Just screaming out for help

[dorafrance]

Hello,
I have been very overweight all my life, I am 23+ stones and have tried many a diet over the years. I have seen various GPs and asked for help, cried and pleaded for someone to help me.

The GPs I have come across are not very sympathetic and do not understand, in the past I have used Oralstat, it got to the point were I was frightened to go out incase of accidents, so come off it. I have lost 3 stone and then put it and more back on. I know I lack motivation and will power, I tell this to the GP and all I get in return on the last visit middle of last year was try to eat bolied cabbage, flavour it with bacon, dont it the bacon and you will lose weight. Naturally I did not follow it.

I am depressed about my weight, I am the heaviest I have ever been, I did in November visit my GP again, cried and asked for help yet again and I asked to be referred to a surgeon as I cannot do this on my own. I think at 41, being overweight has taken enough of my life and I need my life back. I cannot do it by myself so as the last resort pleaded to be referred. I was told that as I have no weight complications, like: diabetes, heart and joint problems I would not be seen. But in the next breath the GP says I am one of the lucky ones! Really! I dont feel that way. I am constantly being told I am killing myself and am right on the edge of getting major comlications, so why does someone not help me??

What do I have to do to get some help, and for someone to actually listen to me and take me seriously??

[Dr James Thompson]

Hi Dora,

Thank you for contacting the TalkHealth online clinic.

Sorry to hear of your struggles, it sounds as if the weight problems that you mention have truly taken their toll on you. What you have written has made me consider a few points regarding both weight loss surgery and your struggles themselves.

- Referral for Bariatric/weight loss surgery.

From what I can tell your GP has acted within the "NICE" guidance with respect to referral for weight loss surgery and the guidance is fairly strictly adhered to by the specialists also. This means that even if you were able to persuade the GP to refer you, if you do not meet the criteria you may still not be seen. Take a look at page 25 of this NICE guidance http://www.nice.org.uk/nicemedia/live/1 ... /30364.pdf which will give you an oversight of what the referral criteria are.

- Depression and weight

It is clear from what you have written that your weight problems have impacted quite negatively on your psychological well being, with crying and being "depressed about my weight" being mentioned. You also say that you lack will power and motivation to take control of the weight problem, did you know that these are symptoms of depression also? It is important to uncover what is driving your low mood as it may not just be your weight. If you can identify the drivers then you might be in a better position to try and find solutions. If you can find ways of improving your mood then hopefully the motivation and will power to stick to diets or eating plans will strengthen and you will be able to lose weight and keep it off. It might be useful to see a counsellor, who would have the time and the patience to listen to you and to explore your problems with you.

-Dieting

The dieting advice that I give my patients is to manage their portion sizes. If you can use a smaller plate (for example) and eat regularly your body will naturally get less calories through your normal diet. Managing portion size is one of the easiest ways to maintain a diet. Eating regularly will mean that your metabolism never slows and it deals with the calories in your meals in a more efficient way.

I do hope that my advice will help. All the best.

Dr James Thompson
www.askdocjames.com

[Jenny Radcliffe]

HI Dora

Jusr a quick note to add to Dr Thompson's very sensible advice above. Weight loss surgery, while it can offer great health benefits and a level of weight loss beyond what can normally be achieved through dieting, is not without physical and psychological risks. It requires a life long change to eating habits and people who comfort eat (use food to calm or soothe themselves when stressed upset or lonely) may struggle. My new book "Cut Down to Size: achieving success with weight loss surgery" (available on Amazon) may help you think through all the issues you will need to consider before moving forward with your decision. As Mr Thompson says though if you you do not fit the BMI and health criteria you will not be offered surgery so that's your first step. The NHS Choices website has an easy to use BMI calculator.

I wish you well and hope you get the support you need.

Jenny Radcliffe

[dorafrance]

Hello,

And thank you for your replies its more than what any of my GPs have done. ( I thought I had done a reply, I must of deleted it accidenty?) I can post on here till the cows come home, its not actually solving anything.. I am not sure why I am posting here to be honest? Maybe because I feel that I need help, or someone to listen to me?

