100 lb. Club - Opinions?




View Full Version : Opinions?


matt_H
08-24-2005, 12:04 PM
http://news.yahoo.com/s/ap/20050824/ap_on_fe_st/obesity_complaint

I happen to agree with the doctor here. Sometimes the truth hurts. I don't think he was abusive to this woman, he was honest.

Do you agree?


shedilbry
08-24-2005, 12:11 PM
i watched a segment on the today show about it this morning. they were talking to the doc. i do agree with him. my first thought was about how my doctor called me a fat sweat hog... and she's complaining about what her doc said to her?!?! i wish my doc had said to me what her's said to her. it would have helped to have the helpful criticism instead of the insults.

newfiedarling
08-24-2005, 12:19 PM
To me this just seems, unfortunately, like another case of someone that wants to lay blame for their problems. Sometimes the truth hurts but you need to hear it. I would guess that this woman thrives on attention and that bringing this to the level she has is right up her alley. Good for that doctor - to me it is no different than telling a smoker or alcoholic that their habits may kill them. Arhhh, things like this really gets my goat! Next thing you know people will be suing their doctors for telling them they need to shed a few pounds (which this this situation only seems one step short of).

~Dee


Jillegal
08-24-2005, 12:27 PM
Geez..some people are just litigation happy. I don't see anything wrong with his comments. She went to her doctor for advice to improve her health and he gave her a professional and honest assessment, as is his responsibility. If she's not prepared to hear the truth, that's her problem. Of course there are doctors who need help in the "bedside manner" department (oh Shelly, I'm so sorry your doctor called you such an ignorant and degrading name. Now HE should be called on that). As for this woman, yes the truth hurts, but it can also save your life if you heed the warnings.

barbygirl43
08-24-2005, 12:43 PM
OMG. I would be offended if my doc didn't bring up my weight and it affecting other areas of my life.

Venus In Mourning
08-24-2005, 12:55 PM
That is ridiculous! That's up there with suing Mc Donald's for hot coffee and fattening food. I agree with everyone else's comments so far, so I don't have much to add. I don't know what this world is coming to where a doctor can't even be honest with a patient.

ChocLabLover
08-24-2005, 12:56 PM
Okay, political correctness run amok! :?: I do not think the doctor did anything inappropriate at all. I was in that women's shoes about a year ago, when my doctor said about the same thing. Sure I was p'ohed :mad: , but again, I was mad at myself, not at the doctor. Pretty sad statement of affairs that a doctor is going to be reprimended for doing his job!

lucky
08-24-2005, 01:10 PM
I agree 100% that he did the responsible thing. Even if his bedside manner left something to be desired (I've been to those doctors!). First of all, if he hadn't put it as bluntly as he did and she missed the point then consequently developed major complications as a result of her obesity would she have filed a complaint against him? Second of all it may very well that she forced him to take this approach.

I know that in the year or so leading up to my highest weight I went to the doctor more often then I had my entire life. I had so many aches and pains, heartburn, headaches, etc. I knew what the problem was but I didn't want to face it. I made appointments hoping that my doctor could pinpoint a some culprit besides my weight and lack of exercise. I wanted a quick fix to all of the side effects of my weight gain or an easy way to shed the pounds. Each appointment there was a gentle reminder that my weight was having a significant impact on my health. Finally, he just had to say it. None of my problems were going to go away until I lost weight and started exercising. Again, I knew this to be the case but I did NEED to hear it put so bluntly. Not rudely, mind you - just bluntly.

It must be frustrating to deal with obese patients these days. Our weights are such a sensitive issue to begin with and having it called to our attention, necessarily or not, is never pleasant. And since there isn't a pill to fix it doctors really have no choice but to tell us what we don't want to hear.

hautbois
08-24-2005, 01:43 PM
If my doctor, the person I trust to monitor my health and raise flags when needed, did not mention my weight, I would find another doctor. Yes, doctors need to be tackful, especially with such a sensitive topic, but they also need to be truthful. While it's no fun to get the "talk", I usually leave the office with a renewed energy to get going on my weight loss. I'm never angry at my dr. She isn't the one putting food in my mouth, I am. I'm the one who decides if I'm going to exercise or not. When she notices that I have lost weight since my last visit, she congratulates and encourages me. If the scale moved in the wrong direction, she asks if I want her help - nutritional counseling, medication, etc. I know how to lose weight, just need to do it. :)

I don't know what exact words the dr used in this particular case, but he was right in pointing out her need to lose weight. I like how the article ends with the story of another patient who took his warning to heart and lost the weight.

howie6267
08-24-2005, 02:11 PM
I do think people should be told this by there doctor. However in some cases where they call names or really insult a person that is wrong and really ticks me off. They should push the point that you need to lose and offer the support and help you need after they tell you. People just seem to want an argument over everything anymore.

