Gp's And Obesity

lucylocket61 said:

do you have a date for your surgery yet?

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No. Meeting surgeon on Wednesday. Fingers crossed he can give me an idea of how long I'll wait.
Watched a TV programme yesterday about 70st man who died after sleeve op. He lost 25st on liquid diet to shrink liver before op I think he may have been diabetic, it was hinted by surgeon or anaesthetist.
He panicked about stay in hospital sooooo long and discharged himself, twice. He died from the 2nd wave of pneumonia at home due to leaving hospital too soon. A big mistake and I bet irratic mind from irratic sugars. Hospital couldn't stop him discharging way too early as he was of sound mind. Which I feel is arguable after his traumatic weight loss programme. He wasnt expected to have his own mind about things. All good on paper but his mind scuppered it all for him and his family. A very sad end to so much work from all concerned.
I won't be discharging myself but many ops are only 3 days in hospital. We'll see what surgeon expects for me. I'm ready to walk as much as they need for my discharge as long as not painful back pain. I'm on dihydrocodeine and paracetamol which is working well at mo but my walking is slow and arkward. I'm looking forward to possibly walking properly again. Maybe losing IBS too and losing some or all high blood pressure tablets. Betablockers especially. I do have high hopes but prepared for some disappointments. If I can walk and swim again, I'll be happy. Reversal would be the icing on the cake. I've deteriorated these past few years. I'm feeling 47now but luckily don't look it. Ha ha
I'm hot on making sure I don't go anaemic again but it's caused by lansoprozol not bad diet. I'm over compensating for that tablet too. Not sure if I'll be able to one day stop it.
Like anything, we are all different.
How are you?

I think the media have at least as much to answer for as HCP's. Every single show I've seen about obesity and weight loss never deals with people who have health issues beyond overeating or binge eating. Every show has people living off junk food who then "miraculously" lose weight when they stop eating carbage. People who get obese eating according to the guidelines or those with hormonal or medical issues are never shown.

Indy51 said:

I think the media have at least as much to answer for as HCP's. Every single show I've seen about obesity and weight loss never deals with people who have health issues beyond overeating or binge eating. Every show has people living off junk food who then "miraculously" lose weight when they stop eating carbage. People who get obese eating according to the guidelines or those with hormonal or medical issues are never shown.

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I know.
About time someone put the public right. Well those that will listen or understand.
They portray a simple problem fixed in a simple way. If it's too complicated, they switch off. That's ignorance for you.
We need our own version of the spoons theory for simpler explanation of why type2s don't lose weight on 1500cals.

Mr_Pot said:

What treatment would you suggest they need to offer?

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Why not hand over all treatment of overweight/obese patients to the nurses as they hand over dressings , taking blood, diabetes, doing ecgs etc. Nurses become very skilled at what they do and can take the burden off GPs especially of tasks which involve a lot of time consuming weighing measuring and record keeping. They could also put up a notice in every waiting room saying " If you think you might qualify for vouchers for a local slimming club please make an appointment with the nurse". Apparently slimming clubs work really well, partly because of the level of support from the rest of the group. Personally I would avoid the ones that are in business to sell their own products like ready meals and cakes.

In that case you would have to retrain all GPs, all nurses and all Dietitians as well as change the way those who run slimming clubs operate. Why? Because patients would benefit from an all round change in attitudes toward nutrition and weight management, and from avoiding a situation whereby a nurse says one thing but another HCP says a different thing. As for slimming clubs and vouchers, this has been tried and as long as the clubs advocate a reduced calorie approach i.e being the only approach then the rise in the rates of obesity will not change.

This forum itself has sub fora for all the different approaches to weight management and I personally think that it reflects what could work in the real world just as easily. To clarify, a lot of people manage their weight by managing their Diabetes so there's little reason to suggest that these methods would not work for the general population.

Tannith said:

Why not hand over all treatment of overweight/obese patients to the nurses as they hand over dressings , taking blood, diabetes, doing ecgs etc. Nurses become very skilled at what they do and can take the burden off GPs especially of tasks which involve a lot of time consuming weighing measuring and record keeping. They could also put up a notice in every waiting room saying " If you think you might qualify for vouchers for a local slimming club please make an appointment with the nurse". Apparently slimming clubs work really well, partly because of the level of support from the rest of the group. Personally I would avoid the ones that are in business to sell their own products like ready meals and cakes.

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My nice GP (who has now left ) referred me to a Slimming Club. I told him I would go for the weigh in but would be following LCHF and not their diet. I wouldn't be buying their ready meals and snack bars. He said that was fine. After the initial 3 months I was given another 3 months as I had lost over 5% of my body weight (it was in fact over 10% ). I had a thread here at the same time where I reported my weight loss every week to give me an incentive to keep going.

Guzzler said:

As for slimming clubs and vouchers, this has been tried and as long as the clubs advocate a reduced calorie approach i.e being the only approach then the rise in the rates of obesity will not change.

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I remember very well when I first started to follow Tesco Diets, I was overwhelmed by the volume of food. And I only lost weight for the first 6 weeks, then nothing. The major benefit was that I became disciplined in keeping a food diary, following instructions, I've got loads of recipes for some decent meals (even low carb recipes), and knowing that there was something else going on that I couldn't quite put my finger on at that time.

