The Role of Doctors in Weight Loss
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I had one, then he went concierge. Probably because random patients are as big a PITA as doctors are.PeachyCarol wrote: »My doctor encouraged me to start exercising and gave me a recommended caloric range. She didn't really give me any tips on how to eat within that range or anything, but I'm not exactly a spring chicken and don't need to be treated like a child to figure things out. She told me only calories mattered after I told her that I was eating well and not losing weight.
I really like my doctor.
Yep. Common sense doctors rock.
Where are they
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Being a general practice medical doctor is pretty difficult. They get to see patients for 20-30 minutes each, and most patients have a number of particular issues they want addressed in that amount of time. Not to mention a physical exam is performed in that time, as well. The doctor needs to remember information about the entire visit so that he or she can effectively chart what happened during that time to meet legal requirements and have information to refer back to the next time the patient comes in.
Also, a GP has to have general knowledge of the entire body. They don't specialize in anything, so they have a little bit of information about the entire thing. Not all the indepth information that a specialist has. Yet every patient expects the doctor to know everything about the body and all medical issues, and still remember each patient who walks in the door. That's not really possible. GPs do learn as much as possible to get their licenses, and do have to take continuing education to keep up with new advances, but they don't know everything there is to know.
When a patient has a specific need or complaint that requires more attention and time than the GP can address, he or she refers that patient to a specialist. That's not always another doctor. Sometimes it's a cardiac nurse or physician's assistant. Sometimes it's a behavorial health therapist. And if the patient has an issue with obesity and doesn't know how to eat correctly to lose weight, the referral can be to a dietician, and sometimes a physical therapist to address exercise options.
Good GPs will do this.
Right but as others have said, many just don't. They have to be confident to even complete their training, but it too often leads to arrogance.
I'm going to stop there so I don't derail into a rant.0 -
Maybe I'm just lucky, but I've always been quite happy with my doctors. I'd find a new one if I were not.0
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lemurcat12 wrote: »Maybe I'm just lucky, but I've always been quite happy with my doctors. I'd find a new one if I were not.
How would you, if there were a shortage of GPs taking patients? Access to care differs by region. And other things, probably.0 -
lemurcat12 wrote: »Maybe I'm just lucky, but I've always been quite happy with my doctors. I'd find a new one if I were not.
How would you, if there were a shortage of GPs taking patients?
There doesn't seem to be, where I live.0 -
lemurcat12 wrote: »lemurcat12 wrote: »Maybe I'm just lucky, but I've always been quite happy with my doctors. I'd find a new one if I were not.
How would you, if there were a shortage of GPs taking patients?
There doesn't seem to be, where I live.
Then, you are lucky.0 -
My parents moved and found new doctors quite easily too. My mother's was a referral due to specific health issues, but my dad just found a GP with the same practice.0
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lemurcat12 wrote: »My parents moved and found new doctors quite easily too. My mother's was a referral due to specific health issues, but my dad just found a GP with the same practice.
Then your parents were lucky too.
There really are places where GP shortages exist (like where I live, or some rural areas).0 -
My hubs and I both had to find new GPs when we moved back to our home town, and did so with no problem. The first one I tried, I didn't like, so I switched to another one. When I am not satisfied with the care I am receiving from a doctor, I always switch to another one. It's my medical care, and my health. I consider that very important.0
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There are a shortage of doctors in my province and when my old doctor closed her practice, it was very hard finding a replacement. I insist on having the same practitioner over time so we build some history and trust, and I want a doctor who will explain things to me. So Medi-Centre doctors don't cut it for me. Other doctors in town have waiting lists months long.
So I followed the suggested plan offered by our provincial health care insurance provider, to pick a doctor looking for patients off their website. I found out why those doctors were still taking patients. They sucked. One even refused to do an internal exam.
After three years of not finding a suitable replacement, I wrote a pleading letter to my husband's family doctor to take my file. She did, thank goodness.0 -
My hubs and I both had to find new GPs when we moved back to our home town, and did so with no problem. The first one I tried, I didn't like, so I switched to another one. When I am not satisfied with the care I am receiving from a doctor, I always switch to another one. It's my medical care, and my health. I consider that very important.
If the implication is that people who aren't happy with their care are just whining, or don't prioritize their health, I really suggest you look a bit more into different health care systems (not everyone posting here is in the US) and disparities in access to health care within your own system. Because there are some alternative hypotheses that might explain it.0 -
Looks like the doctor did help. She made you angry enough to take action
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Seriously though, I'm not really sure what a doctor can do on the NHS. They aren't trained in nutrition and the NHS guidelines really has no assistance to give people with a BMI under 30. Above that it seems they can offer NHS funded WeightWatchers subscriptions and after there is WLS, but even that is a bit of a postcode lottery and BMI requirements vary across the country.