YP1
08-24-2005, 02:12 PM
Personally, I avoided the doctor for a long time because I knew they'd say it. and I didn't want to hear it. I knew they'd be doing exactly the right thing to say it, but denial was just easier.

I agree with the comment above - as a doctor he has a duty of care to his patients, and if he knows that something is damaging their health and could lead to serious health problems, I'd call that negligence if he didn't raise it. OK, there are varying degrees of tact that could be used, but essentially he has to say it in a way that's understood.

It seems harsh, but I think he did exactly the right thing.

Gardenwife
08-24-2005, 02:17 PM
This doctor did what he is being paid to do: Strive to help this woman be healthy. The woman turned her self-loathing outward and targeted the messenger.

boiaby
08-24-2005, 02:39 PM
I agree, it's what we pay them for. If anyone should be concerned and have the right to speak up when we're hurting ourselves, it's our doctors. My problem with this whole ridiculous mess is not that he said it, rather how he said it. Just because you're and MD and are trying to save your patients' lives, it doesn't give you the right to be an a**hole about it. I say he needs to learn a little more about appropriate bedside manner.

Beverly

looosingit
08-24-2005, 02:41 PM
I would suppose it would depend on how it was presented....from the article it sounds like the doctor was more than reasonable...he addressed her weight as a health issue, which is his JOB! On the other hand...I have been to doctors who have been dismissive of health issues by saying "Oh well loose weight...". I agree that this is a MAJOR factor in health (Heck, it's why I've undertaken this whole weight loss process in the first place), but I do think that it important that health care professionals ensure that they are treating the whole patient, with all mitigating factors taken into consideration (including weight). To me this means not dismissing the health concerns of someone merely because they are overweight, but it also means that the doctor has a responsiblity to point out when weight is adversly affecting their patients health. Obviously I am taking the conversation beyond just the example that Matt listed! ;)

Gardenwife
08-24-2005, 02:47 PM
I didn't take what the doctor in the article said as particularly offensive.

Universityprincess
08-24-2005, 05:17 PM
I think some doctors need to be more mindful of how the addess certain issues. Doctors being rude and inconsederate is not necessary. My mother has issues with her doctor because he wont treat anything that is wrong with her. He just tells her to lose weight. I'm not joking, she had a cold and just wanted some medicine...he told her she was too fat and needed to lose weight. She had a sinus infection one day...he told her she was too fat and needed to lose weight. Granted, some of her problems are weight related, but a common cold is not one of them!

I went to see the doctor one day, something was wrong with my mouth. He told me I needed to lose weight...WTF? My mouth...my fat...my mouth...my fat, excuse me if I cant see the correlation.

However, he was right. I did/do need to lose weight. That wasnt the time or place for that comment. I was having a problem with my mouth and he was not my regular doctor. Another doctor I went to see told me I needed to lose weight, but I was having a physical...OK, I can accept that. Even though she didnt believe me when I said I worked out (probably exercise more than she did).

So, yeah, I think docotrs should tell you if they see a health concern, but they should watch how they do it. Hopefully they wouldnt tell someone "you have cancer, you are going to die, bye" so why do it to a fat person.

Gardenwife
08-24-2005, 08:29 PM
I would drop any doctor who refused to treat me and only harped on my weight. There is a whole person to treat, not just a number on a scale. Harping on the weight is their job, but they need to treat other things, too. Bedside manner is very important, but I think I'd suffer a rude doctor who was very, very good at what he or she did rather than go to one who said what I wanted to hear and missed out on important issues.

DeterminedInGA
08-24-2005, 09:17 PM
I once had went to a doctor specifically for weight issues and never went back because when I walked it he said "My God! You're fat!". At the time I weight 180 or less so yes I was overweight. BUT - I never even considered filing a complaint because he was telling the truth.

