Doctors advice really upsetting, any support and advice would be appreciated

[Bolt21]

Due to my asthma, I have been on multiple courses of steroids, leading to a lot of weight gain and water retention (I have gone from size 8-10 to a size 16). I was trying my best to embrace my body as it has gone through an insane amount of medical trauma the past few years, as well as transitioning from a teenager to a young adult. However, I've found this increasingly difficult and I seem to be gaining and gaining weight and lost control of it despite regular eating habits. I rarely drink alcohol and I eat healthy balanced meals. Unfortunately the amount of exercise I can do is limited due to the severity of my asthma. I went to the GP about this last week, who firstly measured my height incorrectly as 160cm (I am 5'11 so around 180cm!!), therefore telling me I was extremely obese and unhealthy. Although this mistake was eventually corrected (I didn't realise until after the appointment there was an error), the words have really stuck with me and they hurt. I went to another appointment this week where the GP advised me to fast, or try slimming world. I shared my concerns for slimming world as I am very anxious and shy and I am worried about becoming obsessed with calorie counting and my weight as a figure etc. Despite me stating this to the GP and this being clear on my medical records, they proceeded to send me a text today with the link for slimming world. I don't know if my mental health is just bad at the moment but I am feeling really upset and triggered by 'obese', 'slimming world' and 'fasting', and I just feel as though my feelings and personal opinions about my healthcare and wellbeing were completely disregarded and neglected, and now I am completely lost and don't know what to do. I apologise for the rant but I haven't found anybody who can relate in any way so I'm hoping on here I may be able to seek some comfort and advice on how to start my weight loss journey. For reference, my BMI is around 29 so I do not want a massive transformation, and I am not overly bothered about the numbers, I just want to feel like myself again. At the moment I can feel myself slipping into an eating disorder, I have been avoiding food and wanting to throw up after meals.

[BridgeGirl Administrator 2 stone]

Hello, Bolt21, and welcome to the forum

Maybe you'll be more comfortable here, where you can join in without being visible. I hope you'll give it a go.

You'll find everything you need if you scroll through these posts healthunlocked.com/weight-l... When you're ready, join the weigh in and Daily Diary - that can be so helpful with planning. Also, have a look at this post: it may give you some meal ideas, building on a wide range of plants healthunlocked.com/weight-l...

Make sure you chat to other members, and we all appreciate encouragement

[elliebath Maintainer]

Welcome Bolt21. I have a friend with very severe arthritis , on regular steroids and limited mobility, so I see how hard it is to cope with the weight gain. I've always found everyone on this forum to be friendly and supportive, all with different reasons for weightgain, and all trying their best to lose and maintain. You will be in good hands.

[Philfran Visitor]

Hi, I used to do Slimming World & there are no calories mentioned. Maybe go one week & see. Tell the person leading it that you are shy & don’t want to speak. Your doctor needs training on his communication skills!

Exercise isn’t just the gym. SW advises starting with just walking a little bit further than usual - even just to the end of the drive.

[Eryl Visitor]

Its all to do with glucose. Glucose causes fluid retention. Glucose causes inflammation in the body which is contributing if not causing your athsma. Glucose increases your hunger pangs wich makes you want snacks, reduces your sateity during meals so you tend to eat more and if glucose not used immediately is stored as glycogen in the muscles and liver. When the muscles and liver can't hold any more the liver turns the excess glycogen into triglycerides which are the basis of body fat. Another problem is that although the body can run on glucose or ketones it will preferentially burn the glucose first in order to keep it in check (as it can damage nerves if it gets too high), so you can't burn off body fat without going into ketosis (the body burning ketones).

If you look at a graph of glucose levels in the blood it looks like a saw tooth whith spikes just after a meal and a gradual slope down as the glucose is processed so to get into ketosis you need to get the lowest part of the graph into the ketosis range. This can be done in three ways, by reducing the height of the spikes (i.e. eating less glucose), speeding up the fall by excersising, or lengthening the gap between our last meal of the day and your next meal the following day (often called intermittent fasting or more acurately tie restricted eating). As glucose is turned into glycogen and stored in the muscles if you have more muscle you can store more glycogen so less of it will end up as body fat.That would suggest that resistance training (e.g wight lifting, squats, aerobics, sprints, crossfit etc.) is more efective tha waliking and similar excersise.

Flucose is found in sugar (table sugar is 50-50 glucose and fructose ) but fructose (and alcohol) has to be processed by the liver which turns it into glucose and a few other things, one being uric acid which aues gout amongst other things.