I am aware that I am depressed, it goes hand in hand with my current situation. My husband had a works accident in 2010 and now needs help 24/7 as he has a chronic back problem now. I help my husband but for me its very frustrating, I have my own back and joint pain when pushing his wheelchair and daily tasks I am finding more and more challenging. I think my depression is due to my body, I have grooves where my bra straps are on my shoulders, right to the bone. I am always hunched over as it hurts my back to sit straight, from the weight at the front. I have knee pain most days, depending on what and how much activity I am doing. I said I lacked will power and motivation as I cannot do this by myself.. I want to lose weight so badly its like I have foggy goggles on and cannot see what to do. But then again I know and understand what I must do to lose weight so why cant I do it? Something that has never been looked into is the fact I have learning difficulties, dyslexia, dyspraxia and dyscalculia. Maybe this plays a part in why I am having difficulties?

I have tried to improve my mood, I am trying to stay positive but its really had when it seems no one wants to help you. I try new ways to lose weight, I do really well, then after losing 3 stone I have no idea what happens, I just need more support I guess? At that point I dont feel depressed... that comes later when I would go shopping for clothes and it dawns on me I have failed again. I have never been offered to see a counsellor, I did not even know anything could be offered to me. You say seeing a counsellor would help me talk through my problems... I am not in dinial, I know I am over weight, I know what I need to do, I dont understand why I cannot get there. I do not have any skeletons in the closet, I had a very happy upbringing. My parent were in the forces and I lived abroad, and I would say I was spoilt.

I looked at the 'nice' guide and it seems I have to have something major wrong with me besides having a BMI of 52 and the problems I list above. Sure I understand why the guidelines are there, but the system is NOT helping me. The last serious chat I had with my GP, last year we basically covered nothing, they were not interested in anything I had to say, they clock watched and then said that I had taken too much of their time up and they needed to see other patients with actual medical problems. Its really no the wonder when I am treated like this that I get depressed. At the moment I am a ticking time bomb waiting to develop diabetes and heart problems... as I am getting no help now am I just to sit at home and get bigger then develop the problem....maybe then someone will help me as I will 'fit' the criteria! This is NOT what I want to do, I want help now as I do not want to get any further complecations. All writing in here is doing is frustrating me more as she there is a panel of experts listening but thats all... I need help... my GP is not helping, not following and 'nice' guidelines as they should to offer me the correct help... so what and where do I go now??

I am not looking for help on a plate, I know I have a lot of hard work ahead. I understand its a life long challange and change of life style. Jenny you said that eating habits need changing for people who comfort eat... yes I eat, I eat because I like to. I like and enjoy eating all the wrong, high fat, high sugary foods. I do not binge eat, I over eat, and its not because I am upset or lonely. Thank you for thinking I may want to read you book, I dont really read, and find it difficult due to my learning problems. I posted in the section as I am starting to think surgery is my only way out. What am I to think... someone please help and support me.

[Jenny Radcliffe]

Hello dorafrance

I'm very sorry to hear that you are having such a difficult time - it sounds as if you have a lot of life stress at the moment and combined with your weight, its all getting on top of you. It's not usual for people to become depressed when they are trying to cope with so much & perhaps the most important first step is to get help with this.

It may help to make two seperate appointments with your doctor (or at least ask for a double appointment when you book) so you have time to talk about the two issues you're trying to get help with - your weight and the way you're feeling. I understand that you feel the doctor is not listening to you, but having a bit longer and dealing with one problem at a time will help you both.

1. If your BMI is 52 and you have not been able to maintain weight loss through dieting, it is reasonable to talk to your GP about weight loss surgery. You can ask what the criteria are for funding is in your area and how the process works. If you were able to get funding you would be assessed by the bariatric (weight loss surgery) team to see if surgery might be the right thing for you. As we talked about before it would mean that you have to make life-long changes to your eating habits. Depending on where you live there may be a specialist weight management service that could help you make changes to your eating to prepare for surgery.

2. The second issue (but equally important) is how you're feeling at the moment. It seems as if you feel pretty down and hopeless about things. It may be helpful to talk to your GP about whether you need treatment for depression with medication and/or psychological therapy. Your GP can refer you to the local psychological therapy service.

Good luck.