Nhs treatment when over weight: Hello all... - PCOS UK (Verity)

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Nhs treatment when over weight

bbymz
bbymz

Hello all,

I was wondering what everyone's experience was like when going to the gp/nhs for treatment when over weight?

I am 29 now and I was diagnosed at 15 haven't had a "natural" period since I was 13 or maybe 14. I am overweight now and have been for the past few years but when my periods stopped I was within the normal weight range. I feel that evert time I make an appointment with the gp to discuss my reproductive health they concentrate on the fact that I'm over weight without listening to anything else I have to say. So far everything I know and understand about pcos is mainly based off of my own research (this may be due to me being diagnosed such a long time ago).

I eat healthy, try to exercise as much as I can but my weight is not shifting and the drs don't seem to understand or support me with this.

The last time i visited the gp around a year ago about my concerns with fertility they advised me to loose weight and then go back. Recently me and hubby have really been thinking about having a baby, and we have agreed to make a joint appointment with the gp but my fear is that once again they will advise that I need to loose weight and keep trying.

Gp seems to think that loosing weight will mean that I have natural periods again, my argument is that when they stopped I was a normal weight and was a normal weight uptill maybe 5years ago?

I'm currently on metforming and folic acid

Any feedback or input about your experience and maybe how to kick start our journey to having a baby will be appreciated

Thank you for reading my post and stay strong everyone!

14 Replies
Hidden
Hidden

Hi bbymz,

I’ve always struggled with my weight too. Nothing I do seems to shift it. My GP has suggested losing weight on many occasions but she still did all the right tests and referrals for me. Like you, I’ve had hardly any advice since my diagnosis, and a lot of what you find on the internet is just people trying to make money out of it - I don’t think there are any magic secrets to dieting with PCOS, just less food and more exercise. Working from home at the moment isn’t really helping me with that, not that it was much better before the pandemic...

Check the guidelines where you live because each area has their own rules. For me, we had to have been trying for a year before the GP would run blood tests etc (6 months after 35, and I was on the cusp so it was maybe 10 months). The tests were more of a formality as I’d known for years I had PCOS. At 35, I was too old to qualify for IVF on the NHS, but that depends on where you live. My BMI was too high as well (over 30). However, I did get access to several months of Clomid on the NHS. We were also lucky enough to be able to afford to try IVF privately.

The one thing I will say though, is the chances of success with IVF do depend on age and weight, so while I don’t like the NHS restrictions, I do understand that they need to focus their funds on treatments that are most likely to be successful. But having spoken to a consultant, I’ve been reassured that while BMI may be a part of it, the age of the mum makes far more difference to the quality of the embryos and that puts you in a far stronger position than I ever was. Wishing you lots of luck and strength for your journey ahead.

bbymz
bbymz in reply to Hidden

Hey FairPenelope,

Thank you for your response, how did you find being on clomid and did a specialist put you on it after a referral or was it your gp? I wish you luck with the IVF and hope you have some good news soon!

I have tried to get a referral towards the end of 2018 and although they verified my diagnosis (which I found pointless because I had already been diagnosed) they never made it past the "you need to loose weight before coming to us" stage and I kind of gave up because it kept frustrating me to constantly be making an effort to loose weight, not loose any, and for them to dismiss me as being lazy when I was doing all the right things. It made me feel like I wasn't doing enough to the point I was only drinking water and avoiding food for days!

Me and hubby are going to give the gp one more go and see if they finally give me a referral but like I said my weight is my biggest concern right now.

Hidden
Hidden in reply to bbymz

It’s so frustrating, isn’t it! I sometimes manage to shift a couple of kilograms but it all goes straight back on again. But if your GP can’t get past your weight then you need a new GP. Any health concern you have could be written off as weight related and, while losing weight certainly helps a lot of things (if only it were that easy!), there’s a lot that could be missed by focusing just on weight. But I wonder if they will do more now that you’re actively trying. I was told to come back after a year of being unsuccessful and they were never really interested until then.

After my diagnosis was confirmed again, the GP referred me to a clinic at the local hospital and it was them who gave me Clomid. I used provera to induce a bleed, then took Clomid on days 2-5 (I think). They wanted me in for a scan around day 10/11 of the first cycle to see if I was likely to ovulate, then I needed a blood test at the GP later in the month to check I had ovulated. I needed to up my dose after that and needed another scan and blood test but then I just kept going without supervision until I ran out of pills. I haven’t had too many side effects from either Clomid or IVF, but the hormones from IVF make me very emotional. Add the stress of a global pandemic and working in a school with lots of potentially infectious teenagers... well, I haven’t always been very relaxed about everything! 😂

One thing I do know though, is that we are trying everything we can, but sometimes it’s all down to luck. Most people get a chance to try every month. My mum is as regular as clockwork but it still took 8 months for my brother to be conceived. When it was my turn, they were lucky first time. If we’re not successful, I’ll never know if it’s bad luck, weight, age, or something else altogether. All we can do is try our best, and you are definitely doing that.

bbymz
bbymz in reply to Hidden

Sounds like you are now on the right tracks and I really do hope that the ivf works out for you. I understand that with the lockdown everyone is borderline depressed I can only imagine how you feel with all the hormones plus school kids!