The NHS is already very stretched and it will cost huge amounts to retrain doctors to look at prevention rather than treatment right now. It is what it is and we all have to take responsibility for ourselves.0 -
My hubs and I both had to find new GPs when we moved back to our home town, and did so with no problem. The first one I tried, I didn't like, so I switched to another one. When I am not satisfied with the care I am receiving from a doctor, I always switch to another one. It's my medical care, and my health. I consider that very important.
If the implication is that people who aren't happy with their care are just whining, or don't prioritize their health, I really suggest you look a bit more into different health care systems (not everyone posting here is in the US) and disparities in access to health care within your own system. Because there are some alternative hypotheses that might explain it.
Certainly not. I am aware that in some areas there are shortages, I was just stating a fact.0 -
My hubs and I both had to find new GPs when we moved back to our home town, and did so with no problem. The first one I tried, I didn't like, so I switched to another one. When I am not satisfied with the care I am receiving from a doctor, I always switch to another one. It's my medical care, and my health. I consider that very important.
If the implication is that people who aren't happy with their care are just whining, or don't prioritize their health, I really suggest you look a bit more into different health care systems (not everyone posting here is in the US) and disparities in access to health care within your own system. Because there are some alternative hypotheses that might explain it.
Certainly not. I am aware that in some areas there are shortages, I was just stating a fact.
Good to know, thanks for clarifying.0 -
My doctor -- who I love, btw -- gave me some fantastic insight into this. I should put this in context: I was his patient for a long time and I was super-morbidly obese, and he really didn't have much advice to help me, and he felt bad about that. When I successfully lost weight on my own, he was really supportive and he also spent some extra time "interviewing" me because he wanted to learn what I was doing that was working.
Anyway, he said: Doctors (in the US, anyway) are not required to learn hardly anything about weight loss or weight management to get or keep their medical credentials. In addition, what they're required to know about nutrition is really just the basics and doesn't go much beyond info easily available to you and me on sites like myplate.gov.
So bottom line, weight loss and weight management advice you get from most doctors is no better than advice you might get from diligent, skeptical research you can do on your own. If you want medical advice on weight loss, you should seek out a doctor who has a reputation as especially knowledgeable in this area.
Next piece of bad news my doctor gave me: just because a doctor is associated with a weight loss clinic does not make them an expert in weight loss either. My doctor told me this because his first job out of medical school was at such a clinic. And his role was strictly circumscribed by the company: they didn't want the doctors to have too much interaction with the clients (the clients spent more time with lifestyle coaches / trainers, and a bit of time with dieticians). My doctor said his job was limited strictly to monitoring blood panel and other lab test results to just raise a warning flag if clients' health was going outside of acceptable parameters. He noted that the clinic didn't make money off of clients being successful: they made money off of client subscription fees and any supplements or meals clients bought from the clinic. It's not to say the clinic deliberately sabotaged clients, it's just that financially their weight loss success was secondary.0 -
My hubs and I both had to find new GPs when we moved back to our home town, and did so with no problem. The first one I tried, I didn't like, so I switched to another one. When I am not satisfied with the care I am receiving from a doctor, I always switch to another one. It's my medical care, and my health. I consider that very important.
If the implication is that people who aren't happy with their care are just whining, or don't prioritize their health, I really suggest you look a bit more into different health care systems (not everyone posting here is in the US) and disparities in access to health care within your own system. Because there are some alternative hypotheses that might explain it.
Actually, no one said that everyone has access to great health care (in the US I think the issue has had more to do with access to insurance, though, and you are not filling me with envy for the Canadian system). My response, and I assume Cindy's, was more to the idea that most people have bad doctors. The majority of the posts commenting on inadequate dr responses did not at all suggest that they had no choice. More that they expected better and in many cases changed doctors.0 -
PeachyCarol wrote: »PeachyCarol wrote: »My doctor encouraged me to start exercising and gave me a recommended caloric range. She didn't really give me any tips on how to eat within that range or anything, but I'm not exactly a spring chicken and don't need to be treated like a child to figure things out. She told me only calories mattered after I told her that I was eating well and not losing weight.
I really like my doctor.
Yep. Common sense doctors rock.
Where are they
Apparently in New Jersey/Philadelphia? I've had terrible doctors in the past, but the four I see now (GP, neurologist/migraine specialist, rheumatologist, and endocrinologist) are all fantastic.
+1 on awesome docs in NJ/Philly. I had been seeing my GP for a while and I went in for my annual about 3 years ago. The doc looked at my chart, glanced up at me, back to the chart, back up at me. "You know, TinCan, you've gained some weight since your last visit."
"I know, doc." I said. "I quit smoking and decided to put the scale away so any weight gain didn't distract me from my efforts there." I patted my paunch and smiled sheepishly.
