Morbidly Obese - does anything work?

[FatsiaJaponicaInTheGarden]

I'm really very very big. I think for a mix of reasons (undiagnosed adhd/autism perhaps, I have an assessment I'm waiting for which should come round in Jan) so difficulty paknning/organising and sticking to routines and meals.

Also I don't seem to be able to recognise full signals or "not hungry" if something looks nice. I've read about hunger scale and tried to work with it and it doesn't stick.

I'm not stupid. I have a v high IQ but this is an area I'm repeatedly failing. It really isn't that I've not tried. Something is wired against me I am sure.

(I do also have trauma/difficult childhood and issues then around scarcity of food...I also have ME/cfs which is when it started building up as I was less active)

I've only really got this ridiculously big since I had children and everything became harder - probably put on 10 stone in the 14 years 😬.

I'm so ashamed. But I also seem to fail at everything. (generally, keeping house organised etc although kids are doing well and have a good life overall).

I am wondering what really works if anything for morbid obesity.

I really am scared of surgery and long term possible danger from it from reading scare stories and having to compensate for it for life. I do realise this has worked for many people.

I'm contemplating injections but also aware that people seem to put it back on when they stop them.

I'm a bit wary of side effects too (especially fatigue as I already suffer fatigue which inhibits what I can do day to day).

We are not high income (just above U level) and if I pay for these it means kids won't get other things but I'm really desperate as it's inhibiting my quality of life (can't walk or stand for long - I used to love walking!)

My hope is to become a different person and by being a normal weigh be able to access fitness and walking again and deal with other physical issues as doctors only see "fat" at my weight. I want to take part in society again and choose clothes and be normal.

But it looks like all roads lead to weight regain, and in scared.

I'm at such a huge weight that I know my brain/body/chemistry etc has been altered so it's different to someone trying to lose a few pounds.

I understand the not understanding hunger, I am ashamed to say I don't know if I have ever felt hunger until very recently when I have started calorie counting.

Have you ever spoken to GP, I would suggest that as first stop and see what they can offer.

There is a supportive 10 stone to lose plus thread on Mumsnet that you may find helpful.

Your GP surgery should have a weight management programme. Would you tell your GP everything you have said here?

You may need to be on the injections for life, but a first step would be to lose the weight and then worry about what happens next. It will be quite some time before you are a healthy weight which will give time for your body to adjust.

I have been on the injections for six months.

It really helps you control what you eat because you feel full for longer, you feel simply couldn't binge anything.

It just wouldn't even occur to you to do that.

However there are side-effects such as it can make you feel a bit sick if you do eat too much and it can make you feel very uncomfortable if you do that as well

It's been absolutely life changing for me though. I've lost nearly 3 1/2 stone although I do wonder what will happen when I stop, that would happen with any diet anyway. If I can I will always try to have a very low maintenance dose afterwards.

The absolutely fantastic thing is that I know I won't be overweight again. I feel much more healthy already even though I have another stone or 2 to go

I do think if you do it you should plan it properly and look at what people are saying e.g. don't eat after 6 pm if you can, don't drink any alcohol don't drink eat high fat foods, because they are all things that will make you feel sick

Listen you will probably be able to stay on the weight loss injections on a maintenance dose for the long term if you need to.

If you can afford weight loss injections I would go and discuss them with your gp and see what they think. Then if they agree that they sound suitable you could go to a private provider for the prescription.

If you don't have the funds the GP might be able to refer you on the NHS if you are very overweight.

Good luck!

A lot of people on the weight loss injection threads are saying the injections really help their ADHD symptoms, so they might have wider benefits for you OP.

Regarding the cost of injections, many people find the saving on food costs (esp snacks) more or less pays for the injections. And it sounds like your DC would benefit very much from you dealing with your weight so this should be balanced against having less money to spend on them if there is still a net cost.

