Residential clinics in Ireland for the Morbidly Obese?

Does anyone know of any clinics in Ireland that provide residential weight loss / counselling programmes for the morbidly obese?

I have a relative who is very depressed, smokes 60 cigarettes a day and is morbidly obese. I feel the only way to help (many other approaches have been tried and failed) is to persuade this person to take part in a residential programme where medical doctors, psychiatrists, nutritionists and physical fitness experts are on hand to assist.

I've tried google and not turned up anything. Maybe there aren't any clinics in Ireland?

Title expanded by ajapale

Re: Morbidly Obese

I'm not an expert....

Talk to your GP - they've seen/heard everything before. I'd suggest treating the depression first, then they might be motivated to stop smoking and address their weight afterwards.

Also, under EU rules, if the facility you're looking for is not available in Ireland, one can go abroad for treatment and the health board (?) is obliged to pay for it. Didn't Tommy Gorman of RTE make a programme on this issue when he had some sort of brain cancer?

Re: Morbidly Obese

Talk to your GP - they've seen/heard everything before.

I'd second that. If depression has been diagnosed then treating this will go hand in hand with dealing with other issues such as general physical health etc.

Also, under EU rules, if the facility you're looking for is not available in Ireland, one can go abroad for treatment and the health board (?) is obliged to pay for it. Didn't Tommy Gorman of RTE make a programme on this issue when he had some sort of brain cancer?

As far as I recall he availed of cover available under the E112 scheme and this, along with E111 and other schemes, has not been superceded by/subsumed into the ECIC scheme.

Re: Morbidly Obese

Thanks for your responses. This person has been treated for the past 20 years by a GP who, after trying various anti-depressants, seems to have given up. His attitude at the moment is 'there's nothing more we can do for you until you want to help yourself'.

Very easy to say when your not in the black hole that is depression and the vicious circle that makes exercise difficult because of the weight and lung damage.

Her partner has recently come into some money and feels that throwing some of it at the problem as a last resort might bring some normality to their lives. Maybe residential care in a clinical environment might prove to be the catalyst which leads to some improvement.

Currently she is up most of the night watching TV and eating. She sleeps until around 2pm and only gets up for a cup of coffee and goes back to bed again.

He's a nice person, maybe a bit too nice bordering on the 'enabling', who's at his wits end and I'm trying to come up with some suggestions / solutions which may be of some help.

Re: Morbidly Obese

a GP who, after trying various anti-depressants, seems to have given up.

If the GP only recommended a course of medication without any form of talk therapy/counselling then I'd strongly recommend that the patient consider choosing another GP who knows how to treat illnesses such as depression properly! If what you say is truly representative of the GP's attitude then it is a complete disgrace and something that should not be tolerated. Can you say what sort of depressive illness was diagnosed and what medications were prescribed? Has any specific underlying reason for the depression been identified? Has any sort of talk therapy/counselling been attempted? Has the person ever sought support from other self-help, counselling, helpline services etc.? Did they ever find that one particular attempt at a solution showed more promise than others? I would caution against people expecting a "big bang" solution to all of the issues here (depression and related illnesses if applicable, obesity, smoking, insomina (?) etc.) in one go as this is unlikely to be a reasonable expectation.

Re: Morbidly Obese

I recall seeing a programme on RTE some months back which revealed a frightening level of willingness among GPs to prescribe medication as the first option to deal with depression.

I would agree that in the first instance, this person should seek (or a friend should seek) the advice of a good and interested GP.

In my opinion, the faith that patients have in their GPs is undeserved in many cases.

Re: Morbidly Obese

To be fair, many GPs these days are aware that (a) medication should only be prescribed where absolutely necessary and (b) that a two pronged (drug and therapy) approach to treating depression and related illnesses is generally the most appropriate strategy.

As an aside.... in my opinion the concerns about most modern anti-depressant medications and treatments are rather overstated (e.g. that tabloid style Panorama programme about Seroxat a few years back, the regular rolling out of horror stories about ECT which is still a useful therapy in some circumstances etc.) and much of the media coverage breeds ignorance (e.g. anti-depressants are addictive, change personality, always cause the side effects listed etc.) rather than enlightenment about mental illness and its potential drug and talk theraputic treatments which helps nobody, especially those affected directly or indirectly by such illnesses.

Re: Morbidly Obese

Hi

Is she in Dublin ?

You could try the Marino Centre for eating disorders.

Its not residential but they do offer counselling for eating disorders, compulsive eating and 'eating distress', where food causes the person a problem.

They have a no diet approach and try to get to the root of the emotional component of the overeating.

Its a horrible place to be and it can be heartbreaking to live with someone in that space. At the root of the problem is usually very low self esteem, and a belief that life would be perfect if only the person was thin.
There are a number of good books out there...anything by Geena Roth is good, espically a workbook called 'why weight' which challanges the reader to confront why they eat and how they can overcome the eating problem.
You could also try www.bodywhys.ie
Best of luck

Edited by ClubMan to fix link.

Re: Morbidly Obese

Thanks again for the replies - Holly23, she actually lives in the North, that's why I'm looking for some sort of residential programme.

She's very difficult to help at this stage - particularly with the rock bottom self esteem and feelings of hopelessness. Is currently very unapproachable and will not even answer the telephone if it's not her husband on the line - she has caller id and knows who's calling.

