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Old 11-28-2007, 05:27 PM   #1
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Default Medical Professionals & Obesity

I'll preface this by saying I do realize medical professionals have a responsibility to talk to their patients about weight and unhealthy habits. But sometimes I think they get so fixated on the weight, they neglect other issues.

I'm going to be "firing" my gyn. She's taken an interest in the whole weight issue, which I don't have a problem with, but IMHO, she's a bit extreme saying bread only once a month, have sashimi instead of sushi to avoid the rice. Yeah, because a sushi roll is just a carb bomb waitng to go off

I'd be willing to take that with a metaphorical grain of salt, but at my most recent appt., she completely overlooked giving me a referral for a mammogram. I've already had my baseline done a few years ago & I had my most recent one in Feb of 2006. I remembered before I left the office, so I asked the staff, saying, "I'm 41, I had my last mammogram in early 2006, do I need to get another one?" They couldn't answer off the bat & asked her. I got the response, "if the patient wants one, we'll write one." So I took it to mean that I didn't need one and left. But the uncertainty made me look into it & sure enough, the recommendation for women over 40 is once a year. So now, I have to go get the referral. I think it's kind of disturbing that she'd use our appt. time to go into the nutrition issues (which I think she's somewhat obssessive about) and neglect the mammogram issue. Not to mention, I have lost some weight since the last time I was at her office, my cholesterol's down a bit and my blood pressure is a bit lower than it was. And I let her know I'm working with these issues with my GP.

It would be bad enough if she neglected anyone's mammogram recommendations, but we did discuss during our last appt. that my mom has had breast cancer & a mastectomy (she's doing well, thankfully). Even though it's less likely to be heriditary due to the age of onset being over 50, it's still a concern and I think she really dropped the ball on this one.

I wouldn't go the extreme of firing if we both just forgot to bring it up. But I remembered and I got bad info. That makes me doubt the quality of care.

Weight loss is since May 2004

Last edited by nylisa; 11-28-2007 at 05:33 PM.
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Old 11-28-2007, 05:51 PM   #2
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The whole gyn visit sucks enough already without having to add being concerned about the quality of care. The "if the patient wants one, we'll write one" response seems very dismissive to me, especially with your family history.

I'd probably change as well if I wasn't comfortable. Of course I'd fire anybody who tried to tell me that I could only have bread once a month.

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Old 11-28-2007, 06:08 PM   #3
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This has always made me really upset. I had SO much trouble getting doctors to pay attention to actual, genuine problems when I was obese. All of them focused on the weight, and none focused on the actual issue at hand. My period stopped for 6 months due to a weird hormonal imbalance, and it took 4 doctor visits to get someone to say something other than "lose weight" - turns out my hormonal system had gotten completely out of whack, and it was a relatively easy fix...a pill to introduce the right hormones into my system to induce a period and my cycle got regular again. The problem itself may have been related to my weight, but the solution wasn't at all!

Then there was the knee issues. I've had painful knees since middle school...to the point where I couldn't really be active without a lot of pain. It took 5 years of going to doctors before they gave me an MRI to figure out of there was a real source for my pain - shocker, there was, and I had surgery to correct it. Fast forward to now, normal BMI me goes into the doctor with the same symptoms, have an MRI a week later, and am getting surgery within 2 months. Every doctor when I was heavy told me that losing weight would solve my knee problems, with no investigation into what the problem might actually be.

It is very important to find a doctor who can look past size and won't neglect your other care in favor of weight management. Hopefully you'll find a better GYN.
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Old 11-28-2007, 06:54 PM   #4
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I could have gone to any number of my friends for my annual this year but I went to a family practice doc so I could have some anonymity. Big mistake. Her bedside manner was horrible and the actual pap took way too long. Was my cervix MIA? I don't think so!

Next time I'll go to one of my friends....but I digress. I'm sure that I have had patients who were not thrilled with me, cause that's the way life is (when I tell them there is no medical reason for a 3D ultrasound and their insurance won't pay for it, for example, or they have chlamydia and they get mad at me for telling them---hey, don't shoot the messenger)! But many many of my patients are referrals from their sisters, cousins, mothers, etc. Yesterday one of my longtime patients said she is sending her teenage sister to me cause I am nice and I am gentle. Women are so much more than parts stuck together.

