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Does your doctor comment on your weight?
Replies
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I agree with you to a point. I hate BMI as a standard because for me it COSTS me more money. How? Well my life insurance policy is higher due to me being "very overweight and bordeline obese" based on BMI. And there's NO WAY if you saw in me real life that you'd say that.It's weird that people accept that the BMI is terrible and inacurrate but also seem to be defending it's use. Being over weight CAN be a major health issue. But since it's that big of a deal, shouldn't we want accurate measurments and guidelines?
I would prefer if we had BODY FAT PERCENTAGE measured accurately as a more usable standard. Lol, but could you imagine how some people would flip out over that? Finding out they could be 40% body fat and still think they aren't unhealthy?
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
Prediction: if we went to that system, we'd quickly have people telling us that body fat wasn't a reliable indicator, that it didn't tell you how fit someone was, etc etc.
Many of the people who are critical of BMI would be equally opposed to any sort of metric because the goal isn't to introduce a more accurate system of measurement, the idea is to attack and discredit the idea that there should be ANY system that's identifying people who are at risk due to weight/body composition.17 -
Agree with you completely.janejellyroll wrote: »
I agree with you to a point. I hate BMI as a standard because for me it COSTS me more money. How? Well my life insurance policy is higher due to me being "very overweight and bordeline obese" based on BMI. And there's NO WAY if you saw in me real life that you'd say that.It's weird that people accept that the BMI is terrible and inacurrate but also seem to be defending it's use. Being over weight CAN be a major health issue. But since it's that big of a deal, shouldn't we want accurate measurments and guidelines?
I would prefer if we had BODY FAT PERCENTAGE measured accurately as a more usable standard. Lol, but could you imagine how some people would flip out over that? Finding out they could be 40% body fat and still think they aren't unhealthy?
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
Prediction: if we went to that system, we'd quickly have people telling us that body fat wasn't a reliable indicator, that it didn't tell you how fit someone was, etc etc.
Many of the people who are critical of BMI would be equally opposed to any sort of metric because the goal isn't to introduce a more accurate system of measurement, the idea is to attack and discredit the idea that there should be ANY system that's identifying people who are at risk due to weight/body composition.
I do have clients that state they want to get to say 10%-15% body fat and super fit with abs. And when I take their age and current health into consideration, I let them know that while possible, the amount of change in their life may be quite drastic to achieve it. Especially if they are near the obese category on BMI.
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
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rheddmobile wrote: »MargaretYakoda wrote: »Tweaking_Time wrote: »Has your doc ever suggested you lose weight? If so, were you offended?
I asked my doc if she ever suggested people lose weight, eat better, exercise more, etc. She said that her answer would be mostly "No." When I asked her why she explained that being a doctor is a business and if she would critique each patients weight, she is sure she would lose patients, especially the easily offended ones. She also said if the patient asks her opinion about their weight, should would gladly help them with a diet/exercise plan.
My current GP first met me when I was about 160 and beginning to have problems with my balance. That was just over twelve years ago.
I had been on a weight loss journey then. I was running almost daily, and was in decent shape. Running. And did I mention the unicycle??? My true exercise love since I was a tween?
She watched as I got larger and larger.
Not once did she mention weight. Diet was mentioned. And alcohol. And I could see disbelief when I would say I rarely drink. Or that generally my diet was decent. (Obviously I was eating more than I was expending, but that was because of increasing disability) And a couple times in the early days I had to fight to get my thyroid meds properly adjusted. I also had to fight so much for my ADHD meds that I just stopped taking them and that hasn’t been my best decision either.
She also asked me what kinds of activities I liked. When I said I liked walking on the beach with my partner she told me that was “too dangerous” and that was my last walk on the beach. At the time I was using two canes.
When I told her I enjoyed using my small chainsaw to cut trash trees in my yard? She was absolutely aghast and told me I should not be using a chainsaw. The fact that it was very small, and I was sitting well braced on a firm seat? Meant nothing. So I stopped working in my yard.
I got no diet advice. I got no referral to a nutritionist. I got no advice for exercise I could do And - crucially - when I said something like “well, I feel like kitten all the time so it’s kind of hard to tell…” she didn’t order any blood tests except thyroid.
I developed a fatty liver. My cholesterol went up, which is against my genetics. And my BP went up, also against my genetics. All with no apparent concern from my GP.
Physical therapists I got sent to clearly thought I was faking my balance issues. Completely ignoring the fact that I used to unicycle all the time so my baseline balance is excellent.
Meanwhile I have other issues that the doctors just roll their eyes when I mention because obviously I’m fat. So I must just be looking for attention…. A hypochondriac.
Which is why I can’t feel my toes now. Because the people I trusted to advise me just looked at my size and my mystery balance issue and decided I was fat and stupid and lazy.
Doctors treating fat people as if being fat is their only problem is a very real issue. I was only a bit overweight when my current GP met me. And that was enough for her to mostly dismiss my concerns.
Oh. And she’s one of the better ones in my area.
