I would always be afraid that the doctor was going to tell my parents that I was fat because they would've humiliated me about it. When I first began getting stretch marks on my arms when I was about 13 my dad lifted my arms and asked very loudly "What happened to your arms!?!" I haven't worn a sleeveless shirt in public since. Seriously, Never.
I never got told by a doctor that I was fat, though I obviously knew.
When I tore my ACL in 2007, it wasn't brought up, I've always been athletic, but VERY overweight. Just before my surgery in March, my doctor finally said that to help me recover, I should PROBABLY try to lose some weight before I got older. He said before I was forty! I'm 20!
I guess it's just to sensitive a subject for them to bring up. I do hate being told I'm fat and I believe the best way to avoid that would be to not be fat.
My doctor's have always encouraged me to lose weight- and it's funny cuz this time I have honestly tried and have lost. So last time I go the doctor gives me a referral for a nutritionist. I was like "I know what's good and bad to eat" and she was like "well just go."
Needless to say I tossed it out. I KNOW why my loss has stalled, I KNOW why I got fat in the first place, and so on. I eat very healthy now and don't plan on going back, I honestly don't think a nutritionist will tell me anything I don't know at this point.
There is some evidence that diet (especially fruits and vegetables) and regular, moderate to intense exercise (a lot more than most Americans get or would like to), may have more to do with health than body weight (at least until you get in the obsese and morbidly obese categories - I'm well past the point of thinking that my weight isn't causing health problems directly not just incidentally, but someone who is only a few pounds "overweight?" Maybe lifestyle changes ARE more important than the extra weight.
Sadly, getting people to commit to eating better and exercising is actually harder than getting them to lose weight. In general, people are more willing to eat less (at least temporarily) than are willing to change what they eat, and how much they move. There are a lot of factors, reasons, and even excuses, but that's human behavior.
For me, ironcially it was the fat acceptance movement that got me started on the path I am now. In magazines like Radiance and BBW (both now defunct, I believe), they pushed the theory that it was entirely diet quality (not necessarily quantity) and exercise were the "real" causes of good health, and that a fat person could be healthy and fat - if they ate well and exercised. The encouragement to be active and exercise without apology, really gave me the courage to demand access to an active lifestyle. I didn't have to let my fat prevent me from doing anything it didn't physically prevent me from doing. So, I could and should be active.
The world doesn't always see it that way. A couple years ago, I decided I wanted a bicycle, but I didn't know anything about what kind of bike a person of my size would need. So, I started an internet search. Now, I'm pretty good with internet searching, so I certainly expected to find some information, and instead found very little. There were some really high end bikes that listed wieght limits, but for anything under about $600, I was left clueless. There were very few sites that talked about very overweight bicyclests. It was if they didn't exist (but I've seen a few, so I knew they did). Finally, at about the third specialty bike shop my husband I shopped,
we met a guy who seemed to have some knowledge (ironically, a buff 20-something racing bicycler). He told us what to look for in a bicycle that would support the extra weight (and ironically, the older "cheaper" style bike was perfect - no fancy spring suspension, but an old-fashioned Schwinn style basic bike).
It's rather sad that there is social pressure against overweight people being active. Especially for women, there's a huge pressure to isolate, because of fear of looking foolish. That's slowly changing, but I still encounter it so often, in women far less overweight than I saying they "can't" swim, or bicycle, or go dancing or whatever "until" they lose the weight.
For some people, maybe weight loss has to come first - but I think for others diet and/or activity can be the beginning. I think alot of the barriers to weight loss are psychological and social - we teach people to expect weight loss to be something it doesn't have to be, and expectations create reality.
In a lot of ways, I feel I had to unlearn most of what I read or heard about dieting and weight loss, in order to finally succeed. Teasing the truth from all of the mythology isn't easy. Some of it is so ingrained, we don't even realize we've been taught how to diet unsuccessfully (even something as simple as what do you do when you eat something off-plan, even though we're taught we're supposed to get right back on track, we also see that what most people really do is start fresh the next day, or the next Monday, or the next first of the month.... while we're taught it's not the "right" thing to do, we're also taught that it is what most people do. "Do as I say, not as I do," doesn't work very well, as a teaching tool - children and adults both are most likely to follow examples than rules (Who hasn't read an employee manual as a new employee, and realized that the rules and what people actually do are very different - and that the "real" expectation is that you follow the unwritten rules, not those that are written down).
Well, I know you (kaploids) already have a bike for many years now, but I have seen this come up a few times, like on the men's thread. My father has a 'trike.' There are many; his is similar to this one:
He is new to having a trike but tells me that there are groups of people all over the country who get together to go out on their trikes.
They are expensive, of course, though there are ones cheaper than this one. I know this is kind of a thread-hijack but I figure it might be useful to someone.
