Weight Loss Support - Insensitive Doctor Rant-so upset




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sapostrophee
02-14-2007, 07:20 PM
Four years ago I lost 64 pounds, going from 204 down to 140. I have kept it off very well, but in the last year I quit smoking and was on high dose prednisone and ended up gaining about 20 pounds back. Now I am six weeks pregnant and 165 pounds at 5'4". I know this is not ideal but my BMI doesn't even qualify as obese, only overweight. Keep in mind I have large bones/muscles and this puts me wearing size 8 skirts and dresses, size 10 pants.

I went to the dr. today for my first pregnancy check up and she told me that she is so concerned about how "heavy" I have gotten that she thinks I should gain NO weight, zero pounds at all during my pregnancy. She is very skinny and not only does this seem like bad medical advice from everything I have read on the subject, it also was not delivered with any concern or sensitivity for my feelings and I am very very very upset about it.

She was talking to me like "oh you should eat vegetables before candy" and
"try exercise, just a little walking" as if I have no clue how to manage weight. I can't stand people who have never had a weight struggle and don't understand that I do all those things, I do not eat insane amounts of sweets and candies and I am doing the best I can.

This same doctor never said A WORD to me when I lost all that weight. Now I feel like I am getting no credit at all for the additional forty pounds that I have managed to keep off for five years now.

Anyway, just really really really needed to vent on someone besides my poor husband since we are keeping quiet about the pregnancy until we are further along.


P.S. This doctor won't be delivering my baby anyway, she doesn't do deliveries only gyn


veggielover
02-14-2007, 07:24 PM
Well, if she's never had a child herself then maybe I'd understand her ignorance... Doctors aren;t the brightst and smartest people in the world. Many of them are very impersonal and got lucky when applying to medical school.

shelby897
02-14-2007, 07:31 PM
Do you think you will be comfortable during your pregnancy seeing her or would you rather see the doctor who will deliver for your prenatal care? Someone who understands it's healthy to gain a reasonable amount of weight?


lilybelle
02-14-2007, 07:33 PM
I think she was being totally insensitive. As someone who has been on high dose prednisone , I commend you for only gaining back 20 lbs. Great job. I gained 50 lbs. in last 3 years while on a lot of prednisone. (I'm on a lower dose now but still on it). I'm glad to hear she won't be doing your delivery. As a former OB RN, I have seen many women twice your size or more deliver healthy babies. I think her advice on not gaining any weight during the pregnancy is ill-advised. Congratulations on the pregnany and I hope you can find a Dr. that is more caring of you as an individual.

ennay
02-14-2007, 07:38 PM
First of all :woohoo: :carrot: congratulations!

VERY VERY bad medical advice.

The recommended weight gain for someone of your height and weight is 15-25 lbs.

Personally, having done this twice. Try not to stress about your weight. Eat healthy foods, get exercise and what will be will be. My metabolism went to pot and I overgained both times - stay active though

from a dietary standpoint, there is no additional caloric need during the first trimester, and only about 300 calories/day extra during the other trimesters, so if you have an idea what maintenance was for you - that gives you a ballpark.

Ash15+
02-14-2007, 07:40 PM
I know that this is probably not what you want to hear, but I think she is trying to look out for you. In medical school they are taught to be blunt, I really don't think she was trying to hurt you. I think that if she said it, she truly believes that it would be best for you. The fact that she did not notice when you lost a significant amount of weight does not surprise me. I have had a lot of experience with doctors and in my experience none of them have ever been the most personable people. My sister is starting medical school and to be honest she is not the most personable or sensitive person, but I know she will make a great doctor because she is very smart and very intuitive. I have crohn's disease and have been with my specialist for just over two years, by all accounts he is the best in his field, but he is very blunt and not very friendly. Why do I keep going to him? For me, what it boils down to is, do you want to put your life in the hands of someone nice or someone who is a subject matter expert?

ennay
02-14-2007, 07:42 PM
I should add that my OB and many others think that the weight gain guidelines are utter crap. That the stress of trying to gain more or less than your body wants to is more harmful than over/under gaining. That's not to say go hog wild, but if you are eating healthy foods most of the time then just accept what your body needs to do.

ennay
02-14-2007, 07:43 PM
For me, what it boils down to is, do you want to put your life in the hands of someone nice or someone who is a subject matter expert?

a subject matter expert would not say gain zero unless you were morbidly obese, ACOG minimum is 15

redlight
02-14-2007, 08:04 PM
Congratulations on both the weight loss and the new pregnancy! The doctor definitely sounded insenstive.

willmakeit
02-14-2007, 08:09 PM
I once met this very skinny dietician who was bragging about how she gained 10 lbs last month from her leg fracture but lost it all in a week by brisk walking for 30 minutes a day!!! (probably implying that its as easy as that and fat people cant even walk for 30 minutes a day or it'd be all gone)...