That said? Body positivity is a good thing at any size. And doctors need to pay attention to their patients of all sizes
They generally don’t. And that likely has some effect on why larger people have worse health outcomes.
I know it absolutely was a factor in why I have neuropathy right now. If my doctor had encouraged exercise instead of shutting me down when I mentioned the things I liked to do even with my balance disorder? Or had encouraged me to find an assistive device that would make those activities safer in her eyes? Or had sent me to a nutritionist? Or done a simple fasting blood sugar???? I would have been able to reverse the diabetes in the early stages. I know this because my diet was already not that bad. And I was already exercising some. I just needed to be told to step it up a notch.
I am diabetic in some part because my doctor chose not to encourage me to exercise. Chose to only look at my fat and not my symptoms And that’s a big problem for a lot of overweight people.
Oh, this is a terrible story, I’m so sorry. There’s no excuse for not running a regular a1c, yet my doctor didn’t do it either.
Did your neuropathy improve at all with good glucose control? I ask because I used to have neuropathy in my hands and it mostly disappeared after a year or so with good control.
Off topic. I would love to explore in a different discussion if you need more information. But the answer is at this point is my control is super tight, has been since the diagnosis, and I’m only 4 months past diagnosis. AND the neuropathy may be caused by whatever is causing the balance issue and exacerbated by the diabetes but it’s still really too early to tell. But to me it felt as if it came on suddenly, and my glucose was never in the astronomical range. (A1C was 9.2 at diagnosis) and my doctor did change my chart from “diabetic neuropathy” to “idiopathic neuropathy” at my 3 month checkup. Without me mentioning it. And then she attempted to define “idiopathic” for me even though I didn’t ask and didn’t show any confusion when she used the word. I just smiled and said yes, I know.
Ha ha classism ….
There’s a type 2 diabetes group here. https://community.myfitnesspal.com/en/group/1772-type-2-diabetes-support-group We can discuss neuropathy there.1 -
I am late to the conversation here, but it just amazes me that people (both doctors and patients) have such an issue with the concept of the doctor mentioning the patient's weight. I am paying the doctor good money to help me manage my health in the best way possible, and as it has been well demonstrated and determined that excess weight is detrimental to my health, I EXPECT my doctor to mention it and then help me manage it - whether that be thru referrals to specialists or to simply schedule regular progress check-points to help keep me on top of the issue.
I don't think the doc should be a total *kitten* about my weight and to be totally dismissive about any health concerns I currently have (you know - 'lose the weight and it will all go away'), but seriously, I ditched my previous doctor for the one I am now seeing because he would rather manage the symptoms (high blood pressure, sugar and cholesterol) than try and get rid of the cause of those symptoms. The doctor I am now seeing has been absolutely supportive and one of my best cheerleaders in actually losing the weight to solve the issues.8 -
Well at least that's one thing you'll get from me. No *kitten* footing about weight and how it can affect their long term health when I speak to a possible client. I do intros all the time and sometimes you need to let them know where they really stand because it's been dismissed for a long time and they hadn't had concerns until they come in.I am late to the conversation here, but it just amazes me that people (both doctors and patients) have such an issue with the concept of the doctor mentioning the patient's weight. I am paying the doctor good money to help me manage my health in the best way possible, and as it has been well demonstrated and determined that excess weight is detrimental to my health, I EXPECT my doctor to mention it and then help me manage it - whether that be thru referrals to specialists or to simply schedule regular progress check-points to help keep me on top of the issue.
I don't think the doc should be a total *kitten* about my weight and to be totally dismissive about any health concerns I currently have (you know - 'lose the weight and it will all go away'), but seriously, I ditched my previous doctor for the one I am now seeing because he would rather manage the symptoms (high blood pressure, sugar and cholesterol) than try and get rid of the cause of those symptoms. The doctor I am now seeing has been absolutely supportive and one of my best cheerleaders in actually losing the weight to solve the issues.
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
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NVM - wrong thread.1
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Yes. My doctor mentioned my weight at my last physical and suggested I consider weight loss surgery. I love my doctor. He's direct and to the point. I told him "no" on weight loss surgery and jumped back here to MFP and organized a small group of friends to begin our weight loss journey. I am "morbidly obese" on the charts. It is what it is. I know it and just needed a push to get back to focusing on my health. I have a long way to go and while I'd love to be in the "normal" BMI category some day, the lower end of "obese" is still way better than "morbidly obese". So just like I step on the scale every day to see my progress, the BMI chart gives me an idea of progress and where I'd like to be. It's one marker of many that I'll be using as I move forward.12
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Yes I gained weight during the pandemic, as did many people. But I’ve been overweight (according to the crappy BMI system) my whole life DESPITE eating healthy for years.
I know MANY women who eat healthy and are relatively active but they are STILL overweight according to BMI.
