What to tell my doctor.

ChgingMe

Okay MFP's I need advice. 3 months ago I went through a series of blood tests to determine if I was diabetic etc. The tests came back pre-diabetic. At that point the endocronlogist told me based on my weight that I was obese (bmi). I am a 47 year old African American woman. I am 5'3 and at the time weight around 175.. She told me that she wanted me to lose weight using the scarsdale diet... I told her no. While i needed to lose weight I was no where near obese and her charts were flawed.

Long story short I know all about those fad diets and what they do to your body and metabolism etc. At my age the last thing i need or want is to lose muscle mass. So the next day I started back on MFP really being dilegent with diarying everything and exercise. Fast forward 3 months. I have been exercising 6 days a week. about a month ago I have incorporated weights into my routine. Lifting heavier than I ever have. My clothes are fitting better, people have finally started asking if I'm losing weigh and yesterday I was told I looked skinny in my pencil skirt. Okay so here is the issue. I go back for a follow-up visit this coming Tuesday Aug 14. I have lost exactly 3- 5 pounds. It fluctuates. So for the sake of argument we will say I've lost 5 pounds since my last visit. So at 170 pounds and 5'3 I am still 'technically' by her bmi standard obese.

But I do have a ton of muscle mass. I am in now way ahhnold. But i'm firm and getting stronger and leaner every week. Unless I go to the visit in my birthday suit she won't be able to see the changes. And when she weighs me again she will think im not improving. What do I do. Oh i forgot at the last visit when I told her I wasn't obese cause muscle weighs more than fat she laughed and said yea like 1/2 a pound.

Thanks for letting me rant...

Koldnomore

What's wrong with the truth? You are under no obligation to take any advice /steps from a doctor that you feel are unhealthy. I would tell her what you have been doing and that it is working for you Doctors are not the be all and end all of everything - even if they seem to think that they are. I have no problem saying NO to mine (especially when they suggest pills for anything)

Congrats on your gains! (and loss)

CherBear1958

Give your doctor a copy of the reports you can get from this site. Since I am at day4, I don't know how create those reports. My Mum has Type 2 and was in her 50s when she was diagnosed. The most important thing she could do when trying to incorporate a treat into diet was to go on her stationary bike afterwards. Some how this kept her sugars in check. So, in my humble opinion (sorry family joke, we have a family member who always says that because she thinks she is always correct) is that your emphasis on exercise is great. I need to follow your lead. In addition, Mum eats 5 to 6 real small meals a day, and I mean small more like two large snacks and three smaller snacks. Hope this helps with your doctor. Is there a diabetes clinic where you live? They were very helpful with Mum and since their speciality is diabetes, they had more current information then GP.

ChgingMe

Thanks for the advice. For some reason I feel like I can't go against what the 'expert' says even though I know she is wrong. I did push back about the scarsdale diet. But i know when I step on that scale she is gonna give me the look. Cause technically im still obese.

But Im not diabetic yet. just pre.. ive tried to change my diet so i dont fall into the diabetic catagory.

gerripho

Well, there is a good possibility this particular doctor is just not a good match for you, medical-wise, that is. We all have been taught to respect our doctors and follow their advice. That's good in general but if you have concerns about your relationship with your doctor, perhaps a different doctor will have a different approach that will better match your needs.

Check out my profile for a little description of me finally meeting a doctor (this one happened to be a chiropractor) who has made all the difference in the world. To continue that story, after that, when I was due for my next annual medical appointment, I asked to see a different doctor, tho staying in the same practice. The doctor I had was one of those who had a my-way-or-the-highway-and-don't-question-me-'cause-I'm-the-doctor attitude. Sorry, but I was always uncomfortable seeing her. Well, I switched to a different doctor and he is perfect for me. This one is a good match. He is actually willing to listen to me and make attempts to work WITH me toward my improved health. His bed-side manner is terrific.

If your doctor is in a practice with other doctors, ask to talk to a couple of the nurses in the practice for advice on which of the other doctors in that practice might be a better match for you. If your doctor is by himself, get recommendations from friends or even call his office, explain your concerns, and ask for a referral to someone else. It's your money and your body and your health. Make sure your doctor fits your needs.

mcrowe1016

Your blood tests should tell her everything she needs to know.

sunshine_gem

Thanks for the advice. For some reason I feel like I can't go against what the 'expert' says even though I know she is wrong. I did push back about the scarsdale diet. But i know when I step on that scale she is gonna give me the look. Cause technically im still obese.

