Disheartened after GP consultation re. Weight

[Lavenderbythefrontdoor]

Booked GP consultation due to low mood and weight gain. Blood tests have come back all clear.

GP said this morning that she will refer me to Weight Management Clinic. "Because your BMI is above 40, you can get in right away, so that's good" 🙄

I asked if that effectively means I will be asked to join Slimming World, she said yes, most likely. You need to start there and then if it doesnt work they look at other options such as injections etc (assuming Saxenda) but they dont "skip stages". God knows how long Id be expected to attend Slimming World until they moved a step?

I have explained to my GP numerous times that I pay a bloody nutritionist a large sum each month and follow a calorie deficit food plan. I lift weights 5 times a week and get my 10k steps a day, minimum. I also do some fitness classes, swim and climb hills at the weekend! On paper, I should not be as fat as I am. I am pro-active about my weight gain, Ive been working hard to lose weight for 18+ months. I've got nowhere with it, couple pounds here and there but then I get a bad menstrual period and it all goes back on.
I hold hormonal contraception to blame for the weight gain but just pointed to my ok blood work and told me thats not it.

Feels like a right kick in the face that, when Im at my lowest and finally decide to seek actual medical advice, Im being told to go back to the beginning and prove I dont sit on my arse eating Maltesers all day.

Oh, and my low mood is "probably because of your excess of fatty tissue playing havoc with your estrogen levels".

Righto.

That seems like an enormous amount of food to me for someone on a diet. I'd cut out the bagel and protein drink at breakfast, meal 3 and meal 5.

I've lost 7lb in the last fortnight: Yoghurt for breakfast, salad with egg, ham, chicken, cheese or tuna at lunch with some olives thrown in. A small family meal in the evening and one g&t with slimline tonic.

If you want drugs to kick start weight loss then I think you should pay for them. The NHS is to help people who are ill not help people to lose weight.

I know it's cals in and out but have you tried lower carb? I hate doing it but it's the only thing that seems to work for me combined with fasting

Really OP your diet isn't going to make you lose weight no matter how much you exercise. It's not even healthy.

Swap bagels for brown bread
Cheese for lean protein
Fresh veg
Cut out the protein shakes and eat proper food
Jam is just sugar.

How many calories is that plan OP?

My thoughts would be there is quite a bit of UPF there with the bagels and protein shake. I would be a bit sceptical of any nutritionist advising this, given the increasing understanding of the impact of UPF on appetite regulation.

And don't get me started on the fact that the NHS refers people to Slimming World with their dreadful 'Syns' and recommendations that people swap out healthy, calorie-dense wholefoods for processed low-calorie shit.

Have you considered some kind of fasting approach?

You say you know what the calories are but if you're estimating with things like "a small bit of jam" then there's no way you know the calories.

Do you log it on something like My Fitness Pal?

That's a lot of food op....protein shake? Is that needed ?

A lot of cheese and bagels. Maybe cut down a little on that menu and see if you lose?

Water intake?

I didn't start this thread to get nutrition advice. I pay a licensed nutritionist £80 per month for a plan so I will go with their expert advice.
It's not just about calories, it's about macros and making sure you are getting a balance of cards, protein, fats and veg.

I started this thread as I'm feeling particularly low and wanting to understand how weight management clinics work, not to have my (pretty damp good) diet ripped to bits.

But you don't have a balance 😂

And when you get down to the bones of it then it really is all about calories to lose weight.

If you're eating 1600-1800 cals per day you're very unlikely to be in calorie deficit!

Cut the carbs, increase the protein

I'm sorry OP, I was trying to be helpful. I do really think you need to look again at spending money on that advice and then at your diet.

Good luck anyway.

Depends on weight/height/exercise tho
I'm 5ft 10 and that would be a deficit for me as I'm also doing 30-90 min spin classes

Where did you get 100g cheese per day from? I clarified that it's 25g in 2 meals aka 50g per day.

And it's skinny Bagels, which are around half the calories of a normal bagel.

You're clearly determined to find fault in a pretty good, reasonable calorie & macros balanced diet.

That's not true. It's very easy to eat that much and be in a deficit. The problem is that's it's also very easy to overestimate exercise and underestimate calories consumed.

You don't need to eat something silly like 1200 calories to lose weight.

Again, it's provided by a nutritionist. He knows my height and weight. I'm not just pulling this stuff out of thin air fgs!

I do get that OP, and it's crap that you haven't been better supported by the NHS.

But honestly, just because you are paying someone £80 a month does not mean that they are giving you good advice. They are just one person and they are not infallible. And the diet they have given you is objectively not a good one, and it isn't realistic to expect people not to comment on that.

What is your calorie goal for the day? As your goal is to lose weight and you haven’t has your nutritionist not suggested altering your plan?

You clearly need to eat fewer calories if you want to lose while still fuelling your exercise.

There are lots of great resources online. I’d be tempted to ditch the nutritionist and go it alone and use MN to get support.

But your diet isn’t that good. A good nutritionist shouldn’t be recommending processed junk like skinny bagels, protein shakes, jam, or that much cheese as the basis of your everyday diet for weight loss. You need more protein (from sources that aren’t shakes) and way more vegetables and sociable fibre than you’re currently getting.

I appreciate you don’t want diet advice so I’m out now, but honestly, if my diet were so lacking in decent nutrients I’d probably have a low mood, too.

@Lavenderbythefrontdoor I was agreeing with you! Of course if you're taller, bigger, and exercising a lot your calories will be higher than if you're 5ft nothing

It's literally broken down by calorie & macros. It's the epitome of balance!

What’s a skinny bagel?

I reckon that’s easily about 1800 - 2000 calories. Maybe more if you’re having treats like wine too. It’s a good amount of calories to maintain a healthy weight - but not to lose weight I don’t think. You are very active but it doesn’t sound like you do much intense cardio to burn off a sizeable amount of calories.

A nutritionists or a dietician....?

A nutritionist is basically bunkum.
A dietician is a recognised medical practitioner.

Maybe switch out for a better advisor?

I know you're not keen on SW, but having been on it and lost weight by following it properly I would suggest giving it a go - I couldn't be arsed counting my calories but the pack that you get with it is really easy to follow in terms of what's unlimited (within reason obviously), what's limited and what's allowed as a treat. If you ignore the stupid stuff that you see on websites it's basically low carb, limited dairy, high protein - 3 bagels and that much cheese would not be in the plan.

If you don't want to go down that route then I'd suggest ditching the nutritionist (anyone can call themselves a nutritionist) and going with a properly qualified and registered dietician.

Just track your food on My Fitness Pal for a week and see why you're actually eating. Then you will know either way.

Sorry, quote fail. Was trying to respond to the person you responded to 😣

I'm shocked that a nutritionist approved that diet, it's obvious why you're not losing weight.

I'd sack them and find an actual dietician.

Honestly op, I'd gain weight on that diet. That's a lot of carbs and cheese.