Does anyone know anything about a dietician/nutritionist, I’ve been referred via my doctor and pulmonary rehab team NHS . I’ve lost a lot of weight over the last year or so, over a stone and half, anything I eat makes no difference, I can eat all day anything and everything, nothing puts weight on. I’ve been told it’s all part of the condition but I now weigh so little, just under 7 stone, my bmi is 17, which is far too low, I’ve been told I have to be at least 19 for health reasons. It seems getting hold of these people is quite difficult on NHS, someone phoned when I was out but didn’t leave a number so I’m no further down the line than before. Has anyone had help from these people, if so how did it help.
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Don’t wait for nutritionist to contact you. At the chemist you can purchase drinks like complan and others to try to increase weight. If you find something you like then once nutritionist contacts you you can discuss this and in many cases can then have drinks given on prescription.
Hi Mayo, I was referred to a dietician by my Bronchiectasis specialist. I am very underweight like you and have lost about 1 and half stone in the last few years. The advice given was to think of your plate as a capital Y with carbs and protein on the sides and veg in the small bit at the top. Also to eat lots of snacks. I have a very good appetite and eat very well. I was referred in lockdown and I haven't put on any weight (but it is stable). They also offered me drinks to help increase calories which I declined as being thin doesn't concern me as much as other health/life problems and although the drinks are very good at adding calories they are full of dairy which I try to limit because it thickens my mucus which makes it harder to get rid of. Despite this it was worthwhile and the dietician I spoke to was very kind and knowledgeable. I hope you get some help. Take care and keep us posted as to how you get on. xxxx
Yes thank you, I agree with what you are saying, it’s interesting re the high calorie foods and dairy products, I’ve also got high cholesterol and problems with my heart as a result, so I think adding the calories they will suggest will be counter productive .
I’ve been offered a tel call with them (nutritionist) 4th April so I’ll see what they say
Hi, they may give you different advice as you have heart and cholesterol problems. I think they deal with all health issues so hopefully will be tailored to your needs. My consultations were all on the phone as it was in lockdown. I only expected one call but they kept in touch for a few months which was good I thought.
Now have a confirmed appt 4th April for nutritionist, again it’s a tel appt, really don’t think life will ever get back to normal pre covid with the NHS. All appt are done over the phone these days, it’s just not the same as seeng some one in person 🤷♀️
Hi I agree its not the same but I was pleased on a personal level as the hospital I was referred to was about 3 or more changes of bus for me . Couldn't face that! 🙂xxx
I have suppliment shakes supplied by nutritionist on NHS im just under 8st male 5ft 8" i used to be 12st they used to visit pre covid and take my weight and check how I'm doing i was under 7st when I started the nutrient shakes few years ago and am stable with my weight now at 8st. They should keep in touch i would have thought after a visit then by phone to ask how your weight is doing and supply you with supplements if 7st is way off your normal weight so keep at them as NHS is not at its best at the moment. I hope this has shed some light on this issue for you and best of luck.
The weight loss is due to having COPD over the years it can have this effect, I do have an appetite but this adds to increase breathlessness which is very frustrating, I'm told you use more energy to digest food and am more breathless for some hours after eating .
I have been told this recently, I’ve queried this for over a year and half, they done all kinds of test but no one said it was the copd, only now since I’ve had pneumonia have I been told why I keep losing weight. I too find it difficult to keep eating lots and lots, it hurts my stomach.
Its a viscous circle Mayo low weight causes all sorts of issues, I have osteoporosis and get sore just sitting as I have no meat on my bones so to speak, I have many problems associated with COPD if you have this diagnosis then you should have an assessment on what is best for you to move forward by docs or clinic but you have to be at them to get things moving unfortunately due to cuts etc. I have limited mobility and use a mobility scooter and NHS electric wheelchair and use oxygen I can get around indoors ok but do get out of breath, there are many options available to help manage such conditions. Best of luck Mayo 👍
thank you, you have given me loads of info, I am under the respiratory team but yet to see any doctors or nurses, just pulmonary rehab. I was supposed to see the the doc when I was in hosp with pneumonia but all that done was send a physio🤷♀️🤷♀️, should I push to see the respiratory doctors?
Have they diagnosed COPD Mayo, if you are at respiratory there must be a problem, i would have thought they would give more explanation on your condition?
Ah yes that rings bells now. I think when I told her what I eat (I like to try hard to eat healthy foods). She thought that apart from not eating enough dairy that my diet was very good. Think we felt that the problem did not lay with the calories or type of food I eat but an underlying health issue. I've always been thin (but not as thin as I am now) and my bronch specialist says I have marfanoid features which might help explain it as a family member has EDS which is a form of marfans.
Hi Ergendl, hope you don't mind me asking but have you got any information on coconut oil? I love it and use for cooking and spread it on toast. It said on google that it is healthy but on another site it said the opposite - all very confusing! Thank you 🙂xx
Coconut oil contains a lot of saturated fat, which makes it something to avoid if you have blood circulation problems. It is higher than both lard and butter for saturated fat, so should be used with caution.
