100 lb. Club - New doctor reset weight goal (higher)




chicpanda
03-02-2010, 04:11 PM
My new GP reset my final goal weight to 190 pounds. I had my goal set at 135, a personal choice. I wanted to weigh what I was on my wedding day. I am a little upset, 190 pounds is still very over weight. I know that I can renegotiate if I get down to 190, but .. hmmmmmm

Anyone else have a doctor reset a weight goal to a higher point?


ubergirl
03-02-2010, 04:20 PM
My new GP reset my final goal weight to 190 pounds. I had my goal set at 135, a personal choice. I wanted to weigh what I was on my wedding day. I am a little upset, 190 pounds is still very over weight. I know that I can renegotiate if I get down to 190, but .. hmmmmmm

Anyone else have a doctor reset a weight goal to a higher point?

I went to a weight loss nutritionist who told me that my goal weight (150) was way too low for a woman of my age and height and why didn't I shoot for 200.

My GP told me he thought I'd have a huge amount of trouble losing more than 10-15 lbs.

I can tell you that the trend among health care professionals is to counsel patients to try to achieve a ten per cent weight loss-- because that is associated with health benefits and is considered "achievable" but I also think that it reflects and underlying belief that significant weight loss-- like down to a healthy BMI for morbidly obese people is unachievable.

I'm thinking your GP would rather have you set what we would call a "mini-goal" and achieve it, then set an impossibly difficult maxi-goal and fail... becasue he (or she) may believe that "nobody" loses 100 lbs.

I know that until I found 3FC, I never believed that I could lose 100 lbs, or learn how to run again, or do any of the many things that I NOW believe I can do thanks to the gracious ladies here.

Oh-- I just realized that down to 190 for you would hardly be a mini-goal-- since you're starting where I started, so 190 is a hundred pounds-- but I still am guessing the concept is the same. Your doc probably was worried that if the number was too huge, you'd end up discouraged.

WHEN you get to 190, you can just ignore the advice and keep going!

BeachBreeze2010
03-02-2010, 04:21 PM
I am about your height. As much as I would like to weigh 190lbs today, it isn't my goal. I wonder why he did that? Maybe as a short term goal for you? Did he give you any reasons why? I am just as puzzled as you are.


JustBeckyV
03-02-2010, 04:34 PM
Interesting - I haven't had anyone tell me either way I guess lol I just went by what felt right to me and what would be considered a normal weight range.

bargoo
03-02-2010, 04:38 PM
My new GP reset my final goal weight to 190 pounds. I had my goal set at 135, a personal choice. I wanted to weigh what I was on my wedding day. I am a little upset, 190 pounds is still very over weight. I know that I can renegotiate if I get down to 190, but .. hmmmmmm

Anyone else have a doctor reset a weight goal to a higher point?

Did your doctor happen to notice that you are only 5'2" tall ? 190 seems like you would still be overweight.

BeachBreeze2010
03-02-2010, 04:41 PM
I bet you're right, uber. That's really sad. We know we can do it! One of the maintainers (I can't remember who?) had mentioned as part of thier story that they shocked thier doctor because he didn't think it was possible. That's my rx for you - show them it can be done! I plan to.

eclipse
03-02-2010, 04:41 PM
Why be upset about it? Don't waste your time - no one gets to pick your goal weight but you.

time2lose
03-02-2010, 04:42 PM
I find that interesting too as I am the height as you are. My doctor did not set a goal weight for me. When I first started I saw an obesity specialist and she did not even want to set a final goal for me. She told me to aim for 10% loss and then we would set another goal. I think ubergirl is right about the doctor not wanting to discourage you. I agree with her too that you should get to 190 and then keep losing if you want to.

I really have not set a final goal for myself. I plan to just keep losing until it seems right. When I started getting under 200 seemed like heaven on earth and I thought that if I got below it, I would be fine. But nope, I am hovering a hair above 200 and I still have loads of fat. I can't see 190 being low enough but, right now, I just have to keep losing.