And, yeah, you should have that mammo and your gyn shoulda scheduled it. Ask around to find someone who will listen to you! A health care provider might have an agenda for the visit, but it is pretty much irrelevant unless it is the same agenda as the woman's.
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Old 11-28-2007, 07:11 PM   #5
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Um....why is your Ob/gyn dealing with your weight and your nutritional status? Isn't that kind of...not her speciality? Color me confused.
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Old 11-28-2007, 08:09 PM   #6
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i was actually upset that my gyno didnt mention my weight. i thought it was something he should have mentioned. it was my first time there. i complained of irregularity and pain....things that could actually be related to my weight.
i think theres a fine line, but i dont think doctors should just look past weight.
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Old 11-28-2007, 08:15 PM   #7
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The first time I went to this one doctor, I mentioned my weight, and he said that all my tests were fine, and I shouldn't worry too much about it. Six months later I went back to the same doctor, and suddenly he was all over my weight--I had to lose, I was obese, etc. Now, I didn't change a whole lot in those six months--I hadn't suddenly ballooned up. All I can figure was that the first time he was in a different frame of mind than he was the second time.

I think all these experiences go to show that we really need to be looking after our own health, and not rely on a doctor to always tell us what's right. They are just people, after all.

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Old 11-29-2007, 11:15 AM   #8
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Originally Posted by sidhe View Post
Um....why is your Ob/gyn dealing with your weight and your nutritional status? Isn't that kind of...not her speciality? Color me confused.
Her approach is based on how a lot of women don't necessarily go to GPs for annual check ups so she wants to make sure they're aware of health issues. To an extent, I agree and respect that. Where I take issue is trying to advocate a particular diet (low carb vs. just generally healthy) without regard to whether it will work for the patient. And she knows that I'm working with my GP on it, so the not going to the GP for annual check ups doesn't really apply to me. I'm sensing she has her own issues with weight (she mentioned that she "blows up" when she eats a lot of carbs) or that someone in her family has had them and she's afraid of developing a weight problem. If it weren't for what I consider the negligence (neglecting to refer for the mammo & the answer I received when I rememembered to follow up on it), I'd probably just let it slide or have a discussion with her about it.

My previous gyn had a nurse who was gung ho Atkins & Billy Blanks. And was trying to push that on me. What is it with gyn offices & carbophobia? I've cut down substantially on both carbs & fat & I've lost 60 lbs over the last 3 years. I've upped my activity levels & even though I've been in a plateau for a bit, I've went down a dress size & generally feel more fit even during the plateau. Plus the blood pressure & cholesterol are continuing to go down too. But I do like the occasional carb treat (pasta/rice). Having talked with a nutritionist, she confirmed as long as I watch the portions & frequency, it's ok. And I do look for the Whole Grain Council's stamp when possible to make sure they're better carbs (e.g. brown rice instead of white rice). I just don't get the carb demonization.

Though, to be clear, I'm not criticizing Atkins/other low carb plans. If they're what works for you, great, go for it.

I've also had a tendency to yo-yo. At 5'8, I've been as low as 120 & as high as 250. What I noticed is that each time I regained after a loss, my high weights kept getting higher. So, I gave up on diets & focused on lifestyle changes. In fact my initial goal was just not to gain anymore weight.

Weight loss is since May 2004

Last edited by nylisa; 11-29-2007 at 11:19 AM.
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Old 11-29-2007, 11:26 AM   #9
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. Every doctor when I was heavy told me that losing weight would solve my knee problems, with no investigation into what the problem might actually be.
I've been having knee problems the last year. My mom never really took me to the doctor. I said, "I feel like it's helping it with loosing my weight."
She told me that if I went to the doctor the first thing they'd tell me is to lose weight.

When I was having UTI, I had to change from my peds doctor to the adolescent doctor. Evidently, this doctor went on and on about my weight. Honestly, I blocked it out. The next appointment was with my peds doctor. He wanted me to loose the weight but he was nice, supportive and wonderful about it. I rememeber exercising when I was young and thinking, "I'm doing this for him." I'm going to send him a nice before and after picture and letter to thank him. He and my mother were the only POSITIVE people about me loosing weight when I was a teen.
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Old 11-29-2007, 11:42 AM   #10
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Strangely enough my worst memory of a horrible doctor's visit was with a very heavy doctor. She was meaner to me than anyone I had ever seen and I left the appointment in tears. I am not a person who has ever responded well to negative motivation, which I think exacerbated my problems a lot over the years.