And at the same time, my regular doctor has been ill for a few months so I had to go see her partner back in March. I left the office a little perturbed that he didn't comment on the fact that I had gained so much weight in such a short time. And when I brought it to his attention, he didn't seem concerned. Luckily my regular doctor is back now so I have someone that is watching out for my health.

Now that I've gone around the world with my response :) my answer is that I agree with the doctor. Now, he could have said it in a way that would have been offensive, but just based on what I read there was nothing wrong with what he said.

Jillegal
08-24-2005, 10:26 PM
Okay...I think I might have different feelings on this matter now. I was basing my original opinion on the article linked in this thread, but have now received a message from a friend on the subject:

"Just to clarify - the doctor was on the Today show this morning and said (and I'm paraphrasing) that her husband would most likely die before her (because he was heavy as well), and she would find herself amongst thousands of other obese women who are not attractive to men, and she would be alone. He said he was stating the cold, hard facts. The woman is complaining about that statement, not about the fact that he told her she was obese and should lose weight."

If that's the case then I believe what he said was totally offensive. I don't consider a suggestion to a patient that she'd have difficulty finding potential suitors upon widowhood to be medical advice! :mad: This woman no doubt needed to receive a message but the way it was given was totally inappropriate!

matt_H
08-24-2005, 10:49 PM
I agree with you Jill...the article didn't really give the whole story and I guess there are 2 sides to everything.

SwimGirl
08-24-2005, 11:19 PM
I recently went to the doctor because my bf has mono, this wasn't my regular doctor, and he immediately told me that I needed to be tested for Diabetes because of my size. And he just wouldn't let it go... I KNOW I'm overweight, I don't need someone pointing out the obvious. Now I might just have horrible luck with doctors, but I went to my old doctor complaining that I was only losing 1 pound a month, even though I was running 3 miles a day, and dieting. Without even asking any questions, she told me that I was just too much. Jill, thanks for looking up that other part, it's hard to know both sides, and onesided stores just don't work. Know what? I hate doctors, infact, if I was that woman, I would totally sue my doctor too! You just gotta have some tact, it's called respect, kindness, etc! I'm done venting now!

-Aimee

TakinBabySteps
08-24-2005, 11:30 PM
I think it's fine to be perfectly truthful, i.e. obesity is dangerous, etc. but at the same time, I pay the doctor to dispense medical advice, not marital. That being said, all of these trivial lawsuits get on my nerves. If you are suing for a principle, donate the award for obesity research or doctor sensitivity training. If you just want to make a quick buck, then I don't have a lot of respect for that. If I sued everytime someone said something offensive, I'd be richer than Bill Gates by now :).

lessofsarahtolove
08-24-2005, 11:37 PM
I didn't take what the doctor in the article said as particularly offensive.
I didn't either. :dunno: I think he did his job, and would have been remiss not to have addressed it. As it was depicted in that article, his communication to this woman doesn't seem out of line to me, and the fact that her complaints escalated the situation to this point is just sad. Denial is a very powerful thing. :(

SuchAPrettyFace
08-25-2005, 12:25 AM
Her doctor's still an ***. Your medical degree doesn't give you carte blanche to diagnose my personal life. Telling her she was going to be alone crossed the line, IMHO.

But to sue? Just wrong.

lessofsarahtolove
08-25-2005, 12:36 AM
I started to respond to this post, had to leave the computer for a while, and then finished up my post. Now, on reading Jill's post, I see that maybe the article doesn't give the whole story. The article doesn't make it seem like he was out of line. I understand what he said on the Today show; did he say that this was what he'd said to her initially? Obviously he's an *** and has an unfortunate case of fat phobia.....I'm just still not hearing that he said that stuff to her directly back in the office. Of course he could have!

Suing though, if she's doing that, is a real misuse of our already overburdened judicial system, and is downright silly, in my opinion.

Gardenwife
08-25-2005, 12:41 AM
His saying she was killing herself was one thing. If he made the personal statement that she'd be alone with no hope of finding a spouse should she be widowed? That was beyond necessary, though he probably said it in hopes of shocking her into changing her ways.

Did she just file a complaint? I don't recall there being a lawsuit filed, right?

It's the stupid lawsuits that make medical care so dear to the pocketbook and the wait so long to see specialists. Howie's neurologist told us yesterday that in just a few years' time, the number of practicing neurosurgeons in the U.S. has dropped from 5000 to 3000. I'm sure it's high malpractice premiums, the insurance plans dictating what care their patients can receive, and the risk of lawsuits that did it.

