Is my doctor loony?

annie_p

I went in to see my Primary Care doctor in August, as I thought I had a thyroid issue (was exhibiting all the signs for hypohyroidism). I was 267lbs at the time. My doctor sat down with me and said, "It could be a thyroid issue, but let's talk about what to do if it isn't." She asked me what a typical day is for me, as far as food. Really? I don't eat the same thing every day...I rattled off my diet the day before, and said on some days to add this or that...She did a quick calculation and said I was taking in far to little calories a day. I may a fibbed a little, as I was drinking regular pop as well.

Anyway...obviously, I needed to lose weight, and we both knew it. She said I could very easily lose 4lbs a week....wait, what? I thought it was healthiest to lose 2lbs a week. How can a doctor tell me to lose 4? Not to mention I'm struggling to even lose 1lb a week. But she said with exercising 4 times a week for 60-90 minutes each day, I could do it.

What do you guys think? Should I be pushing myself harder to lose 4lbs a week? I don't forsee it happening, and feel like when I go in for my annual my doctor will be proud of me as it is(she's also my mom's doctor and knows how both of us struggle with weight).

Edestiny7

She may think that you can lose more faster because of the large amount you are trying to lose. It seems when there is a lot to lose, it comes off pretty easily, but when you get closer to your goal, it becomes more of a struggle. I lost between 1 and 1 1/2 pounds per week when doing this, but only had 32 pounds to lose.

SandraMay1982

She sounds mad to me

you're losing, she will be happy with you regardless.

Phatpatty

Well for starters.. I believe it is possible on a"really really good week". But knowing what we know about numbers and calories in vs calories out... you would have to loose/burn 7000 more calories more a week than if you were to loose just 2lbs a week... seems a bit insane, unless you aren't exercising now. Otherwise if you are i think your doc is off her rocker...no offense of course!! Good Luck

BrentGetsFit

I lost 3 this past week and 4 the week before that. I've lost as much as 8 in a week a couple of times. I'm tracking my calories closely and getting exercise as I can. I expect it to slow down at some point but this is how it is for now.

orting514

honestly i think 4 lbs a week is to much, 1-2 is reolistic and wise, now when i started here i lost 4 lbs 1 week and 5 lbs the next, now was that water weight gain or was i overdueing it???

iluvsparkles

Also, she could have been referring to the first several weeks. Typically within the first 2-3 weeks of a new healthier lifestyle you will shed several pound per week in just water weight alone. The downside is that when you shed all of your excess water, you will hit a plateau. I think that you should stick to the 2 lb per week goal, and if you lose more, awesome. At least you know that you are doing it the healthiest way.

annie_p

She sounds mad to me

you're losing, she will be happy with you regardless.

LOL Yeah, I'm a little excited to go to my annual (ha...not many women will say that) just to see what they say.

melodyg

Honestly, I think doctors overestimate how quickly "larger people" can lose weight. I had a doctor tell me to "work hard for a couple months and lose 30 pounds". Um... I've been working hard for 8 months now and haven't hit the 30 pound mark yet. I personally wouldn't aim for more than 2 pounds a week unless I was going to the doctor for regular checkups (like every 3 months) *and* had ruled out any medical issues that might make weight loss difficult (thyroid issues, PCOS, etc.)

Izzygirl1985

I lost 3 this past week and 4 the week before that. I've lost as much as 8 in a week a couple of times. I'm tracking my calories closely and getting exercise as I can. I expect it to slow down at some point but this is how it is for now.

I am officially GREEN WITH ENVY!

annie_p

Well for starters.. I believe it is possible on a"really really good week". But knowing what we know about numbers and calories in vs calories out... you would have to loose/burn 7000 more calories more a week than if you were to loose just 2lbs a week... seems a bit insane, unless you aren't exercising now. Otherwise if you are i think your doc is off her rocker...no offense of course!! Good Luck

I think I'm gonna go with what the majority is saying...in the first few weeks I would've lost more. I definitely hit a plateau for a while, but I also wasn't logging my calories and exorcise.

I think my body is getting back in the grind of things.

annie_p

Honestly, I think doctors overestimate how quickly "larger people" can lose weight. I had a doctor tell me to "work hard for a couple months and lose 30 pounds". Um... I've been working hard for 8 months now and haven't hit the 30 pound mark yet. I personally wouldn't aim for more than 2 pounds a week unless I was going to the doctor for regular checkups (like every 3 months) *and* had ruled out any medical issues that might make weight loss difficult (thyroid issues, PCOS, etc.)

