amount you can eat and stay the same.

The 2000 cals often mentioned for women is sometimes way to high. Mine stable point is around 1500-1600 cals. I have to drop below 1200 per day to lose weight.

To maintain I allow some occasional treats but I eat a lean, vegetable rich, low processed food diet 95% of the time. I find carbs make me hungrier so I keep these low.

It's not easy to change the way you have eaten for ever. Maintenance is harder than weight loss. To do it successfully you need to say good bye to the way you currently eat forever I'm afraid.