I've located a few private hospitals on the UK mainland who provide residential care and will try to suggest to her husband that one of these may be worth a try.

I think at this stage she is incapable of making rational decisions for herself and it's up to him to take matters into his own hands and to seek the appropriate care for her. Unfortunately, after over 20 years of dealing with her depression, anxiety etc. and walking on eggshells, he has become somewhat desensitized to her plight and cautious about rocking the boat.

I'll update if we manage to find some help - it may help someone else who's in the same situation.

Depression and Obesity are a lethal combination

Now you mention 'husband ' I confess I am surprised he never 'signed her in ' for a programme ?

..

I know you said youre in the north, but is there anything useful on the [broken link removed] website?

check out their home page for a wide range of medical services and a chat room.

Re: ..

Now you mention 'husband ' I confess I am surprised he never 'signed her in ' for a programme ?

Not sure what you mean. Can you explain.

Is there any possibility that this individual might be in such a bad state that they may need to be sectioned/committed for a period of treatment for her own good and that of others around her? I just get the impression that the situation is pretty serious?

Re: ..

She should ask her GP to refer her to a psychiatrist. Her GP is not a specialist and after that sort of time frame without results they should have sent her on to a consultant.
I agree with Biggles comments about too much faith being placed in some GP's.

yes Clubman

"sectioned/committed for a period of treatment"

is what sign her in means. In other words I am afraid the poor womans health will not improve unless a responsible relative makes the decision for her.

Re: yes Clubman

Thanks Tonka - I just wasn't sure what you meant by "signing in".

Re: Morbidly Obese

This is what I would suggest:

(1) See a Consultant Physician preferably an Endocrinologist. There are many hormonal conditions that she could be suffering from. At the very least these should be outruled. In addition, gross obesity results in many health risks which may also be inpinging on your relative.

(2) See a Consultant Psychiatrist for a full assessment. There are many new drug treatments available now and a good Psychiatrist should be up to date with other adjuncts like psychotherapy.

She could be suffering from an obsessive compulsive disorder but I wouldn't prempt a specialist's diagnosis.

If you want to help your relative just remember that however well intentioned you may be, "help" is not always welcome. Sectioning a person is a very serious step and is usually reserved for the psychotic. It doesn't sound as if she is psychotic but she does need help. Since her condition is a long standing one, even if she has had these examinations years ago, it would still be sensible to be seen again assuming she is co-operative.

These are simple steps to take and likely to be the least disruptive and most acceptable. There is an excellent health service in Northern Ireland from what I hear. Even if it means going privately, it would be money well spent and a lot less than private institutional care which may not be available anyway. She might even be admitted to hospital for her examinations. Just make sure that the specialists are attached to the same hospital, preferably a University Hospital.

I hope you are successful in getting the ball rolling. She's lucky to have a relative who is concerned for her welfare.

8)

Re: Morbidly Obese

I have a close relative who works in the St Francis Medical Centre in Ballinderry, Mullingar, Co Westmeath. They run, as far as I know, a programme for treating clinically obese people. A few years ago, under the VHI, people could go there for treatment and usually were in for 3 weeks to begin with. I don't know how they continued the treatment after that. Then the VHI pulled the plug because they decided people were availing of a 'holiday' - (in a private hospital)! There are ways around this if you have private health insurance if you are being treated for 'something else' that necessitates in-patient treatment and can as a separate issue be treated for one of the 'causes' of the symptoms - i.e. obesity. You need a sympathetic GP and if the one you have isn't find someone else.

As for Ballinderry, my husband was there for varicose vein removal and my daughter for an eye complaint and both had very satisfactory treatment.

Hope this helps or gets the imagination going on finding a solution.

Re: Morbidly Obese

Sectioning a person is a very serious step and is usually reserved for the psychotic.

Just to be clear, I was not recommending this as a course of action and in no position to recommend any course of action in this context (even less so than offering financial advice!). I was just throwing out ideas in a brainstorming fashion as food for thought and in the hope that there might be some useful suggestions in there.

Re: Morbidly Obese

There seems to be some misunderstanding here - I didn't think you were recommending anything. In fact it wasn't you who wrote

I confess I am surprised he never 'signed her in ' for a programme

Click to expand...

I confess to being somewhat dismayed at this discussion about an ill woman, not to mention the notion that a person could be 'signed-in' at the proverbial drop of a hat. That kind of thing did happen in the last century. That it was even mentioned as a possibility shocked me. I wished to dispel that. That's all. Neither would I give advice in an area about which I knew nothing more than the average lay person - Finance, IT, Insurance, Engineering, Accountancy, etc etc. That list is quite long!

The brainstorming has come up with some good suggestions but unless the person concerned chooses to co-operate, there is nothing anyone can do. OK?

8)

Re: Morbidly Obese

Sorry - I wasn't having a go at you but was just clarifying my position. No offence intended. I agree that there have been some useful suggestions here and that it's difficult to come up with the "right" answer at such a remove and with only partial information (not to mention that most of us are not experts/practitioners in this area). I know first hand how difficult it can be to deal with issues of depression and related illnesses with compassion, pragmatism and efficacy. There is definitely no "one size fits all" solution in this sort of situation. I am heartened that such a topic, which I was afraid might attract the "wrong" sort of attention when it appeared, has actually elicited such constructive and caring responses. I must remember this next time I argue that AAM should be restricted to financial topic only!