Thighs Be Gone
03-02-2010, 04:42 PM
I am unsure what his motives are--maybe he/she thinks it's more achievable setting it higher. He isn't aware of the power of the 3FC though. For me, I would never allow anyone take my goal and dream of being fit away. If you aren't comfortable with the way he/she is dealing w/you--I would certainly shop for a new doc.

jigglefree
03-02-2010, 04:56 PM
:mad::mad:That makes me angry when people try to impose their ideals or preconceived notions on me :blah::blah::blah:. I would have told the dr I'm getting to my goal and I let him/her know when I was passing through the 190s. :wave:

You work on getting to your goal that you have set and don't let anything or anyone discourage you.

I'm with the OP, they don't know the power of the 3FC Crew. :balloons:

kaplods
03-02-2010, 05:09 PM
I've had a doctor reset my weight goal lower and one who reset it higher, and I can tell you that the former was far more traumatic.

It's not as simple as that (but it makes an interesting opening statement).

In 8th grade, I was put on amphetemine diet pills. By junior year, I'd lost 70 lbs (from 225 to 155). My goal was 150. The pills were no longer working, so I was off those (diet pills typically are effective only for several months) and I was struggling like mad to lose the last 5 lbs. In hindsight, I suppose the doctor assumed that I thought I'd gotten complacent thinking I was "close enough", and thought a lower goal might remotivatea me (it had the opposite effect and I gave up entirely, feeling I was doomed to failure so why bother).

I don't blame the doctor, he really was a very caring and empathetic physician. About a decade later, when I was in a car accident with a semi (mild because I was uninjured, for my car it was fatal), and had no one to take me home, this same doctor gave me a ride home (I didn't even realize until later that I didn't have to tell him the address, and he'd only been to the house once for a housecall for my mother five years before - even in the 80's and early 90's most doctors didn't do housecalls - or charged outrageously for them).

I go out of my way to illustrate that the doctor wasn't careless or callous, because it was MY misinterpretation of reality that caused the trauma of his recommendation to lower my goal. Doctors are not infallible and their recommendations are only recommendations not God-gifts written on stone tablets. I wish I'd been older and wiser, and wouldn't have let his goal for me affect my goal for me.


The second goal reset by a doctor occurred a couple years ago when I joined TOPS and needed a goal slip (TOPS is usually pretty flexible about when you provide your goal slip, but I wanted to get it done so I had the goal in mind).

My doctor asked what I wanted my goal to be, and I suggested 200 lbs (still obese). The doctor raised his eyebrow, and asked "are you sure about that." I explained that I thought I'd try to get to 200 lbs and maybe try to maintain it for a while before deciding whether I thought I could lose more.

He smiled and said he meant "the other direction," and suggested 250 (still morbidly obese), and we agreed on that for my TOPS goal slip. I was actually relieved to have a doctor who didn't have much more stringent goals for me than I had for myself. It didn't make me feel like I had to stop or should at 250 lbs.

Older and wiser, I was able to see that the doctor's goal for me wasn't as important as my goal for me. Although I'm not yet wise enough to have patience with doctors who do have more stringent goals for me than I do. I had no patience at all for the rheumatologist who insisted that I have wls - and refused to treat me until I'd had a consult with a wls, even though I explained why my gp and I felt I wasn't a good candidate for the surgery. The rheumy insisted that I could find a surgeon willing to do the procedure, and he wouldn't treat me unless I tried to find that surgeon. Yeah, I didn't go back to that doctor.

Yes doctors have knowledge, skills and sometimes wisdom that we lack - or we wouldn't need them at all. But a roofer has knowledge and skills I lack also. When I hire either, I don't surrender my wisdom and common sense when either make reccomendations.

I respect my doctor's opinion, but ultimately I'm in charge. I found it refreshing to have a doctor suggest that I was being overly ambitious, but ultimately it doesn't matter. He could have suggested any weight from 90 lbs to 900 - and it wouldn't have changed my goals for me (it might have changed my opinion of his sanity if he'd chosen "you're fine as you are," or if he'd said "you need to weigh 115 lbs.")

I do trust and respect my current doctor, and when I do get to 250 lbs, I'm sure he will support my decision if I want to keep losing (I don't imagine he'd say "oh no, you're now much too thin to lose any more.")