We actually have considered the trike for hubby. His balance isn't very good because of neuropathy and spine issues, so we can't ride together until we find a bike he can ride safely and comfortably.
I have found more resources in the last year, so I think the word is getting out - but back to the original topic, with obesity being so common a problem - doctors would be the ideal desseminator of such information. They wouldn't even have to broach the subject with patients, they could just offer pamphlets and magazines and such in the waiting room - they have information on practically everything else. Our doctors' waiting room is pamphlet central. I've always wanted to start up some sort of resource-sharing service, but haven't really given it much thought as to how that would actually work. It's such an emotionally-charged and even taboo subject, I'm not sure where I would start.
When I was 25 my GYN wrote down a Rx for exercise upon checkout. I was probably 185 pounds at the time and didn't ask him at any time during the appt. about losing weight nor did he bring it up. He was about 150 soaking wet. I went home and told my hubby and he was like "WTH--you look great!" What a great hubby.
Hey I just bought a trike a few weeks ago Although the type I have is a sporty type and I think they have maximum weight levels around 300-350, depending.
Even as a kid, at the ripe old age of 10, my doctor was telling me to lose weight. I saw a dietician, and my family went on all kinds of diets. I would lose ten or fifteen pounds, but never anything significant. Not that I was an obese child really, I was just heavier than the other kids.
I think foreign doctors are more likely to point out a person that is overweight because America has a much higher standard for what is overweight. Doctors from India or China are used to much much smaller, lighter people, and those who are overweight are much more rare, so foreign doctors in their own countries probably point it out immediately since it could be a sign of danger. Here, overweight is normal, and American doctors are likely to size a heavy person up with their eyes, look at their charts, and if there's nothing wrong the doctor won't say anything because he knows, just like you know, exactly why you're heavy. Plus I think foreign doctors probably worry much less about political correctness.
I'm afraid the American culture is just fatter. I've been realizing this recently--that i was never taught as a child that some food is worse than other food, only to eat what tasted good. My mom was a single mom so there was a lot of cheap filling stuff like mac-and-cheese around, and that cheese in a spray can, lots of cheese. If your parents don't teach you from the get-go how to eat properly, and you're a heavy kid, you're going to be a heavy adult. At least that's my experience. And I think we get here and we look around and we wonder how it happened, while our fridges and cabinents are stocked with totally empty, nutritionless and perfectly commonplace foods like Doritos, pizza rolls, Twinkies...you know the rest. Food like that has billions of dollars of advertising behind it, and absolutely NO advertising that it's not REAL food. If there aren't any veggies in your house growing up, how are you supposed to know that veggies are real food, not totally gross--it's weird how we get those two mixed up, thinking doritos are real food but broccoli is disgusting.
When I was probably ten or eleven my doctor told my parents I was going to be FAT when I got older if I didn't change my habits. I was 160 then. Sure enough, she was right, but my parents surely didn't start buying different groceries or taking me to eat at a salad bar instead of CiCi's.
In high school around 195 I had a doctor tell me to lose weight, but I was such a fragile flower then that it just crushed me. Actually, it crushed me both times.
And that's the problem. Like Lori said, you're damned if you do and you're damned if you don't. And doctors know that better than anyone. There's absolutely no incentive for them to talk to you about your weight unless they absolutely have to due to a health problem the weight is causing. Some doctors care enough to sit down and have a considerate discussion with overweight patients, but some doctors are afraid of lawsuits (rightfully so), some doctors avoid it if at all possible so as not to hurt feelings, and some doctors probably feel like it's your fault you're a fat lazy slob, you know you are, and you know why, so why should he say anything?
It's a catch-22. I sure don't want my doctor saying anything about my weight! but I went to the gyn today and my blood pressure was a little high (like 143/78? I'm 18 and that's the highest it's been) but it's the day before finals so she said that's probably it, since "you lost a whole pound since last time!" which was like three months ago and i actually lost and gained that pound probably twenty times, but i told her it better not be weight-related, I'd been eating nothing but salad and grilled chicken for a week, which I have.
Sorry this is so long!
Another part of the equation is that many doctors are overweight themselves (I read that the percentage of doctors overweight is exactly the same as everyone else, so if 1 in 3 Americans is overweight, then 1 in 3 doctors is), and they may feel like a hypocrite telling people to lose weight, when they haven't been able to themselves. Even if a doctor is "only" 20 lbs overweight, telling the person 100 lbs overweight that they're too fat, may still seem a bit awkward (and what doctor wants to be asked why they don't practice what they preach).
I know my doctor is slightly overweight, but still well within a normal range. He's certainly not in the obese category, he just looks like you "average" 65 year old male, with a bit of a tummy. From some things he's said, I know that he's struggled with those few pounds, and often he will say things like when I asked him for suggestions and he said "I don't know, but if you find something, will you let me know?"
