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.

But you've said yourself it's not working. You can't just keep doing the same thing and expect different results.

It might be worth listening to other advice and just giving it a go? If it makes no difference you can ditch it but I'd try it first.

a lot of people are very anti-carb. it's true, there's not as much nutrition in them as fruit and veg or protein.
with three skinny bagels and 1700/1800 calories, you are getting almost a quarter of your calories just from that.

Stop spending the money on a nutritionist and spend it on Ozempic instead. Will be the best money you have ever spent.

Losing weight is really hard, I have 2 stone to lose myself. Honestly though I think you would be better off with a different nutritionist, what you are eating is too processed and clearly not working. More fresh veg and proper home made meals, lower the carbs. Three meals not five. I would sack the nutritionist. Best of luck.

No one is implying anyone.

You are eating less cheese than you originally stated, but other than that everyone is just looking at what you've listed.

It seems a lot of the wrong kinds of food to me.

Fwiw I'm doing slimming world and I've lost a stone and a half so far.

I had a mirena coil and piled on the weight. Doctors insisted there was no link, but when I had it taken out I dropped 5kg within a month despite thoroughly enjoying myself over christmas. I continued losing slowly and 6 months later I settled about 10kg below my mirena weight without actively dieting. My BMI still puts me quite high in the overweight category but I'm now at an easily maintained size 12. I'd have to put in a lot of effort to drop any lower.

Your coil may have contributed to the issue, and hopefully it will slowly come off some over the next few months. I hope you work out what works best for you OP.

80 pounds a month? That’s crazy!

3 bagels a day is also crazy. Cut the carbs down and increase the protein.

Hmm Calories in and calories out is reliant on everything else being static - so hormones etc. I am a type 2 and like you having trouble shifting weight despite following the rules and weighing and counting etc. The referrals for the slimming world and gym membership are for 3 months only to a max of 6mths in any one year. I did the gym referral and not slimming world - at the end of the day its a choice and if you can show you are doing something already in its place and have a diary/programme etc then they shouldn't be slotting you into their pigeon hole. I would go back with your evidence and see if you can actually move along as per the programme as you are already doing it - they are just using delaying tactics.

My diabetic meds are changing at the moment partly as I am menopausal - on HRT but low dosage but Estrogen helps control blood sugars (well release of insulin) and mine is all out of whack at the moment so I would have a look at pre or meno and if you need treating for that as well as diet and exercise factors.

They have just put me on Ozempic which is a semaglutide not dissimilar to the one you are talking about, but there are some quiet serious side effects on top of the bonus of weight loss.

Before the Ozempic I was down 3 stone and have probably another 4 to go so hopefully this will help and also bring blood sugars into control ie bring them down. My issue is only 54 and already resorting to more than one drug to help manage - despite diet and exercise. I think mine is also a hereditary weakness unfortunately so is only going to get worse - and yes I tried these wonder diets supposed to get rid of diabetes and whilst it worked int he short term Diabetes is a progressive disease even when you address the issues.

You’re a strong healthy woman but just for a week try this: porridge and fruit for breakfast and the triple your veg intake and scrap the processed food. Good luck

Stop paying your nutritionist, go to slimming world and stick to the plan. You are eating a tremendous amount of food, that's why you are overweight, nothing to do with hormones.

You're eating 456 calories in skinny bagels in one day alone. Stop it. Fill up on decent lean protein (not shitty chicken sausages) cut the cheese and start piling on the vegetables and salad.

As per pp, I recommend 'Why we eat (too much)'. Have a look at the thread here in Weightloss Chat.

There's nothing to be gained by examining your present diet in forensic detail or arguing the number of calories in a bagel. The simple fact is that, for whatever reason, it isn't working for you so you need to try something different.

I’d sack the “nutritionist”, what you’re eating sounds ultraprocessed and repetitive (3 of these bagels a day?) and lacking in variety needed for range of vitamins and gut health etc. Do 5 meals a day work for you? I do a similar amount of exercise as do friends and don’t have any protein shakes. another skinny bagel plus jam with dinner on a training day as you eat dinner sounds slightly odd to me - I would maybe have a larger lunch or dinner if I felt hungrier or have a banana or something in gym bag. It sounds quite disconnected from cooking and eating for health and well-being.