My neurologist only asks for 10 lbs a year. That doesn't mean that he expects me to stop if I lose those 10 lbs in the first three months.

My ENT (struggling with weight himself) has always said "if you can lose weight, do it," but never stresses a number and just says "do what you can."

None of these doctors (even the first) were "wrong" they just expressed different recommendations. Ultimately YOURS is the most important opinion.

I know I took a lot of words to give a relatively simple opinion, but this has been a bit of a hot button topic for me, because I'd like to prevent anyone from repeating my first mistake - which so often still happens. People giving up because their goal seems impossible. If your goal seems impossible make a smaller goal, get there and then decide if you want to take on more.

PeanutsMom704
03-02-2010, 05:20 PM
I've never had a doctor set a goal weight for me. Sure, they've been happy if I've lost weight (and esp. if lab values, BP, etc. improved). But it's never gone beyond the general concept that weight loss would be a good thing.

I would probably ask the doctor for his or her rationale on why they think that is the right goal for you, but it probably is what others have suggested - fear that something lower than that might seem unachievable and the hope that a significant loss, even if it still left you obese, would be a positive thing.

Like everyone else has suggested, I would agree with treating it as an interim goal. And yes, when you get there, it will be absolutely fantastic that you will have lost over 100 lbs! But like so many others, before finding 3fc, I didn't believe that people could lose that much weight and more. You have a secret weapon your doctor probably doesn't know about. When you surprise him or her by losing that first 100 lbs, I suspect they will be completely supportive of your plans to keep losing!

FitGirlyGirl
03-02-2010, 05:28 PM
I do not know your doc's reasoning. I suggest asking why he suggests 190. I (as a fellow 5'2" chick) also suggest ignoring it. Your goal is between you and you. Nobody else can/should tell you what you are capable of. Now, if you were aiming for something unhealthy it would be another story. However, at 5'2" most charts have the healthy weight range being something like 105-135. Aiming for 135 is not unhealthy or unattainable. 190 as one of your mini-goals along the way makes sense to me, but as a final goal it does not make sense to me. My doc asked me what my goal was, he did not tell me what it was. Same thing with my diabetes nurse. They each also asked me why I had set my goal there and when I answered that it was in the middle of the healthy section of charts for 5'2" they were happy with my answer. I would ask the doc why and if he really did mean it as a final goal I would tell him he's nutty and then proceed to prove it to him.

lovemyboy
03-02-2010, 08:18 PM
I am an inch taller than you and just under 190. I am looking and feeling better than before I started but I am nowhere near "normal." I've got plenty of extra flab to get rid of. I'm thinking maybe your doctor set it as a temporary goal. Either way, the GP isn't in charge; you are. If 190 doesn't feel done, keep going.

CJZee
03-02-2010, 08:39 PM
I think the general health care community is now "thinking" that weight loss is virtually impossible without WLS ... I know my doctor does. The last time I saw my doctor he said as much. At the time, he was amazed I had lost 30 pounds, he said most people can't lose 10% of their body weight. (I wonder what he will say next time I visit, as I'm down 70 pounds now and may be approaching the 100 pound mark by that time.)

I have mixed feelings about this trend in health care. I am glad that doctors know it's not easy to lose weight, but I think referring all morbidly obese people for WLS is not right either. There must be some sort of middle ground, the path that many here on 3FC have forged themselves.

I wish that the kind of support offered to those undergoing weight-loss surgery was readily available to those, like me, who want to "do it on their own."

eratosthanes
03-02-2010, 09:08 PM
Lol, my doc suggesting that I consider wls, and recommending me to a nutritionist, as the first step, was what kicked me into this final (I hope) round with the 120+ lbs. I started CC and logging my meals because I have been fat all my life and to a million different nutritionists as a child/teen. I know what they want from me! Consequently, I have lost 24 lbs. and may not qualify for the surgery (need to lose another 26) by the time I do get to my first appointment in May.

