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Old 04-24-2008, 02:07 PM   #1  
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Question Doctors puzzle me...

I am 5'6 and currently weight 217 (down from 231) and I just turned 37 this past weekend. I have a regular family doctor that I've gone to for years (maybe 8-9 years) and as you might guess, I've just gotten progressively more overweight until I hit my high of 231 not long ago. I also have a regular OB/GYN that I've gone to for 5 years or so.

10 years ago I had knee surgery -- not caused by being overweight, but definitely exacerbated the situation.

2 years ago I had back surgery -- again, not because of my weight, but certainly was much more miserable because of my weight.

I've also recently started seeing another orthopaedic surgeon (again) because my knees are totally shot and I'm experiencing severe arthritis. In fact, my surgeon said had he not seen me after looking at my x-rays, he would've guessed I was in my 60s. He also said I was probably facing total knee replacement within 10 years.

So my question is -- why hasn't ONE doctor, over all the many years I've been overweight (all my adult life, to varying degrees), EVER told me that I should lose weight? I understand that it's a touchy subject, but if your doctors can't even be honest with you, then who will? Yes, I knew I was overweight - but it makes is SO much easier to ignore & justify when your doctors ignore it, too.

I went to see the ortho surgeon and I had to point blank ask him, "Is my weight a factor here?" Then he told me I'd definitely benefit by losing weight. But why did I have to ask? Why couldn't any one of my (many) doctors tell me that my weight was dangerously high? I've even been tested for things like diabetes in my past...but no one confronted me.

Has your doctor ever told you -- unsolicited -- that you should lose weight? I do understand it's my responsibility, but might it not help us to hear straight talk from our doctors instead of so easily putting on blinders and eating that Twinkie? Are my experiences unique? Do you think if doctors started speaking up, people might listen...at least a little?
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Old 04-24-2008, 02:17 PM   #2  
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From years of working for doctors, I agree they should bring it up (my doctor does), but so many people don't want to hear it and, honestly, those of us who are overweight already know, it just takes us a while to commit to do something. I've heard so many excuses from patient's when the doctor does mention it, it's almost worthless to discuss. The only time the doctor's I work for really get into it is for purposes of borderline diabetes or some other health problem caused by weight.

I have a pet peeve on this topic -- why are my overweight doctors always telling me to lose weight when they haven't??
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Old 04-24-2008, 02:20 PM   #3  
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I've only ever had one doctor tell me that I should lose weight. And that is the doctor I have now. She only said it because we're TTC. All my other doctors never mentioned it. Not even the doc who told my mom I was overweight when I was 13.

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Old 04-24-2008, 02:21 PM   #4  
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My doctor was not shy last May about telling me that I'd be on blood pressure and blood sugar meds in a matter of months if I didn't lose the weight.

That being said, there are a lot of people who complain that their doctors want to blame everything on their weight, regardless of the actual cause. I think that's pretty common, too.

I think most doctors don't have any faith in our ability to lose the weight so they worry about what your problem is now, not what carrying around less weight would take care of.
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Old 04-24-2008, 02:21 PM   #5  
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You know I broke my ankle as a teen and my DR flat out told me (mind you I was 13 and 185lbs) that I HAD to lose weight because I was too FAT for the state my ankle would be in if I ever was able to walk again! That made me so mad (I wouldnt have if he would have done it tactfully).
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Old 04-24-2008, 02:34 PM   #6  
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Default I'm a patient who prefers NOT to be lectured about my weight.

To be honest, I didn't have a serious weight problem until I started having serious health problems. I began to gain weight AFTER being injured and losing a great deal of mobility.

I get frustrated because I think people make a lot of assumptions about overweight people. A lot of people may consider me "in denial" but I don't believe that I've ever had a weight-related eating disorder. I don't down twinkies. I don't eat cheeseburgers. I don't eat when I'm bored. When I consume a lot of calories, it's more that I've eaten something highly caloric (who knew a Togo's sandwich had 1,000 calories ) than because I've eaten a ton of food.

