Morbidly obese at 26 stone- lost cause?

[AppleJuiceAvid]

Is a woman weighing over 26 stone at 5ft4 a lost cause? She is currently taking Aripiprazole 15mg daily and Fluoxetine 20mg daily due to hearing voices and suicidal ideation. Previously she was on Olanzapine and Paroxetine. Before that she was taking Sertraline and has taken Citalopram and Mirtazapine in the past. This morbidly obese woman struggles to walk even short distances and gets out of breath going up the stairs. She cannot afford to take Mounjaro and might not be eligible anyway due to an immediate relative having a form of thyroid cancer. Any success stories from people who have lost big amounts of weight?

Id suggest she speaks to her GP about weight loss surgery, she’d likely be eligible on the NHS.

Nobody is a lost cause
there’s a woman at one of our local slimming world groups who has got her 10 stone badge she’s been in the local paper!
id be looking at that - cheaper than surgery or WSI
never give up!

Honestly, no, she will not succeed without either bariatric surgery or medication. The medications she is or has been on are notorious for weight gain and in the case of olanzapine developing T2DM. There are now trials of using tirzepatide alongside these drugs because of it.

It's really important to understand the role of the medications here, she's been on two of the most widely reported drugs for major weight gain (mirtzapine and olanzapine).

Mirtzapine is a weird drug. I ate til I threw up when I was taking it.

I think there is every chance if she has the support of her Drs tgat she can lose the weight. She needs to accept that she is going to feel uncomfortably hungry but that she is also going to feel extraordinarily better in so many ways.

I can’t comment on the medications she’s on, maybe that changes things. I can tell you that I have been obese almost my whole life, peaking at over 22 stone. I’m now under 14 stone and this time it looks like I am keeping it off.

Several things happened. An acceptance that I had a seriously disfunctional relationship with food, which needed addressing, plus realising that I am addicted to sugar and certain other UPF’s.

I have succeeded in making permanent changes to my eating habits, eliminating the sugar, UPFs and snacking, and addressing my compulsive eating through Overeaters Anonymous. I haven’t used weight loss injections and have been able to stop the medications I was on for type 2 diabetes.

These medications both make you eat more and cause metabolic changes that may be permanent. Patients don't tend to be able to overcome this via diet and willpower. It's a challenge for psychiatrists.

Worth adding Metformin while being referred to weights management clinic ( and hopefully getting WLI from that)

This woman has also had irregular periods for the last year or so, along with an increase in chin hairs. A parent of theirs also has an under active thyroid.

She needs more blood testing. I’m not aware of any of the drugs she’s taken are known to trigger PCOS, but those are symptoms.

Nobody is a lost cause.
I've followed a lady on FB whos lost stones by diet and exercise.
She bought two infinity hoop things because one wasn't big enough shes lost slowly

But if the meds this person is on will fight against diet then it has to be worth looking at gastric band or something

Of course she's not a lost cause, if she eats less she will lose weight. A pound at a time, a stone at a time. She can do it. She can start to move more which will be easier the more she loses.

Given her weight she’d surely be eligible for WLI on the NHS? If her thyroid cancer risk has not yet been evaluated that would be the first step.

plus changing her diet as outlined by @PuzzledObserver .

It’s not just BMI that the NHS uses as criteria for WLI. For Mounjaro it’s a BMI of 40+, and then also 4 out of 5 specific weight related health conditions (T2 diabetes, obstructive sleep apnea, high BP, high cholesterol, heart disease). The woman in question likely would not qualify.

Even if she doesn't qualify for WLI there are other weight loss procedures that she could try.

I think someone that size is going to need some sort of help to lose the weight.

My 600 lb life shows nobody has to be a lost cause. Some people are on a more difficult journey, true.