I was coming on to say what @waszpy said. I have ADHD and depression and anxiety ( and dyslexia and dysbraxia) and one of the most amazing things the weight loss injections have done is fix my mood. For the first time in my life I don't have depression. I can focus better and honestly my ADHD symptoms are under control.

I am also losing weight. In terms of the price I do completly understand the concern however with vouchers and switching suppliers you can get the price down to 140 ish. However while this sounds like alot personally I'm saving that other place. No nipping into the shop for a treat and our food shop has drastically reduced so I think we're roughly breaking even.

It's hard to imagine anyone opting for surgery with the advent of the injections. I'd be really interested to know who is still considering the surgical route.

Whichever way you go, @FatsiaJaponicaInTheGarden , just be confident that there are options and you can do this. Deciding to start (injections, intermittent fasting, exercise or whatever) is one of the biggest hurdles. I know, I too was stuck for a long time in an indecision paralysis. Once you just think "from today I am tackling this" you have taken the most important step.

Just for information, I used a combination of low-ish carb, intermittent fasting and exercise- this was before the injections became widely known though. Now the injections are there, they are apparently very successful so that changes things.

I don’t know anything about weight loss injections, but I am autistic and I was morbidly obese. I lost about 10 stone over a couple of years (before injections were a thing). I tried many different diets and most failed. The thing that worked for me was one day deciding that enough was enough and completely overhauling what I ate. I cut out all sweet things and all snacks - chocolate, biscuits, cake, ice cream, crisps etc.
I then added huge quantities of vegetables to lunch and dinner. I didn’t even really change my dinners, just smaller portions of the main bulked up with a lot of vegetables.

I understand that cutting out whole things etc isn’t supposed to work, and the idea is to make small changes, but I found that small changes were too easy to forget or “cheat” at, whereas point-blank saying to myself “I don’t eat cake” was much easier.

I think as an autistic person, so much of life is a routine, and so making small changes just feels wrong because you’re corrupting the routine. But making huge changes is like resetting the routine/starting a new one, so actually much easier, especially if you’re motivated and excited to start it, as that helps cope with the change initially.

After my weight loss, my weight has been pretty steady for the last 5 years. I do now eat the odd bit of cake or chocolate, and I do enjoy it, but it’s everything in moderation.

I’m not saying this is the best way (or even a good way), it’s just what worked for me.

It's not you, it's physiological processes. I was reading a study this morning that proves that fat cells basically 'remember' obesity and strive to return to that state.

It still might be worth it for your health to lose weight for short periods.

There's going to be a wave of cheaper weight loss pills coming out over the next few years. Apparently.

Thankyou all for your replies.

Sunshine - yes I've spoken to my GP, and also the nurse practicioner at a different appointment. Pretty unhelpful all round which is a shame as I doubt myself so much I could do with support from somewhere. GP said it's "calories in/calories out so could just eat several mars bars a day if it meant coming in under calories". NP was sweet but had lost a few stone herself and said you just have to walk 10 a day (I have limited mobility) and control eating. I think to get to morbid obesity it's a whole different game tbh.

Frozen - there's a local number you ring (tier 2) and you get 12 weeks slimming world or weight watchers. Or phone calls. I had phone calls last year and lost a stone but they finished and I've got 10stone to go. They were general "what are you going to try this week" chats which were nice but not enough. Dr was quite dismissive other than I needed to lose weight and seemed to suggest I go back to her if I want surgery. But I don't. I'd rather try drugs first before something lifelong.

Its great to hear some people are flinging it helps with mood. One of my fears both with this and adhd meds if I get them is lack of sleep/increased anxiety and I saw some people with MJ get weary/low mood.

I can't really afford them. I think I grasping at straws. I'd like a better job but it goes round in circles with what I'm fit for. I'd pay long term if we earnt enough.

I don't want to do it for a year, lose the weight and it all come back on. That's probably my biggest fear and would be a waste of money that otherwise would have been spent on kids.