Glucose is found in grains (starch is just a bunch of glucose molecules joined together which are easily split by enxymes in the digestive tract) and the more processed the grain is the quicker it is metabolised which explains why flour based foods will spike the blood glucose faster than table sugar. The starch in beans has a different structure which slows down its metabolism.

To summerise, 1. Cut out bread, biscuits pasta and other flour based foods. 2. cut out sugar (both table sugar and fruit juices, smoothies etc) 3. have your evening meal earlier and delay or skip breakfast. 5. Do some excersise preferably resistance and preferably after your evening meal or before breakfast.

[Frenchfields 2024 January]

Hi and welcome. Sorry to hear of your anxiety and the insensitivity of your doctor, but remember doctors are just people, you get good ones, bad ones and a whole range in between. They often have little up to date knowledge of whats considered good practise in weight management -nhs guidelines still seem to favour low fat everything, the faker the better. And I also think the word obese is no longer considered acceptable. Look at the slimmers world suggestion as a positive, its just one suggestion, and it might help -there’s no shame in seeking help. You may even be able to do it online rather than meetings -I know you can do weightwatchers online. But if its not for you that’s fine too. Do you see an asthma nurse regularly, he or she might be more helpful. In terms of actual weightloss -if that's what you want -its hard to suggest changes without knowing what you are eating. You can lose weight without exercising but if you can add in some ’passive’ exercise that will help too ( walking to work, going for a walk at lunchtime, brushing the stairway carpet instead of vaccuuming, that kind of thing). Do join in on the forum if you think its helpful,

Edited to say -oops, brushing stair carpets is probably the worst thing for a chronic asthmatic , sorry.

[Eryl Visitor in reply to Frenchfields]

I agree that most doctors are out of date with current science. It is often said that "Science advances funeral by funeral". Similarly clinical practise always lags the science by a generation.

[Beth_19 5lbs Restart June 2024]

Hi Bolt21, I am so sorry to hear you are going through this and I absolutely can sympathise and empathise because I am in the same boat. Covid kicked my asthma back into the uncontrolled category a year and half ago (lots of high dose steroids and hospital admissions, latest just 2 weeks ago) and I've piled 6st on due to meds and my own mental state being in a bad place. Fortunately I am back under the respiratory team at the hospital and I having more tests done to find out exactly what is going on in my lungs as the right is worse than the left.

Are you just under your GP for your asthma or under the hospital? If your asthma is being difficult to control it might be worth asking for a referral to your local respiratory hospital team if you are not already. What sort of inhalers do you currently take?

I am so sorry that the talk with your doctor left you feeling so down and hurt, sometimes I don't think doctors appreciate how a few words can be so damaging especially when not discussed in a kind way.

I was fortunate that when I started my first journey back in 2016 I had an amazing respiratory consultant who didn't critise me for being overweight but instead patiently and kindly talked me through the connections between weight and asthma. At the time I had approx 8 stone to lose, but he didn't ask me to do that, he gave me a goal of 1 stone over 6 months (which really is absolutely nothing just over 2lbs a month, but it was at the time for my mind a realistic goal) and see how I felt. He advised I check out the NHS BMI calculator which gave a calorie allowance range at the time and look at the 12 week plan for ideas, which is how I found here. I calorie counted using the calorie allowance and my exercise started off small. I did 1hr pilates lesson a week (which I still do to this day) because I could stop / start / reduce as I needed and sometimes skip if things were really bad. I started talking the stairs from level 7 to level 8 where I worked and gradually increased until I could do all 8 flights as the weight came off, my asthma came under control with the team and meds and my fitness improve and lastly I started some some gentle stretches every morning with wii fit. I managed to lose 8st in about 18 months because once I found a sustainable weight loss measure for me it worked and it fell into place in my brain.

I found calorie counting worked for me and being accountable by posting my weight weekly on here as like you I didn't like going to physical groups, the step away you have with the internet holds you accountable but its easier. However losing weight is not a one size fits all. Look into various weight loss measure and find one that is sustainable for you and works with your lifestyle, if it doesn't work then you can try something else.

As for exercise as I said I still do pilates 1hr a week but I do it at home via zoom and I can modify dependant upon my breathing and enery lessons. I plan to start doing 1 min of very gentle cycling and if possible 5 minutes of gentle stretching to start with every day and see how I go with hopeful increases in time. My goal is simply to try and do something no matter how small.

Don't be too hard on yourself as losing weight while sick is hard but possible. Set yourself small but achievable goals it can even be just a couple of pounds a month if that is all you feel you can achieve. You have support here too, you can do it.