He nodded and looked back down to the chart. "That's really great. I wish a lot of my patients would take that approach. But, um, it's time to take the ****ing scale back out, man."
The next time I saw him was about 8 months later and I was about 30 pounds lighter. He asked what I had done.
"I took the ****ing scale out."0 -
tincanonastring wrote: »PeachyCarol wrote: »PeachyCarol wrote: »My doctor encouraged me to start exercising and gave me a recommended caloric range. She didn't really give me any tips on how to eat within that range or anything, but I'm not exactly a spring chicken and don't need to be treated like a child to figure things out. She told me only calories mattered after I told her that I was eating well and not losing weight.
I really like my doctor.
Yep. Common sense doctors rock.
Where are they
Apparently in New Jersey/Philadelphia? I've had terrible doctors in the past, but the four I see now (GP, neurologist/migraine specialist, rheumatologist, and endocrinologist) are all fantastic.
+1 on awesome docs in NJ/Philly. I had been seeing my GP for a while and I went in for my annual about 3 years ago. The doc looked at my chart, glanced up at me, back to the chart, back up at me. "You know, TinCan, you've gained some weight since your last visit."
"I know, doc." I said. "I quit smoking and decided to put the scale away so any weight gain didn't distract me from my efforts there." I patted my paunch and smiled sheepishly.
He nodded and looked back down to the chart. "That's really great. I wish a lot of my patients would take that approach. But, um, it's time to take the ****ing scale back out, man."
Love it.
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OP sounds like you had a poor experience. GPs arent perfect, but there are good and bad ones. If you were unhappy with the advice or service given, then you could have raised the issue with the GP, complained, asked to see another Dr or moved to another practice. The GM might have been rubbish, but they do have to know about a wide variety of medical conditions so its no surpise some of them arent that ip to date on weight loss. Id have expected you to be referred to the practice nurse who is much more likely to be in charge of weight issues and give you support. Not sure the pracctice Dr has time to do so, unless you were a more extreme case.
The NHS provides a wealth of diet information on its website.
Public health responsibility has now moved to local government in England, no idea about Scotland.
Theres probably important differences in the way healthcare works depending on which country.0 -
tincanonastring wrote: »PeachyCarol wrote: »PeachyCarol wrote: »My doctor encouraged me to start exercising and gave me a recommended caloric range. She didn't really give me any tips on how to eat within that range or anything, but I'm not exactly a spring chicken and don't need to be treated like a child to figure things out. She told me only calories mattered after I told her that I was eating well and not losing weight.
I really like my doctor.
Yep. Common sense doctors rock.
Where are they
Apparently in New Jersey/Philadelphia? I've had terrible doctors in the past, but the four I see now (GP, neurologist/migraine specialist, rheumatologist, and endocrinologist) are all fantastic.
+1 on awesome docs in NJ/Philly. I had been seeing my GP for a while and I went in for my annual about 3 years ago. The doc looked at my chart, glanced up at me, back to the chart, back up at me. "You know, TinCan, you've gained some weight since your last visit."
"I know, doc." I said. "I quit smoking and decided to put the scale away so any weight gain didn't distract me from my efforts there." I patted my paunch and smiled sheepishly.
He nodded and looked back down to the chart. "That's really great. I wish a lot of my patients would take that approach. But, um, it's time to take the ****ing scale back out, man."
The next time I saw him was about 8 months later and I was about 30 pounds lighter. He asked what I had done.
"I took the ****ing scale out."
Heh, this is great.0 -
I don't know. I don't have a GP, I'm 29 with no health issues. But my OBGYN that I have seen since I was 19 has been absolutely instrumental. If she doesn't know, she gets the answers for me, she refers me out if needed, we talk about different choices. This all started last year when I told her at my exam that I wasn't sure if I was done having kids or not. She said straight up, Ashlie you're not 19 any more. Its gonna be harder. And you're obese. If this is something you want, we need to get to work. And she has been my number one team mate in this since.0
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lemurcat12 wrote: »My parents moved and found new doctors quite easily too. My mother's was a referral due to specific health issues, but my dad just found a GP with the same practice.
Then your parents were lucky too.
There really are places where GP shortages exist (like where I live, or some rural areas).
Ya, I'm with the VA and we didn't have a GYN for three counties in Florida for a few years and when we did get one, he sucked. (The people who filled in before he arrived were quite good, however.) I'm in Massachusetts now and the GYN I have now is marginally better. I'm not sure if I have a choice in primary, but if I was able to see someone else, I'd have to go up to Boston. My primary is ok, however.
