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.

To some extent the calories in/out point isn’t an unreasonable one, but taking it a step further and considering your macro’s (protein? Carbs, fats split) too will ensure you’re getting the right balance.

Online, there are total daily energy expenditure (TDEE) calculators. You add your height & weight, and movement frequency and it will guide you on how much food you need to consume. Note that as your weight reduces, you’ll need to rerun the numbers because you’ll require less calories.

From there, you can download my fitness pal and input your numbers, and then track your food against your plan. It has a barcode scanner so it’s really easy to upload what you’re eating on the go and stay on track. If you’re able to follow this religiously, you will likely see some success, but it’s an honesty piece with yourself in terms of tracking everything.

Once you’re a more comfortable weight, you should find movement easier too. Ignore the 10k steps per day guide, but if you can increase your step count beyond what you do currently then you’re heading in the right direction.

Above all else, be kind to yourself and don’t try to make huge unsustainable changes all at once. You’ll feel a sense of failure when you inevitably have a.bad day (this happens to us all). Instead, I’d say try to make a small change each week, and bake that into your routine. You might even prefer to start with hydration. Glass of water in the morning as you wake & take vitamins. Then move onto understanding calories & macro’s and focus on finding a nutritious breakfast. Then add in lunch, then dinner. And by that point you’ve built some really healthy foundations.

I'm afraid it's about jumping through the hoops though. It's only by completing the Tier 3 programme (even if you feel it's useless) that you could have access to weight loss injections on the NHS. Otherwise you have to pay as GPs literally are forbidden to prescribe them apart from for diabetes. I would think that, as you are not looking to start injections straight away, you could enroll in the Tier 3 and possibly by the time you are ready you might be eligible to get them without paying.

@Caffeineneedednow really? That's encouraging as I have been afraid to consider them as depression is supposed to be a side effect, and I already suffer from it.
OP, I am autistic too, and rubbish at interoception, so can't tell if I'm hungry or full. I share your problems with executive function also, so I do sympathise.
If you're very obese, can you not get the injections on the NHS?
I am on the waiting list for Tier 3 "complex obesity" services, but am in Wales and our waiting lists can be one or two years. 😔

It looks like from Google MJ injections were very recently okayed and in our area there's a 3 year plan. Initially you have to have 3 of their additional factors from a small list and I have none of them.

So it doesn't look like I could get injections on the NHS.

Yes I completely agree it's mad NHS will do surgery before it will try drugs I'm already 50bmi so I need help now...

Re "wasting money" I just mean if I do it for say 2 years then stop and all the weight just goes back on (set point theory?) then it will have been a waste.

It absolutely won't be if it works...!!

To the GP who posted. THANKYOU SO MUCH. I feel so unsupported by my gp and just looked down on/willpower etc etc. and it means a lot to have GP say yes this could be a way to reduce weight risks (yes it scares me, as well as risks of inactivity etc)

Re calories in calories out. I think some of the books people have mentioned shows it's purely not that simple. If I just ate 3 mars bars for breakfast (as per my gp) then nothing all day I'd be under calories but ravenous by night. It's got to be what the food is and the effect of food and also our inner drives.

Ive really found those posts by others with adhd/autism helpful, as yes I am hoping the dopamine seeking type behaviour might reduce. The "I need this now" also the going for cheap cars as I don't have mental energy to wait/make something.

Sorry long post but appreciating everyone's comments. I'm not quite sure what to do right now as it does look like I'm hoping for adhd drugs and then a few months later MJ.

I used to want to dk it all without drugs but I failing.

Try not to be too hard on yourself OP, you are where you are, acceptance of that without beating yourself up about it is important.

The great news is you want to do something to solve the problem and you’ve lost a stone before which is great, you can do it again. Try to focus on the positives, these are the first 2!

I’ve found calorie restriction is always a temporary gain - try reading The Diet Myth by Tim Spector.

You say it’s taken 14 years to gain the weight so it will be a long process to lose it again, important to prepare yourself for that psychologically and not to expect miracles, because it’s really easy to lose motivation if the scales don’t drop everytime you step on them.

Avoiding UPF if possible has been great for me in terms of weight (possibly not so easy if money is tight) but I would maybe just try and focus on eating better this week than you did last week. You say cheese and crisps are your thing, if you’re eating these every day can you try cutting down? Say 4 days next week, then 3, 2 etc. Trying to go without altogether is bound to lead to failure.

Maybe try weighing carbs as well so you are eating a typical portion, it’s so easy to overdo these things.

But I think the main issue here is a mental one, try being kind to yourself, and if you do fall off the diet wagon (which you’re bound to at times) remember that’s OK, but get back to the plan as soon as possible, try not to despair too much.

The NP at the surgery said it was unregulated and the best way was exercise /diet. But for whatever reason my brain is sabotaging all my attempts at this.

I think for losing a stone or two lifestyle management can work. I think at 50bmi my own fat is doing its own thing with hormones and brain signals and what not.

I agree with you. Can you see a different GP?
I use carbs to self regulate and as a stim. Am working on changing the behaviour (binge eating) but have done it for decades so it's not going to go quickly. Also looking at harm reduction.
I pay for private therapy,which is great but not specialised. tThere is.no specialised therapy here for ND people and we are not permitted to access usual therapies as our brains work differently.

I was like you @FatsiaJaponicaInTheGarden and just couldn't put down the food, then a friend introduced me to Overeaters Anonymous oa.org/ (like AA but for food). It's incredible and it brings food sanity and abstinence. For me that is 3 meals a day with nothing in between. There's meetings online almost 24/7 including specialist ones for people with over 100 lb to lose, neurodivergent, etc as well as face to face meetings. It's all volunteer run so funded by donations only and every meeting would rather have you there than your money. It's also much less risky than operations/drugs which often stop working when you stop talking them. Happy to be DM'ed if that would help.