In any population you are going to have some individuals who are naturally thinner and some that are naturally heavier. It’s called genetic diversity. Even if every individual “ate within the calorie allotment they’re supposed to” guess what? You are STILL going to see a range of weights among the population - some lighter, some heavier. Caloric intake is only ONE factor that influences an individual’s weight. Genetics also plays a major role. Not everyone is genetically predisposed to be in the “healthy” BMI range, which is a completely arbitrary range. Case in point: in the U.S. the “overweight” BMI range starts at 25, but in Asia, it starts at 23. It modified to fit that population, which is genetically predisposed toward lower weight.
There are plenty of women who are predisposed to higher weight. They eat right and exercise regularly and are STILL labeled as “overweight” according to BMI… even though they are at their natural body weight that genetics has predisposed them to, and would need to starve themselves with an unhealthily low caloric intake in order to get their weight any lower. No thank you!
Anyone who thinks an overweight person is automatically an overeater is just uneducated. There is so much more that influences a person’s weight than caloric intake alone.
[edited by MFP Moderators]5 -
Eating healthy and being 'relatively active' doesn't mean you cannot be eating more calories than you burn - which will lead to weight gain.
Yes, different racial groups ( and genders and ages) can have slightly different best BMI ranges - that is the sort of thing we mean by context.
Quite possible an older Asian woman will be healthy slightly under the standard BMI lower limit, quite possible a young muscular causcian man will be healthy at slightly over the standard BMI upper limit.
And of course you are going to see a range of weights, even amongst people who are a healthy weight.thats why healthy BMI is a range, not a single figure
But nobody is healthy far out of it.
You seem in a lot of denial.18 -
I saw my doctor today and was disappointed that he didn't mention my weight. I've lost 30+ pounds since my last appointment. Although I did get a 'good for you' for exercising. Lol
I normally don't pay attention to BMI so it was nice to see I've dropped out of Stage 3 obesity and am firmly in Stage 2. Another 25 pounds will put me in Stage 1. That's a good goal.17 -
Yes I gained weight during the pandemic, as did many people. But I’ve been overweight (according to the crappy BMI system) my whole life DESPITE eating healthy for years.
I know MANY women who eat healthy and are relatively active but they are STILL overweight according to BMI.
In any population you are going to have some individuals who are naturally thinner and some that are naturally heavier. It’s called genetic diversity. Even if every individual “ate within the calorie allotment they’re supposed to” guess what? You are STILL going to see a range of weights among the population - some lighter, some heavier. Caloric intake is only ONE factor that influences an individual’s weight. Genetics also plays a major role. Not everyone is genetically predisposed to be in the “healthy” BMI range, which is a completely arbitrary range. Case in point: in the U.S. the “overweight” BMI range starts at 25, but in Asia, it starts at 23. It modified to fit that population, which is genetically predisposed toward lower weight.
There are plenty of women who are predisposed to higher weight. They eat right and exercise regularly and are STILL labeled as “overweight” according to BMI… even though they are at their natural body weight that genetics has predisposed them to, and would need to starve themselves with an unhealthily low caloric intake in order to get their weight any lower. No thank you!
Anyone who thinks an overweight person is automatically an overeater is just uneducated. There is so much more that influences a person’s weight than caloric intake alone.
[edited by MFP Moderators]
No one is "naturally" obese. You can eat healthy and be overweight simply because you eat too much food. The average american is overweight/obese so "average" is not something to compare to. Being obese is not an "insult" or "body shaming" it is simple an unbiased medical diagnosis.20 -
I saw my doctor today and was disappointed that he didn't mention my weight. I've lost 30+ pounds since my last appointment. Although I did get a 'good for you' for exercising. Lol
I normally don't pay attention to BMI so it was nice to see I've dropped out of Stage 3 obesity and am firmly in Stage 2. Another 25 pounds will put me in Stage 1. That's a good goal.
Yay!4 -
I know MANY women who eat healthy and are relatively active but they are STILL overweight according to BMI.
Yes, it's very easy to eat a generally healthy diet in terms of nutrients and to be relatively active and yet be overweight in our current food climate.In any population you are going to have some individuals who are naturally thinner and some that are naturally heavier. It’s called genetic diversity.
Sure, but that doesn't mean calories don't matter and that doesn't explain the BMI gain over time -- which is one f the most useful ways to employ BMI. If the average person was BMI 22 50 years ago and is 28 now (made up those stats) then it's not likely to be "some people are naturally bigger boned or more muscular."Caloric intake is only ONE factor that influences an individual’s weight. Genetics also plays a major role. Not everyone is genetically predisposed to be in the “healthy” BMI range, which is a completely arbitrary range. Case in point: in the U.S. the “overweight” BMI range starts at 25, but in Asia, it starts at 23. It modified to fit that population, which is genetically predisposed toward lower weight.
No. Calorie intake still determines weight. Genetics will play a role in what a healthy weight is and (to some degree) what muscle mass is, and also probably how easy eating at an appropriate cal level is (although there's a lot more to that). The differences are that Asian women have bad effects statistically at lower weights.Anyone who thinks an overweight person is automatically an overeater is just uneducated. There is so much more that influences a person’s weight than caloric intake alone.