When I told my GP that I had been having some joint issues she decided to test me for Lyme disease since that can be one of the symptoms. I didn't have it buy I love the fact that she didn't say "it's just because you're fat". What if I had gotten Lyme disease and because of my size a doctor failed to diagnose it?

If you are not happy with your doctor and you don't feel like you are getting adequate treatment you should definitely switch.

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Old 11-29-2007, 03:54 PM   #11
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When I was in Illinois, I had terrible problems with doctors attributing every health problem and even minor symptom to my weight AND leaving it at that, basically saying "Weight loss will solve your problem, so go lose weight." I had to tell several doctors, "I'm trying, but you know what, I'm not going to lose this weight in one week or even one year, so could you please address the body I have now, not the one I might have next year."

In Wisconsin, I have had only one bad experience with a doctor, a rheumatologist (new to the area, interestingly enough) who wouldn't listen to anything I said, and basically told me to get WLS and come back if I still had problems after I had lost the weight (If I really do have a serious autoimmune condition as the doctor referring me suspects, I could be dead by then). I went back to the referring ENT and my family doctor, and apparently they can deal with the issue unless (or until) it gets much worse, they just would have preferred to get a rheumatologist involved early on, rather than "eventually." I'm just hoping by then the rheumatologist (the only one available on my health plan) has been replaced or I will choose another health plan. Even if I have lost the weight, I'm definitely not going back to him.
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Old 11-29-2007, 08:11 PM   #12
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Hi, I've been lurking for awhile and haven't gotten around to introducing myself. (I guess I wasn't quite ready to start this journey again.) I saw this topic and just had to add my own experience.
I'm female, 30 years old, and have been big for as long as I remember. Every doctor I have ever been to (that I can remember, anyway) has made an isssue of my weight. I was put into a kids weight loss program in second grade, which didn't work, and I went on Jenny Craig in eighth grade. It only worked for awhile. Everybody made my weight such an issue when I was growing up that it became intricately tied to my identity, and really messed me up. I admit I still struggle with a lot of the issues today.

Anywho, growing up, I didn't like doctors. Being told I needed to lose weight was like being told I was a lesser person, and I avoided going to see a doctor as much as possible. Well, in my junior year of high school, I started getting horrid, painful, clenching, stomach aches off and on. The only things that really seemed to help were warm baths and forcing myself to empty my stomach; I got pretty good at it. It went on for about two years. When it got real bad, my mom would take me in to see my doctor even though I didn't want to go. He'd address my weight and didn't take the stomach pains seriously. Maybe he thought I was making it up to get out of school- who knows. I know there were times when my parents didn't beleive me, but a particular episode where I spent a couple hours in the bathtub, literally howling in pain, convinced them I wasn't faking.
Finally, I was taken to urgent care. The doctor took my complaints seriously and scheduled me for an untrasound. Turns out I had a galstone the size of "a chocolate covered peanut," and my galbladder removed a couple weeks later. I haven't had any problems since.

Last edited by call me e; 11-29-2007 at 08:13 PM.
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Old 11-29-2007, 08:43 PM   #13
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I remember watching a show on Discovery or FitTV that had people who had lost weight talk about how they did it. One woman said that she had horrible periods, lots of pain, and the doctors just said "lose weight." On a plane ride, she ended up bleeding copiously and was taken off in a stretcher because she had some kind of (benign) tumor that had grown large and burst. It's hard to be an overweight person trying to get your doctor to look past the weight--kudos for anyone who can be assertive enough to do it.

My DD has PCOS and because she's not very obese (perhaps 40 lbs. overweight) and doesn't have some of the more observable symptoms, new doctors question her when she says she has it. She has to tell them that yes, indeed, she has seen the ultrasound of the polycystic ovaries. Now, you can have PCOS without visible cysts, but because of her (lack of) weight, she's always having to "prove" that she has PCOS. And her doctor won't test her for insulin resistance because she's not morbidly obese, which, IMHO, is stupid. So in some sense, she's experiencing reverse discrimination because she's not fat enough for the diagnosis. Weird!

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