Booked GP appointment, what can I expect?

[TheSweetEndOfTheLollipop]

Essentially my appointment is to talk about weight loss, but possible perimenopause symptoms too (brain fog, tiredness, anxiety)

I'm 43, 5'7", haven't stepped on the scales yet but imagining it will be about 19stone.

I've been overweight since puberty was consistently 14 stone until I married and had 3 children.

I eat fairly healthily, mainly all cooked from scratch, plus snacks, but I have an issue with portion sizes, and emotional eating. It's taken me a long time to start facing it but I have a very narcissistic mother with her own weight issues, and I'm desperate to unpick it all, both emotionally and physically, and have a healthier outlook for both too.

I'm not sure what I can realistically expect from the GP re weightloss/medication/therapy/dietician?

I filled in an online form and was very honest with them on why I was booking the appointment. They have done blood tests which were hormones, thyroid and liver. Liver came back ever so slightly sub par, others normal.

My appointment is on Tuesday, and I'm not sure what I should be asking for or expecting?

Any help gratefully received.

I got a referral to a 12 week weight loss group hard to get to on a day I work. And a link to healthy eating websites. Could get 6 free counselling sessions based at Gp’s though. But my issue is eating too much and liking unhealthy food so my bmi is 32!

hope it is helpful.

Thanks Springing, that's very helpful.

Lots of people seem to be ordering weighloss medication but paying privately. I'm not sure what kind of things I can realistically expect the GP to suggest. I'm pleased hear they offered emotional support.

I got a referral to a stupid weight loss app which is tier 2 in the NHS. I have an eating disorder and it really doesn't suit me. They don't have enough staff to give any personal help which the NHS is paying them to do. Got an appointment to tier 3 soon but it took 8 months on the waiting list.

brain fog, tiredness, anxiety

Those symptoms can be caused by plenty of other things. Did you have your B12 checked? What was the level?

All I can say is good luck and I hope you have a better outcome than I did!

I'd already done the 12 week programme twice and all I got from my GP recently was a text after our phone consult to another 12 week programme that was online (that I'd already done!). I've been asking for help for 3yrs.

I'm under the chronic pain clinic and it's 'lose weight, lose weight' but with medication that piles weight on and no GP support, I'm seriously thinking how heavy do you have to be for help and how much more should I eat to reach critical mass?

Thank you Jessie, I'm sorry you've had to wait such a long time.

I'm a bit worried I might get locked into not getting help, but at the same time no idea what I can be realistically asking for. An app feels pointless for me, there are plenty out there and I use MFP. It's more psychological help.

It's a great point Waist, I don't think I've ever had vit levels measured. I take a multivitamin so assumed that would cover it, but I'll definitely run through it with the GP, thank you.

Tin, I'm so sorry for your experience. The media, NHS, gov etc constantly bang on about obesity and how it must be reduced, yet when people approach GPs it seems like there isn't much help. It's such short-sightedness.

What is the 12 week programme? Is it dietician/therapy/dietplans/gyms?

What would you like your GP to do? I'm wondering this myself, what am I actually expecting them to solve (without a magic wand!)?

Call me a tin foil hatter but I don't believe the government really wants to reduce obesity, they haven't done much to show that they do.

I mentioned vitamins because I found out I had a couple of pretty hefty deficiencies. They didn't cause weight loss directly but getting them sorted gave me the energy to lose weight.

I was in a similar situation to you before losing weight this time. I used to cook healthy meals from scratch. But I used to taste during the cooking process (which sometimes you have to) and always have an extra helping.

I have stopped cooking in that way because it was something that made me overeat. I now have much simpler meals lower carb meals like wilted spinach, feta and a poached egg (I'm veggie).

Yes, it's a shame because I know how to cook amazing lasagnas etc. but I'm far happier/healthier now I've broken my ties with cooking. Maybe you could consider switching like me?

I hope you get some help from your GP.

probably diet and exercise advice, possibly in written form or through the diabetes 12 week programme

its not really a GP issues thought really, is it, it is something mostly under individual control

My brother got the 12 week weight loss app thing and some diet advice. He drinks quite a but if alcohol and was told to quit that too and had bloods, blood pressure etc.

I was told they can't prescribe the injections (wegovy or whatever) unless you're diabetic as the trend for everyone taking these (even thinner people, including celebrities) was affecting supply for the patients who need it to help control their diabetes.

*quite a bit of alcohol

We can refer to a weight management team. There's a twelve month wait.
Two year wait for a dietitian.
Usually point them in the direction of the local weight watchers or slimming world if bloods are normal.

I disagree, I think it is a GP issue because once someone develops type 2 diabetes that's got huge health implications. Not to mention the role of obesity in causing cancer.

This is the advice the GP will (should) follow. If you scroll down the link you’ll see the scenarios in which a weight management service can prescribe the weight loss injections.

might be helpful to read this through prior to your appointment so you know what to expect.

it might be necessary to book a separate appointment to discuss menopause symptoms

https://www.nhs.uk/conditions/obesity/treatment/

Don't expect much they know very little about nutrition they'll probably refer you somewhere else.

If your diet is healthy but portions are wild get some kitchen scales and start weighing things out. Weighing food is the only way to grasp what a portion actually is! A correct portion of things like pasta and rice is depressingly small but until you see it's hard to grasp how big a calorie difference 100g is as opposed to 200g which still doesn't look like a vast amount of food.

When I was obese I'd guess my portions were 3 or 4 times what they are now.

They're not trained to deal with it properly and they don't have enough time during an appointment to address it even if they were!

It's true that some of the NHS advice is plain wrong. For example they still advise type 2 diabetics to eat carbs 😒
I'm not in any way implying the OP has type 2 diabetes, btw.

@TheSweetEndOfTheLollipop do you feel you know what works to lose weight but struggle to implement it, or do you think you need to know more about effective methods of losing weight? I think the two situations are pretty different.

I've had weight issues all my adult life, and found NHS help, very limited. I was first recommended the 12 week nhs weight loss plan, WW or Slimming world, then reffered to tier 3, but only when my weight had reached 18 stone and I had sleep apnea, diebetes and very high blood pressure. Tier 3 can access, tier 4, weightloss surgery, but this can take years in my area, I was told 4-5 year wait even if your approved for surgery. I knew I couldn't wait that long as my health was deteriorating, so I chose to have a mini gastric bypass, last month, privately in the UK. It was expensive, but worth every penny, as I feel I've got my life back, I've lost 3 stone, and feel so much healthier, although I realise it's drastic and not for everyone.

I agree, obesity is a public health issue, and affects everyone, as we all pay for it, but it is not a GP issue, in that a GP can't do anything about it, only an individual can.

I hope you understand that cancer causes obesity more often than the other way around

12 week programme - definitely no therapy or dietitian support. No gym! It was a series of online Teams meetings or face to face group with a nhs paid worker who read from a script and pressed buttons to show nhs videos. A fancy booklet that was rarely referred to or used. When asked questions, the said worker had no idea.

oh did get a video about doing exercises using a chair!

How did it go in the end, @TheSweetEndOfTheLollipop ?

I went to a private GP at the start of August because I wanted a longer appointment. He listened to my web of issues, weighed and measured me, then recommended the keto diet. I lost 2.5 stone in first 2.5 months, next check is new year. I don't weigh myself in between , but my DH is having to punch extra holes in my belt so that's good.