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I love my primary care physician. He and his staff have been very supportive of my weight loss. When I developed pre-diabetes he said if I could lose 20% of my body weight I could probably avoid the full blown diagnosis and additional medication. When I went back three months later having lost over 10% of my body weight my sugars were in the normal range. I didn't need another medication. I was able to cut my blood pressure medicine dosage in half. He encouraged me to continue with my life style changes to see if we can decrease other medications as well. I have less than 3 pounds to go before I have reached his challenge of the 20% goal. I had to go in a few weeks ago for help with a couple of injuries, he cheered my progress. My physical therapist is a gem. My health insurance also has provided a resource adviser to help me with nutrition and fitness goals. My insurance, Humana, covers my gym membership. Over all I am very pleased with my health care here in Lincoln, NE, USA.0
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Not knowing much/anything about nutrition, dieting and weight loss doesn't make a GP/PCP a bad doctor. A lot of other things (including their attitude) might, but like many others have said, most doctors aren't trained in that stuff. My best friend is a doctor and has struggled with anorexia and if I asked her tomorrow for advice she'd likely recommend a juice cleanse.
I agree that some doctors need to accept what they know and don't know and not attempt to advise on what they don't know. My doctors (also in Philly/NJ) have always been pretty decent but I've heard stories of doctors suggesting really off-the-wall diets. And other times, there probably is quick judgment that any and every symptom is caused by weight. But generally speaking, I think the best thing a doctor can do for you for weight loss is to refer you to other good resources and people who DO specialize in such things.0 -
I know I need to lose weight, a lot of weight. I balked going to the doctor because I didn't want to be lectured and I didn't want to be weighed (the ostrich mentality.). When I finally went, I told the doctor I hated getting weighed and he said I could just decline. I didn't know I could do that! It was a fabulous realization.
And just this past week, after losing 20 pounds using MFP, my doctor walked into the room and immediately said "You've lost weight!" Then he looked at the chart to confirm (unfortunately the chart has a lower weight loss because I stopped weighing for awhile.) And this is the reason I love my doctor: he knew not to lecture me about my weight but he was also very appreciative when I did lose some.0 -
BradandLibby wrote: »I know I need to lose weight, a lot of weight. I balked going to the doctor because I didn't want to be lectured and I didn't want to be weighed (the ostrich mentality.). When I finally went, I told the doctor I hated getting weighed and he said I could just decline. I didn't know I could do that! It was a fabulous realization.
And just this past week, after losing 20 pounds using MFP, my doctor walked into the room and immediately said "You've lost weight!" Then he looked at the chart to confirm (unfortunately the chart has a lower weight loss because I stopped weighing for awhile.) And this is the reason I love my doctor: he knew not to lecture me about my weight but he was also very appreciative when I did lose some.
So, a little off-topic, but I make sure to at least get weighed during my annual. Sure, you may have some reservations about stepping on the scale, but rapid weight gain or loss can be an indicator of illness. Without that metric, you're not giving your doctor everything they need to monitor your health. Obviously you can do what you want, but it's just something to think about.
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Havent read through the entire two pages but thought I would chime in. It seems as though I got very lucky! I went to see a new doctor at the clinic I usually go to and happened to meet , the best, most lovely doctor I have ever been to!
I asked him about a couple of other issues one of which he suggested might be linked to my weight. He then offered up all sorts of methods of weight loss to help me and even recommended this site!
He had recently bee. To a few conferences on weight loss which covered various methods (including surgery) and he was also doing his own research on the side which was quite comforting. We went through a lot of info about adequate nutrition and portion control and balanced diets etc. Now here I am 2 years later, 40kg down and maintaining. I could not be happjer with the service from this GP.
I know this isn't a true experience for most people but it can happen you just ne0 -
Havent read through the entire two pages but thought I would chime in. It seems as though I got very lucky! I went to see a new doctor at the clinic I usually go to and happened to meet , the best, most lovely doctor I have ever been to!
I asked him about a couple of other issues one of which he suggested might be linked to my weight. He then offered up all sorts of advice to do with weight loss to help me and even recommended this site!
He had recently ben to a few conferences on weight loss which covered various methods (including surgery) and he was also doing his own research on the side which was quite comforting. He did discuss the option of surgery but greatly recommended against it because he believed armed with the right information most people can succeed in this journey without surgery. We went through a lot of info about adequate nutrition and portion control and balanced diets etc. Now here I am 2 years later, 40kg down and maintaining. I could not be happier with the service from this GP.
I know this isn't a true experience for most people but it can happen you just need to find the right GP who has the right attitude and you can connect with
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What one of my friends did when she went to the Dr and didn't want to get weighed was have the Dr weigh her and log it so they know it but not tell her what it was. Even if you don't want to know what it is your Dr should know it if even just for helping decide dosages of meds.0
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That's what I've always heard -- not that you can refuse to be weighed, but that you can ask the doctor (or nurse) not to tell you.
I was at one point tempted, but I figured I'd bring up my knowledge that I was too fat anyway so might as well face the number. (At that point I'd forced myself to get on the scale at home already anyway.)0
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