If overeater is not a moral judgment, as you seem to have made it, but merely means "eats above maintenance at one's healthy weight," then no, an overweight person IS an overeater, but that's easy to be in this food culture so not an insult. It often needs a strategy to avoid.17 -
In any population you are going to have some individuals who are naturally thinner and some that are naturally heavier. It’s called genetic diversity. Even if every individual “ate within the calorie allotment they’re supposed to” guess what? You are STILL going to see a range of weights among the population - some lighter, some heavier. Caloric intake is only ONE factor that influences an individual’s weight. Genetics also plays a major role.
There is lots of really good quality evidence that genetics play a significant role in determining weight. There are a few mutations which are extremely high risk for being obese, and then there are many others which contribute a lesser amount. In this study mutations in over 97 different genes are associated with obesity in humans. The functions of the proteins involved range from neurotransmitter receptors to cholesterol transporters. As it happens, genetic diversity in almost any part of the system from cognitive and psychological aspects, to appetite and satiety and to biochemical processing of food, leads to variation in weight.
There is even evidence of a genetic predisposition to maintaining weight loss here.
>in the U.S. the “overweight” BMI range starts at 25, but in Asia, it starts at 23. It modified to fit that population, which is genetically predisposed toward lower weight.
This is somewhat true: the drive to reduce the thresholds for people in Asia (which I believe is on a national level rather than WHO) is a public health measure related to the relative increase in risks at lower BMI for people of an asian background, rather than a predisposition to lower weight.
All of this speaks to the fact that BMI is a useful public health tool as a gross measurement of the population's adiposity. It is a useful tool to screen for people at increased risk of CV disease and diabetes etc. It is a useful tool for a person who carries adipose tissue to measure progress (but is confounded in this by muscle gains etc).
>There are plenty of women who are predisposed to higher weight. They eat right and exercise regularly and are STILL labeled as “overweight” according to BMI… even though they are at their natural body weight that genetics has predisposed them to, and would need to starve themselves with an unhealthily low caloric intake in order to get their weight any lower. No thank you!
I agree with the first part of this statement: there is a predisposition to weight based on genetic factors. I disagree with the second part though: there's little population wide evidence that any diet that would induce a stable, gradual loss of weight while maintaining nutrient diversity is harmful. Although it is likely they would feel starved. Looking at the genes involved the difficulty is the work that is involved is widely different for different people: some people are genuinely extracting more energy from the food they eat and storing it more efficiently, and the neurotransmitters which regulate appetite and satiety clearly work differently in different people, meaning the unconscious signal to eat is that much stronger for some. And none of this addresses the other main issue of psychological or social factors which contribute a huge amount.
I know that I can lose weight through diet. I have done it before. But the effort required feels unsustainable in the context of a professional job, where I frequently put my personal needs behind the needs of the job (have you ever got to the end of a 12 hour shift and realised that you haven't passed urine all day?) in that context and the balance between the conscious hope to lose weight and the unconscious desire to get some calories regardless of how they are prepared I will always gain weight. My biology, psychology and social factors combine to make losing weight extremely challenging: I'd have to change how I work at my job, ask others to help out more, feel more vulnerable and risk being unsupported, and even then I'd feel tired, headachy, and hungry all day. At some point personal health has to be more important - so I changed my job role and started to learn how to function properly.
Given the polygenic nature of this illness (and it is an illness, not a personal failing as some people seem to suggest) I think it is very personal as to what will work to achieve a persons health goals. And I think that isolated weight loss, as a goal, is hollow and bland, preferring to set a goal of sustained increase in physical activity (with an aim to be able to do sustained aerobic exercise) and controlling calorie intake. Once this is stabilised and sustainable, considering how to improve further by losing weight is a valid goal.
@glassyo Congrats on your weight loss. But your individual experience is not CurvyEmmy's, and you don't know where she is on her path through life. I think it's unfair that you use the word delusion when she has a right to frame her journey in her own terms, and I think it is not helpful to suggest medical diagnoses (depression) based on posts in an internet forum to invalidate her perspective, which actually has a substantial grounding in the science of obesity (whether or not it is relevant to her weight, weight loss journey or overall health - which is way more than just a function of her current weight and BMI reading). Even if everything you've written was (or turned out to be) true, I don't think it's helpful or constructive.6 -
When I got hired for my job, I had to have a physical done. The doctor that was performing the physical said that I was 2.2 LBS away from being what he considers overweight. I am 5'6" and was 130 lbs at the time. I also had a very low body fat. I don't know if there is something that i am missing when it comes to what classifies as overweight but i did not consider myself such. I have recently bulked up to 175. I am still only around 16% bodyfat but i do feel the affects of being heavier. Is there a reason that the doctors standard always feels so much lower than mine% is it because i spend to much time in the "bodybuilding" community?5
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I recently had my first doctor's appointment in over two years. I was wondering if she was going to "yell" at me about missing last year's physical, but instead, the first thing she said was "I'm so glad you maintained your weight!" She said most of her returning patients that she hadn't seen in a while had put on some pandemic weight.