When I first went in talking about losing weight, he encouraged me to try, but also asked me to be patient with myself and not to get discouraged if I found it difficult, that most people do. When I asked him for a goal slip for my TOPS meeting, he asked me what I wanted the goal weight and when I picked 200, he asked me to consider a higher weight - just because weight loss is so difficult - and the fact that I hadn't weighed less than 200 lbs before or since high school (I weighed 225 in 8th grade, and dieted with diet pills to 155 freshman through junior year).
I think there's a very fine line between realistic and unrealistic expectations, and doctors aren't always any more skilled than we are in walking that line, especially since medical schools require little or no nutrition classes. I do find it surprising that preventative medicine isn't focused, at least during the medical education, but it's not. Your average doctors may have less knowledge than most of us here, and you can't expect doctors to teach what they haven't been taught.
Our doctor did refer us to diabetic education classes. Our insurance covered one meeting (ever) for me, and I believe one per year for my husband (because I'm "only" insulin dependent, whereas my husband is diabetic). If you're neither insulin dependent or diabetic, the insurance wouldn't cover any (this was true of my husband's last work insurance also, we're both now on Medicare).
It's crazy really, because one meeting with a dietitian or even a diabetic counselor would be such a great preventive strategy. When I think about how much that one meeting might save the insurance companies, it's rather surprising that they don't do so (especially since most people aren't going to do it, unless and maybe not even if they need to). The people who would choose it, are probably the most likely to benefit from it.
We just found out last month, that Medicare won't cover a tetanus shot. Our doctor wanted my husband to have one, since he hasn't had one in over ten years. Medicare does cover one (preventive) mammogram a year for me, but they won't cover one tetanus shot every ten years? Seems insane. We were told to go to the Health Department, were tetanus shots are cheaper.
I think anyone who doesn't think the American health care and insurance system needs an overhaul, has never been on the wrong side of the system. I have to admit, that all of my working life, I had great medical coverage, and had no idea how many Americans were living without vital medications and medical treatment because they couldn't afford it. Because I didn't know anyone who had had to go without medication or medical treatment, I didn't understand how common it was. Even when I worked in social service, I would refer patients to funding sources, making sure they were aware of the charity medication/medical treatment available, and it wasn't until I needed them that I learned how difficult accessing those programs are. Even with a masters' degree I wasn't able to navigate the Medicare system easily (and when I talked to my doctor, he commiserated because he had tried to help his own mother with her Medicare and he got so frustrated that he couldn't figure it out that he gave it to his billing department to sort out), so his advice ot me was "good luck". We eventually learned that almost anyone who could answer our questions, couldn't legally answer them. Pharmacists and medical billing folks knew which programs paid the most and best with the least hassles, but legally couldn't share that information because it "might unduly influence" our choices (heck, yeah it would influence our choices).
I went and got an age-appropriate physical at the urging of my employers last year (having a physical every year reduces our health insurance premiums) and the doctor told me to lose weight and do it immediately, because I'm not getting any younger (I'm 25) and she predicted I'd almost certainly be diabetic by the time I turn 30 unless something changes.
I have a male friend who weighs over 500lbs who insists that there's nothing wrong with his weight because if there was, his doctor would have told him. That astounds me. According to my friend, his dr. has never had anything negative to say about his weight, and has never attempted to attribute his debilitating knee problems to anything other than genetics and "it just happens that way sometimes." My friend will say, "yeah, I weigh 500+, but you gotta remember, I'm 6'3''!" I don't have the heart to tell him he'd have to be near 10 feet tall to be healthy at that weight. Maybe I'm the coward, just as much as the doctor is.
Yes after the birth of my first daughter (I was about the same weight as now) the doctor just said to try and lose a little weight. Another time I went for a medical and the doctor discussed why I'd put on weight (the discussion was required for the medical) and then said to try and lose weight and come back to discuss it if I couldn't. I always worry about going to the doctors in case they nag me about my weight so if they'd said more than that it would of put me off so I think what they said was about right. When I was having my third daughter the hospital made such a big thing about my weight being so high and in front of other patients which upset me a lot (especially as it was because the staff at that hospital had caused me to fall into depression in the first place which was the beginning of my comfort eating )
Lately my docter hasn't said anything about it (yet), but when I was 13 (I'm 22 now) he was incredible rude to me. I went up to see him in order to get in touch with a dietician, and he said; "you'll never become beautiful and thin, but..." In other words, I'll never be pretty because I'm already so far gone that it will be impossible to get rid of all the weight I had gained back then, and thin is pretty and fat is unattractive. What a nerve!
Little does he know that I got anorexia nervosa three years later. I still think I should have gone back to him in that era to show him how "beautiful" I could be (which I obviously wasn't with that grey skin and that terrified look on my face).
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