I think for me lockdown has been a major motivator to try and have our own 1) everyone seems to be having a baby and 2) i haven't been able to keep my mind as occupied like pre covid so all those feelings and thoughts of having my own family have been coming to the forefront of my mind.

The thought of seeing a gp again has made me feel insecure and I guess guilty & ashamed ? Is it so wrong for a larger lady with fertility issues to want to have her own family? I would just like to be seen as a normal patient and not just as someone who is fat... what's frustrating is that I know ladies who are much larger than me who don't have any issues and manage to get pregnant naturally. No one says to them they need to loose weight first then have a baby so why do they say it to us pcos ladies?

Sorry I had a rant there 😅 but honestly I wish you the very best and hope you are successful! Keep us updated about your journey and informed of all the ups and downs. ❤️

When I came of the pill I ballooned. I've not had much problems getting pregnant, but have had many miscarriages. I'm actually early pregnant again now.I am still just in the obese category but because of what has happened to me and my age, the suggestion was to have IVF. I've not needed it but, assuming you are not having periods you may not be ovulating and you may struggle to conceive. For me to have IVF I have needed to loose weight, to getting into a overweight range, and I'm about 4 pounds off it.

Reasons why loosing weight is so important, coming from someone who is not slim at the moment and knows the struggle of loosing weight, I've lost about 18lbs now. One reason is your health, being overweight can cause diabetes and other health problems. Another is when you are pregnant, it can increase miscarriages. You don't want to go through all the joy of getting pregnant to go through what I have a loose the pregnancy, so give yourself the best chances. Being overweight can stop your periods, this is why your doctor is also saying this. When you do get pregnant you can suffer from gestational diabetes, again another complication in pregnancy you don't want. Also, you may just feel better in yourself losing some weight, I know I do. Give you and your future baby the best chance. In my case my first few miscarriages I did no exercise, and they were all early on, I truly believe when I swapped jobs and was pregnant and getting exercise everyday my pregnancy went further, I believe I had an infection or maybe even covid, as I did have a later miscarriage last time, but the results were inconclusive, so they have no reason why what happened, happened. However I take from all that has happened to me is, losing weight and being healthier is good for you and your future child.

Unfortunately the hard part of losing the weight, I've eaten 800 some days and now go for 10,000 steps everyday. If I wasn't pregnant, I would start running or cycling in the summer. It's not been easy as I love food, and eating healthily does take up time cutting vegetables and making meals from scratch. All I will say is avoid bread and pasta and drink plenty of water. Don't eat after 5-6 is you can and no snacks. With PCOS your body is over producing insulin, and everything you eat that is adding on the pounds, so try stick to meal times only.

Metmorfin is supposed to help your weight I believe, I only took one tablet and was violently ill, so I don't know how much effect it has.

I was recommended alpha infolic from my fertility nurse, it is supposed to help with PCOS and fertility, I also tried MyOva for a bit. I can honestly say whether it has helped or not as I've got pregnant on it and off it and I've been on it 8 months before getting pregnant again. Have a look and see you want to try it, they recommend at least 3 months for your periods to come back.

Good luck on your journey.

bbymz
bbymz in reply to LisaEB

Hey LisaEB,

While it's saddening that you have miscarried I am glad that your now pregnant.

I think my biggest struggle with health care professionals has been the fact that historical o have had to "fight" for them to support me with my reproductive health.

As far as diet goes I cook from scratch and only have 1 cheat meal in a week (during lockdown its been 1 every 2 weeks), I portion control and a lot of people in the have been surprised by how little I eat in comparison to my size (people just assume I'm fat because I eat too much junk food).

I fully acknowledge that weight does play a huge role in reproductive health especially when you have pcos. What frustrates me is that the Dr rights everything off as me being over weight and does not look into any other medical reasons. For example i haven't had a normal period since I was 14 up in till 22 I was a normal weight bmi was not an issue 22-25 Is where I went overweight as everything kind of depressed me I did a lot of comfort eating ect as I was overwhelmed by it all. The previous gp refused to acknowledge that although I became overweight initially my weight had not played a role in me not having periods.

At 26 I moved and changed gp, the new one is much better but now the damage is done and I'm overweight and they did not know me before I put on weight so I do also understand why they have concentrated so much on my weight. At least at the current gp they have prescribed metformin as the previous one did not.

Good luck with your pregnancy, I really hope you make it full term!