My doctor is way more interested in my exercise routine than my diet. She always asks about, and stresses the importance of, weight and resistance training. I think she sees too many older women with poor bone health and no muscle mass. She's starting to give me the "At your age...." advice.
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LGreenfield7 wrote: »When I got hired for my job, I had to have a physical done. The doctor that was performing the physical said that I was 2.2 LBS away from being what he considers overweight. I am 5'6" and was 130 lbs at the time. I also had a very low body fat. I don't know if there is something that i am missing when it comes to what classifies as overweight but i did not consider myself such. I have recently bulked up to 175. I am still only around 16% bodyfat but i do feel the affects of being heavier. Is there a reason that the doctors standard always feels so much lower than mine% is it because i spend to much time in the "bodybuilding" community?
A doctor doing a routine company physical has a box to tick: BMI normal, overweight, obese. They may be paid or contracted based on giving dietary or weight related advice. Those few words are enough for the doc to write down: "Discussed weight, noted BMI in normal range but close to overweight category." The issue is that BMI is a gross calculation that is useful on a population level and sometimes for an individual to track weight over time, and as a screening tool. As a tool for determining an individual's actual health though, it has significant limitations.
As for lower standards? A decent majority of people a doctor sees are overweight or obese, and I would venture most to far less than the recommended level of physical activity. So when confronted with someone who is generally around the upper limit of a normal BMI, who clearly exercises, their input is limited. They are going for the low hanging fruit of encouraging a person who does nothing to do literally anything active...4 -
LGreenfield7 wrote: »When I got hired for my job, I had to have a physical done. The doctor that was performing the physical said that I was 2.2 LBS away from being what he considers overweight. I am 5'6" and was 130 lbs at the time. I also had a very low body fat.
That's truly insane. I would have questioned why he thought that, and what his understanding of a healthy weight was based on. (It's not BMI, as 130 and 5'6 is 21. Nor is it because he's not a bodybuilder, as I don't think only bodybuilders would consider someone 5'6, 130, and with a low BF% to NOT be near overweight.)6 -
autobahn66 wrote: »LGreenfield7 wrote: »When I got hired for my job, I had to have a physical done. The doctor that was performing the physical said that I was 2.2 LBS away from being what he considers overweight. I am 5'6" and was 130 lbs at the time. I also had a very low body fat. I don't know if there is something that i am missing when it comes to what classifies as overweight but i did not consider myself such. I have recently bulked up to 175. I am still only around 16% bodyfat but i do feel the affects of being heavier. Is there a reason that the doctors standard always feels so much lower than mine% is it because i spend to much time in the "bodybuilding" community?
A doctor doing a routine company physical has a box to tick: BMI normal, overweight, obese. They may be paid or contracted based on giving dietary or weight related advice. Those few words are enough for the doc to write down: "Discussed weight, noted BMI in normal range but close to overweight category." The issue is that BMI is a gross calculation that is useful on a population level and sometimes for an individual to track weight over time, and as a screening tool. As a tool for determining an individual's actual health though, it has significant limitations.
As for lower standards? A decent majority of people a doctor sees are overweight or obese, and I would venture most to far less than the recommended level of physical activity. So when confronted with someone who is generally around the upper limit of a normal BMI, who clearly exercises, their input is limited. They are going for the low hanging fruit of encouraging a person who does nothing to do literally anything active...
Just for the record, I think this is way too much of a generalization about doctors. A doctor who relied on assumptions like that and didn't have an actual conversation and assessment about fitness is IMO a bad doctor. Also, it can't be just relying on BMI, since the BMI was nowhere near overweight. If the doctor was used to dealing with overweight/obese and inactive people (which seems likely enough), they should be immediately able to see the difference.5 -
autobahn66 wrote: »LGreenfield7 wrote: »When I got hired for my job, I had to have a physical done. The doctor that was performing the physical said that I was 2.2 LBS away from being what he considers overweight. I am 5'6" and was 130 lbs at the time. I also had a very low body fat. I don't know if there is something that i am missing when it comes to what classifies as overweight but i did not consider myself such. I have recently bulked up to 175. I am still only around 16% bodyfat but i do feel the affects of being heavier. Is there a reason that the doctors standard always feels so much lower than mine% is it because i spend to much time in the "bodybuilding" community?
A doctor doing a routine company physical has a box to tick: BMI normal, overweight, obese. They may be paid or contracted based on giving dietary or weight related advice. Those few words are enough for the doc to write down: "Discussed weight, noted BMI in normal range but close to overweight category." The issue is that BMI is a gross calculation that is useful on a population level and sometimes for an individual to track weight over time, and as a screening tool. As a tool for determining an individual's actual health though, it has significant limitations.
As for lower standards? A decent majority of people a doctor sees are overweight or obese, and I would venture most to far less than the recommended level of physical activity. So when confronted with someone who is generally around the upper limit of a normal BMI, who clearly exercises, their input is limited. They are going for the low hanging fruit of encouraging a person who does nothing to do literally anything active...
