Why do doctors put so much focus on weight?

stumblinthrulife

Edited to add : Since I first posted this, a very succinct, common sense answer has been given to the focus on weight versus fat loss. However, I still think the sentiment of the post is valid - shouldn't doctors be able to guide us in our weight loss a little more than simply saying 'lose weight'?

Why not body fat? Shouldn't the fat-loss vs. LBM-loss battle be fought by doctors on the front line? Shouldn't they be the ones explaining that resistance training plus moderate calorie deficits are the way to go?

I love my doctor, and he is usually excellent, but on the subject of weight loss the most I get from him (and any other doctor I've ever seen) is "you need to lose weight".

Had I not spent the time researching the issue myself, I'd have just restricted my calorie intake, and probably just go from a big guy with a high body fat percentage to a slightly smaller guy.... with a high body fat percentage.

I recognize that doctor's are busy people, and maybe don't have time to do a full on nutrition and exercise consult with every patient, but what about replacing -

"You need to lose weight"

With -

"You have a high body fat percentage. You can reduce that with some resistance training and a moderate calorie deficit. I'll have the front desk email you some links to tools you can use to measure your approximate body fat at home, and create a personalized plan. Call me in a month to check in with your progress."

Of course, we all know how few people follow doctor advice that's any harder than "take three a day with meals", but if only 1% of people paid attention, it would still be a ding in the obesity stats. And if only 10% of their friends take note of the progress and ask their doctors, and so on and so forth....

So how about it? Who will suggest this approach to their doctor the next time they go? Great things start small.

ninerbuff

Because weight is the NUMBER ONE predictor of health related issues. You can still be overfat without being overweight.

A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 28+ years and have studied kinesiology and nutrition

Annaruthus

Because weight is the NUMBER ONE predictor of health related issues. You can still be overfat without being overweight.

A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 28+ years and have studied kinesiology and nutrition

happens in the Army all the time. People will pass their tape test, but still look like slobs....

Chief_Rocka

Weight loss and fat loss go hand in hand, for the most part.

stumblinthrulife

Because weight is the NUMBER ONE predictor of health related issues. You can still be overfat without being overweight.

A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 28+ years and have studied kinesiology and nutrition

A fair comment, from someone obviously much more qualified than me. But surely the underlying sentiment remains valid - doctors will always say 'lose weight', but will rarely provide or suggest the best ways to lose weight, or tools to aid in it.

This isn't a 'down on the establishment, doctors know nothing' kind of thread, by the way. I have massive respect for my doctor, and most doctors in general, and I follow the advice given closely. I just noticed that weight loss is an area where doctor's advice has been sorely lacking in my experience.

Fozzi43

My doctor knows jack sh1t about weight/ exercise and stuff like that.

n0ob

My doctor knows jack sh1t about weight/ exercise and stuff like that.

Ditto...I've seen mine try to work out...

stumblinthrulife

My doctor knows jack sh1t about weight/ exercise and stuff like that.

Since weight is the number one predictor of health related issues, as has been pointed out by ninerbuff, shouldn't that be a massive concern?

In the western world, obesity is increasingly rampant. Shouldn't it be on the priority list of every doctor in the developed world? Shouldn't they all be able to at a bare minimum guide people through something similar to the 'in place of a road map' thread put together by a lay-person on an internet forum?

Should I really have to consult webpages and internet forums to get healthy weight-loss advice? Shouldn't it be part of my doctor's tool box?

erinsueburns

My doctor knows jack sh1t about weight/ exercise and stuff like that.

Since weight is the number one predictor of health related issues, as has been pointed out by ninerbuff, shouldn't that be a massive concern?

In the western world, obesity is increasingly rampant. Shouldn't it be on the priority list of every doctor in the developed world? Shouldn't they all be able to at a bare minimum guide people through something similar to the 'in place of a road map' thread put together by a lay-person on an internet forum?

Should I really have to consult webpages and internet forums to get healthy weight-loss advice? Shouldn't it be part of my doctor's tool box?

Nope, it won't happen because there is no reimbursement for it in a GP's office.

MB_Positif

From what I understand, the typical general practicioner does not study nutrition or fitness in school. Maybe they should start, but ultimately they want you to go to someone else to figure out what you need to do to lose weight. See a nutritionist and maybe a personal trainer.

snarkysneak

Then there are those of us that looked great, passed the tape tests, and passed the PT tests and they still tried to declare that we are out of the height/weight requirement even though we are 6-10% under the body fat requirement. That totally pissed me off. 5' 11.5" tall and 170 lbs and I was still on extra PT. I never did drop below 170 lbs. My body just wouldn't.

stumblinthrulife

My doctor knows jack sh1t about weight/ exercise and stuff like that.

Since weight is the number one predictor of health related issues, as has been pointed out by ninerbuff, shouldn't that be a massive concern?

In the western world, obesity is increasingly rampant. Shouldn't it be on the priority list of every doctor in the developed world? Shouldn't they all be able to at a bare minimum guide people through something similar to the 'in place of a road map' thread put together by a lay-person on an internet forum?

Should I really have to consult webpages and internet forums to get healthy weight-loss advice? Shouldn't it be part of my doctor's tool box?

Nope, it won't happen because there is no reimbursement for it in a GP's office.