There's no lack of articles available (http://news.google.com/news?sourceid=mozclient&num=30&ie=utf-8&oe=utf-8&hl=en&edition=&q=Dr.+Terry+Bennett) on the story, that's for sure.

Gardenwife
08-25-2005, 02:26 AM
Here's a transcript I found on Rush Limbaugh's website, including a quote from the doctor: Transcript (http://www.rushlimbaugh.com/home/daily/site_082405/content/cutting_edge.guest.html)

Jillegal
08-25-2005, 02:43 AM
Since when is someone's "desirability" a medical condition? He overstepped some bounds there in informing her of his obesity diagnosis. Yeah, I think some sensitivity training is in order.

My understanding is that the woman's unsatisfied with the response to her complaint (by both the doctor and the board of medicine) and is now considering legal action. I hope she changes her mind and doesn't sink to the doctor's level to prove her point (however valid).

taekwondomom
08-25-2005, 03:09 AM
I'm suprised a doc would say something that inconsiderate to a patient. But maybe I've just been lucky with the docs I've seen. Of course, none of my doctors have said to me, in anyway, subtle or point blank, that I needed to lose weight. And if it had been said and then was followed up with an offer to hook me up with nutritional counselling and other help, I wouldn't have been offended. Embarrassed, YES. Relieved the issue had been brought, YES. Willing to accept the help offered, YES.
The only comment regarding my weight came from a doc while I was pregnant with my 3rd, when she told me it was OK I was maintaining the same weight for most of my pregnancy and could probably lose a little and it would still be OK as I started "ahead of the game so to speak" and she is keeping a close eye on the baby's growth and baby is growing fine. (With my last pregnancy I started out at 280 and was 285 right before I delivered-after delivery I was down to 260, but packed on 29 lbs over 23 months getting up to 289. I wish my doctor while I was pregnant with my first would have cautioned me to lay off the ice cream and eat healthier. I ate what ever I wanted (lots of junk and fast food), including almost 1/2 gallon of ice cream per day the last 3 weeks of my pregnancy, and figured I would lose it easily while breastfeeding. How foolish of me. :duh: )
Anyway, I think the doc was trying to do his job, but he crossed the line with the remarks about not being able to find anyone attracted to her, after her obese husband dies. File a complaint? Sure. Reason enough to sue? NO! Reason enough to find a new doctor? DEFINITELY!

ChocLabLover
08-25-2005, 08:19 AM
Okay, now having heard what the doctor actually said, he is an a**! There were a lot better ways for him to phrase to the woman that she needed to lose weight. I would have complained about him as well.

looosingit
08-25-2005, 10:14 AM
Hmmm....I've never thought about going to my family doctor for hook-up advice for after my husband dies. I wonder if there is a specific billing code for this type of service? ;)

I guess the bottom line is that a GOOD doctor is going to address health issues directly and forthrightly and keep the social commentary and personal opinion to him or herself! Unfortunately, doctors are just humans...and there are some bad apples among them!

mnemosyne
08-25-2005, 11:13 AM
It's the stupid lawsuits that make medical care so dear to the pocketbook and the wait so long to see specialists. Howie's neurologist told us yesterday that in just a few years' time, the number of practicing neurosurgeons in the U.S. has dropped from 5000 to 3000. I'm sure it's high malpractice premiums, the insurance plans dictating what care their patients can receive, and the risk of lawsuits that did it.

I may be opening a kettle of fish that I don't want to open, but what your neuorsurgeon told you actually isn't true. It's an urban legend, perpetuated by well-meaning people, but it just isn't true.

Here's an excellent article from the American Association of Neurosurgeons regarding a study of the current number of neurosurgeons in the US from 2000. It is VERY difficult to estimate the number of neurosurgeons in the US at any one time. And, neurosurgeons have long been concerned that there are TOO MANY neurosurgeons in the country, while... patients who face long waits to see a neurosurgeon are obviously concerned that there are too few.

I realize that this article was written in 2000, but the point remains quite salient. Remember, it is in any professional's economic interest to remain well-booked over a long period of time. If an expert has loads of downtime, he or she probably can't maintain a practice for long in the local area (certainly not at the level of compensation he or she would prefer) and will need to relocate, etc. Check out the "trends influence the debate" the author references. Malpractice insurance isn't much of an issue: reimbursement rates through managed care, however, IS a big influence on the number of neurosurgeons in the US. Moreover, according to the study, the number of Board-certified neurosurgeons in the US remained steady at 3500 (!) from 1990 to 2000.