Too bad for her...she lost one patient!

midwife
02-14-2007, 08:13 PM
Yeesh. Find a new doc. Or find a midwife. Find someone who is knowledgeable and compassionate.
And congrats!

Ash15+
02-14-2007, 08:18 PM
a subject matter expert would not say gain zero unless you were morbidly obese, ACOG minimum is 15

I just mean that sometimes what they lack in social skill, they make up for in smarts and knowledge. That is just one person's opinion, you always have the option to seek another opinion if you are not comfortable with what is being recommended.

Gogirl008
02-14-2007, 08:31 PM
sapostrophee, the first pregnancy can be nerve wracking enough with out having an insensitive Dr scolding you. If you are only 6 weeks along you have plenty of time to find someone that you are comfortable with. I agree with a couple others that she probably was just very matter of fact in her mind, but but that is just not cool. A little hand holding is a good thing when you're pregnant and nervous. You have another 7 1/2 mos to go. Ask your friends who they'd recommend.

AquaWarlock
02-14-2007, 08:36 PM
I think the doc could be more tactful on her own delivery of advice -- yes, it's a bit alarming to gain 25 lbs. @ 6 weeks into pregnancy (though this is MUCH better than you smoking through it), but there are some special weight/nutritional concerns that you should be aware of as well as you go further into pregnancy, such as continuing to do exercises that are friendly for pregnant women & their changing centers of gravity. Also, dietary changes are needed because you're eating for two now -- you want to be eating healthful foods but not depriving yourself from so much calories that the baby will be negatively affected from development.

problysewin
02-14-2007, 08:44 PM
All I can say is MIDWIFE!!!! I had a similar thing happen to me and I switched to a midwife and it was the best experience of my life!!!!!

midwife
02-14-2007, 09:05 PM
Gosh, I like you, probly!

Here is how I approach a pregnant woman who has had wt issues in the past.
I start by asking about her history and I also gain insight about her knowledge re: nutrition, exercise, etc.

I talk about what the books, studies, professional organizations say. ACOG says about 25-35 pounds or so. That is not really based on any studies. They just increased it from the 10 pounds they recommended in the '60s.

We discuss how she will feel watching the scale go up. Some women choose not to be weighed during the pregnancy. Weight is just a single component of evaluating a healthy pregnancy, and not often all that great of one. Other predictors of fetal growth are fundal height measurement (also not that great) and the woman's perception. I ask women, "Do you feel bigger?" How often do you think "no" is the answer? : )

I talk about WHAT the weight is. Some fat, yes, but the blood volume increases by 30+%, boobs grow, then you have the kid, the placenta, the fluid around the baby, and those swollen ankles at the end.

We review her diet and exercise. I offer a referral to a nutritionist. Quite frankly, as long as the kid is growing, I will not live and die by the scale. I have caught 8 pound babies pushed out by women who have gained 2 pounds and also by women who have gained 60.

I look forward to the day when it is routinely recommended that women eat between 2000 and 2500 calories of nutrient dense food and walk every day (except in cases of previa, triplets, preterm labor, etc). Eat healthy. Move. Push out a good baby.

Off the soapbox now!

sapostrophee
02-14-2007, 09:18 PM
Feeling much better to get so much support. I obviously didn't expect her to be overjoyed at my weight gain, but I definitely do not think it is at all normal to advice someone to gain no weight at all, that is what I objected to. Just to clarify, I didn't gain 25 pounds this month in response to the pregnancy, it was gradual over several months previous with prednisone/quitting smoking. So my starting pregnancy weight was 165, I haven't gained a pound since getting pregnant.

Anyway, I really really appreciate all the support, I am definitely going to get a new doctor,and pick myself up and just eat healthy and be happy! thanks everyone

redlight
02-14-2007, 09:26 PM
Good for you!

I wanted to add a positive doctor weigh-in story. Two years ago, I went in for a routine physical, and was weighed by the nurse. I knew that I had gained some weight, but hadn't been checking. She knew that I had gained, cause I had been with that doctor and nurse for a couple years before that.

She didn't say that I should lose, I did and she nodded. She struck just the right tone.

Angihas2
02-14-2007, 09:49 PM
I was 127 when I got pregnant with my twins, I ended that pregnancy at 35 weeks, weighing in at 269, AMAZING amount of weight gain. I went from very active to very very inactive. Complete and total bedrest through the pregnancy due to health issues. After the babies were born, at my eight week check up, I weighed in at 229. I had lost the "baby weight" but kept the fat I had accumulated. When I got pregnant with my daughter, I used a midwife and started her pregancy at 255, highest weight of 289 at term, 8 week check up, weighed in at 255. Same with my son. I lost all the baby weight from the last 2 pregnancies but kept all the weight I had accumulated from the first pregnancy. Regardless of starting weight, unless you are absolutely morbidly obese, being told to NOT gain weight is unrealsitic. Your very organs are going to gain weight, your uterus will gain, your blood volume increases as does the amount of water you gain. Not gaining any weight at all, in my opinion put not just you, but your baby at risk. No, you dont need to go on a food binge, simply because you're pregnant nor do you need to eat for 2, as most people think, simply because baby doesn't NEED 1200 calories a day, so, guess where those extra calories are going to go? Right.