JayEll
03-02-2010, 10:19 PM
Oh, don't let it get you down! Just do what you plan to do, and when you get to 190, you can reevaluate. If you want to keep going, who'll stop you? It's not like the doc will show up with an arrest warrant at your weigh-ins! :rofl:

Jay

chicpanda
03-02-2010, 11:28 PM
wow! really nice feedback, it sure helps. my GP is a she and is new to me. I had to change docs when my health insurance changed in Jan. I will see her in April and we can clear up the goal setting. thanks for your help

duckyyellowfeet
03-03-2010, 12:32 AM
my ob/gyn said 140lbs, my endocrinolgist suggested 160, my GP said to foucus on getting under 200lbs, maybe settling around 180. in the end, i'm going to have to find a range that works for me and my lifestyle...and i think you'll have to do the same.

rockinrobin
03-03-2010, 07:35 AM
Well at your height, 190 puts you high into the obese category. In fact just a mere 2 lbs up from that (192) and you'd be MORBIDLY obese.

So, I am scratching my head at this one.

I had to ignore my docs and take my weight, my health into my own hands. My doctor told me that it would be next to impossible for me to lose all the weight that I needed to without WLS. That it was unheard of.

Yeah, right ;).

dangerousfish
03-03-2010, 07:51 AM
Wow, people are really angry for you! On the other hand I am quite positive that if you showed up 190 at an appointment your doctor would bring up setting a new goal. He wants the scale to be lighter, and hopefully make health easier and he is probably REALLY USED to most of his patients not losing weight, even ones who say they want to. My mom is a urological nurse and barely anyone follows the recommendation to lose 10% and see what happens.

When you go back in he will be pleased as punch! And you can tell him how you picking a weight goal that is still overweight made you feel. Doesn't he know you're a CHICK?! You have POWER.

Heh. Don't let it get you down and MARCH FORTH.

Rainbow
03-03-2010, 07:56 AM
Well, it's a good minigoal. Get to it, then carry on until you're at your goal weight. Goal weight's a personal thing which we used charts, measurements, nyumbers on scales, dress sizes and doctors to help us decide upon. Just nod and smile at your doctor and do what's right for you.

time2lose
03-03-2010, 08:50 AM
Robin orginally posted
Well at your height, 190 puts you high into the obese category. In fact just a mere 2 lbs up from that (192) and you'd be MORBIDLY obese.

This threw me a bit, I thought that morbidly obese is a BMI of 40 > and at 5'2" the weight for that is 219. This one time :) I hope that I am right and you are wrong because I thought that I had dropped the "morbidly" part. It makes me sad :( to think that I am wrong.

Nada
03-03-2010, 08:52 AM
I was already rehearsing how to argue ith my doctor about choosing a target weight for WW that is higher than the charts. Maybe I won't have to.

rockinrobin
03-03-2010, 08:59 AM
This threw me a bit, I thought that morbidly obese is a BMI of 40 > and at 5'2" the weight for that is 219. This one time :) I hope that I am right and you are wrong because I thought that I had dropped the "morbidly" part. It makes me sad :( to think that I am wrong.

I apologize. I'm sorry I didn't mean to upset you. I thought I had remembered that a BMI of 35 or more was considered morbidly obese. Actually certain sites say yes, some say not, others say *severely* obese.

http://www.newimageweightloss.com/resources/obesity_info/index.html

BMI Calculator

Body Mass Index (BMI) refers to a person’s relative weight for height. BMI can be used to assess overweight and obesity, and to measure change and body weight. BMI correlates significantly with total body fat. The BMI calculation is: weight (lbs) divided by height (in ).

Healthy Weight: BMI between 18.6 to 24.9
Overweight: BMI between 25 to 29.9
Obesity: BMI between 30 to 34.9
Severe Obesity: BMI between 35 to 39.9
Morbid Obesity: BMI over 40

ShylahEQ
03-03-2010, 09:00 AM
I think 190 is a great goal, considering where you are now. The hospital in my area does a Body Test that measures fat, bone and organs to see the composition of your body. According to that test they concluded that even at my height of 5'3" a weight of 180-200 would be a healthy goal (110 lb loss). They even had broken down what percentage of fat I should aim for, those numbers I can't think of without the sheet.

