Surgery and a high BMI

shortstuff007

Hello I am so glad to have found you. I will try to keep this short. I was first advised I had arthritis in my knee 5 years ago. I was put on a list to see a consultant but advised then I was a bit young and should lose some weight. I joined a gym and was working out 3 times a week until a flare up meant suddenly I was in immense pain.

Back in 2021 I was invited to have a new x ray and it was decided I needed surgery, my BMI was checked and I was advised to lose weight, I am only 5foot so BMI isn't very forgiving! A few months later I received a pre op appointment.I was delighted. I was in the ward and first thing was to take my height and weight, I was told to come back when I had lost weight. I was out in 5 minutes absolutely devastated.

I can't exercise as I can only walk now with a walker, I need 2 knee replacements, I have lymphoedema which makes my legs ache, I had surgery for cervical lymphoedema in 2021 which has halted symtoms but not improved them. I have lots of problems as a consequence. Including weight gain partly from the side effects of drugs. My mental health has just got worse and I feel hopeless.

My question is how can I ask the GP to help me get surgery based on the fact that research has shown that BMI shouldn't be a reason to refuse surgery.

Sorry for the long post and thanks for reading

Debbie

noddingtonpete

Hi @debbiegough and welcome to the Community. We are a friendly and supportive group and I hope that will be your experience as well.

I understand that you have arthritis in your knees and been denied surgery due to your BMI. I also understand that your medical condition makes reducing this very difficult. I hope others on here can help you from their experiences.

Have a look through the following and see if it helps

https://www.versusarthritis.org/about-arthritis/treatments/surgery/knee-replacement-surgery/

and

https://www.versusarthritis.org/about-arthritis/exercising-with-arthritis/lets-move-for-surgery-toolkit/

Please let us know how you are getting on.

With very best wishes,

Peter (moderator)

frogmorton

This is a really really tough one @shortstuff007

Like your name BTW!!

Increased immobility, medication and pain do make exercise really hard therefore losing weight even harder. Resulting in you feeling lower and the pain getting worse the mobility getting worse etc a vicious spiral downwards.

I am so sorry it's an awful position to be in.

If it helps there are people on here, some even wheelchair users, who have been able to lose weight. They have had to do it predominantly with diet though so it wasn't pleasant at all.

I know this because some of them used to check in with us and we all supported them.

This is one of their threads, but there are others if i could remember everyone's names:

https://community.versusarthritis.org/discussion/47105/am-still-chipping-away-at-the-weight

If you wanted to do the same I for one would support you and you might find others joining you as well.

Take care ((()))

Toni x

Fif

If I were you, I'd go back to my GP and ask for help/support to lose the necessary weight. It's not much use someone telling you to come back when you've lost weight without offering any assistance. If you were a smoker trying to give up, you'd be given lots of different strategies and support, why not the same for weight loss? There is a new injection which seems to have helped people shed the extra pounds. Ask if you're eligible for it or any other treatment. In addition, I'd probably consider something like Weight Watchers. Mutual support can often be a help rather than struggling along by yourself. Having been overweight myself in the past, I know how difficult it can be, particularly with reduced mobility, but everyone on here will be rooting for you to succeed. Good luck and keep us posted.

veryaraf

Hi, I lost weight to stop taking diabetes meds but also have crippling arthritis. There are ways of coping. Once you reach your target - mine at around 10 st. it gets easier and you can level off.

Eat fresh as much as possible, avoid foreign fruit that is too sweet, try and have a friend doing the same to encourage you, the first few weeks are the worst as the body gets used to the changes and quantities. Maybe keep a food diary. I still have treats but not random. If I have something sweet it is a yogurt, fresh fruit etc. and at certain times of the day. Nuts and dark choc are good. It is do- able. Not sure if this helps but it is worth it. Maybe do more things to distract you from food like puzzles.

You have a goal which is achievable but it won’t happen overnight. Take care and lots of love. Sadly you are not alone. xxx

TLee

I see a hip replacement in my future, although I have yet to seriously discuss it with my doctor. I took it upon myself to lose weight in order to have an easier time when it does happen. I have lost 20 lbs so far, after having several false starts and returning to old habits (still sometimes an issue, but I swear that carrot cake was calling my name!). I started with a strict calorie count, cutting anywhere and everywhere I saw a possibility. Some low cal substitutions were not at all to my liking (Ever try the Japanese rice substitute sometimes called Miracle Rice? It's definitely not miraculous!). Trial and error has given me a pretty good handle on healthy food options that I enjoy, and I might be almost to the point of preferring them. I am not someone who enjoys exercise, but as I lose weight and gain energy I find that I can move more. Even caught myself dancing in front of the dog the other day! Best of all, my hip hurts less. With less pain, my mental health is much better as well. I think that you can do this!

Try to keep things positive. It's a little thing but I never say I'm dieting, I say I'm eating healthier. It can be fun to get inventive and imagine ways to cut calories. If an idea doesn't work for you, move on but don't give up. Some discoveries that I can't be without: Vanilla low-fat Greek yogurt--you can mix in fruit (or fruit preserves) or a small amount of cocoa powder, but I love to crumble a couple of ginger snaps into it. Wraps to use in place of bread, but they need to taste good (not like plastic!). I use tortilla wraps that are high fiber & low carb. You can use them for sandwiches, but I really like to warm one in a toaster oven, spread on a thin layer of cream cheese & sprinkle with everything bagel seasoning for breakfast. If you are tempted by crunchy snacks, see if you can be happy with crunchy veggies instead. I love the colorful, small sweet peppers you can buy by the bag. My trick is to have them with a really tasty dip (there are some yogurt-based salad dressings that are nice--I enjoy a ranch or bleu cheese flavor). Finally, I think that one thing that has helped me, even when I allow some extra calories to sneak in, is that I try very hard not to eat after a certain time in the evening. I sometimes go to bed feeling a little hungry, but I try to see that as a good thing!