But Im not diabetic yet. just pre.. ive tried to change my diet so i dont fall into the diabetic catagory.

As someone else has said, dr's don't know everything. It sounds like you're doing what you need to do, exercising and eating right and that it's working. 5lbs is awesome! How much does she expect you to lose? Just keep doing what you're doing. Awesome job!

akdoxrud

A pound of muscle is the same weight as a pound of fat, but it takes up less space. That's probably why she laughed at you. Your blood work should tell the story, as someone mentioned. If you aren't comfortable with this doctor go to a different one. I tell you this from experience. Sometimes personalities just don't mesh well and you need to find a doctor who listens to you.

kellygirl5538

I weigh the same as you and my height is the same. 170 is too heavy period. At one point I got down to 150 and looked really good, since i workout a lot etc. You be amazed how much better you look when you get to your upper weight range. I would continue to do what you are doing and things will continue to work out.

ChgingMe

Well, there is a good possibility this particular doctor is just not a good match for you, medical-wise, that is. We all have been taught to respect our doctors and follow their advice. That's good in general but if you have concerns about your relationship with your doctor, perhaps a different doctor will have a different approach that will better match your needs.

Check out my profile for a little description of me finally meeting a doctor (this one happened to be a chiropractor) who has made all the difference in the world. To continue that story, after that, when I was due for my next annual medical appointment, I asked to see a different doctor, tho staying in the same practice. The doctor I had was one of those who had a my-way-or-the-highway-and-don't-question-me-'cause-I'm-the-doctor attitude. Sorry, but I was always uncomfortable seeing her. Well, I switched to a different doctor and he is perfect for me. This one is a good match. He is actually willing to listen to me and make attempts to work WITH me toward my improved health. His bed-side manner is terrific.

If your doctor is in a practice with other doctors, ask to talk to a couple of the nurses in the practice for advice on which of the other doctors in that practice might be a better match for you. If your doctor is by himself, get recommendations from friends or even call his office, explain your concerns, and ask for a referral to someone else. It's your money and your body and your health. Make sure your doctor fits your needs.

Thank you. . She came recommended by my gyno. I love that this doctor is really thorugh..But I dont like that she is using the bmi scale as a measure of my fitness and basing my weight loss goals on that. At 170 im in a size 9. I can do an 8 but they are super tight... So i stay in a 9/10. When I go to her next week Im going to tell her all that I accomplished and see what she says. If she still appears to not be in my corner. Then I'm looking for a new doc...

PuggleLover

If she does blood work again, that should prove where you are at. If you are no longer pre-diabetic, then you are on the right path, weight loss or no weight loss.

saragato

I would look into another doctor. If she's telling you to go on fad diets and is relying on outdated BMI scale numbers versus looking at you and doing the proper tests to see about your health, she may not be for you. I know a few years ago when I ask my primary physician about losing weight he gave me a sheet that basically said eat more fruits, veggies, and proteins and exercise and while it still was flawed (I ended up borderline anemic from an iron deficiency because most things high in iron were a no-no on the list) it wasn't some flavor-of-the-month diet.

You're obviously trying and there are lots of people who are lean and healthy who still technically sit in the "overweight" or even "obese" category on the BMI scale because while their weight is not low, it's consisted of healthy muscles and not fat.

jiddu17

Your blood tests should tell her everything she needs to know.

This.

If your Body Composition has changed, then she should be able to tell by going through tests. Further, unless she is trying to get you to take medication, you could always just take what she says with a grain of salt. I had many arguments over 3 months with my doctor, she let me do it my way, she didn't think I could lose weight. I have lost and I still ended up taking the prescription she was pushing because, even though I didn't feel like there was anything wrong (I thought I was a healthy obese), she did send me for an echocardiogram and it confirmed that I have done some damage to my heart. The key thing here, though, is that, regardless of meds or weight, your doctor DID motivate you to get back on track with your health. If she is going to base everything on the weight, then finding a new doc might be the answer. But she may still be the right fit for you if the tests continue to show you're in danger.