So I think depending on your frame and other factors, 190 isn't so bad. If you want to lose more after that, I think that's great too.

time2lose
03-03-2010, 09:17 AM
Robin, I am not surprised that I am severely obese, I just really don't want to be morbid any more :) I am not too far from being plain 'ol obese!

rockinrobin
03-03-2010, 09:39 AM
Robin, I am not surprised that I am severely obese, I just really don't want to be morbid any more :) I am not too far from being plain 'ol obese!

I completely understand Cheryl.

At my height and my (former) weight I was not only morbidly obese, I was SUPER morbidly obese. It is frightening. I was thrilled to be plain ol' obese. In fact I was thrilled to be just plain old overweight. Those are some BIG milestones.

As long as I'm here, I was just thinking about these docs. Ya know since we did start out at such high weights and they really don't hold out much hope for us losing all the weight, *they* are just happy for us to IMPROVE our health.

But me, nu-uh, I wasn't settling for better - not any more - not when BEST was available. I had SO many people tell me, that yes, they could see why I'd want to lose weight, but did I have to go and lose THAT MUCH weight? Well, ummm - YES. Why is health-ier good enough for me, when I can have HEALTH-IEST? Just because I started out so high, I should settle for less then optimal? Good enough was no longer good enough for me. Makes. Me. Crazy. :dizzy:

Jilu
03-03-2010, 10:03 AM
Speaking from the pharmacist side of health care professionals.

It's like people mentioned before, you want to suggest 5-10% of weight loss. Because it's thought that a goal like that seems more attainable to most people.

I mean, from a personal perspective, at my heaviest (and most depressed) if my doctor told me to lose 125 lbs I would have probably cried right there. But the suggestion of "let's lose x amount and then see where to go from there" worked for me.

So, I would imagine that the doctor's intention (purely my speculation, mind) is just trying to break it up and give you a mini-goal in an attempt to make it not so overwhelming

marigrace
03-03-2010, 10:42 AM
Boy, this topic kind of makes my blood boil. Maybe she was just breaking it up so that the goal seemed less insurmountable...or maybe she is not giving you enough credit. Doctors are scientists, how can they presume to place limits on what a determined SPIRIT is capable of ?

chicpanda
03-03-2010, 12:31 PM
thanks Robin, I just refigured my BMI. For me, 218 pounds puts me in Obese Class II, which sounds like a reasonable goal for 2010.

kaplods
03-03-2010, 08:32 PM
Boy, this topic kind of makes my blood boil. Maybe she was just breaking it up so that the goal seemed less insurmountable...or maybe she is not giving you enough credit. Doctors are scientists, how can they presume to place limits on what a determined SPIRIT is capable of ?

I don't see anything worth boiling blood over. Doctors give opinions and recommendations, it's what they do. It's what we pay them to do. I've seen so many posts of righteous indignation over a doctor

1. Making a recomendation of a weight goal that's too high

2. Making a recommendation of a weight goal that's too low

3. Not mentioning weight at all

4. Mentioning weight at all


I don't really understand what's so horrible about any of those things. I don't expect my doctor to be godlike and know the perfect thing to say to me. I don't need a doctor telling me I'm fat, or that fat is bad for me because I know, and I'm adult enough to bring it up if he or she doesn't (and I have on many occasions).

I also don't have a problem with a doctor mentioning my weight (as long as it's not with obvious contempt), because it is a medical issue, and I'm there to discuss medical issues.

I don't have a problem with a doctor who overestimates or underestimates my goals or ambitions as long as he or she is willing to listen to my opinions on the matter.

I didn't have a problem with the doctor who thought the only way I could lose weight was wls. I suspected he was wrong, but he's entitled to his opinion (and research statistics being what they are, I can understand why he'd think it unlikely for me to do it on my own). What I wasn't willing to tolerate was his unwillingless to treat me unless I found a surgeon willing to perform wls, despite my increased risk factors for death and other severe complications.


Doctors aren't mindreaders, so there's no way for them to give the "perfect response" to every patient. A doctor can give the same recommendation to three patients with seemingly identical situations, and one will think the doctor gave the perfect, most compassionate advice and the other two will think the doctor was a heartless ******* (but for opposite reasons).