I think so too. Not to mention my doctor is a very skinny woman. I don't think I'm going to PUSH to lose more than 2lbs. Yes it would be great...but no. Two pounds a week would be great in my mind.

kimwig

I went in to see my Primary Care doctor in August, as I thought I had a thyroid issue (was exhibiting all the signs for hypohyroidism). I was 267lbs at the time. My doctor sat down with me and said, "It could be a thyroid issue, but let's talk about what to do if it isn't." She asked me what a typical day is for me, as far as food. Really? I don't eat the same thing every day...I rattled off my diet the day before, and said on some days to add this or that...She did a quick calculation and said I was taking in far to little calories a day. I may a fibbed a little, as I was drinking regular pop as well.

Anyway...obviously, I needed to lose weight, and we both knew it. She said I could very easily lose 4lbs a week....wait, what? I thought it was healthiest to lose 2lbs a week. How can a doctor tell me to lose 4? Not to mention I'm struggling to even lose 1lb a week. But she said with exercising 4 times a week for 60-90 minutes each day, I could do it.

What do you guys think? Should I be pushing myself harder to lose 4lbs a week? I don't forsee it happening, and feel like when I go in for my annual my doctor will be proud of me as it is(she's also my mom's doctor and knows how both of us struggle with weight).

Losing 4lb a week is probably more healthy than carrying significant excess weight, with the impact that has on all of your internal systems.

Try cutting out the regular soda that you didn't tell the doctor about as this would be a good start. Never "drinking your calories" is a great principle.

LaurenRose2011

Just out of curiosity, did she even do a thyroid panel to find out if you do have hypothyroidism? She's PROBABLY right about you being calorie deficient, but there's a chance, based on what you said, that you may have hypothyroidism or a similar condition. If I were your doctor I would have done a thyroid panel on you just to be certain of my diagnosis. It would just be responsible.. However, I am not your doctor, and she knows your body function far better than I do at this point.

I do recommend cutting out regular soda completely, and switching to diet soda if you need to drink soda. I've studied diet drinks, and found that Fresca, though an acquired taste, is the best diet soda you can drink.

4 pounds per week? It's not outside of what's possible. Especially given your current weight, estimated metabolic rate, and calorie intake. I strongly believe that you could do 60 to 90 minutes of exercise per day, reduce your calorie intake, and probably lose about 4 lbs per week to begin with, but you must realise that holding that rate beyond a certain point would be harmful to your health.

I am going to have to conclude with: your doctor knows best (at least in this situation). It's good that you don't foresee a 4lb loss per week happening only because it will probably save you some emotional rides IF you don't lose that much per week. There are a lot of factors that play into our weight, especially as women. (genetics, emotion, menstrual cycle, hormone balance, birth control, etc.), but success is possible.

If you believe that your lie may have reduced your calories enough to show a deficiency in her calculation then you should certainly schedule another appointment and give her the most accurate information possible.

lisateachawa

I have thyroid issues and it makes it harder to lose weight. I struggle to lose a pound at a time. I watch my calories and always go to the gym. Losing weight is hard - no matter how much you have to lose. Just hang in there and the doc will be happy that you are making changes. 1 to 2 is a healthy amount. The slower you lose it - the better it is. It will stay off. You can do it! I know you can!:happy:

TropicalKitty

I don't think she's mad.

Yes, the more you weigh, the more than can come off quickly. Smaller folk (those who have say 30lbs to be at a normal weight) deal with a different set of rules to some extent. Larger people, like myself, will shed a chunk quickly. For example, when I did Atkins, I started about 80lbs overweight. I lost 12lbs in the first two weeks, then it "slowed" to maybe 3lbs a week, then finally to about 1lb/week. It's relative to how much you need to shed. Of course the first little bit tends to be water weight.

Also, you could need to eat more. Sometimes we undereat thinking that's what is going to be the way to do things.

I do think, however, that she should have been a bit more understanding of the situation. Giving someone a tough goal when they are already trying hard can make them feel bad about themselves. I'd just keep on doing what I was doing, as long as I'm being healthy about it. The point is to get the weight off, not win the race.

PS- you should be honest with your doctor. If you want good info on how to be healthy, with diet or whatever else, you need to be giving your physician the proper information. Otherwise, you can't get upset with them for giving you feedback that doesn't jive with your situation because you didn't detail the correct situation.

AntoinetteONeill

I think any Dr. who would start addressing your weight before running your labs (especially your thyroid) is one to avoid! My advice would be to find a new GP if at all possible. If not, I hope she ran all your labs and you can talk with her when you get back. You could also ask for a referral to a nutritionist, who may be better able to help you? Not all Dr's know about safe weight loss and this one doesn't seem to.

