I'm a member of TOPS and this Saturday two women from my group and myself are going to be interviewed for a documentary about obesity and the struggle we go through to lose our weight. Should be fun and interesting...I hope!

One of the things I have to do is come up with one question that I would ask if I was face to face with one of the leading obesity experts in the nation.

I can think of a few good questions but I thought I would ask you all for what your question might be so that I can pull a few really good ones.

Thanks!

Not a question, a suggestion:

There needs to be a board-certified medical specialty called "weight management" or some Latin version of the same. It's RIDICULOUS that if you have cancer, you go to an oncologist, if you have a heart attack you go see a cardiologist, if you are pregnant you see an Ob/gyn, if you have kidney problems you see a nephrologist, if you have ACNE you see a dermatologist, but if you are fat, you see your GP, who probably knows about as much about weight loss as your average issue of Family Circle. Other specialties touch on weight loss, but they all are only looking for one solution--endos look for hormone/insulin issues, surgeons think surgery, psychiatrists think mental health--but no one is trained or certified in the big picture.

I mean, if you had cancer and your GP sent you first to a chemotherapist, then to a radiologist, and then to a surgeon--none of whom ever talked to each other or knew anything about each others fields--you'd think it was an insane way to cure cancer. But that's how we treat obesity, which kills as many people as cancer, and makes many more miserable.

A board-certified weight management DOCTOR would know about nutrition (and way more than a dietitian, who has a bachelor's degree and takes maybe 8 classes specifically about nutrition) and be able to talk about a variety of eating plans. A certified weight management doctor would know about physical therapy/exercise and be able to build a reasonable, steadily increasing and safe exercise plan for an individual. A certified weight management doctor would know about the drugs and surgical options, and would be able to recommend for or against them as best suited an individual patient.

There are 26 board-certified medical specialties out there, and not one to deal with the greatest single health issue in this country.

Well I certainly agree with you, Shmead! My GP is overweight and just tells me to eat less. He sent me to a dietitian who was no help except to try to convince me that her side job in selling MonaVie would surely get my weight off. Not for that price thank you! Next week I'm going to a physical therapist for a groin pull injury and I can't wait to see what they think I should do to heal this injury and get my weight off.

My question for the obesity expert might center around how much harder it is to lose weight the older I get. I honestly thought that if I cut my calories down to 1500 and started exercising the weight would just fall off. Yeah, no that isn't happening and it's been very frustrating.

I'd like to ask an obesity expert if any studies have been done of people who've lost a significant amount of weight (let's say 100 lbs.), comparing the ones who did a psychological component along with the weight loss, vs ones who JUST went on a diet -- if they were any more/less/same successful at maintaining the loss?

I've seen my close friend lose 80 pounds about FIVE times but she will not, categorically refuses actually, to TALK about why she's fat....so she banishes ice cream and cookies religiously for a few months but never deals with anything and eventually the old behaviours come roaring back and we're back to square one. I've lost so much weight, worked so hard, done so much emotional and psychological work to get sane about food, that the notion of gaining it back is enough to wake me in a cold sweat!

What is the best way a person can adjust from losing to maintaining since so many people lose then gain a significant portion back and the statistics seem to say few maintain long-term?

It is easy to say "Oh I could never go back to my old ways" but people do all the time

WOW!! Well said Shmead....!!! Maybe that should be the question.... Why DON'T we have a board-certified medical specialty called "weight management"? That would make total sense!!!

Trazey, I like your question a lot because I really do feel it's about getting to the root of our psychological issues as to why we are overweight, and then learning how to work through our issues so that we can keep the weight off.


Popspry, your question is great as well and I would love to tie that in with Trazey's question. It sure stands to reason that maintaining is going to be much more doable if you get to the cause of why you got fat in the first place.

Shmead. That is just an excellent question!!!! I work in health care, and currently work for a large prestigious medical center. When I first arrived, I looked up weight management on my new workplace's website-- guess what I got. Nothing except a link to the WLS-- housed in the department of surgery. That is inexcusable. Obesity is the number one major health threat in the United States right now, but the problem is just not being addressed in any kind of logical way. I believe that will change.... but there is a major obstacle and it has to do with insurance. Right now, WLS is a huge cash cow for hospitals. Whereas, right now, weight management services are either not reimburseable, or reimuburseable at very low primary care rates. That's a problem with the health care system, with the state of the science, and with our predilection to prefer quick fixes, like surgery, to low-tech primary care type approaches.

My question would be this: what insights have been gained from successful long-term losers, and how are those approaches being incorporated to help others?

Also, is there any truth to the idea that it may be harder for formerly obese people to maintain a normal weight than it is for normal weight people? In other words, are formerly obese people significantly different from never overweight people, and if so, how?

Shmead, you are spot on.

In the same vein, mine is not a question, but a suggestion.

Kids. School. Why oh why are we not educating our children on good and proper nutrition? Yes, I know it's the parents responsibility, but why not get the schools involved?

Robin, I absolutely love my daughter's school. She started 9th grade this year. Her first class is mandatory....Physical Fitness! She comes home sore some days, but she can now run a mile, do 25 pushups and 50 situps. She also knows how to do squats and lunges and interval training. One of her other classes is Health. The teacher eats organic foods and really knows her stuff. So, there is hope for our schools.

Sorry, OP, I can't think of a great question. But your thread has certainly got me thinking about it!

I agree with the others about GPs. Mine is a wonderful woman who is slightly overweight herself (nothing much). When I was younger she was concerned for my weight, and when I really hit obese a few years ago she was very concerned. But she sat me down and said I had to lose weight. That's it. Just "lose weight - eat right and exercise." Done. Not helpful. I agree that I don't think they know much about weight loss at all. Or not as much as they should.

Since then I've been educating myself. I've read books, articles, and any other info I could find. I've put together a bunch of what I've learned and adapt it to work for me. I take it all with a grain of salt and make sure it works for my body.

I do think that most times obesity is a choice (choose to not prevent/fix it, choose to prevent/fix it). Not for everyone, but for me it has been so far. I eat less, exercise more, and the weight comes off. And thank GOODNESS it's a choice, because no one else was helping me at all throughout my childhood. Apparently I was expected to always just know how to eat healthily. It's not inherent - I had to learn.

I would like to ask the obesity expert if he or she has ever been obese.

It's the difference between studying auto mechanics from a book and studying auto mechanics on your own car.

Jay

My daughter is in first grade, and her school offers a wide variety of fruit and vegetables that they can choose from. I know that in class they talk about healthy food, and how much of what food they should have. Of course, they make it simple for 6-7 year olds, but still, the school IS teaching them about proper nutrition.

Shmead, I totally agree with you! Ubergirl's reasoning for why it doesn't exist makes sense. I think another reason may be that obesity is looked at as the fault of the obese person. He or she ate too much, didn't exercise and gained weight. Therefore, he or she just needs to eat less, exercise more. While someone with an illness like cancer didn't "choose" it.

Now - please understand - I do NOT agree with that thinking. I don't think any of us CHOSE to be fat. But I think our society looks upon weight as something we can and should control.

Rhonda and Lindsay - I am so glad to here there is hope for our schools! I worry so much over what it will be like for my toddler as he gets older. He LOVES fruit and does pretty well with veggies, too. I am hoping to encourage this forever!