Kind regards

LisaEB
LisaEB in reply to bbymz

Hopefully your GP will help, the issue is I don't think there is a magic solution to you have periods. I didn't have periods for most my life, but I wasn't trying to get pregnant either. I was on the pill and that is supposed to help with the hormones but obviously counter productive when trying to conceive. There is drilling procedure on the ovaries I've read is one thing that can help. Unfortunately I think I'm only being taking really seriously now due to the amount of miscarriages I have had.All I will say with the weight thing, is I have been pregnant every time as an obese person, so obviously it is possible. However, I do think to give your best chances for everything gets pregnant, keeping the pregnancy, having a healthy pregnancy and baby, losing weight before conceiving will help and although it's not nice to hear I believe your doctor is give you good advice overall.

Are you taking 5mg of folic acid? That's what I've been recommended, if you were to get pregnant that helps. But on the NHS at £9 a time it might not be worth taking it, so it's good you are at least taking some folic acid.

They can scan you and check for anything in your womb. Have they done this?

Then their are fertility drugs, are the next option. Then you have the risk of multiples is it were to be successful.

Then it is IVF and if you want to try that as an option. They wouldn't consider me unless I was in the overweight category, it's taken 8 months to loose 18lbs, so been slow. I also lost a baby, so there was emotional eating at one point and I actually put on weight afterwards.

Weight is one thing you can control, it might be slow, it might be hard, it takes motivation, but anything that can help you on your fertility journey, sure its worth trying? It's annoying being judged for being overweight, even after all my progress, I'm still not slim and when my doctor told me to loose weight to be considered for IVF. I got defensive and told him it was hard. I totally understand your frustration.

I wouldn't wish what has happened to me on anyone and I totally understand how frustrating it must be not to even get pregnant as it took me over a year most times because even when you ovulation you only actually have a small window to get pregnant.

Has your partner been tested? 50% of not getting pregnant also is to do with the man. So make sure he has been tested so you are not totally focusing on yourself.

Also get tested for stis and infections, you haven't already, as that can affect getting pregnant.

Hopefully they have done blood tests for you to check for any abnormalities.

Thanks for your well wishes and really do hope it all works out for you xx

Sadly with Pcos the eat less and exercise more doesn’t work that well. My weight has always fluctuated like crazy until I got professional help. In my case what worked was eating more of the right things, and exercise the right way, weight lifting. Get a certified dietitian or a personal trainer to help you and ignore any advice from the internet.

LisaEB
LisaEB in reply to alohalu

To be fair you need to at least try, I feel alot of people just want this magic pill from the NHS, which does not necessarily exist. I know I've put on 4 stone due to not great habits. You can't blame PCOS fully. How many fat people were there in the UK in the 1980s for example or during the war with rations? Or pre cars? PCOS still existed then, so we need to take some acknowledgement that we can help ourselves and if we don't try then it is only ourselves to blame. Exercise and healthy food helps, it is a very good start.

alohalu
alohalu in reply to LisaEB

I don't disagree with you, I eat extremely healthy, and I train 5 times a week, and love long walks.

What I'm saying is that lowering your calories until you are eating toddler portions is not a long term solution, that was particularly bad for my pcos as well. For me it was weight training and putting on more muscle that made the biggest difference, I can easily have 2000 calories a day without putting on weight. But again, the important point, none of this would have been possible if it wasn't because I reached for professional help.

LisaEB
LisaEB in reply to alohalu

It isn't a long term solution, but if you are not willing to put the exercise in, let's face it, most people are not, food intake needs to go down. If you are willing to put on the training in, you will loose weight. To be fair, eating veggies and eggs and fruit, its very hard to eat alot of calories, that's why mine has been so low. I've not been hungry. I took out sugar, dairy, meat as well. Me and my two sister have PCOS, one sister is very active, she is very slim, my other sister I believe doesn't eat that much she is tiny and I was a normal weight most my life, PCOS does not equal being overweight in every case, it is hard to loose weight I truly believe that. But we need to stop using it as an excuse for bad habits, because not everyone has PCOS and there are alot of overweight people in the UK, let's face it. We saying all these overweight men have PCOS too? Let just get real and look after ourselves.

Hey, I feel your pain! 100% agree that losing weight with PCOS is not that easy. I'm dairy and gluten free, eat healthy, very rarely drink, exercise 3 times a week and I've lost 3 pounds this year. Very frustrating!!

Did you have to ask for metformin? My gynaecologist has not offered any medication and just tells me I need a BMI of 30 for IVF.

bbymz
bbymz in reply to Anonymous29

I know how you feel! They say change your diet and exercise more, iv done both and still not having much movement!

Iv been on metformin on and off a couple of years with my old gp. The new one has just given it to me on repeat prescription so I don't need to keep asking for it.

Anonymous29
Anonymous29 in reply to bbymz

I think I might speak to mine and see if they would offer it because I've heard a few people who have had success with it.

It's such a pain having PCOS but I follow a group on Instagram called pcos.weightloss and it's actually quite helpful. I haven't paid for their subscription or anything, just listened to their free stuff! X

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