MyaPapaya75

Hi,
You saw your Doc in August? did she ever find out if you had thyroid issue? I think that its possible to lose 4lbs with really hard work and really strict eating habits ..I do think she asked you what your plan was "if" you didnt have thyroid issue because she didnt want you to have any setbacks and probably to get your idea of a healthy way of eating and exercising.

TropicalKitty

I think any Dr. who would start addressing your weight before running your labs (especially your thyroid) is one to avoid! My advice would be to find a new GP if at all possible. If not, I hope she ran all your labs and you can talk with her when you get back. You could also ask for a referral to a nutritionist, who may be better able to help you? Not all Dr's know about safe weight loss and this one doesn't seem to.

That's pretty harsh. Why shouldn't weight be addressed? The physician is going to need to know what other things are possibly contributing to what is going on. Eating healthfully is important regardless of what the labs say. Nor do I think it's fair to judge the PCPs ability to deal with their patients' weight when we don't have the full story on the patient or the physician. Not to mention, it was the OP who thought there was a thyroid issue, not the PCP, according to the first post.

TrainerRobin

I suspect that she was addressing the problem aggressively because of the serious health consequences of obesity -- typically worse than quicker weight loss due to a highly restricted diet. Doctors routinely prescribe pretty radical/aggressive diets to folks with considerable pounds to lose because in the risk/benefit analysis, quickly losing those initial pounds (when they do come off quickly and more easily) is the preferable option to slower weight loss.

I also think that she was addressing the issue before diagnosing the potential thyroid issue because either way, you're going to have to assertively diet that weight off. I know ... I've been there. A good 70 pounds of weight attributable to a thyroid issue was the same frustrating problem to deal with, even after I was started on thyroid meds.

So, no I don't think she's nuts. But I understand how it feels to stand in your shoes facing such a challenge. And I will admit to you that it's harder to lose weight with a thyroid issue (even when your meds straighten it out) and it always will be. Total dedication is the only way and it's hard. You'll have good months and bad days and even weeks. But if you get it right more often than you slip up, you'll gradually make progress and find yourself much healthier in a year or two. It's a long row to hoe, but you're not alone.

Good luck. Keep us posted.

MzBug

Just slightly. It is possible to lose a lot when you are larger, but it does slow down too. If you are out of shape you will need to take it slow at first to get "in gear" exercise wise. When I started I did lose 20 in the first 6 weeks, but then it slowed down because I wasn't eatting enough and had to do trial and error to find where I lost consistantly. I also got my GP to send me to a dietician/nutritionist. She got me going in the right direction as far as what I needed to be eatting to get the best nutritional value within my calorie goal. So far in almost 6 months (25 weeks) I have lost 57 pounds (before MFP and with MFP). Considering I had 2 week long vacations and the holidays in there...I don't think I have done all that bad!

dwarfer22

When you are just starting out, with alot to lose, it would drop off of you quick. However, working out 60-90 min a day, every day IMO is highly unrealistic. My hubby is a big guy, he's been dropping about 5/week, he works out 45 min a day about 4 days a week. Unless you have the time, and the desire to spend a good chunk of time working out in the gym, I would be happy losing 2-3 lbs a week, assuming your diet improves (no soda, not even diet, lotsa fruit and veg, whole grains, lean meats etc.) Good luck!

kimwig

I think any Dr. who would start addressing your weight before running your labs (especially your thyroid) is one to avoid! My advice would be to find a new GP if at all possible. If not, I hope she ran all your labs and you can talk with her when you get back. You could also ask for a referral to a nutritionist, who may be better able to help you? Not all Dr's know about safe weight loss and this one doesn't seem to.

It could be that the Dr recognized through lack of other symptoms that thyroid was not the issue and that it would be a waste of resources to do the test.

Being seriously overweight and tired does not mean thyroid problem. Especially as the OP mentions that this Dr has known her a long time. I think the Dr did the right thing saying that the OP should consider paying more attention to weight loss

SandraMay1982

I went to my doctor feeling light headed / dizzy / foggy headed / VERY tired. Clearly I am overweight.

First thing he did was bloods.

Iron.
Thyroid.
Cholesterol.

and there were a couple of other things I don't remember / didn't know.

At that point I was just hooking myself up in October to the join the local gym so he knew i was doing something about my weight and wanted to check all of the above things because he didn't want me to be trying so hard to not lose - the term "pushing poo up hill" comes to mind

catherine1979

Medically supervised weight loss is different than losing weight on your own. If you are under the care of a physician, then losing weight at a rate greater than 1-2 pounds a week might be OK. However losing weight at a rate of 1-2 pounds a week is great as well. If I were your doctor, I probably would have ordered a panel of tests to get a baseline, but I wouldn't have immediately jumped to thyroid.... I would however have checked your liver enzymes, cholesterol, and a fasting glucose.