I wasn't sure whether to put this in body image or in weight lifting, so I put it here cause I think it gave me a really interesting perspective on maintenance.

I work with a woman who is in excellent shape. She eats extremely clean, does lots of cardio, and lifts weights. She has actually been an inspiration to me cause of how great her muscles are. I know she has had to work very hard to get them. As an aside, I have heard other people comment that her muscles are "too big" for a woman, but whatever. I am a great admirer. I've known her for about 6 years and she has always been in great shape---and I know she works hard for it.

So yesterday we were talking about my weight lifting and my trainer and she was asking questions and we were sharing experiences....and she shared with me that she used to be 50 pounds overweight. It was, doing the math, must have been 15 years ago. Her story was a lot like mine, she started with calorie counting, got into weight lifting and the rest is history (hopefully 15 years from now, my story will still be like hers! )

She was asking me what my patients have thought about my weight loss, and that is something that has been on my mind quite a bit lately. Many of my ladies have seen me go through this journey, and their reactions are as varied as they are. All very kind, but some make self-deprecating comments and it hurts my heart. Sometimes I wish I could wear a box into the exam room because it is not at all about me, it is about them....and each of us is in a different place regarding weight and exercise---and of course many of these are either brand-new mothers, or I am seeing them back for gyn stuff and they have preschoolers or whathaveyou.

So this other lady does BMIs on her nonpregnant patients and shares the results with them. This is not without flak. Even on 3FC, posters report feeling annoyed that their health care person mentions their weights or doesn't mention their weights. I think it would be hard to hear from an in-shape provider that your own BMI is overweight or obese....and like I said, her practice sometimes gets her some flak. But should a health care provider then NOT mention weight, unless she herself is overweight?

I was so surprised to hear about her own weight loss journey and maintenance. I was stunned, actually, cause she is so healthy and fit....but of course, she made a life change and has stuck to it.

Anyway, this is a long post, but I realized that I now see her through new eyes after hearing about her weight loss journey. I am not saying this is right or wrong, it just is.

So, part of my rambling is curiosity---those of us in the health care industry or personal training world---do you think that your own journey gives you more credibility as you offer weight loss counseling? Do you think that your patients or clients who are not aware of your own journey think you less credible? In general, patients do NOT like hearing this other lady talk about their BMIs (maybe it is her style, but I have had lots of ladies express consternation)---I wonder if there would be less consternation if she had her before and after pictures somewhere or shared with these ladies that she herself has been in their shoes to some degree. I do not think we are obligated to share our personal histories with other people, but I wonder if the judgement on how we look would be altered with that awareness.

Anyway, I would love to hear other people's thoughts on this, especially if you work in health care or personal training, but everyone's thoughts are welcome.

Well, I'm not in the health care profession, but here are my thoughts.

I think a health care professional who does NOT mention his/her patients' weights is not doing her (I'm gonna use "her" as a default to make this easier) job properly.

Now, I know that a lot of people get offended by it, and don't want to hear it, and think it's inappropriate, but I truly believe that's THEIR issue. A health provider who is doing her job will try to help a patient be healthy and that includes helping them maintain a healthy weight.

I think as far as whether the health care provider is overweight or underweight or buff or wimpy or whatever ( ) is irrelevant. As has been shown here time and again ... none of us knows the full history of other human beings. And it shouldn't matter anyway. I can fully support that my father told me not to take up smoking, despite the fact that he himself smoked 2 packs a day most of his life.

I honestly think ... and I know this is going to come out really blunt and some people may be offended ... if you are offended because your health care provider discusses your weight with you, then you need to get a grip.

.

It's a health care providers job to discuss weight if it's an issue, whether the person is overweight or underweight.

The people that give flak obviously have issues with their own weight and are annoyed of being reminded of it. But a health care provider is the one place where it should be okay to discuss it. I would rather hear it from my doctor or trainer than any of my friends or family.

I've always felt my patients to be receptive of weight loss discussion during our visits. Some of her patients don't seem to be as receptive. I thought perhaps the difference might be the fitness of the messenger, so that made me curious. Perhaps it is in the delivery of the information. Or perhaps I am seeing themes that do not really exist.

In my experience having a health care provider mention weight in a supportive way is a good thing. Letting me know that they acknowledge it and are ready to help when I'm ready but not making every visit all about the weight.
I had one pcp that would never say anything if I lost weight but if I gained weight would be all over me and not in a supportive, educational way. My pcp now is ready to help me when I'm ready but is not pushy about it. She does mention it gently whenever I need to see her.

The question here as I read it isn't "Do healthcare providers have a right to talk about weight with patients?" Most people will say they do, even if it often isn't what the patient wants to hear and may lead to conflict or offense.

The question is, whether or not it makes intellectual sense or not, might it help for patients to know a weight loss history of someone advising them about weight, regardless of whether that is logical/sensible/fair. In an ideal world, its absolutely true that it wouldn't matter the current physical state of the person giving the information. Real world, though, it DOES matter to many people.

Midwife, to address your initial question, I think it would help some of the people, but not all or maybe even most, to know her previous weight history. She'd probably get about an equal split between people thinking "Hmm, she knows where I've been and what I need to do, so I might want to listen to her" and "Grr! I've been trying to lose weight for so long and SHE succeeds. She must have forgotten what it is like to be me!".

It could also just be her delivery...some nuance she isn't aware of. How do your NEW patients treat you talking to them about obesity, Midwife? I mean, at this point, you're pretty darn smokin' fit, yes? Maybe as you get patients who have never met you, you'll be able to get a sense of whether it is weight (in which case, you'll start getting the same coldness in response) or delivery (in which case, if your delivery remains the same, your responses will also).