I remember once I lost about 20 pounds from being sick. I'll spare the details but let's say I wasn't digesting a lot of food. When I went to the doctor he praised me and told me to "keep doing what I'd been doing." He had no idea HOW I'd lost weight, just that I was thinner

Anyway, I guess I agree that overweight people KNOW they're overweight. I think an overall healthy lifestyle should be encouraged, especially if someone has health issues (diabetes, high blood pressure, high cholesterol) that can be helped a lot by healthy changes.
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Old 04-24-2008, 02:40 PM   #7  
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I think Doctors are in a touchy situation. We're now living in a society where "political correctness" is paramount, and it could be considered politically incorrect to tell people that their weight could be causing so many of their health problems. I haven't had a doctor ever tell me that I needed to lose weight, unless I asked if being overweight could be exacerbating or causing some of my health problems. Their answers were even vague: that losing weight would help--but they never would said that it was paramount.

I've known I was overweight since I was probably 13 or so...when I was young and overweight, I never thought about it. I knew I was overweight all through high school and the first couple years of college... I think if a doctor was frank with me and said flat out: "You need to lose weight. Being overweight can cause X problems, you're suffering from X. If you don't want Type 2 diabetes, you should probably lose some weight", then I might have been more motivated to lose weight and just DONE it.

I'm so sick of political correctness. It's not just in the medical community. At college and in elementary, middle and high schools, we can't tell someone that what they've written is terrible and that they should re-write it. God forbid you mark a paper with a RED pen or tell a child that his/her thesis statement isn't really a thesis statement--you wouldn't want to mar his/her self esteem! It's because of a kid glove sort of society that we tiptoe around the truth and touchy subjects...and I think we just need to knock it off. We shouldn't be so afraid of offending everyone.

If more teachers could be honest with students without repercussions, we would have a higher quality education system and more intelligent people. If doctors could be more honest with their patients ("Being obese is killing you"), we might have a healthier population. I'm sorry if this seems ranty or off-topic at all...the topic just ignited my thoughts and feelings on the issue.

Last edited by Azure; 04-24-2008 at 02:42 PM.
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Old 04-24-2008, 02:42 PM   #8  
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On my last visit my doctor actually told me that my weight wasn't an issue, as long as I didn't gain anymore than 30 pounds. Which is crazy, because I know I need to lose at least 30 pounds, according to most charts. Maybe it was because I wasn't experiencing high blood pressure, or diabetes, or anything like that? I was just in for my yearly tourture, and had made a comment that I knew I needed to lose weight and I was working on it, so we could skip that part of the exam.
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Old 04-24-2008, 03:12 PM   #9  
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I've had doctors whom I swear if I went in with a knife in my eyeball would find a way to blame it on my weight and send me home, refusing to treat it until I lost 50 lbs.

I've also had doctors that when I brought up wanting to lose weight, would shrug and say "don't we all."

I don't think that a doctor telling me to lose weight has ever been productive. I've been fat since age 5, and have dieted since age 5. I don't think most fat people have to be told that they're fat or that losing weight would be healthier. They know it.

I'm not offended when a doctor raises the issue, though generally even those who do have absolutely no practical advice on how to accomplish it. 36 years of dieting and self study has made me the expert and they the novice. I think raising the issue without any practical advice is virtually useless.

The best advice I ever got from a doctor regarding weight loss was from a doctor who had lost nearly a hundred pounds herself (and her husband over 100 lbs). Which really only reinforces my belief that most fat people know more about dieting than thin people (even if they're doctors)

Last edited by kaplods; 04-24-2008 at 04:15 PM.
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Old 04-24-2008, 03:19 PM   #10  
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One year, my gynecologist told me she had noticed my weight increasing over the previous few years. It made me mad and sad, my face got hot. It wasn't a big relevation to me - I knew my weight was increasing and it embarassed me. In my whole life - she was the ONLY PERSON to ever comment on my weight gain.

I didn't immediately lose weight (I don't think I would have until I was ready - maybe if a doctor said I was literally DYING), but honestly, her comment was in the back of my head a lot. When I DID LOSE weight and went back to see her the next year, you better believe I pranced up to the scale and she was very effusive in her praise.

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Old 04-24-2008, 03:20 PM   #11  
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I have been overweight most of my life, and I have had doctors tell me I need to lose weight. I think it has been more in the fore-front of my mind because I had to deal with a husband who was diagnosed diabetic in his 20's. I ended up doing SO MUCH research on the condition and everything that leads to it, so on and so forth.

The doctor I have now tells me regularly that I need to lose weight. However, she also blames any problems that I come in to see her for on my weight, that I need to reduce stress, the "typical" things. This frustrates me to no end, and I am now looking for a new doctor.

