Is there any point talking to GP.

[ArtichokeAardvark]

If you went to speak to your GP about weight loss, what did they actually advise? Beyond the standard "eat less, move more".

I desperately need to lose weight. My BMI has recently hit 40 and my chest hurts when I'm stressed. I have a very volatile 7 year old and a needy 5 year old, so I get stressed a lot. I live in my kitchen (open plan kitchen/ playroom / living space) and don't realise I'm eating half the time. I have no time to exercise (genuinely - my children wake up before 6am, I get them to school, go to work, leave work at 2.45 and hurtle back to school, then have kids with me until they go to bed at 8pm). DH works USA hours so can't look after them in the afternoons at all.

I'm worried that if I go to GP and tell them I'm obese and my chest hurts, I'll just get the standard advice - which I already bloody know and is so bloody unhelpful. I don't have time to attend group weight management sessions (and I'm too embarrassed to ask someone to do childcare so I can go). I want to try the injections but can barely afford it, and I hear more and more stories of the weight piling on again straight afterwards. I'm also reluctant to try them without talking to a doctor first about risks...

Is there any point?

Your current health risks are high, as you know, and you hit the criteria for jabs on the NHS. Definitely speak to your GP. Good luck.

If you have underlying conditions and a BMI of 40 they can prescribe the injections on the NHS. If you don't, it's worth asking them for a Right time Choose referral to Oviva. I know someone who doesn't have the NHS conditions but has asthma and they were prescribed wegovy through Oviva.

Otherwise the GP is potentially less useful I found. They will refer you to a local weight management course, but in my experience that was very much "each vegetables, do exercise" style advice.

I think you can get wegovy for under £100 per month. Can you shave £25 per week off your food shopping bill? You may find you don't buy as much once you are on it.

If your chest hurts with stress Talk to your GP about that, more so than the weight- it may be you need to check blood pressure cholesterol etc

Could be an anxiety response but better to be safe. I honestly don't think the Gp can help much with weightless without long waiting lists and bog standard advice.

Do what you can to get the injection is your best bet.

No she doesn't, not as per the post. Current criteria is BMI 40 and four out of five co-morbidities (diabetes, hypertension, sleep apnoea, high cholesterol, heart disease). The NHS plans to move towards meeting the NICE criteria over the next 12 years in England. Devolved nations similar. And in the area where I am a GP it is a moot point as we have no service, so even those with BMI 40 and 4 comorbidities can't get them.

4 co-morbidities are the criteria. Do you have 4 diagnosed conditions such as diabetes, cardiovascular disease etc OP?

You can't just get them for being over a certain BMI

AFAIK GPs have very little training in food/nutrition - so you’ll likely get given the usual ‘eat less/move more’ advice. However, in your situation it sounds like they would be at least open to prescribing WLI injections for you. (There are other conditions you need to fulfil, beyond just being overweight, but I’m sure they’d test you for those, and they may apply anyway, given your weight.)

WLI are a relatively short term fix - but they seem to be incredibly helpful to get weight loss started, and to allow you to lose a lot of weight fairly easily. (From what I’ve read - I have no direct experience.). BUT - like any weight loss approach, you will need to change your eating habits. They are not a magic solution, and once you stop using them, unless you have changed your diet, then yes, the weight will come back.

But it sounds like they would be the best solution for you right now. Go and see your GP and ask them.

I'd be amazed if at that BMI with chest pain there aren't co-morbidities. It's worth the GP trip just to check for that.

Even if she is eligible it won't be the registered gp unless they have been commissioned to do it, which most haven't, it'll be referral to a wt loss service.

If I have the kids (aged 5 and 2) for the whole afternoon/ evening and haven't worked out, I'll rope them in.

Something like a cosmic kids yoga on YouTube is a fun workout you can all do, or my 5yo would even do the 20 minute HIIT workouts on YouTube with me now

Or why not all go for a walk / cycle?

Think of it like any activiity you'd do with the kids- they may not be that interested some days, but you should still manage to get a work out in

If your DH works US hours and is already missing out in time with the kids in the evenings, could he do the mornings and you join a cheap gym (so you are out of the house so the needy 5 year old isnt bothering you instead of getting ready) so he gets more time with them, your 5 year old learns its okay not to be glued to mum all the time, and you get some exercise, win win!

The GP may be able to refer you to the specialist weight loss service in your area, which will be various combinations of coaching, diet advice, apps, maybe gym membership and so on. There may be a waiting list for it, which may be several months. You work through that "tier" of support and if you don't lose significant weight you may be moved on the next tier of support, and potentially be offered bariatric surgery or possibly Wegovy injections depending on your NHS area. That's the tier of support that Oviva provide in some NHS areas, which is what @SoUncertain is referring to I think.

You wouldn't qualify for Mounjaro injections prescribed directly by the GP as although your BMI is 40, you also need 4 out of 5 specific weight related health conditions, which are:

1. Type 2 diabetes mellitus
2. Hypertension (high blood pressure)
3. Atherosclerotic Cardiovascular Disease (ischaemic heart disease [angina], cerebrovascular disease, peripheral vascular disease, heart failure)
4. Obstructive sleep apnoea
5. Dyslipidaemia (high cholesterol)

You could go anyway and ask about the chest pain as that sounds concerning on its own. They will check your BP, and you could ask about blood tests to check for T2 diabetes, or pre-diabetes, and high cholesterol. You might qualify for the third stage of the Mounjaro rollout due in April 2027 where you would only need 3 of the 5 conditions listed above.

Im not advising WLI

Can you not find one hour a week for you?

Im a busy wife , carer, worker, yet I have carved myself an hour between 8 am and 9am on a Saturday morning to go to SW . Yes I had to fight my corner for that one hour "grandkids are here, who's going to get them their breakfast" "oh but I need you to help me with that at 9am" but I held my ground. I needed weight loss more then the grandkids needed a pancake that wasnt home made

And Ive also carved out 9:30 to 10:30 am for Park run. so now, eventually Im not expected home till 11am on a Saturday - and guess what? House never burned down, no one died of malutrition or nappy rash

Now its routine, I get up go to SW, go on to Park run and no guilt, nobody putting their plans on hold, because they know Im not there , its my time to make me the best me - HAPPY

I spend the rest of the week running around and organising and cooking and cleaning and lifting and laying - am I not entitled to a morning to make me a better, healthier , happier person ? Are you not?

Find a group that will fit near enough around DH;s hours and say - this is what Im doing and I expect you to support me by doing xyz"

Weight loss is far more about reducong food intake than it is increasing exercise. As a busy mum you are probably on the go much of the time. Can you skip for 5 mins a day? Increase to 10 mins over a month.

It's essential you see your GP to check out the chest pain and check BP, lipids, etc.

If you want WL injections, then probably you need to pay for them and I'm sorry but I think people should.

I appreciate diets are hard but perhaps half the battle is not to have lots of food available for snacking. Up fruit and veg, ditch refined carbs, ditch sugar, ditch alcohol and/or pop.

Bite the bullet, get the injection, you'll lose weight, happy days. Your gp will be likely next to useless, in the time you've spent pissing around with them you could be on your way to decent weight loss, forget the exercise that's great for your general well being but your diet is where it's at. You can get decent discount shopping around, stop making excuses and just do it.