You've done an incrediable job not just losing weight, but maintaining for 5 years. I commend you for that. Take those same healthy eating habits and apply it towards your pregnancy. My midwife advised me, on my last 2 pregnancies, to get the extra calories you need, roughly 300, have a few low-fat yogurts a day, include them in your snack. Thats all it takes and it gives you extra calcium, which most of us are lacking during pregnancy and afterwards anyway.

If you aren't comfortable with this doctor for your pregnancy, but you're happy with her otherwise, use her for your general health needs, but honestly, if she's not the one who would be delivering my child, she wouldnt be my primary caregiver during pregnancy. I had a great GREAT doc during the twins pregnancies, very understanding and caring, I just wished he had been more stern in the issue of my weight, I like most women, assumed I would lose it all after they were born. My midwife with the last 2 pregnancies was VERY straight forward, while being very caring. She referred me to a nutritionist who taught me what I needed and what my baby needed vs what society/family will tell you.

Good luck with your pregnancy!

ennay
02-14-2007, 10:27 PM
I look forward to the day when it is routinely recommended that women eat between 2000 and 2500 calories of nutrient dense food and walk every day (except in cases of previa, triplets, preterm labor, etc). Eat healthy. Move. Push out a good baby.



The British equivalent of ACOG is considering just that last I heard. Because its true, some women could eat like a pig and gain nothing during pregnancy--I had a skinny skinny friend who couldnt gain no matter what. Her doctor here ordered her to eat a big mac and a milkshake everyday for SNACK and she already ate a huge dessert every day & 3 big meals. Now tell me what kind of nutrition that baby was getting from force-feeding her a big mac? And I personally watched what I ate and ran like a maniac and still gained 46 lbs. Its all in what your body chooses. My baby would not have been as healthy had I tried to force it to only gain 25 lbs.

Nikaia
02-15-2007, 12:58 AM
My baby would not have been as healthy had I tried to force it to only gain 25 lbs.

That's the real thing right there. Why are people - society, many doctors, etc - so obsessed with ONLY a pregnant woman's weight? Why don't they ask "are you eating healthy food?" or "is the baby healthy?"...not "why are you/aren't you gaining weight?" Witness the current obsession with celebrities losing baby weight as a spectator sport. It's always "Ooh, she's back to pre-pregnancy weight inside of two months!" not "The baby's doing really well and she seems to be healthy". Drives me nuts.

But it certainly says a lot about our priorities as a society.

Aquanetrocker
02-15-2007, 04:19 AM
I once had a doctor tell me that she kept her weight in check by fasting for two days every week... and maybe I should try that out... geez...

Isn't it funny that we all just assume doctors are going to give sound advice and then they open their mouths and ruin it?

Mami
02-15-2007, 05:31 AM
I went through a horrific experience with my first ob-gyn last year when I was pregnant with my daughter. I was gaining lots of weight, just like my sister (who gained the same 65 pounds though she has always been naturally a size 0 to 4 so this could very well be hereditary), and this male doctor doctor (who happened to be obese himself) YELLED at me "you're gaining too much weight! do you want to have a child with cerebral palsy! do you want to have a child that can't walk or talk?!". I was so taken aback! He never even explained how my weight could any in any manner cause the above horrible conditions. Needless to say I had to find another ob-gyn, quite late in the game at almost 6 months pregnant, and consequently went longer than I was supposed to without a visit, but it was worth it. The man was horrible and caused me stress and anxiety about my baby's health the rest of the pregnancy. Everything turned out great, the baby weighed 8.14 pounds and I lost 32 pounds in TWO weeks. My next doctor said that sometimes out of heredity people gain a lot of week while pregnant, but she wasn't at all concerned about my weight. My mom thinks the prior doctor, since he was obese, was projecting his own worries onto me. Plus he is mad old school (he's in his late 60's and my mom tells me stories of how in the 60's her doctor's main concern was that she not gain more than 25 pounds and when she had gained about 20 at more than 7 months pregnant he put her on a strict 800 calorie a day diet..I"m not kidding).

JayEll
02-15-2007, 07:04 AM
Drs see hundreds of patients, they can't keep track of them all, they don't remember which one you are, they sometimes don't flip back through your whole records, and as a result they can say different things at different times.

My dr, who is actually a good one, told me one time not to worry about my weight too much, and six months later told me I HAD to lose weight, period. So, it's like anything else, buyer beware. Find someone else. There are plenty of good drs.