@Lavenderbythefrontdoor good for you for trying so hard already and making positive changes . Agree slimming world possible not ideal as unlimited “free” carbs would be a disaster for me! 🤣🤣 Are you really logging all your intake I have found nutracheck really good.
Your nutritionists suggested diet seems really carb heavy. Have a read of “The Obesity Code” or look at “The diet doctor” website lots of information on insulin resistance/metabolic syndrome related to carbohydrate intake

@catfunk there is evidence that more weight is lost if people are part of a supportive group

There's nothing wrong with carbs people. Rice and bread don't make you fat. Eating more calories than your body is using in a day does. It doesn't matter how those calories are made up although obviously some foods are more filling and have way better nutrients.

I looked up skinny bagels - are they the ‘bagel thins’? Sugar is fairly high on the ingredients list. I’m really not really a believer in ‘good food’/‘bad food’ - but there are certain things I wouldn’t have if I was trying to lose weight. A bagel would be one of them. And jam. And chocolate. Half the amount of cheese, probably better to have cottage or feta or low calorie cream cheeses if possible.
Best stick with high protein and slow release whole grain carbs. And loads more veg to fill you up to.

As others have said, with a BMI of 40, you’re eating more calories than you’re burning.
I do a lot of sport (biking, running, football) and rarely eat 1600 + calories in a day. So I doubt that’s much of a deficit.

Keto diet made a big difference to me too, I didn’t feel hungry either and it’s good for muscles if you’re into lifting.

The nutrition plan sounds bonkers, for your sake, give that up. Good luck Op 👍

OP, I know this thread hasn't gone the way you were expecting, but honestly I don't think the criticism is aimed at you - you are clearly committed and working very hard at your diet. The blame is aimed squarely at your nutritionist who is repaying your trust in their expertise by giving you terrible advice and fleecing you of £80 a month. I think people feel quite cross about that.

I agree with this.

“The odd treat” needs to be included in your calorie calculations. Are you certain that every single thing that you ingest goes in there?

Calories that people often choose not to count include those;

On someone else’s plate
Consumed while standing
Eaten while traveling
Eaten while preparing a meal
Eaten as a treat
In a drink

And so on.

I agree with others that you may want to try a new nutritionist, that’s not a great diet that you are on.

The simple answer is you're consuming more calories than you think you are and/or aren't burning as many as you think you are. What does that look like in reality? Are you counting all calories in and out? Do you weigh 50g cheese every time or do you do it by eye? Do you use pre set calories burn figure on an app like my fitness pal, or do you use a heart rate monitor to get an accurate burn? Not questions to necessarily answer here but things to consider.

Nutritionist isn't a protected title which means anyone can do a 2 hour free online course and set up as a nutritionist. And if I was paying someone to devise meal plans for me and that's what they gave me, I'd be asking for a refund.

You'd be better off spending your money on a session with a dietician.

The amount of cheese, and bagels 🥯 is not good. What about more meat, more protein, more greens. For breakfast youghurt and low carb fruit. Or watermelon. For lunch stir fry broccoli and Bok Choi. Very low carb.

I know this must be v frustrating OP and I don’t want to join a pile on.. but that’s an odd diet.

Nutritionists are not regulated the way dieticians are, some are good and some bad. I think you may have a bad one.

16-1800 calories shouldn’t be too much, especially considering the exercise you are doing.. so it’s puzzling.. buy it may be you need to restrict calories further.

Before you resort to drugs I would drop this bloke and find a dietician who is also a nutritionist, quite a few are.

Increasing fibre, which you are currently extremely low on, might be helpful as it fills you up, keeps your system moving and not all of it gets absorbed. I am not an expert of course, but I don’t think the person currently advising you is either.

Use the time you are at SW to work with a new person (you don’t have to take any notice of SW, just say you’re doing it online), and see how that works.

It doesn't matter how those calories are made up although obviously some foods are more filling and have way better nutrients.

That statement is contradictory. In terms of weight management it matters enormously where the calories we eat come from. There is masses of evidence to back this up.

Ignoring the food and 'nutrionist' at the moment.

Having that coil out could have a huge impact on you.

For me, weight loss clicked after having an ablation and no longer having my monster periods. I also did Noom (cheaper than your nutrionist) which helped me come to terms with my eating habits and change them.

I've dropped 10kgs since March and have gone from a 14-16 to a comfortable 10.

As pp said, We're not criticising you OP. You are exercising more than I ever do. We are all cross at your extortionate nutritionist with their poor advice.