Follow the money. I should know that one as well as anyone. Guess I'm having an idealistic day.

Ok then, let's take this to it's logical conclusion. Who pays my healthcare bills? I have excellent insurance, so 99% it's my health insurance. Perhaps they should be compensating for better nutrition advice at the GP. Perhaps there needs to be a basic "Nutrition and Exercise Pack", distributable by GPs, which is comped by Insurance. It seems almost a foregone conclusion that people of nominal weight and fitness are going to be a lower long term cost to insurance companies than overweight, obese and morbidly obese people.

It's hardly a secret that most health problems in the Western world are caused by out excess consumption and lackadaisical attitude to nutrition and activity. So why isn't it a central pillar in our health strategy?

metaphoria

The majority of schooling for becoming a doctor (GP) involves pharmaceutical knowledge, and then they go into different fields. Which pills for which condition, which ones counteract others, which are safe to take together... they do not learn much preventative medicine, and quite frankly, do not get kickbacks from people losing weight unless they can prescribe something to "help it along". And one can hardly blame them, since our society is fixated on instant gratification, bandaid solutions, etc.

GPs also do not give you dental advice, as they are not trained for it. It's simply a matter of going to the right professional.

cleomouri

I was so disappointed with my Dr. that I actually started trying to find a new one.

There's more to the story.. but I think I'll make it a blog entry instead.

Fozzi43

The only thing my doctor will do is give out slimming world vouchers...that's it :huh:

numsquat

Easy calculation and tracking. You can track weight easily with an inexpensive scale at home. Easy conversion to a BMI chart (which as a whole is very accurate but breaks down as you move to the individual level). The BMI is the still the standard for the medical field and insurance companies.

Luckily my doctor is more about BF% than weight and works with me on this. My medical insurance uses a separate company to track and promote wellness. My bloodwork is all good, my BF% is in a healthy range (15.5%) but my BMI is still "overweight" and I get dinged on the BMI every year. Sucks but even with my doctor telling them my weight is healthy the BMI still reduces the discount I can get on my insurance.

stumblinthrulife

GPs also do not give you dental advice, as they are not trained for it. It's simply a matter of going to the right professional.

That's a specious response. The health of your teeth is not as tightly correlated to your health in general as your weight is, and failure to brush your teeth is unlikely to land you in the doctor's office.

Most people do not have a nutritionist, and will not be referred to a nutritionist until they are already morbidly obese with serious health issues.

This is a very real, and very serious gap in preventative care. You don't get professional help with nutrition until you've already done serious damage to your body. I doubt even my insurance would pay for me to be referred to a nutritionist unless I was showing serious health problems related to my weight - even though it was plainly obvious that that was the trajectory I was on. Instead I'm just told 'lose weight', and left to my own devices. Surely it's better to address issues when people are 10 pounds overweight and still healthy, than when they are 200 pounds over weight and knocking on death's door?

stumblinthrulife

Luckily my doctor is more about BF% than weight and works with me on this. My medical insurance uses a separate company to track and promote wellness. My bloodwork is all good, my BF% is in a healthy range (15.5%) but my BMI is still "overweight" and I get dinged on the BMI every year. Sucks but even with my doctor telling them my weight is healthy the BMI still reduces the discount I can get on my insurance.

Your doctor sounds excellent. That your HI company offers discounts for standard BMI shows a long-term view of health (well, in reality it's probably penalties for being over, but amounts to the same thing). Sucks for body builders that they use BMI in isolation, though.

cfregon

Whenever I go in to my annual exam, they take out the height/weight chart and give me a lecture- because based on my height/weight, I come in at like 36% BMI, if they took the time to actually test me, I'm at 33% BF...the high end of the normal spectrum (right now). I wouldn't have to go through that "you're obese" lecture every year if they took the time to listen to me/test me instead of depending on the chart. Estimates put me at a bf% of 26 if I go down to 178lbs....and I bet you, even when I get down to that my doctor will still say- need to lose some weight....178 is too heavy for a 5'6 female! *shakes head* I just ignore him and go to my nutritionist.

metaphoria

GPs also do not give you dental advice, as they are not trained for it. It's simply a matter of going to the right professional.

That's a specious response. The health of your teeth is not as tightly correlated to your health in general as your weight is, and failure to brush your teeth is unlikely to land you in the doctor's office.

Most people do not have a nutritionist, and will not be referred to a nutritionist until they are already morbidly obese with serious health issues.

This is a very real, and very serious gap in preventative care. You don't get professional help with nutrition until you've already done serious damage to your body. I doubt even my insurance would pay for me to be referred to a nutritionist unless I was showing serious health problems related to my weight - even though it was plainly obvious that that was the trajectory I was on. Instead I'm just told 'lose weight', and left to my own devices. Surely it's better to address issues when people are 10 pounds overweight and still healthy, than when they are 200 pounds over weight and knocking on death's door?

And I agree. I think the system is lacking and entirely too focused on treatment, rather than prevention. However, there is only so much a GP can do, and changes need to happen at the education level, and administration. Policy makers will not change anything unless it's lucrative or advantageous for them.

arcticfox04

Because using weight its simple to explain to someone. The average person really wants to get to the bottom line and get out. It really depends on your doctor mostly.