Jay

ennay
02-15-2007, 11:17 AM
I went through a horrific experience with my first ob-gyn last year when I was pregnant with my daughter. I was gaining lots of weight, just like my sister (who gained the same 65 pounds though she has always been naturally a size 0 to 4 so this could very well be hereditary), and this male doctor doctor (who happened to be obese himself) YELLED at me "you're gaining too much weight! do you want to have a child with cerebral palsy! do you want to have a child that can't walk or talk?!". I was so taken aback! He never even explained how my weight could any in any manner cause the above horrible conditions. Needless to say I had to find another ob-gyn, quite late in the game at almost 6 months pregnant, and consequently went longer than I was supposed to without a visit, but it was worth it. The man was horrible and caused me stress and anxiety about my baby's health the rest of the pregnancy. Everything turned out great, the baby weighed 8.14 pounds and I lost 32 pounds in TWO weeks. My next doctor said that sometimes out of heredity people gain a lot of week while pregnant, but she wasn't at all concerned about my weight. My mom thinks the prior doctor, since he was obese, was projecting his own worries onto me. Plus he is mad old school (he's in his late 60's and my mom tells me stories of how in the 60's her doctor's main concern was that she not gain more than 25 pounds and when she had gained about 20 at more than 7 months pregnant he put her on a strict 800 calorie a day diet..I"m not kidding).

When MIL was pg with dh, her doc had a chart and if you were above that chart you had to come back in 2 weeks and if you were still above that chart then you were hospitalized and put on a strict starvation diet until you were within "bounds". She ate nothing but celery and saltines for 3 days before every visit to try to stay in the chart. Cant help but wonder if that is why dh is 5'3"

marbleflys
02-15-2007, 11:37 AM
First, congratulations on your pregnancy, I wish you a happy, healthy time. Longterm use of Prednesone really messes with your body.....the fact that you only gained 20# is great, you have control and good habits too.

You may be interested to know that US medical schools now are recognizing the fact that doctors need effective communication and social skills (talk to the patient, not at them). We grade the senior students during mock exercises and there are teaching sessions that have mock cases to deliver all types of news....I know nothing about the "urtoofateatless", we deal in Trauma, (oops the pt. is gone, its my turn to tell the family, bad news and critical care). but the general principal is HOW you say things and compassion to your patients.

Sounds like your gyn is too focused on her subject and lacks plain old social grace.....and isn't she interested in pre-natal care....dump her, get a recommendation from some friends who had positive exepriences.

congrats again--have a happy pregnancy.

Mom2QJandT
02-15-2007, 11:54 AM
I just wanted to jump in on this thread to second the idea of a Midwife if at all possible. I went to a doctor with my oldest until he really ticked me off (not over weight, but over something else) and I switched to a Midwife mid-pregnancy. I loved my Midwife. I had two more babies with her and I can not imagine having to deal with an insensitive doctor during a pregnancy. She was like another Mom, I just loved her so much. Oh - - and by the way, I gained 30 pounds with my oldest, lost 12 with my daughter (I was really sick the whole pregnancy), and gained 15 with my youngest. All three were born at normal weights and healthy as can be. Take your vitamins and relax...and congratulations!!!!!

ennay
02-15-2007, 03:13 PM
I also wanted to add, my first ob started scolding me about my weight during the 3rd trimester, and like so many docs ignored me when I tried to tell her what I WAS eating (umm not enough to gain 4 lbs a week) and assumed I was eating crap. Turns out she was missing several GLARING signs of pre-e in me, one of which is abnormally fast weight gain. She totally missed my rise in BP because while a bp of 120/78 is considered healthy, it isnt when you START at 95/55. But she looked at the number instead of at my chart. Oh there were so many things she screwed up that I am getting angry just thinking about it.....

nikkimac76
02-15-2007, 03:58 PM
Congratulations! I loved being pregnant myself.

I think that it is good to be conscious of how much weight you are gaining while pregnant, as really excessive weight gain can cause many problems, but the more important issue is healthy eating.

I gained 50 pounds while pregnant, and within a month after childbirth I weighed 5 pounds less than I did when I got pregnant (I would love to be back at that weight right now!). It just fell off. It wasn't fat. My body's metabolism rocked when I was pregnant - since my hormone levels were finally normal. It was all of the things that have already been mentioned here - extra blood volume, the baby herself, etc.

I had a wonderful, wonderful doctor. He told me to eat well and often, stay hydrated with water, and to never go hungry while pregnant. He was more concerned about sodium at the end, because I was so incredibly swollen! That was at least 10 pounds of the gain. He also covered a different set of topics at every visit. I couldn't ask for a better doctor. He did ask me to limit my sugar intake because I was already overweight starting out, but he didn't make such a big deal about it and was not at all insensitive.