Locally, there was a good deal of fanfare when one of three neurosurgeons in the only area practice left to go back to his home country. It was widely rumored that he left because of the cost of malpractice insurance; however, that small practice was able to replace him within four to six months with another skilled and experienced neurosurgeon. I suppose it's possible that our local guy was just... homesick?


Regarding medical malpractice suits more generally, loads of politicians have bandied around the idea that medical malpractice suits are the main cause of the rising cost of health care and it just isn't the case. Malpractice suits are VERY hard to win (honestly!), and the general impact of awards on the overall industry costs is minimal:

http://www.factcheck.org/article133.html

http://www.washingtonpost.com/wp-dyn/articles/A22197-2005Mar9.html

Malpractice insurance rates have risen over the last few years as the stock market tanked. In the 1990s, with the stock market pulling double digit gains, insurance companies could make money even when paying out 100% of premiums in attys fees, admin costs and awards over time b/c of the market. That has not been true since '99, and has affected insurance rates for every industry, every class, everywhere (some more than others, of course).

Are there better ways to handle medical malpractice issues? Yeah, absolutely. The current system does nothing (really) to deter mistakes by physicians, and the cost of suit, likelihood of recovery, and strict standard of negligence mean that loads of people injured by avoidable medical mistakes are never compensated. And... anyway, who on EARTH would take the deal? Michael Kinsley wrote a great story for slate in '03 called the "Lawsuit Lottery," which I thought was really spot-on.

(Admittedly personal story: my aunt's breast cancer was visible on her mammogram for four years before the radiology group reading the mammograms caught it and notified her PCP. Essentially, they should have been comparing the mammograms each year and noticed the obvious changes. They did not. She sued. And won: eventually, but only after investing a substantial amount of her own money in the suit. Had she not had the $ to invest in tracking down appropriate experts, compensating them, and the like, she would not have been able to prevail. Even after prevailing, her managed care program sent her back to the same group for her follow-up mammograms. She had to pay for her own mammograms thereafter, since she obvious didn't trust them to review. Eventually, that breast cancer (10 years later) returned and killed her. Would it have been different had that radiologist done the comparisons he said he did? Had she rec'd treatment 2 or 3 years sooner? Maybe - who knows? But wow - how can you compensate someone for that? It's IMPOSSIBLE to do so. Here's 200,000. So sorry you're going to die (maybe), 30 years before you might've! Every wild "malpractice story" seems ridiculous until it happens to you or someone you know - but even if you DO know someone: would you take that deal? Pas moi.)

There are no fault systems for medical malpractice issues in several countries, that generally work better than the current system. More injured people are compensated, more errors detected, for less $:

http://www.slate.com/id/2113103


Anyway, I'll get off my malpractice soapbox now. I really blame politicians for all the misinformation out there. Unfortunately, the reality is more complicated and less sexy than: too many frivolous lawsuits.

This isn't to say that there aren't frivolous lawsuits; there are. Personally, I think those large-scale small-award class actions are the most offensive (e.g. - the Blockbuster litigation). I think that the states' attorneys general are the more appropriate enforcers of consumer protection issues - although it would be nice if there were some federal consumer protection advocate with the power to bring suit. There *was* some big class action reform instituted this year - I think a stricter definition of "class," but I don't know the specifics or how that will play out.

Oops. More soapbox. I'll *really* get off the soapbox now.

Peace.

Anyway, as far as I can tell, she filed a complaint w/the state medical board. She didn't sue. I don't think she could win a lawsuit. I can't imagine what her damages would be and can't believe that anyone would take her case (unless he/she really just wanted on t.v.).

Okay! /soapbox!

lessofsarahtolove
08-25-2005, 02:27 PM
Thanks for the info, mnemosyne! Thought-provoking, informative, and overall rockin' post -- loved it!

carla49
08-25-2005, 03:44 PM
Just two additional comments: the doctor did send her a letter of apology when he found out she was upset (she said nothing at the time); from the interview clip, it sounded like the doc was a diet doctor, and that's why she was seeing him.

Yes, he shouldn't have made that comment. But it sounded to me like an exasperated reaction to someone who wanted to lose weight but didn't want to work for it.