The only dietician I've had experience of was one I was referred to over 40 years ago when my toddler daughter was diagnosed with coeliac disease. Sadly back then we were given a list of 'forbidden' foods and a prescription for a loaf of white, gluten free bread. It's much easier now but she still gets caught out occasionally.
I worked closely with a nutritionalist. Her advice for weight gain was to add the following foods to the diet:
Nuts
Avocado
Legumes
Tahini
Quinoa
Dried fruits
Eggs
Fatty fish
Sweet potatoes
Smoothies
Peanut butter
Honey
Extra virgin olive oil, drizzled over food. Others prefer to take it neat, it is not unpleasant and has lots of great benefits. Add to cereal, salads, yoghurt, soups, etc. Extra virgin olive oils have undergone the least processing. The best is cold pressed, unfiltered, or stone pressed, the oil has not undergone heating or filtering, which usually adds chemicals to the oil, making it higher in antioxidants, vitamins, plus other natural ingredients.
Cream
Cheese
Full fat milk
Grains, oats, brown rice
Meat, leaner cuts
Whey protein
High protein snacks
Eat your protein and fat sources first. Eat the calorie-dense and protein-rich foods first. Eat higher fibre foods like raw vegetables last. Do not eat empty calories.
Loosing weight has many additional health benefits, but being underweight can have many issues to your body, including heart, muscles, etc.
If you have not been had a micronutrients test, I would suggest requesting one through the dietitian. A healthy diet provides not only adequate fat, carbohydrate, and protein but also small amounts of so-called micronutrients such as trace elements and vitamins. Trace elements can be categorised into those which are essential for human life such as chromium, cobalt, copper, iodine, iron, manganese, molybdenum, selenium, & zinc, and those which are potentially toxic such as aluminium, arsenic, cadmium, lead, mercury, and nickel.
For example Vitamin D status is associated with underweight. Being low in vitamin D can lead to low weight gain and malabsorption of calcium in the body. This in turn leads to weak and fragile bones and conditions such as osteoporosis. A deficiency of vitamin E affects the skin and hair. Vitamin E deficiency can lead to rapid hair loss and aging skin. Vitamin K is an important clotting factor without which blood does not clot properly so a deficiency of this vitamin can lead to several life threatening conditions.
Many interesting articles are available, such as advice here:
You are welcome. I think we have to remember the foods we eat now are nothing like they used to be. The nutrients from the ground have been leached and not replaced, animals are fed completely differently, food is forced and we expect to get every sort of food possible all year round. And its no wonder why millions of people take supplements.
When I had to have my micronutrients tested twice hy the NHS I was amazed to see the results. I really thought my diet was good but it really is what is contained within our food, the conditions we have and what some of these medications do to our bodies.
Good luck with your appointment and make sure you ask about follow ups and when this will be. Too many provide a diet sheet and expect you to get on with it and never know if you have improved, stayed the same or got worse. It is too easy for people to blame what you are not eating, or not eating the right things, it is important that you are monitored to make sure your weight loss is not down to other factors.
I hope you get the help you need. Re appointments, perhaps the telephone you have been offered will be for triage by the nutrition and they may offer you a face to face in future.
It is my understanding that now we. A request either phone or face to face appointments, so you may want to do that when you speak to them.
Adding Complan and other similar items sounds like a good idea but the question that needs answering is why are you losing weight? Until you know, you cannot make the right decisions/choices. Good luck, Chris.
Registered Dietitians are qualified to work in the NHS as well as freelance and have to undergo a 4 year honours degree plus additional in hospital training to achieve that status. There are many dietetic speciality careers open to them now, too, usually based in hospitals. My speciality was mental health dietetics, working with people sectioned under the Mental Health Act.
Nutritionist is not a protect professional title, and people with far less training often set themselves up to practice as Nutritionists.
Unfortunately, Dietetics, like Mental Health, is one of the less well funded disciplines in the NHS. Practitioners are very limited with time and have large caseloads, which can lead to a lot of stress.
However, there are many wonderful dietitians working in the NHS. I hope you meet up with one of those.
Hi, I was diagnosed as having disease based malnutrition and referred to a hospital dietitian. I was prescribed Ensure compact 2 x 125 ml + 3 x 40ml Calagen per day on prescription. Also I was told if the food is labelled healthy, low anything don’t touch it, stick to a balanced diet (forget the word healthy as this has a host of different meanings in the world of food and diet), eat little and often. I have problems with my oesophagus which can make swallowing impossible at times (awaiting treatment) so I have now after a couple of years gone from clinically under weight to the bottom end of the BMI scale for O/K there is still room for a few more pounds. It is hard work but my dietician has phone appointments with me every 3 months to discuss my progress.
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