Why do doctors put so much focus on weight?
Replies
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My doctor does look at BMI along with weight. He also discusses dietary issues and exercise. Is this not the norm?0
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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."
The same reason that police don't take you to driving school to learn how to handle cars at higher speeds. They just give you a fine because it's easier and less time consuming to tell you to just slow down. Slow down fixes most traffic accident issues and "lose weight" fixes most health issues for the general public. Most people know that fast food isn't good nutrition and they're just too lazy or don't care. Doctors expect this from people because that's what the majority do and since they don't have any proof that you're different they just assume you're not.
It was already stated but they're not paid to care specifically about your nutrition. They just diagnose issues and give you the easiest best advice to fix it.0 -
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."
The same reason that police don't take you to driving school to learn how to handle cars at higher speeds. They just give you a fine because it's easier and less time consuming to tell you to just slow down. Slow down fixes most traffic accident issues and "lose weight" fixes most health issues for the general public. Most people know that fast food isn't good nutrition and they're just too lazy or don't care. Doctors expect this from people because that's what the majority do and since they don't have any proof that you're different they just assume you're not.
It was already stated but they're not paid to care specifically about your nutrition. They just diagnose issues and give you the easiest best advice to fix it.
^^^this. And most drs do not have adequate knowledge of nutrition/exercise. They took a few courses on it in med school, but that's it. If you want detailed advice about these things see a nutritionist and/or a CSCS0 -
When I was obese I went to the doctor and asked him; "Am I overweight?" and he said: "No! You're fine!"
When I was struggling with a slow thyroid I went to the doctor and said: "I'm tired ALL THE TIME!" And he said: "You're overweight. Subscribe to Oxygen and start eating clean. You'll feel fine in a few weeks."
*shaking head* I've come to the conclusion that all doctors are not made alike but most of them are idiots.0 -
Well, I don't know about other people's doctor's, but mine is really helpful and suggests ways to help me lose fat but gain muscle. As in, he tells me to lift weights, eat a lot of protien, and mix in cardio.
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My doctor knows jack sh1t about weight/ exercise and stuff like that.
This is the reason. I've been trying really hard to be more of a positive person latly, but I wish people would just tell their doctors to f*** off when they try to give nutritiion or exercise advice. Syaing you need to lose weight is proper, and then they should shut up after that.
Weight loss = fat loss.0 -
Doc said to lose weight.
So I lost 82 lbs.
Now I tell the doctor to lose weight. :laugh:0 -
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.
I do have to wonder how you're measuring your body fat mass.0 -
Doctors know that obesity is a cause of major health issues, and reducing obesity reduces some of the health issues that people have. Thereby reducing the costs of those issues. BUT very few doctors actually tell patients that if they lost weight/fat they would be healthier and spend less time in doctors offices. I find that strange.
There are also very, very few insurance companies that encourage their clients to reduce weight. I actually had an insurance company tell me that they don't cover barbaric surgery because its experimental...but they do cover transplants which have a much higher mortality rate and continued care costs. How messed up is that? Its like experts and ins companies dont want people to get healthy.0 -
Yeah, but when you think about it... people staying fat with ongoing health problems makes money for the medical system. In doctor visits, prescriptions, medications, treatment, etc.
But I would say the real reason is that doctors are too busy, and they probably assume "eat less and exercise more" is common sense. But it's far more complicated when someone has no concept of what's less/more/good/bad, etc.0 -
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.
What scale are you using? Any reference I can find, male or female, has > 30% = obese.
And 25-30% as "Overweight" (which also seems like something to address).0 -
"You know, I've managed to keep the same weight for almost 60 years. First eat breakfast, always break your fast. That's very important... break your fast. Your body needs that energy to start the day. Then a sandwich and soup or salad for lunch, maybe a piece of fruit. Eat a sensible dinner but skip the bread and skip desert. Keep some cut up celery or carrots in the fridge if you want a snack at night."
I hear this same speech from my doctor every 3 months. Then he recommends gastric by-pass.0 -
GPs are like General Contractors...they have a pretty wide breadth of knowledge....but when it comes down to it, if you need a plumber, you need a plumber...if you need an electrician, you need an electrician...but it's good to have the GC around to oversee everything and monitor progress or lack thereof.0
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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?
Maybe where you are. I've requested a referral to a nutritionist with no issue and I wasnt even overweight. My father and husband both have been referred for high blood pressure.
There are a number of doctors in my community that support and encourage physical activity for all ages. They sit on committees like an active living strategy committee, coach sports and their association sponsor local runs and programs like the youth running club and race series, healthy ambassador programs, etc. Our local triathlon/running/swimming/cycling community, huge for a small area, would be no where if it wasn't for two of our local doctors.