@Thriwit wow that's incredible!!! Well done. I think that's part of my problem. So much literature says small changes but my mind struggles with that and wants black and white rules. But then I stick for a few months. I kind of want someone to guide me.

I'm genuinely so impressed you've done it. You must know how amazing that is. Statistically very few people lose a large amount of weight and keep it off.

I think my current plan is to see if I get adhd meds prescribed end Jan and then need to leave that to settle a whole (not sure how long it takes to settle??) and then try injections.

Everythingnin me wants to start injections now but I don't want to confuse with adhd meds if I get those soon and they will be long term hopefully so I guess should have priority.

I don't know where to start (again). My job is variable hours which is a nightmare. I've been for other jobs this year and been thinking "if I just get a routine I can get my eating sorted" but the hours and sleep and stress I currently feel is horrible. Is like a job with set days. Or one I could just turn up to.

I am so tired so much of the time. I am worried about strength too as I sit (or lie) most of the day. I need to lose weight so I can be active and need to be active so I cna lose weight.

Currently it all feels impossible.

I asked the NP what the surgery tended to think of wli and she said it was mixed but overall it was negative...

What I'd love to afford is one of those programs with support. Or a personal trainer (ha not in my budget) or someone to guide me through it.

As for saving money with food. Im not sure. I am very inactive. I am not ordering takeaways. I do eat cheese so that's a few pounds a week, and odd packet of crisps. I just eat too much dinner. And cheese. And eat too many carbs. Often cheap carbs as its quick and easy when my brain isn't functioning.

I suspect going properly upf and eating properly will cost more rather than save money for injections...

I hear you @FatsiaJaponicaInTheGarden and am in the same boat! What's most annoying is that I've lost it all before and put it all back on again.

Speak to your GP and see about the tiered weight management program. My understanding is that when you get to T3 (which usually ends in surgery) there are a number of steps before that, including psychological interventions. I found CBT to he quite useful, although do really struggle with building new habits because of the ADHD

That said, ADHD medication has been a game changer all round. I'm no longer using food to get that much needed dopamine hit and the weight is dropping off.

Stay strong 💜

Two recommendations from me. The book Why We Eat (too much) by Andrew Jenkinson to understand the science of obesity (and also why surgery works) and get some guidance on what to eat and The No S diet (free website or book) for some simple rules on when and how to eat. Sticking to any diet is the key but I think these are the easiest to stick too and make a lot of sense.

@PigInADuvet I don't know if our area is particularly bad but tier 2 is ww/SW or weekly chats which I've had and googling tier 3 it's very much pre-surgery but a session on healthy eating (! Suspect most of us have some idea) and 6 other sessions and not much more other than getting you to lose 10% for surgery.

That said when did you start adhd meds? I'm genuinely hoping they will support me in managing life a bit better and therefore helping with weight regulation. Is it helping with routines and how much have you lsot? I'd love for adhd meds to help me lose 10 stone but....

Voyager - thankyou. I will have a look. I know surgery works for a lot of people but it also doesn't for a lot of others so if I could get there another way even drugs I would..

No one wants to be 21stone. Its such a struggle when people just think "oh eat less" but I feel I'm constantly fighting my brain on so many battles.

Also life is unsettled. If we had a house big enough, tidy, routine jobs etc I could give it more energy but it feels like constant chaos and I'm always anxious about work until I find a new job. Which is ellluding me. Being 21stone doesn't help with that either....

Medication started about 3 weeks ago. I am calorie counting. I've been calorie counting for the last 7 years. Badly. Inconsistently. Will stick to my 3000 calorie a day goal for 2 days and then go spectacularly off the rails for weeks at a time before starting again. And again, and again, and again. I'm on daily medication for an unrelated medical condition, which I've not taken consistently for years. I just can't.

In the last 3 weeks, it's like a switch has been flipped. I've not exceeded my calorie goal once. I've eaten well, I've eaten good food, but there's not been a single binge and I'm not even thinking of food between meals. I've also taken my medication consistently 3 times a day since day one.