Just for the record, I think this is way too much of a generalization about doctors. A doctor who relied on assumptions like that and didn't have an actual conversation and assessment about fitness is IMO a bad doctor. Also, it can't be just relying on BMI, since the BMI was nowhere near overweight. If the doctor was used to dealing with overweight/obese and inactive people (which seems likely enough), they should be immediately able to see the difference.
I'll be honest: I didn't redo the calculation myself and I work in cm and kg, so didn't catch the the calculation was out!
But as to the second part: it depends very much on the specific role of the doctor. A full evaluation of diet and fitness takes way more than even a single appointment. It takes anthropometric and functional tests. Review appointments to assess food diaries and weight change over time. It is a massive investment of time for a doctor (which is why most of these things are done by dieticians or nurses in a multidisciplinary appointment)
This will happen in a weight management clinic, definitely should happen in metabolic/diabetes clinics and would be of great benefit in a general clinic. But the reality is, unless you are specifically there to discuss weight management, at least in the part of the world I am, there is virtually no chance of a full and proper assessment of weight or weight management. I guess YMMV depending on location and other factors, but the reality is that a doctor who is not being paid to specifically care about your weight and activity levels probably just wants to know where you fall on a BMI chart and whether you do 30 mins of activity every day. And even if you are overweight or obese, or completely inactive, the intervention that will be offered is almost certainly going to be "lose weight, do more activity".
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@lemurcat2 i think it depends on where you’re based. In the UK doctors (GPs) have on average 10 mins per person, and they need c3mins to write up notes so you basically get 7 mins to discuss issues. I get weighed regularly owing to endocrine issues and they will always go through the “BMI tick box”. I did have a v short conversation when I’d put on nearly 2kgs over one year but they usually just want to move onto other stuff. It’s not ideal, but the NHS is massively overstretched. I rarely get asked about my exercise or diet as they just don’t have time 🤷♂️1
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Let's be honest here. The US is an overweight nation for ONE reason...........overconsumption. You do realize that when many immigrants come over to the US that a very good percentage of them GAIN weight? Why? Because food is cheaper and can be bought in bulk. And when a lot of food is available all the time, it's common for people to overconsume.Yes I gained weight during the pandemic, as did many people. But I’ve been overweight (according to the crappy BMI system) my whole life DESPITE eating healthy for years.
I know MANY women who eat healthy and are relatively active but they are STILL overweight according to BMI.
In any population you are going to have some individuals who are naturally thinner and some that are naturally heavier. It’s called genetic diversity. Even if every individual “ate within the calorie allotment they’re supposed to” guess what? You are STILL going to see a range of weights among the population - some lighter, some heavier. Caloric intake is only ONE factor that influences an individual’s weight. Genetics also plays a major role. Not everyone is genetically predisposed to be in the “healthy” BMI range, which is a completely arbitrary range. Case in point: in the U.S. the “overweight” BMI range starts at 25, but in Asia, it starts at 23. It modified to fit that population, which is genetically predisposed toward lower weight.
There are plenty of women who are predisposed to higher weight. They eat right and exercise regularly and are STILL labeled as “overweight” according to BMI… even though they are at their natural body weight that genetics has predisposed them to, and would need to starve themselves with an unhealthily low caloric intake in order to get their weight any lower. No thank you!
Anyone who thinks an overweight person is automatically an overeater is just uneducated. There is so much more that influences a person’s weight than caloric intake alone.
[edited by MFP Moderators]
You can eat "healthy" and exercise and OVEREAT. Ever see people on cardio equipment that are overweight, work out for 2 hours and still are overweight? It's NOT the exercise, but their EATING that's keeps them overweight. Quit apologizing for people being overweight. ANYONE can lose weight if they follow a regimen to actually lose it. But organizations like HAES movement sympathize rather than empathize to overweight/obese people.
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autobahn66 wrote: »But as to the second part: it depends very much on the specific role of the doctor. A full evaluation of diet and fitness takes way more than even a single appointment. It takes anthropometric and functional tests. Review appointments to assess food diaries and weight change over time. It is a massive investment of time for a doctor (which is why most of these things are done by dieticians or nurses in a multidisciplinary appointment)
It really doesn't (and I would expect a referral to a dietitian if that kind of diet evaluation was needed or if I'd wanted weight loss help).
Example of what my doctor does is in the thread already, but I'll repeat. Doctor: technically you are a bit over the healthy BMI (I was around 26.5) but seem fit, your blood pressure is good, tests are good (I forget what the doctor had at that point, but also I got other usual tests that were reported later) so it's probably not an issue. How's your diet/exercise? Me: training for a half marathon, and I know I'm a bit over, I'm actually losing weight right now, blah, blah on general diet. Doctor: what's your goal weight and process for losing? (Checking to make sure I wasn't crash dieting or have an unreasonable goal, I assume.) Me: 120, I'm just using MFP, losing about a lb/week. Doctor: that seems great, not too aggressive, that's a healthy weight for you. This was overall a super short conversation.