Are all doctors like this, obviously not. But there are many who do a large part to address this issue. It doesn't have to be just sitting in a office preaching.
I also don't think it's fair to lump all doctors together and say that keeping people unhealthy = more money. Like anything else, there are the good and the bad. The ones that keep up to date, who care and those who don't.
As for referrals to specialists, that's a healthcare/insurance issue.
ETA - my best friends (both in dentistry)would disown me if I failed to mention the importance of dental health and the links to health issues for lack thereof.0 -
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.
What scale are you using? Any reference I can find, male or female, has > 30% = obese.
And 25-30% as "Overweight" (which also seems like something to address).
Remember that women have a much higher acceptable body fat range than men. 33% is the top of the healthy range for women. 'Cos boobs.0 -
Doctors get two weeks nutrition in med school and don't feel qualified. Most would like to refer patients to a dietitian but insurance won't cover seeing a dietitian so they rather say lose weight since they don't know how. They are also required by insurance companies to go by numbers for reimbursement.0
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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?
I'll agree that in a "HEALTHCARE" system, that would make the most sense, but that isn't what most countries, particularly in the US have. We have a pharmaceutical and devices system. Hell, I'm an audiologist, and I know that the counseling and Aural Rehab make as much difference to a person's functional gains as the hearing aids themselves do (and because I work non-profit we do quite a bit of it), but insurance pays nothing for it and very little for devices, and patient's aren't willing to pay for the aural rehab because it is not tangible.0 -
Remember that women have a much higher acceptable body fat range than men. 33% is the top of the healthy range for women. 'Cos boobs.
Huge fan of boobs...
But where are you getting this 33% number from? I'm admittedly just googleing, but body fat or BMI, 33% is listed as obese for a female too.0 -
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.
This is actually incorrect. There is a direct link between gum disease and heart disease (bacterial endocarditis). Your dentist will catch gum disease early when your gums bleed during teeth cleaning (providing you actually go). Your MD/DO might not notice until your gums start receding from your teeth. Many facial tumors are actually caught by dentists rather than physicians.
In addition, it's unlikely your MD/DO will ever tell you to brush twice a day and floss every day, which is what you need to do to avoid gum disease (and this is a very simple self-care routine).0 -
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?
Maybe where you are. I've requested a referral to a nutritionist with no issue and I wasnt even overweight. My father and husband both have been referred for high blood pressure.
There are a number of doctors in my community that support and encourage physical activity for all ages. They sit on committees like an active living strategy committee, coach sports and their association sponsor local runs and programs like the youth running club and race series, healthy ambassador programs, etc. Our local triathlon/running/swimming/cycling community, huge for a small area, would be no where if it wasn't for two of our local doctors.
Are all doctors like this, obviously not. But there are many who do a large part to address this issue. It doesn't have to be just sitting in a office preaching.
I also don't think it's fair to lump all doctors together and say that keeping people unhealthy = more money. Like anything else, there are the good and the bad. The ones that keep up to date, who care and those who don't.
As for referrals to specialists, that's a healthcare/insurance issue.
ETA - my best friends (both in dentistry)would disown me if I failed to mention the importance of dental health and the links to health issues for lack thereof.
You don't mention where you are. I'm in Missouri, which isn't exactly known as being a center of excellence for health and fitness. Prior to that I was in California, but at that point I was in reasonable condition, so the issue never arose. It may be reasonable to assume that my experiences in California may have been much different.
Prior to California, I was in England, and experiences were similar to Missouri. When I was a little over weight I'd be told 'lose weight' with little to no further advice. Not even direction to good resources on healthy ways to lose weight.
I guess that's my point, which perhaps I'm still not articulating well. I'm not expecting my GP to be a nutritionist or a personal trainer. But there are some incredibly basic things that could exponentially increase people's chances of success, and it doesn't take 5 years of school to learn them -
1. Calculate your TDEE. {doc suggests some sites to do this}
2. Create a moderate calorie deficit. Don't go overboard, your body needs a certain number of calories just to run.
3. Track what you eat, and learn what a portion looks like. {doc suggests something like MFP}
4. Resistance training helps you lose fat instead of muscle, it's not just for muscle heads.
5. However you set up your diet plan, make it sustainable for the long term.
I have kidney stones, and my urologist sent me a list of foods to avoid, and yet he's not a nutritionist.
When my cholesterol levels came back high, my doctor suggested foods to eat/avoid to lower it.
I don't see this as being any different. It's a reasonable follow through to increase the chances of someone actually taking advice. If my urologist just told people 'avoid foods high in oxalate' and left it at that, how many people do you think would go away and put themselves together a low oxalate diet plan?0
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