I am not a weight-loss expert (obviously), and I know that 20 lbs, although significant to me, is not a huge loss. I just feel so much better that I'm excited for others to have a similar experience. Thank you for letting me get on a soap box for a minute, and best of luck to you with everything.

stickywicket

"My question is how can I ask the GP to help me get surgery based on the fact that research has shown that BMI shouldn't be a reason to refuse surgery.'

Hi @shortstuff007 , I'm sorry but I'm not sure you can. Different trusts have different criteria and I doubt a mere GP can go against it. You don't say where you got your research from but I'd guess that it might be medics talking about an ideal world. Possibly even U.S. medics where money isn't a problem as insurance companies are paying. The fact is that, if patients are overweight, the ops can taker longer surgery hours and complications are more likely so hospital stays are likely to be longer ie all more expensive. This is hard on anyone needing a new joint but I guess, with waiting lists so long, it makes practical sense.

@Fif , @veryaraf and @TLee - you are all amazing. Well done!

@frogmorton - I remember @GraceB . I also recall @Turbogran losing a lot of weight and someone who lost 5 stones despite being confined to a wheelchair. They were all given a lot of encouragement as, I'm sure, @shortstuff007 would be.

Jewels1973

Hi @shortstuff007 firstly I know how frustrating this must be for you. I have lymphodema in my legs up to my knees and like you I’m only 5ft. I’m sure that you will probably have seen a Lymphodema Nurse if you haven’t and aren’t in any compression garments it might be worth asking your GP for them to send you to one. In 2009 I was diagnosed with Lymphodema and put into compression garments. It helped me lose weight. I’m still very curvaceous shall we say but it might be worth a shot as if you have uncontrolled lymphodema it might be adding to your weight. It was just a thought. I’m sure you’ve been down that path and know all about it. I’m so sorry doctors haven’t been more understanding and I’m sending you my love. I went again in June & they have some great new easier to put on compression garments. I hope this helps in some small way. You aren’t alone xxx

Lambourne

Reading your story seemed very familiar to my own although I am 5ft 8, I have been told by consultation I need both knees replaced and loose weight and come back in 6 months - very unhelpful and unsympathetic, I tried to argue that BMI should not be a factor and was basically told that they are doing the easy/fit patients to get numbers down not those that might be complicated. I asked my GP about the weight loss injection and was told that these things get into the news way before they are actually available and he didn’t really know much about it. GP did refer me to weight management online which was refused as I am not diabetic or have high blood pressure, his only other advice was to ho yo Slimming World. So basically I am on my own trying to loose weight and barely able to walk most days. Sorry I don’t have any practical advice for you but you are not alone. I do go swimming sometimes and the gym occasionally but it isn’t much, I found the older council gym far less intimidating than the shiny new one!

Venuskye

Hello, this is my first post so I am a little nervous as I write. I am in exactly the same position I have been on the waiting list for a knee replacement for 2 years, I was told to lose weight as my BMI was too high. I have so far lost a stone and a half but I have been told I need to lose more as my Consultant wants my BMI to be 33. I am now also finding it very difficult to be active and mobile due to pain and stiffness in both knees. My GP has not been very helpful or supportive regarding weight loss. and pain management. I woinder if it is worth getting a second opinion with a Consultant at another Health Trust. If I could afford it I would pay for private treatment but my weight would probably still be an obstacle.

Poppyjane

Hello @Venuskye and welcome to the online community

Apologies to everyone who has posted above, interrupting the thread whilst I welcome @Venuskye .

Don't feel nervous, you are among supportive friends. We aim to be here to support anyone affected by living with arthritis and as you have been on the waiting list for two years you must have had the condition for much longer.

First, congratulations on loosing a stone and a half that is no mean achievement when struggling with painful knees. Maybe Toni's idea of a group of members supporting each other to loose weight is worth pursuing ?

https://www.versusarthritis.org/news/2021/september/top-tips-to-manage-your-weight/

Is there another GP in your practice who may be more supportive of your weight loss and pain management? Or another Consultant within the same department as the one you have seen?

I hope you will find the support you seek , let us know how you get on.

Best wishes

Poppyjane

shortstuff007

Hello everyone, thanks for your support. My GP has written to the surgeon, and I have embarked on healthy eating. Three weeks in and I feel a bit lighter and it is getting easier. Somehow I am still running my own business, but tbh it is just getting really difficult. It means I am often home late and eating late but I'm trying not to beat myself up about it, it's something I can't change at the minute

Thankyou for being there it really means so much

Debbie

stickywicket

Hey, well done, you! And quite right not to beat yourself up about the inevitable. Keep going😉

veryaraf

It does take several weeks to adjust, particularly the taste buds. The stomach gradually shrinks and the cravings become more controllable. I found things tasted too sweet than before which also helped. Don’t beat your self up just steadily try to improve. .Avoid, pies, floury things and sweet stuff (stick to English fruit). Gets easier.