I think as a consumer of medical services we need to learn to communicate clearly and not assume ill intent of any medical advice. "I appreciate the suggestion, but this is my goal, why do you consider my goal is unreasonable or unobtainable?"

And if the doctor's response isn't satisfactory "I appreciate your concerns, but I still intend to pursue my original goal, can you support me in that?"

(And if not, start looking for a new doctor).


I don't see anything wrong with a doctor having a slightly different goal for me than I have for myrself (upward or downward) as long as the doctor is willing to work with me and isn't openly hostile or rude.

marigrace
03-03-2010, 10:20 PM
I have had much experience with doctors in caring for the people in my life, and I believe have seen the best and the worst.....but I would expect a healer to be more than a glorified pill pusher who is "not openly hostile or rude".

kaplods
03-03-2010, 11:20 PM
marigrace, you're taking my last comment entirely out of context. I did not, in any way suggest that my only qualification in a doctor is that he or she "is not openly hostile or rude," nor that I should think anyone else should. If I didn't make that clear in my posts in this thread, I apologize and will clarify - I expect a doctor to be knowledgeable, skilled in their field of study, up on current research in their field, able to communicate clearly and with a fair amount (but not perfect level) of compassion. What I do NOT expect is for a doctor to be able to read my mind and know what I need to hear, in the way I need to hear it, without my ever sharing my expectations and wishes with the doctor. I expect the doctor to be able to answer my questions, but I don't expect the doctor to anticipate all my questions and answer them all before I ask. I do not expect to agree with every recommendation a doctor makes, and I expect the doctor to understand and accept that. I don't expect to blindly follow doctor's orders, and I don't expect a doctor to blindly follow mine either. We're in partnership to manage my health.

If I did not express it clearly enough in prior posts, I'll try to clarify - in this post, I'm ONLY talking here about a doctor making a recommendation for a patient's goal weight. It's unreasonable to expect a doctor to read your mind and know whether or how best to approach the subject of weight loss. If you want a specific type of approach, your best bet is to ask for it, and if you don't get it, and it's important to you that you do, seek another doctor.

I've seen every possible type of communication described here and on other weight loss sites, and harsh criticism for the doctor regardless (not too many posts though about being satisfied or pleased with a doctor's approach). For the most part, to read posts on weight loss sites at any rate, no matter how a doctor deals with it, he or she is a careless SOB. If the doctor brings up the subject, doesn't mention it at all, if the doctor sets too high a goal (whether or not it's a healthy goal), or too low a goal (whether or not it's a healthy goal), or doesn't set any goal, I've seen posts harshly criticising the doctor for it.

I'm just saying that the doctor/patient relationship is a partnership. It's not a parent/child relationship, it's an adult relationship and a business partnership. The doctor's role is not to perfectly meet the needs of the patient without the patient having to express those needs. If you need a compassionate, caring doctor who will "soften the blow" of harsh medical facts, or if you want a no-nonsense, straightforward, pull-no-punches doctor who will tell you like it is whether you want to hear it or not -or maybe a doctor somewhere in between - that's all fine, but what you can't expect is a doctor to be able to be all things to all people AND to know without being told which approach you the patient wants and expects.

You may have the luxury of doctor-shopping until you find a doctor who's personality suits your prefernce needs, but sometimes you have to deal with the personality the doctor has, not the one you wish he or she did.

I consider the doctor's medical knowledge and skill a lot more important than his or her personality and ability to communicate in the way I want him or her to, so I am willing to work with a doctor who can't read my mind and is good, but not perfect at communication (good thing, because I haven't yet encountered a doctor who is a highly skilled, empathic clairvoyant, except in science fiction stores).

I've found that a good doctor will try to accomodate the style of communication you want, but you have to inform the doctor of that of what that is.

marigrace
03-04-2010, 06:56 AM
That makes sense....and for most people would agree with that, I guess my view springs from the fact that I don't put much faith in the medical establishment to start with....doctors, insurance, drug companies and lobbyists...that's all too cozy for me. I prefer holistic approaches,and believe that health is best achieved by attitude and lifestyle changes . What good is a doctor telling you that you need to lose weight when you already know that?