If I'd thought BMI was not reflective of my actual risk due to BF% or waist to height (which my doctor was already ready to believe), I would have expected her to maybe do the waist measurement as a backup.4 -
autobahn66 wrote: »
@glassyo Congrats on your weight loss. But your individual experience is not CurvyEmmy's, and you don't know where she is on her path through life. I think it's unfair that you use the word delusion when she has a right to frame her journey in her own terms, and I think it is not helpful to suggest medical diagnoses (depression) based on posts in an internet forum to invalidate her perspective, which actually has a substantial grounding in the science of obesity (whether or not it is relevant to her weight, weight loss journey or overall health - which is way more than just a function of her current weight and BMI reading). Even if everything you've written was (or turned out to be) true, I don't think it's helpful or constructive.
I know where she is because I read the other thread. No, my experience isn't hers but she did not gain 80 lbs because she's destined to be overweight. And I wasn't the first to mention depression and she even agrees she feels depressed. Nothing I said was untrue because it all came from her.
The funny thing is I sympathize with her pandemic experiences. I just don't agree with her attitude on this side of the forums but better people than I have already explained why.
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Awwwww my post got delete. Probably for the best because I did end up with low key posters remorse but do you know how long it took to write that??? How I salivated all over my tablet remembering the good old days? 😀4
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Yes I gained weight during the pandemic, as did many people. But I’ve been overweight (according to the crappy BMI system) my whole life DESPITE eating healthy for years.
I know MANY women who eat healthy and are relatively active but they are STILL overweight according to BMI.
In any population you are going to have some individuals who are naturally thinner and some that are naturally heavier. It’s called genetic diversity. Even if every individual “ate within the calorie allotment they’re supposed to” guess what? You are STILL going to see a range of weights among the population - some lighter, some heavier. Caloric intake is only ONE factor that influences an individual’s weight. Genetics also plays a major role. Not everyone is genetically predisposed to be in the “healthy” BMI range, which is a completely arbitrary range. Case in point: in the U.S. the “overweight” BMI range starts at 25, but in Asia, it starts at 23. It modified to fit that population, which is genetically predisposed toward lower weight.
There are plenty of women who are predisposed to higher weight. They eat right and exercise regularly and are STILL labeled as “overweight” according to BMI… even though they are at their natural body weight that genetics has predisposed them to, and would need to starve themselves with an unhealthily low caloric intake in order to get their weight any lower. No thank you!
Anyone who thinks an overweight person is automatically an overeater is just uneducated. There is so much more that influences a person’s weight than caloric intake alone.
[edited by MFP Moderators]
It's a total misconception that "eating healthy" will ensure that one maintains a healthy weight. I've always eaten a diet that contained plenty of the foods that are associated with better health outcomes and minimized those that didn't (except for a couple of years in college). The issue is that you can still consume more calories than your body needs even when you're eating "healthy."
I fought this too and I had periods where I also believed that I was just destined to be bigger. Nope. As soon as I consistently ate the number of calories my body actually required for my desired weight, I was able to reach and maintain that weight.
We don't have a "natural body weight." It would be great if we did because over the course of human history, lack of calories has been a major concern. Eating "right" and exercising regularly are meaningless without the context of calories.
If you're fat, the cause is that you're eating more than you need to maintain a lower weight. "Overeating" isn't a character flaw, it's something that is very easy to do in our current world. Realizing you're overeating is the first step to controlling your weight, even if it feels like you're eating great and very normally. I too fought this for years.13 -
SuzySunshine99 wrote: »My doctor is way more interested in my exercise routine than my diet. She always asks about, and stresses the importance of, weight and resistance training. I think she sees too many older women with poor bone health and no muscle mass. She's starting to give me the "At your age...." advice.
I wish my doctor was as encouraging about weight lifting. I've told her I do it but she always looks a bit alarmed and cautions me about avoiding injury. She doesn't even know how clutzy I am as I've never needed medical attention for any of my bumps and bruises. She's much more enthusiastic about my daily walking, which gets sidelined in the winter months anyway, and isn't going to do much for my bone density.
My wonderful physiotherapist, on the other hand, is thrilled that I lift and is very helpful in modifying movements that I can't do (like bench press -- rotator cuff issues).
We've only ever discussed my diet very recently, in the context of GI issues following a ruptured appendix, not with regard to weight.6 -
autobahn66 wrote: »autobahn66 wrote: »LGreenfield7 wrote: »When I got hired for my job, I had to have a physical done. The doctor that was performing the physical said that I was 2.2 LBS away from being what he considers overweight. I am 5'6" and was 130 lbs at the time. I also had a very low body fat. I don't know if there is something that i am missing when it comes to what classifies as overweight but i did not consider myself such. I have recently bulked up to 175. I am still only around 16% bodyfat but i do feel the affects of being heavier. Is there a reason that the doctors standard always feels so much lower than mine% is it because i spend to much time in the "bodybuilding" community?