I know for myself, I've known I was overweight, I knew no one could change it BUT me, and I think I just didn't know the RIGHT way to do it. For me, it was getting my head in the right place to make something happen. And it is a process. Doctors that I have had in the past have offered a referral to the nutritionist or to a weight loss program through the medical center. So, I guess it is in the doctor that you are working with.
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Old 04-24-2008, 03:32 PM   #12  
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Quote:
Originally Posted by kaplods View Post
I've had doctors that I swear if I went in with a knife in my eyeball would find a way to blame it on my weight and send me home, refusing to treat it until I lost 50 lbs.
That is perfect! And, sadly, those are the same doctors who will either give you no guidance whatsoever or tell you to "just stop eating" Before I found my current doc (whom I dearly love) the last Doogie Howser I was seeing used to actually look down his nose at me and give me that rolling eye, "yeah right" look when I was explaining how little I was eating. I was actually gaining weight while suffering from malnutrition and this thought I was eating too much. Thank heaven's I found the new one who actually is more interested in proper nutrition than writing perscriptions. I honestly think the "veterans" of 3FC are better (albiet usually self)educated and know more about nutrition and weight loss than most doctors.
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Old 04-24-2008, 04:05 PM   #13  
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I think doctors should not only mention it but refer the patient to a dietitian who will give them a plan and some guidance and help them loose the weight in a healthy manner.

I don't think "lose weight" is a good enough answer...most people when left to their own devices concerning weight loss try to do too much too soon, or come up with some sort of self created crash diet.

If someone is morbidly obese, is on a bunch of meds and has a bunch of related health problems the doctor should say something about the weight and refer them to a health specialist that can help them.
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Old 04-24-2008, 04:14 PM   #14  
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I've had doctors tell me I need to lose weight. And they did it tactfully, one of them started my modification in eating habits. And 2 of them were very good about sharing their own coping tips. My current general dr. & I were talking about incorporating strength training which I have a hard time with. She told me how she prefers classes to the machines, so I've recently started trying that for variety.

The only health professionals who really irked me were:

1) a nurse for a gyn who kept yammering about how Atkins & Billy Blanks would solve all my weight problems because it worked for her. She had told me I needed to lose weight & I let her know I'd recently started a program to lose weight. But she was trying to persuade me that Atkins & Billy were the way to go.

2) That nurse & the fact that the office was plastered with Ann Geddes photos (which along with Precious Moments figurines kind of freak me out) led me to choose another gyn. She was encouraging about the weight at first, but at my most recent annual, I had only lost 10 lbs since the year before. She spent so much time doing that, she didn't give me a referral for a mammo (I'm in my early 40s) & my mom is a breast cancer survivor, so I'm supposed to be getting them yearly. I asked at the desk as I remembered on my way out & was told "if the patient wants one". Needless to say, the next annual will be with a new dr.

Last edited by nylisa; 04-24-2008 at 04:15 PM.
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Old 04-24-2008, 04:14 PM   #15  
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Yes, of course doctors should bring up weight loss to their overweight patients! What really sticks out to me in your post though, Lunula, is that it almost sounded like you were transferring the responsibility from you to your doctor for your being overweight just because the doctor hasn't brought it up (until, of course, you said that you realized it was your responsibility). I'm sure there are some people out there who do think it is their doctor's responsibility though and blame them somewhat.

I had a doctor who brought it up to my mother when I was younger and started becoming overweight. My mother mentioned that her family and my dad's tends to be slightly overweight and larger framed. Nothing ever really happened though and I wish the doctor had given her options to help me lose weight (because I tried and tried and I couldn't). "Diet and exercise" didn't help me much. I exercised and thought I was eating healthier but nothing worked. No one ever taught me about calorie counting, etc. I was never able to lose weight until I joined WW and was taught about nutrition, etc. I lost the weight once though and gained it back. As I was gaining it back (mostly due to a medication I was on that there were alternatives for) I had a REALLY hard time convincing my doctor that I was still eating healthy and following the program and that the weight gain was due to the medication. This made me feel worse, and then I started eating more and not following the program and I gained back even more weight. It took me 6 months to convince the doc to change the medication, and by then I'd gained back most of what I lost.

Also, some people I work with told me that they were required to take a nutrition course in high school or college. I wish I had gotten this, I think it would have helped me a lot.

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