I'm not in the health care or personal training world, but I am a patient

Weight is part of the whole health story, and if related, or possibly related, to the reason a patient has come to the office (a yearly exam, diabetes, high blood pressure, etc.) then it should always be mentioned. In a non-accusatory way, of course. It's a simple fact. It's like saying "You're 5 feet, 9 inches tall." Can we imagine how ridiculous someone might sound if they came out of the doctor's office and exclaimed "The nerve of that doctor! Talking about my cholesterol numbers! Why I never!"? However, if you go to a doctor for pink eye, and they end up telling you to drop a few pounds as a result, well that's just not necessary.

I've had doctors say things like "You're still overweight."

But, I had one doctor who said "And now for the part nobody likes, the part where I have to talk about weight. According to the charts you're a bit overweight for your height. Would you like to talk more about that and ways to change it?"

I (unfortunately) refused the help then, but she told me that if I did want to talk about some things that I could do to call and make an appointment.

My current doctor never once mentioned my weight at all. This frustrated me when I began losing, because I wanted to brag! Of all the people you can brag to, I think the doctor is the best one... they seem truly happy for you.

I can only imagine that many health care providers cringe at the thought of bringing up weight to a patient, due to all the possible reactions people have! But, at my highest weight, I can say that I'd be much more receptive to a doctor who said "Listen... I've had to lose quite a bit of weight myself. It's hard. It's very hard. But, it is worth it. Would you like to talk about it with me?" It's true that good advice can come from anyone. Regardless of whether or not they've lost a good deal of weight. But, I'm human, and am much more willing to take advice from someone who I know has been in my situation. I realize that doctors are busy people, and they have a twofold job. Treating patients is just half of it. The other half is treating the people that come in. All responding differently to different kinds of bedside manner. But, a little understanding, a little empathy and a little "Hey I've been there, done that" may open up ears to the good advice doctors give.

When I delivered my son, I saw the doctor's dictation (benefit of working in the same hospital) and it said I was obese. I was livid! Yeah, I was heavy, but darn it, I was pregnant! He never said anything to my face, though, and I did lose the weight. Sometimes I think that having read that really put the impetus in my losing extra. I went from 199 at the time of his delivery to 128 about 9 or 10 months later. Somehow part of me thinks that my having read that I was obese made me want to prove that I wasn't. I don't know.

Later, after having regained a lot of the weight (I was up around 165 at the time) another doctor mentioned my weight and gave me a few things to work on to lose it. I stuck his info in the back of my head and left it there for a year before I really decided to do something about it (by then I was up to 173). I took his pointers and more and lost most of what I needed to. Now he's happy with my results (basically maintained for 2 years) but he'd like to see me about 10-12 pounds lighter than I am now. I appreciate his input. I actually appreciate it more for him being direct with me rather than the other doctor who never mentioned it to me, but did put it in the dictation.

Amanda, thanks for phrasing what I was asking so succinctly!!

It probably does have a lot to do with the delivery, as Faerie also alluded to. I've developed "spiels" over the years and I realized that some of my "spiels" were based a bit on my weight, ie, "yes, I understand how hard it is to lose weight, exercise, etc. cause I am also on that journey." But with the visibility of my struggle gone, the words might ring hollow, even though they are as true now if not more than they ever were.

Thanks for your kind words, Amanda. I don't know if I'm smokin' , but I feel good.

Allison,

That was my original kickstart as well. I read a dictation that said I was a pleasant, mildly obese woman, and I was so pissed off I marched over and did my own BMI calculation to prove I wasn't obese.

Er, except that I was.

That provider never mentioned it to my face. I wish she would have, but reading it in black and white kicked my rear into gear. It took another 4 years for find the sweet spot to lose (and hopefully maintain) down to where I want to be.

It might be true that some people couldn't relate to a fit doctor giving them advice about losing weight. But to be honest, I'd have a harder time with an obese doctor giving me advice about losing weight.

IMO, no the health care provider's personal weight/fitness history should not be a part of the equation. That just gives the patient the "out" to say "you don't understand, so I'm not going to listen to you" if their health care provider has never struggled with a weight issue.

But then again, I'll be honest and say that I purely don't understand why ANYONE would get upset if their healthcare professional said they were overweight. It's not like we all don't know that we're fat. I mean really.

Another thing is that I disagree with this:
Take it out of the realm of weight.

If you went to the doctor for pinkeye and he noticed in the process of examining you that you had a mole on your neck that concerned him, would you say it was "not necessary" for him to say "Btw, while you're here, I really think you should see the dermatologist about that mole. It looks like it could be a problem."

How is it any different to go to the doctor for a specific problem and have him say "btw, this also might be a problem you should deal with". Isn't that what doctors are supposed to do?

If the doctor never said anything about the mole, people would scream malpractice. But put weight in the equation, and suddenly it's different.

Except it's not.

.

I didn't phrase it as clearly as I should have, regardless, in the end, I think we just have different opinions on that matter.

Midwife - Yes, that's what I was getting on about. Delivery of the news, and how the doctor approaches it means a lot.

I would dodge the original question and mention something that happened to me and a friend of mine.

Several years ago my doctor mentioned my weight in the nicest possible way. That was the end of my physicals. I gained weight subsequently and was too embarrassed to return to him. It's only now that I have started to consider scheduling a long overdue appointment.

I know I'm not alone. I have a friend in the exact same situation, and I only found out she was avoiding her physicals for the same reason a few months ago.

Doctors may be remiss in their duties if they don't mention weight to their patients. But there are possible unintended consequences to their actions, even when they try their best to bring up the matter in a nonconfrontational way.

I am quite sure that happens, and I can understand it too. But I also know that people stop going to the doctor to avoid all sorts of procedures they don't like or news they don't want to face. The answer simply cannot be to not mention a problem that does exist.