A doctor doing a routine company physical has a box to tick: BMI normal, overweight, obese. They may be paid or contracted based on giving dietary or weight related advice. Those few words are enough for the doc to write down: "Discussed weight, noted BMI in normal range but close to overweight category." The issue is that BMI is a gross calculation that is useful on a population level and sometimes for an individual to track weight over time, and as a screening tool. As a tool for determining an individual's actual health though, it has significant limitations.
As for lower standards? A decent majority of people a doctor sees are overweight or obese, and I would venture most to far less than the recommended level of physical activity. So when confronted with someone who is generally around the upper limit of a normal BMI, who clearly exercises, their input is limited. They are going for the low hanging fruit of encouraging a person who does nothing to do literally anything active...
Just for the record, I think this is way too much of a generalization about doctors. A doctor who relied on assumptions like that and didn't have an actual conversation and assessment about fitness is IMO a bad doctor. Also, it can't be just relying on BMI, since the BMI was nowhere near overweight. If the doctor was used to dealing with overweight/obese and inactive people (which seems likely enough), they should be immediately able to see the difference.
I'll be honest: I didn't redo the calculation myself and I work in cm and kg, so didn't catch the the calculation was out!
But as to the second part: it depends very much on the specific role of the doctor. A full evaluation of diet and fitness takes way more than even a single appointment. It takes anthropometric and functional tests. Review appointments to assess food diaries and weight change over time. It is a massive investment of time for a doctor (which is why most of these things are done by dieticians or nurses in a multidisciplinary appointment)
This will happen in a weight management clinic, definitely should happen in metabolic/diabetes clinics and would be of great benefit in a general clinic. But the reality is, unless you are specifically there to discuss weight management, at least in the part of the world I am, there is virtually no chance of a full and proper assessment of weight or weight management. I guess YMMV depending on location and other factors, but the reality is that a doctor who is not being paid to specifically care about your weight and activity levels probably just wants to know where you fall on a BMI chart and whether you do 30 mins of activity every day. And even if you are overweight or obese, or completely inactive, the intervention that will be offered is almost certainly going to be "lose weight, do more activity".
there seems a bit of confusion here - the poster you quoted was getting a pre employment medical - of course the doctor wasn't going to discuss weight management in detail or do a referral or anything else , he/sh e isnt even the patient's treating doctor, it is a company paid pre employment assessment, not a medical consultation
How/why the doctor made a comment about poster being overweight is unclear - certainly nothing to do with 'healthy but over the upper BMI limit" - if her BMI was 21
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autobahn66 wrote: »LGreenfield7 wrote: »When I got hired for my job, I had to have a physical done. The doctor that was performing the physical said that I was 2.2 LBS away from being what he considers overweight. I am 5'6" and was 130 lbs at the time. I also had a very low body fat. I don't know if there is something that i am missing when it comes to what classifies as overweight but i did not consider myself such. I have recently bulked up to 175. I am still only around 16% bodyfat but i do feel the affects of being heavier. Is there a reason that the doctors standard always feels so much lower than mine% is it because i spend to much time in the "bodybuilding" community?
A doctor doing a routine company physical has a box to tick: BMI normal, overweight, obese. They may be paid or contracted based on giving dietary or weight related advice. Those few words are enough for the doc to write down: "Discussed weight, noted BMI in normal range but close to overweight category." The issue is that BMI is a gross calculation that is useful on a population level and sometimes for an individual to track weight over time, and as a screening tool. As a tool for determining an individual's actual health though, it has significant limitations.
As for lower standards? A decent majority of people a doctor sees are overweight or obese, and I would venture most to far less than the recommended level of physical activity. So when confronted with someone who is generally around the upper limit of a normal BMI, who clearly exercises, their input is limited. They are going for the low hanging fruit of encouraging a person who does nothing to do literally anything active...
Just for the record, I think this is way too much of a generalization about doctors. A doctor who relied on assumptions like that and didn't have an actual conversation and assessment about fitness is IMO a bad doctor. Also, it can't be just relying on BMI, since the BMI was nowhere near overweight. If the doctor was used to dealing with overweight/obese and inactive people (which seems likely enough), they should be immediately able to see the difference.
I found the doctors comments interesting. My Physio therapist always told me that I looked incredibly healthy around 130 and that he was jealous. While donating blood the nurses would always suggest that I put on a little more bodyfat due to the fact that I had veins very close to the surface and it would make hitting the vein difficult. I wonder if he had to come up with something to note for my employer. I was a swimmer so my lung health was phenomenal, I had recently had laser eye surgery so sight couldn't have been a problem, and I hear well beyond the average person. IF this is the case.... is this really the level of politics that are involved in our workplaces and medical fields... Curious as to how you guys all feel.1 -
My doctor recently commented on my weight and said I should definitely lose some weight because I am high risk for diabetes.
He politely said he would be giving me bad service if he didn't comment because it's his job to look out for the well being of his patients.
I appreciated that and I am back now to lose 12kgs. He recommended I look into nutrition first and make lifestyle changes. Then look into exercising. He said baby steps so you don't fall off the wagon.11
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