Friday, 5 February 2016

A Weighty Matter

One of the most important issues I face is getting my weight under control. For most of my life I’ve struggled to keep my weight down, there have been periods more successful than others, but it really doesn’t take much for me to pile on pounds. Going back ten years when I was still playing low level amateur rugby league, training two evenings plus two or three gym sessions a week, my weight was in the region of 107kgs – 112kgs (17 stone to 17 ½ stone). That isn’t great for someone of my height (a shade under 5’10), and I far from fittest of forwards. By the time I got married eight years ago I was tipping the scales at 114kgs (18 stone), but things really got out of hand around four years ago when I injured two discs in my back and months of enforced inactivity saw me rapidly balloon to over 135kgs (21 stone).
The treatment for my back problem ultimately led to my CKD diagnosis when the hospital advised my GP to investigate my high blood pressure (although earlier warnings of CKD had been missed). Weight was one of the things my first consultant nephrologist immediately picked up on, there was talk of prescribing Orlistat and referring me to a dietician, but these were never followed up even after I raised them independently with my GP. Improvement in my back problem probably masked the issue slightly as my weight did start to drop over the next couple of years without any special effort on my part until it flat lined at around 125kg.
The consultant I’ve been under for the last couple of years suggested bariatric surgery from our first meeting, but again there was no official recommendation to my GP, not even a referral to a dietician. I find it interesting that despite consultants repeatedly writing to my GP advising on new medication schedules none attempted to instigate a process to assist my weight loss. My current consultant tells me this time she will be recommending bariatric surgery, but I haven’t seen the letter yet. Should I need to get on the transplant list in the next few years I need to be down to 100kgs, somewhere I haven’t been for the best part of fifteen years and even then a range I’ve only managed for two or three years out of the last twenty.
I don’t want sound like I’m abdicating responsibility for my weight issues to the doctors, the issues are deep and long standing, but I strongly suspect a referral to a clinical dietician would have been just as helpful as tweaking my pills. Yo-yo dieting hasn’t worked out so good for me and the moderate but regular levels of exercise I try to fit into my busy home and (largely sedentary) work life mean I’m probably relatively fit for an obese man, but there’s limited prospect of me suddenly discovering an athletic streak. I don’t believe it’s the case that I have a horrendous diet, yes I like sweets and beer, but I don’t binge on them. I think I generally have a slow metabolism and professional help figuring out what foods and eating patterns work best could be a major step, a referral for bariatric surgery may be enough to kick start the journey.
In the mean time I have kicked off a new crash diet structured around my new job and enforced by the fear of dying before my kids reach adulthood! In the first week I've dropped 2.6kg from 124.3kg to 121.7kg, but the first week of a new diet regularly over promises. Let’s see how things go from here…

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