I know it will slow down but I'm 3 weeks in and am a stone and a half down, the most I've lost consistently in years.

Wow piglet! That's amazing!!!

I need to check my blood pressure as I don't want to be too high for drugs. Which one are you on? How did you find the whole process?

The book is more about how to lose weight without surgery than it is about the surgery but it explains both in terms of hormones - it is so interesting. It was written before GLP-1 medications were really a thing but does talk about those hormones and how they work naturally.

mounjaro has been the answer for me and fasting 16:8 &18:6

It is the only way I found that works on my mind control and is not an epic battle.

It helps your brain signals to change.

It is not a miracle drug you still have to work with it but the urge to overeat diminishes and I find I can manage hunger much better.

I have lost 5kg in my first month on 2.5 mg and I have another 50kg to go to get to the middle range of my normal BMI. I am hoping to be at this weight by December 2025.

I am in my 50’s with Hashimotos so I have always struggled to lose and keep weight off.

You can’t out exercise a bad diet. It is all about the food.

I am hopeful the NHS will introduce them in the next 12 months anyway.

It maybe a lifelong commitment.

I know the cost of the injections are going to mean other sacrifices for you and your family but I bet your children would rather go without a few things rather than go without their mother.
Sorry I don't mean to sound harsh, but the bottom line is being morbidly obese puts you at significantly higher risk of dying young.
See this as an investment for your whole family.
You will be healthy, happy and be able to do stuff with your children that I bet you avoid or can't do now. Like just playing in the park...
Maybe ask everyone you get Christmas presents from to give you money to start off first month ?
But honestly OP ...the injections are life transforming , even life saving.
I. Am a GP ( part time) and I'm sorry they weren't more understanding, in the end yes you do have to eat less calories but the injections give you the mental control to do this without feeling obsessed with what you can and can't eat.
I was overweight and have used them to lose 12 kgs...so now very much in lower end of healthy BMI, I am titrating a dose to find maintenance to stop it going back on. But first lose the weight, you'll feel more confident to manage maintaining then, and your life will be full of other things rather than thinking about food.
Good luck x

I was started on methylphenidate and wasn't sure what to expect. I expected it to take some time to build up and show any change but it happened pretty much straight away. Was warned about side effects and that it might take some time to find the right medication.

One of the side effects is loss of appetite but I don't think that's what's happening for me. My appetite is fine, but I'm not seeking food for anything other than because I'm hungry. I'm eating 3 meals a day with no snacking in between which is unheard of. Literally never done that in my life before. Instead, what I'm not seeking, is that feeling that only 4+ slices of toast/a family bag of crisps etc. was giving me before, which (no exaggeration) is akin to what I imagine a heroin addict to feel after a hit.

The other thing I've noticed, is that I'm no longer compulsively spending money which is an unexpected win!

What stood out for me is your comment
” I don’t want to waste money on injections if I could spend it on the kids”
you are worth it. They would rather have a happy healthy mum I’m sure.
mounjaro has been life changing for me and I do it with 14:8 fasting plus exercise it changes your hormonal reaction to food it’s like the missing link for me and many others. I’m also suspected ND as have two kids one adhd and one ASD.

For me Slimming World did work, for a time. The last time I joined I got to 3 and a half stone off before it all went to shit, but I hate rules, I hate being told what I can or should eat.... if you like having a clear set of rules, it may be for you and after losing a few stone, maybe it will give you a little more confidence to want to do something for you and jiggle your budget to see if the injections are doable x I am on Mounjaro jabs at the moment and it's going well, but I do have to find the money each month and have to go without other things to afford them (live on my own so it's just me going without), so I do understand the cost thing. I just decided that I am worth it and by cutting here and there (no more food outside my home, packed lunches for work, more aldi, less asda, no new clothes.....) I can just about find the cost each month x x

Op I can't believe the NHS is still sending people for weight loss surgery without trying the meds first. That's madness!