I started Mounjaro last year with ten stone to lose. bMI was 42 and weight 18 stone. I am halfway there now. Still obese at BMI 33 weight 13stone 12 so I count myself successful.

I have adhd and autism and always had terrible interception etc. also eat/crunch as a stim. Mounjaro really helping with all of that after maybe 8 weeks? Also do feel tired, but not much more than usual and mood feels so much more stable. Would recommend and also sending support. Eating can be so very complex for us, I do know I have messed my metabolism up catastrophically over the years so am hoping to lose weight ( have lost a stone already, could lose as much as 4-5 more ) but the quiet of the food noise and blood sugar swings has been even better xx very good luck xx

it is sooo hard. But I like the saying ‘choose your hard’. It is hard being so heavy, and it is hard finding the money/making the changes/facing the fear etc

i can’t always (often) control/actually make choices and the injection is making me feel more able to do so

would be a waste of money that otherwise would have been spent on kids

I think if you could manage to free up the money (and bear in mind you are likely to spend less money on food, which will counteract some of it) that having a mobile and happy mother would be the best possible investment you could make for your kids.

I used to weigh 18 stone... Got fed up and had a gastric sleeve.
It actually cuts out the area that contains the chemicals that tell you your hungry, so not only can i only eat a small amount but i am less hungry.

People think its drastic, but i knew i needed a perm solution for life and i couldn't be more happy. currently weigh 10 stone

We are not high income (just above U level) and if I pay for these it means kids won't get other things

The most important thing to give your kids is a healthy Mum. I'd hope you could get help from your Doctors though. Good luck.

The injections are not a long term solution, I've tried them. I knew I couldn't afford it long term, so I used the lowest dose for three months and as a pp said it completely alters your appetite, and how you feel about food. I thought my system had been 'reset' but within a day of stopping all that food noise came back, along with my appetite and cravings for food. I put all the weight back on again, so I'm going against the grain and advising you not to deprive your dc of things in order to buy the injections. If you could afford it easily I'd definitely say give them a go.

When did you get this done? I know a few women who did it, and over time they all put a lot of weight on again, and had quite serious long term side effects. Have you had any?

Your brain and your body are sabotaging you because that's what they're designed to do, the mechanisms will be dysfunctional.

I second the pp's suggestion of reading Why We Eat Too Much. It's so enlightening, and explains why diets don't work, especially at your BMI. The author is a leading bariatric surgeon.

I would go on the injections if I were you, and stop torturing yourself with traditional diet advice—it just won't work for you, you need to reset the mechanisms in your body.

Different things work for different people. I found that the way I lost the most was prepackaged food, and sticking to it rigidly. I also after a month look up running (with now exh) - this combination of restrictive diet and exercise lost be 1.5 stone in 2 months, I then went into the next phase where you cook your own food and it went to pot.

The only other time I lost lots of weight was when ex left me, don't recommend this method

I have zero willpower so now my kids are left home i have no treats or snack in the house at all, I eat at set times only and I've lost a few pounds this year

Thankyou all. It's been so helpful to hear from other ND mumsnetters - I do think lacking interception (knowing when hunger full is part of that) and seeking instant results /not having executive function to plan and cook etc is as much a part of the issue as anything else. Sorry you're struggling too - we could do with resources or support tailored for us.

A couple of people have again said it's worth the money for a mobile mum. Absolutely of that's the end result!! The fear as a pp said is if I spend all that money but it's a temporary fix it would have been better spent elsewhere.

Re saving money on food. I do t think I will be. Cheap bingey food (toast/potatoes/wedges etc) with cheese vs proper nutritious food. It's been shown again and again the Real Food is more expensive!

Long story short, initially had a gastric band 15 yrs ago. I swapped this over to a gastric sleeve six years ago. My gastric band was done in Belgium, the sleeve in Turkey.

I’ve been really lucky and never had any health issues at all. I can eat what I want just a reduced amount . I wanted the permanent restriction. My weight fluctuates by about 7kg, but if I feel it going up it’s really easy to get back on track and maintain.

Wow well done hairy.

I've messaged my gp econsult asking for a blood test. I don't feel supported at all by the gp but I'm exhausted and thought I ought to rule out all the other things before starting anything.

Haven't read all the thread as I've been a bit ill but do you qualify for this latest announcement of them rolling out injections more widely that's been in the news today?

Thankyou - I've looked into it! But it will take them 12 years apparently....

Following this thread with interest as I am also 10 stone overweight, with ASD (and bipolar, if that's relevant). I've been receiving saxenda on the NHS for almost 2 years ( they found, upon testing, that I had mild sleep apnea which qualified me), but I haven't lost much weight (but nor have I gained any weight). I am hopeful of being approved for NHS bariatric surgery as, realistically, I cannot see any other positive way forward. I need something permanent. Sorry, didnt mean to derail your thread, just trying to say, long-windedly that you are not alone OP!

Scrimp and save and do anything you possibly can to buy the injections privately. Once the weight is lost, if you have to stay on a maintenance dose so be it. You will save some money buy eating less though it may not cover the full cost. But you deserve to give yourself this chance.

Thankyou all.

I don't think I'll save money on food as realistically I'm not eating takeaways/I'm eating crackers/bread and ideally to full up on Real Foood will cost more.

Bur completely agree I want to give it a good shot. I'm desperately applying for more stable jobs to be able to do this.