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.

@Lavenderbythefrontdoor I hear what you are saying, and I know what you mean.

I’m in the same position and I have tried everything to loose weight. Other than being told by my GP to loose weight, that my blood tests are clear (apart from the auto immune disorder they missed for several years).

Like you I don’t spend my days eating, I exercise moderately with the limits I have re health issues and it’s pretty tiring to be told just eat less, move more.

I have now gone down the route of ordering private prescriptions but it’s not what I want to do - desperate person willing to try everything.

Hopefully you will get the support you need and things will turn a corner.

I know several women who have piled on the weight with the Mirena.
Tbh, you are much better seeing a dietician rather than a nutritionist, anyone can call themselves a nutritionist but dieticians are fully qualified and the NHS will only employ state registered dieticians as they are qualified to deal with a whole host of health conditions.
£80 per month is a lot of money to pay for a nutritionist (believe me, I have had my fingers burnt several times by very expensive so called nutritionist) for my health condition.
If you look at the BDA website it will give a list of dieticians in your area who also do private work. I have seen a couple over the years, they are very knowledgeable and they are a lot cheaper than £80 per month, I am sorry but you are being ripped off with poor nutritional advice.
You can also ask your gp to refer you to a hospital dietician, please don’t waste your money any further.

A nutritionist is anyone who says they are. If you want qualified advice the protected title is dietician.

It sounds like you are paying someone with a quack qualification and they are giving you terrible advice.

Why are you not paying a dietician instead?

That's not really true. DH was on a clinical trial run via his GP by Diabetes UK - he wasn't severely obese and was monitored properly, but 800 calories a day for some months reduced his weight down to a correct level and reversed his T2 diabetes. It wasn't life or death, he could have carried on with his medication as it was under control, but that's far from ideal and he wanted to be free of diabetes and lose weight.

What is it about the fact that you are not in calorie deficit, are severely obese, and are clearly paying a charlatan that you don’t understand?

I've just seen the ingredients they've got so much shite in them! There's a huge amount of evidence lately about how UPFs are contributing to obesity which you may benefit from looking into.

It’s huge. That’s a life-limiting size. At 175cm it’s a weight of 125kg, over nineteen stone.

It’s not helping anyone to suggest that that is not severely obese. The middle of the healthy range is around 65kg. She’s carrying an extra one of me around her waist, plus a very large cat.

Slightly diverting the topic but is there a contraceptive option that isn't linked with weight gain?
I'm too old to go on the pill (according to GP last time I asked), I have a mirena and it's due to be replaced in a few weeks. I like the fact that I don't have periods and it's hassle free for 5 years but I do think I've gained weight since having it fitted.
Would love a contraceptive that still stops your periods AND doesn't affect your weight but don't know if that exists??!

Yea she is and she knows she needs to lose weight but she will lose weight on 1600/1800, she doesn't need to be eating 800

She is clearly eating more calories than she thinks though and that's her main problem. It doesn't matter if she's paid someone 80 a month to tell her what to eat if she's not doing it. If she's not weighing and measuring her food and tracking everything that she eats and drinks then she's bound to be eating more than she should be and that's her problem.

Not the rice, not the bagels, not the calorie amount she's been told to eat. Just the simple fact she's eating more than she thinks.

And that's very easy to do if you're not tracking.

Would love a contraceptive that still stops your periods AND doesn't affect your weight but don't know if that exists??!

I think it just varies from person to person. Some people get side affects like weight gain, and some don’t. It’s just trial and error and finding the right thing for you.
It may sound harsh - but I don’t think it’s as simple as ‘the contraceptive made me put on weight’. A contraceptive can slow your metabolism or cause you to hold on to the pounds, and if you realise that’s happening and you choose to continue taking it then you need to balance it out by eating less and possibly exercising more. No pill or medical device can magically make you gain weight from a calorie deficit. Wouldn’t that be a great way to solve hunger and famine?

eating 800 calories a day is not good for anyone unless it's a life or death situation

Being morbidly obese - or even obese - IS a life or death situation.

If you're obese, or morbidly obese, the single most important thing you can do for your health is drop a significant amount or weight ASAP.

Drastic diets such as 800 calories, are recommended when drastic weight needs to be lost urgently. They're approved by actual dieticians (as opposed to unqualified 'nutritionists') to include all the essentials and are evidenced to have reversed T2 diabetes. They are also time limited.

At a BMI of 40 you would easily lose 4 stone + in 3 months on a VLCD and be at a far reduced risk of all types of issues as a result...and in a much better health position than the person of the same weight who lost a pound a week the more usual way.

Saying its not good for anyone is demonstrably incorrect.

Agree. No contraception alone 'causes' a bmi of 40.

Also, have you tried intermittent fasting? I stop eating at 6 or 7pm and don’t eat again until around 11am, I have eaten like this for years, way before it became a thing and I’ve kept the same weight for years. If you follow this with a lower carb, higher protein way of eating (definitely dropping the skinny bagels and jam) you should definitely start to lose weight especially with the exercise you do.

For significantly less than the £80 you're paying a nutritionist a month can buy Saxenda from an online pharmacy without going through your GP. I did exactly this only with Orlistat.

