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.

You are maintaining at 1600-1800 calories so to lose you need to cut that down.

This exactly.

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

But it isn't that simple. It is possible to have two diets with identical macros and calories, yet one made up of wholefoods and one made up of processed shit. They are not equally good for you, and they will not work equally well.

I'd really recommend listening to A Through Examination podcast, it literally talks about this exact issue and why skinny bagels and protein shakes are not a good thing.

Why a TIN of peas out of interest? I've just put all that into my app and it's 1600 calories but only three portions of fruit and veg

You need to go low carb, it does help. Breakfast can be poached egg, grilled bacon and tomato. That will keep you full for a few hours. I have a small fruit salad first - small amount of grapes, cherries, strawberries, orange segments, pomegranate seeds, blueberries. Plus raspberries and blackberries from the allotment if they're ripe.

Lunch, I usually eat a small amount of peppered mackerel with a handful of mixed beans and a handful of pea salad (both from M & S)

Dinner varies - chicken leg or breast with cabbage, and mashed carrot & parsnip.

Or grilled fish fingers with peas, mashed carrot and parsnip.

Or smoked salmon pâté on toast followed by a prawn salad.

Or chicken liver pâté on toast followed by a salad. I make my own pâté.

There are tons of options that don't involve loads of carbs.

surely anyone would gain weight on 3 bagels a day

People do need to take account of the "calories out" part of the equation.
If the OP is doing a decent amount of exercise (which they are with gym, hiking etc) then you need to fuel that - you can't be healthy if you're doing a huge hike on one ryvita and a carrot stick.

I'm absolutley not against advice and will take comments on board. I want to lose weight and if it means dropping a SKINNY bagel that's fine!

But people coming on to imply I'm secretly eating hundreds of grams of cheese and full sized NY Bagels each day are not helpful. That's never what I said I eat, they're not reading properly

As many previous posters have pointed out to you though op, the nutritionist recommended diet isn't working for you. Therefore it may be helpful to try something different before expecting the NHS to fund a weight loss drug.

It's good that you are taking fitness seriously. It's my understanding that weight loss is obtained 30%, from exercise and 70% from food reduction and you are eating a lot of food and none of it sounds particularly tasty or satisfying. I would be much more overweight if I ate all that you do. I'm dieting from a lower intake than your starting point and I wouldn't dream of taking slimming drugs.

I am sorry that you are frustrated by your GP but your bloodwork is fine, so now you need to try a different diet. I don't disagree that Slimming World and Weight Watchers are poor, but you could track your own calories and limit yourself to 1200 a day and see how it goes. You will need a good pair of scales.

You could try dropping one of them which (I'm not sure how many cals is in them) drop about 100-200 cals a day and do that for a month and see if it makes a change?

Sadly if you want the treatment on the nhs you have to do it their way. For what it’s worth I totally agree with you about slimming world-it does nothing to address poor eating habits and almost encourages poor choices. I was once told I didn’t lose weight that week because I’d been at the gym too much!WTF??

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

But it’s not working, is it? Seems a lot of food to me. Also that you’re eating constantly.

Jesus, they are the SKINNY Bagels
They are half the cals of a normal bagel. They're made by Warburtons and sold in Tesco, not some secret item.
What is it about this that people can't understand??

Op I empathise. Have you read Why We Eat Too Much?

I heard this shocking stat that if you have a BMI of 40 or over your chances of losing weight and keeping it off without intervention is something like one in 4,000. Better chance of recovering from a bad cancer.

Good luck!

Your nutritionist has come up with a plan. It doesn’t work. If it was a good plan you’d be losing weight you’re not. it doesn’t work.

That's what I thought!

This doesn't look like a calorie deficient diet really.

What are you drinking, as you haven't listed this?

Do you drink alcohol?

You could cut out meal 5 altogether OP. Would that help?

Because 3 SKINNY bagels is still a lot?!

Honestly OP, you seem really defensive. 3 skinny bagels a day is not much of a diet. As PP have said, you would be better on more protein not cheating with pills

That’s a really strange diet-bagels, jam, packet of rice. Just go for lots of fresh veg with chicken, fish etc. & get rid of the processed crap.

I think you need to ditch the bagels and jam, and the shake and up veg and lean protein. Im not sure that the diet is currently balanced (disclaimer not a nutritionist but do have a degree in food science and nutrition) I wouldn't be eating anything that's ultra processed and I'd be dropping calories- protein will make you feel fuller than bagel carbs 80 pounds a month seems a lot for a plan that's not working and tbh I'm not sure what it's based on as nutritionally it's not good

Eating constantly 😑 You have no idea of my waking hours. I could be awake at 4am and bed by 11pm for all you know. How do you know if I'm eating
constantly?!

If I wanted to be attacked I'd have posted on AIBU. I assumed this was a thread category for support. I'm done. Thanks for making me feel like 10 Tonne Tessie.

I know the bagels you mean. :) They're only 160 each but sure they count as ultra processed food therefore won't be giving you much nutritionally.

In your initial “daily food” list you mentioned two of your meals each having 50g of cheese in them, hence people understood you were eating 100g of cheese each day. If that’s not the case / it was a typo, fair enough.

But several skinny bagels, shakes and energy bars as integral parts of your daily diet; plus only three servings of vegetables as dietary advice from somebody you are paying money for healthy diet and weight loss advice to is shocking, it really is.

Oh and swap the rice for leafy and lower carb veg (so those grown above ground)

They’re still carbs though, sadly.

Would you consider switching to a private dietician?