I have seen the benefit of Weight Watchers that was prescribed to an elderly person I know, she lost 5 stone in as many months, then she was diagnosed with cancer and having gall stones and told to stop following the diet. Big mistake, she put all the weight back on. Had she continued with the diet but in maintenance mode (I'm sure WW do that), I think she would have been OK. The cancer was treated and then the gall stones removed/sorted out. But she's that 5 stone heavier again and sees no point in dieting again.

I feel pretty sure that dieting organisations want to maintain their revenue fstreams and having a lot of slim members isn't the way to do it.

bulkbiker said:

For the slimming clubs maybe... they are a great money spinner. Repeat business model. Lose weight on restrictive diet, go back to eating "normally" put weight back on go back to slimming club. Yet another way to bankrupt the already stretched NHS.
Eat food made by you from raw ingredients - make these very low in carbs high in protein and fat and for most the problem would go away .. repeat forever. Sustainable, value for money and extremely effective. If the Health Service generally could only start to get this message across just imagine how much better the nations health could be.
No "slimming products", no shakes and better nutrition for all, a lot less money for food "manufacturers" though... a win win all round!

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lol yeh they put a minder near me when I went to Slimming World in case I spouted more of my 'fat is good' mantra. Well the SW woman did ask me to tell the class how I was managing to lose so much weight. And I did. Strangely I was never asked to do so again.

bulkbiker said:

You rebel you .... well done!
I'm tempted to join a local one just to be an undercover agitator and leave lots of keto meal ideas around with links to diet doctor.. but don't want to give them my money...

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lol I only went cos my doctor wanted me to go so he could box tick. That was my nice doctor so I was happy to oblige to go for the weigh in only. When I had had my free 6 months I stopped going

Tannith said:

Why not hand over all treatment of overweight/obese patients to the nurses as they hand over dressings , taking blood, diabetes, doing ecgs etc. Nurses become very skilled at what they do and can take the burden off GPs especially of tasks which involve a lot of time consuming weighing measuring and record keeping. They could also put up a notice in every waiting room saying " If you think you might qualify for vouchers for a local slimming club please make an appointment with the nurse". Apparently slimming clubs work really well, partly because of the level of support from the rest of the group. Personally I would avoid the ones that are in business to sell their own products like ready meals and cakes.

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they do at my surgery. and then we get handed the eatwell plate, told to exercise more (I have ME) and thats that. Slimming clubs only work if you can actually lose weight, and some, like me, find it near impossible - even though your comments lead me to think that you dont or wont believe that.

Well I hope you guys at diabetes.co.uk are working to get the guidelines changed as Nina and others are in the States.

Pipp said:

It would be more useful to have a protocol or flow diagram for GPs and other HCPs to deal with the issues of not recognising that the accepted protocol of recommending diet of carbs with every meal, fruit, low fat products, etc, etc, has created a huge problem for so many. Add in to the protocol that obese people are very likely to be pretty angry and demoralised that the people advising them, go on to treat them with contempt and ridicule, when the said advice they have followed does not work.

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Not to mention David Unwin i.e meeting with officials. No use changing guidelines whilst ignoring outdated attitudes by those who are supposed to be in the position of first line defence.

bulkbiker said:

I think if you check out what Arjun and Charlotte are doing to promote a Low Carb lifestyle you would be pleasantly surprised.

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@lindisfel have you done that? Are you impressed? Will you say so publicly....

bulkbiker said:

Maybe ask your daughter if she has seen the Royal College of GP's Low Carb online training that DCUK and Dr Unwin have put together..

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Hi Bulkbiker
She is fully aware of the current low carb input and has given me articles on Dr. Unwin etc in the medical literature. She was willing to go to one of his forums in NW England with me but I was not able to get.
I honestly don't know what's she says to the obese patients, they can have multiple isues, I would be shocked if she was not compassionate and helped them as best she could.

She prefers working amongst the poor in a run down area. They have multiple issues, although, unlike some middle class, they can be quite knowledgeable.
I gather compliance may not be the same issue though in Southport.
We're, I think, a self selected cohort was used.

With most of my family the enthusiasm of the convert must have been very wearing!
Added to that they all thought when I got down to 13stone at.1.96 and my ribs and bones were visible I had overdone it. I was a big powerful guy when they were young.

But my problems were caused by another metabolic problem that caused carbohydrate intolerance which is not genetic and if I had found out as a younger man, it was potentially reversible.
She knows of my difficulties with potassium / sodium balance which Jerome Conn MD knew caused carbohydrate intolerance over 50 years ago in more than half is patients and 80% were cured by tumour removal.
It damaged my heart and likely the pancreas ilet cells by stuffing sodium into tissue and leaking potassium.

GPs realised our problems are complex, its a real problem for them having 10 min appointments, reading notes and recording included. No wonder she goes home at the end of a very long day completely spent.
D.

I respectfully suggest that if a GP suspects a complex and on going condition, like type 2 diabetes, for example, they schedule double appointments, meet their patients over several appointments, and see that all relevant tests are carried out.

I do not think anyone is suggesting that such treatment and diagnosis takes place within a single 10 min appointment.

Taking one look at us, telling us the problem is we are fat, and dismissing the possibility of other health conditions is not on, time constraints not withstanding. There is no excuse for a doctor to state they cannot do their job properly. They are either doctors, or they are not.

My mechanic spent more time checking out a problem with my car than my GP did checking out my health, despite numerous obvious symptoms and research by me, because I am fat, and menopausal, and a woman.

It is not my job to make my GP do their job properly.