Gardenwife
08-25-2005, 05:24 PM
Mnemosyne, thank you for a well documented and well considered post.

Jillegal
08-26-2005, 12:34 AM
I, too, appreciated your different perspective and accompanying links, mnemosyne. Thanks.

In the past, Canada has suffered by having so many of our young doctors migrate to the States because of the higher fees they could charge compared to that allowed under our national medical program. However, just yesterday morning it was on the news that doctors are flocking back to Canada because of the prohibitive mal-practice premiums they're subject to Stateside (although I think some came back because they missed Tim Horton's Canadian Maple doughnuts) ;)

looosingit
08-26-2005, 09:23 AM
Well....they are good doughnuts Jilly!! ;) Perhaps there could be some kind of a Tim Horton's recruitment program??

howie6267
08-26-2005, 11:02 AM
I don't think that's it jill. Sorry to burst your bubble but we have Tim Horton's all over the place. MMMM Maple doughnuts my favorite. But we won't go there.

looosingit
08-26-2005, 11:32 AM
Americans get Tim Hortons??? Huh. You learn something new everyday! Glad to share the maple deliciousness with our American neighbours and friends! Next thing you know there'll be hockey in Florida! ;)

matt_H
08-26-2005, 12:19 PM
Worse is that Tim Hortons is owned by Wendys now....On a weight loss site we should cease all discussion of donuts and fast food! :)

howie6267
08-26-2005, 12:36 PM
Here here down with the food porn. LOL It does not bother me as much as it once did but I know how it can trigger you to eat. Your probably right Mat.

slimmingsi
08-26-2005, 01:54 PM
no real food porn is when you are a bit drunk and people yoru with stop for a kebab with huge lashing of chilly sauce smothering it mmmmmmmmmmmmmm

Jillegal
08-26-2005, 02:05 PM
Okay, looosingit...straight from Timmy's site (not that I didn't believe you, Matt and Howie): ;)

"In 1995, Tim Hortons merged with Wendy's International, Inc. While Tim Hortons continues to operate as a separate entity, the merger provided a new focus for the expansion of the Tim Hortons concept in the United States. Tim Hortons locations can presently be found in Michigan, New York, Ohio, Kentucky, Maine, West Virginia, Massachusetts, Connecticut and Rhode Island. The Canadian operation is 95% franchise owned and operated, and plans in the U.S. call for the same key strategy to be implemented as expansion progresses."

Whew, now I don't have to fill 3 large thermos with the world's best coffee before heading to the States any more (although I didn't see a single Timmy's on my recent trip to Kentucky). :?:

As for the doughnuts, they're a thing of the past for me (though I do have a "Timbit" now and then since its only 1 Weight Watchers point). Its their coffee I can't live without. :cloud9:

howie6267
08-26-2005, 04:25 PM
I really dislike Tim Hortons coffee. To bitter for me. Maybe it's because your so sweet Jill, you tame it down. I've never been a big dougnut fan but when I do induldge the maple is what I would choose. We have two Tim's in town and they are all over Columbus. I do like there iced coffee though.

looosingit
08-29-2005, 04:29 PM
Looove the Tim's coffee! Gets me through the work day...truly! ;)
No doughnuts for this girl anymore...I order one timbit. The Tim Horton's workers always seem concerned & confused when you order only one timbit (doughnut hole). Every time I order one timbit, they give me THREE for the price of one (only 15 cents - CANADIAN!). Fortunately, I always go for coffee with 2 other co-workers, who now believe that I am the most considerate and sweet person on the planet, because I always bring them a timbit each! HA! ;) That way I can stick to my one timbit plan without wasting free food....oh...I am so resourceful!

boiaby
08-29-2005, 05:28 PM
That way I can stick to my one timbit plan without wasting free food....oh...I am so resourceful!

:yes: Now that's what I'm talkin about! Perhaps we are long lost twins, that sounds just like me!

Beverly

Burgie
08-30-2005, 01:39 PM
This doctor is a major jack ***. He has no business stating his personal bias in that manner. He could have easily identified the well docummented risk factors of not losing her excess weight. If he was truly concerned for her sex life, he could have asked her is she has concerns in that area. Or are there things she feels limited in doing on that regard. That would open the door to the topic.

By telling her she won't ever get laid because she is fat is akin to telling someone they need a nose job because they are too ugly to find anyone to sleep with them. Shame is not an acceptable motivator for any physician!