I don’t think OP will be back, she didn’t sound too happy that people didn’t like her nutritionists advice - which is a huge shame.

Its always sad to see people getting ripped off by quacks who claim to know what they’re doing.

Especially sad as OP if feeling so low about it all :(

@Chillypetal I agree, it’s a real shame as there is some sound advice on this thread. I feel bad for the op as the ‘nutritionist’ is the one in the wrong here, taking her money and giving her a plan with so little real nourishing food.

Is your 1600-1800 a day including your extra treats and wine? Those little things can add up quickly. 1800 probably isn't a massive deficit, so adding a few treats can easily take you out of your calorie deficit.

Either way, your nutritionist sounds awful if he's kept you on the same plan for a year while it's clear that it's not working. I wouldn't sniff at giving another diet like Slimming World a go if that's what the clinic recommends.

I haven’t read all the replies so sorry if I’m saying the same thing as everyone else but I’m alarmed at what your nutritionist is telling you to eat.

I also pay a nutritionist for weight loss advice so I don’t agree that they’re all charlatans, but for me it is actually working…

I’m stunned that a nutritionist who knows you want to lose weight is recommending so much sugar/carbs. Bagels? Rice? JAM?! Surely your body can never burn fat if you’re feeding it a constant supply of sugar to burn first?

Maybe it is the contraception that’s causing the plateauing but my first port of call would be to cut the extra snacks, the wine and all that sugar and increase the protein (lean protein, not cheese).

@Clettercletterthatsbetter if you are paying someone why would you not pay a dietician?

Well, yes, I probably could, but I like the lady I’m using (nutritionist & PT) and it’s the accountability I need, not the science behind the food (which I have a reasonable grasp of anyway), although she does that too.

It’s working for me, and it’s a short term cost that’s providing me with a solution to a longer term problem.

You need a new nutritionist
that example day of food is awful.
and clearly it isn’t working if you want an injection that will stop you eating

Why after 18 months is your nutritionist not doing something to help you, just taking your money each month

slimming world is clearly shite and so is all nutritional advice on the nhs so I do get your frustration there

Ah the op has gone?!

&80 a month on. Nutritionist? They've done a plan....what else are they doing that they need paying monthly for?

That £80 and a £ reduction on food costs could fund her saxenda

And then she would be in my position... 3 stone down in 4 months and in desperate need of a belt today as work trousers keep falling down!

That nutritionist saw the op coming!

Dh has lost nearly 3 stone in 3 months by graft- he was eating anything he felt like-fries, sandwiches, crisps, coke and has turned into a 3 meals a day where he now has eg a smoothie for breakfast with flaxseed, oats, carrot, pineapple, apple, banana, berries, and water. Lunch egg fish or chicken and a salad but with tons of superfoods in there. Dinner what we eat but a healthier version which nearly always has turmeric in it. He never eats after 8 but has a health food store tea. He has a coffee at 11. He has changed his attitude to carbs and now has 2 slices of homemade brown bread. He says he thinks more of it is the not eating after 8, cutting out white bread and fizzy drinks and crisps. It was a month of misery at the start and then he started loving all the different foods and he said you just have to get used to being a little hungry sometimes but not as much as people think. His mood is much better because of all the superfoods. This is not for you OP and not for anyone who's weight is because of medical issues but just in case the smaller change can help someone because this is a helpful thread. He swears by the book how not to die and cookbooks from jamie oliver and joe Wicks. Hope things get sorted op

I love bagels, but will eat one bagel a week only. Can’t imagine eating 3 a day. Agree with others your nutritionist is a joke and you should aim for around 800-1000 calories a day + exercise to lose weight.

Is this recommended for weight loss by your nutritionist? They’re a quack.

THIS WITH BELLS ON!!!! Your "nutritionist" is a scumbag who is every bit as bad as slimming world. You're not going to lose weight on this diet, and with 6 meals a day (all bar one carbs based - WTF) christ knows what it's doing to your health.

The reason I hate slimming world is because I automatically think of stuff exactly like skinny bagels and 1 cal salad sprays. No. Swap the bagel for an egg, drizzle some olive oil, and you're not going to feel hungry enough for your next jam bagel 2 or 3 hours later.

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.

Please stop paying them. Seriously. You can talk all you want about macros but you might as well be eating McDonalds all day every day for all the good this diet is doing you. In fact I could probably give you a better one using just the McDonalds menu 🫠.

Stop eating processed food and stop spiking your blood sugar 6 times a day. Have two meals with as much veg and fat as you want and a moderate amount of protein and you won't need Sexanda.

I'm honestly not sure what you expect Sexanda to do for you anyway? Afaik it just suppresses your appetite, but your appetite is such a mess because of the way you're eating. You could fix that yourself in a relatively short period of time by fasting and getting rid of all those full-of-shite ultra processed foods like skinny bagels, shakes, 1/2 bags of rice (sounds like Ben's?), chicken sausages, protein yogurts etc.

I'm sorry, I know you posted because you're feeling low but I just can't not say this when you are being taken for a ride by this charlatan and defending them. It sounds like they've really pulled you into their web because, well, who in their right mind would listen to a nutritionist who tells them they can have an extra jammy bagel if it's a training day WHERE THEY LIFT WEIGHTS.

A fucking jammy bagel. 💀