Also, my doc did want me to use a "hospital wellness" based shake program, which I woul consider a fad, BUT she wanted me to lose as much as possible as soon as possible to stop the damage sooner than later. She was not a proponent long-term, nor for the entire duraion of my weight loss, she just wanted me to get things under control fast since it's the weight itself that is creating the problems. Perhaps your doc is taking the higher incidence of Type II diabetes in African-American women into account and wants you out of that zone as soon as possible. It is my understanding that, being at a greater risk, it doesn't take as much weight to create the problem.

swordsmith

I am diabetic- let your A1C and other tests tell the story.

I also agree that BMI tends to be flawed and the more in shape one gets the more flawed it becomes.

skylark94

It sounds to me like you need to get a BodPod or other legitimate body composition test done so you and your doctor can know for sure what you are made of.

This may not be you, but I do think a lot of people use the criticism of the BMI scale to shoot down the fact that they are indeed overweight.

rebeccaboer

I think that you should definitely tell her everything you've been doing, and how much healthier you are now. She'll run tests, which should definitely show a change. And when it comes down to it, if she's still not supportive and still gives you a hard time, I'd definitely find a new doctor.

ChgingMe

I also agree that BMI tends to be flawed and the more in shape one gets the more flawed it becomes.
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I absolutely love this!! Thank you

jebo1982

Sounds like you need a new dr. No dr should laugh at something a patient said (unless the patient was telling a joke). Your new eating habits and exercise regime should show improvements in all your blood tests.

zombilishious

This is a perfect example of the fact doctors are not gods or experts. They "practice" medicine, because the human body is complex and they don't know half of it yet. Doctors know alot more about pills than healthy lifestyles. Your blood work should be much better, but if she pushes the diet on you, ask for a referral to a nutritionist. Then start interviewing for a new doc.

MFPBrandy

Many docs stress BMI because there is some research that points to a high BMI -- regardless of whether it's muscle or not -- correlating with certain medical problems. Seems counterintuitive to me, but docs are trained o think in worst-case-scenario mentality.
Personally, any doc that laughs at me is getting the boot. If you want to give her another chance, though, show up to your medical appointment in snug clothes (I.e., your workout gear) so she can see the changes. If she pushes the extreme diet agin, tell her what you don't like about that plan, and get another blood work up to compare to your last visit. If the numbers are improving, you have concrete proof for her that you're on the right track. If your numbers aren't improving, you know you need to reevaluate your plan.
On a side notes, many medical professionals go hard core on the pre-diabetics and newly-diagnosed diabetics because diabetes patients have a really high rate of non-compliance. They're sick of seeing amputations and deaths that could have been prevented.
Or your doc could just be a tool.

*ETA: I don't think you have to like your doc; sometimes we need an impartial observer to tell us we're full of crap. To me it comes down to how two-directional the communication is. Laughing at you isn't a great indication; I hope your next visit goes well. Remember, you're the one who decides what happens to your body. Her role is to advise.

meli_medina

Honestly, doctors can guide you in ways to be healthier with diet and exercise, but they are not experts, for the most part. I take dietary advice from my doctor pretty lightly. He is vegan and fancies himself to be a Lance Armstrong type, a marathon bicycler. That doesn't say I don't respect his opinions or advice - he does well with the way he chooses to eat and with his fitness regiment. But a) he is not a woman, so can't understand where I come from the hormonal perspective, even if he can from a medical perspective, and b) I have absolutely no desire to ever stop eating meat again (I did for a while and I was miserable... it's also how I gained most of my weight).

If you go in and you get the eye, just explain what you've been doing, that you'd like another round of tests, and that you refuse to talk about alternatives to your current diet and exercise plan until you see the results of the blood tests.

Be your own advocate. It sounds like you've already done a great job!

wewon

It can be intimidating to argue with a doctor, so just tell them what you have done and instead of letting the final tale being told by weight alone, tell them about other changes such as the changes in your waist size and have them check your body fat percentage.

mermx

Okay MFP's I need advice. 3 months ago I went through a series of blood tests to determine if I was diabetic etc. The tests came back pre-diabetic. At that point the endocronlogist told me based on my weight that I was obese (bmi). I am a 47 year old African American woman. I am 5'3 and at the time weight around 175.. She told me that she wanted me to lose weight using the scarsdale diet... I told her no. While i needed to lose weight I was no where near obese and her charts were flawed.

At 5`3" and 175lbs then I am sorry it is obese. I know because I am 5`4" and was 180lbs when I started and I was obese.

On the up side good for you for starting to make a change. As this means you have accepted the fact that your weight is not good for your height or health. Whether you think you are obese or overweight, you have had a wake up call with the blood tests.

Tell your Dr that you wish to carry on with your own weigh loss plan. Just because they recommend you follow their plan does not mean you have to do it their way.

But most importantly keep up with what you are doing and get out of the pre diabetic stage that you are in and prove to yourself how important you are to you!

Akimajuktuq

Your doctor is correct about you falling under obese, but they have a pretty low criteria for obese. They will usually give your "ideal" weight as something crazy. For me, they would say 125, which is too small for me. Also, doctors do not generally know much about nutrition, and will base their advice on what I consider incorrect info. One of the best doctors that I had admitted that I shouldn't ask him about what to eat because he only had one course in nutrition while studying to become a doctor, but he still prescribed me some medication that was supposed to send fat through the body undigested; I was still in my 20s and thought it was worth any risk to lose weight. lol It's hard to believe that doctors don't learn much about nutrition, and few will be honest about their lack of knowledge, when what we eat largely determines our health!

About BMI, here on MFP, they have my low range at 114 pounds. I am 5'6" with a medium build and tend to be a bit more muscular than average. If I were 114, I should be in the hospital! I was about 140 at age 14 with a waist of 28, and I was slim. So now that I'm old, had a child, etc, I'm good at anything under 180 but would be best at about 150. Some doctors would still call me obese at 160, NOT. I don't talk to doctors about nutrition, and just avoid them in general.

ChgingMe

I am going to change my profile pic so you can see what i looked like at 175. I would classify myself as overweight with most of it being around my middle. Middle age spread I guess. Since this pic has been taken ive lost an inch and a half in my waist. The irony of it all is that my original blood work came back-- in her words-- impressive. Cholesteral and all that junk was text book as she called it. The only snafu was my gluecose which is pre-diabetic at 6.1 I think it was. so give me a sec to change my profile pic so you all can see me.

tcunbeliever

Ask your doctor to track your body fat percent in addition to your weight. Any medical profession should be ok with using that as a standard of measurement, and it will take into account all your hard work.

VogtAndrea

Do yourself a favour and click on reports. Build every set of reports over a 30 day period that it will give you and print each one out. Take them with you when you go to the doctor next including a printout of your goals and maybe even a sample of most days' food diarly.
The consternation in her eyes from knowing you expect her to actually read the reports alone might make you smile later.
If she won't, she's not a good fit for you. If she does and still pushes fad diets at you, you might want to consider seeing a dietician and asking her for a referral, along with her suggestions in writing.

sacorner

Personally I would ask my doctor to redo the blood work. Making a judgement about your overall health can not be made using one single number. It is very likely with the changes you have made to become healthier that those numbers will have changed much more significantly then the scale.

Good luck!

kiminikimkim

If you are comfortable losing 1.5lbs every month, then keep it up.

If you want to see a 1lbs loss every week, you will need to adjust your calorie intake. "Burned exercise" calories aren't every accurate. I find them to be over-estimated. They may be hindering progress.

thedancingleper

The fact your doctor shot you down in a really rude way would send me to another doctor pretty much immediately. I mean even if you were wrong, that sort of response seems out of line. Maybe I'm just overly sensitive though.

allnewellie

Muscle DOES NOT weigh more than fat! 1 lb of muscle = 1 lb of fat.

That aside, your A1C will tell the truth. Also ask for a full CBC and tri-panel. Those numbers should blow that doctor away. If they don't, find a Dr. that is more involved with sports medicine-minded people. That Dr. will be able to appreciate your new lifestyle, and find ways to encourage you on the path you've chosen.

Well done!