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How to you tell someone they need to lose weight?
Replies
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From the age of 9, I was told by every doctor at every appointment to lose weight. It became annoying. It became the standard prescription: ear infection? sore throat? pneumonia? car accident? second degree burns? "lose weight". Had anyone ever made a suggestion as to how to lose weight or offered some sort of help, I might have done something. I rarely go to the doctor unless it's for an annual physical or I'm sick and need medicine. I don't have medical issues that losing weight would/did solve. I have HBP (BP average 135/90 since childhood) and lost 181#. Guess what? Still have HBP. The only reason I decided to lose weight was that I couldn't find clothes in my size. The prospect of wearing the same pair of khaki jeans for 40 years was the kicker.
IMO, unless you can a) give reasonable proof that losing weight will solve/cure/fix/help with a person's health problems, and b) give assistance on how to lose weight (eating plan, exercise plan, etc.), don't say anything. Since you sound (read) like the type of person who will tell someone to lose weight regardless, go ahead, but don't expect many of your patients to be grateful about it.
No weight loss isn't the golden ticket. Can't do much about genetics so there's that to compete with as well. But limiting your modifiable risks are advised.
I have given advice and even help build plans, but guess what...in follow up most (if they even follow up at all) haven't started the plan. And its pretty simple : Recommend using myfitnesspal.com or similar program for weight reduction. Diet should be rich in fresh fruits, vegetables, beans, lean meats (limiting red meat), dairy (as tolerated) and whole grains. Limit prepackaged/processed foods. Drink at least 64oz water daily. Exercise 20-30min 4-5 days a week.
I've even given custom macros, but its all for not.
Guess I'm not the person you say I read like.
ETA: and no I don't advise using pills or shots or some of the crazy money making weight loss gimmicks I read about.1 -
VintageFeline wrote: »I think if it's urgent care unrelated to weight loss then it doesn't need to be said. If it's something you're seeing your GP for I think it would somewhat worrying if they never mentioned your weight given it can have so many negative consequences. The willingness of the patient to hear it is somewhat irrelevant.
Saying it to a 9 year old however shouldn't happen but I think we have moved on from that. At least I hope.
Yeah. I think it's a yearly physical type of thing, not an every time you see a doctor for an unrelated problem type of thing.
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There are a lot of different opinions - and many people addressing the "if you don't have a solution/can't prove it will help my health or well-being then don't say it" issue. This is how I see it:
Fact: I am overweight - by all measurements and statistics I fall under "obese" on the scale
Also a Fact: I also have no health problems from this - I don't have high blood pressure, no diabetes
Another Fact: My weight has made my life harder - I get tired easily, I don't love my body, and I can't always do what I want - and if not addressed there is a chance that it will give me health problems in the future
I equate it to this:
Fact: I love candles - I use them all over my house
Also a Fact: I have never had my house burn down or caught anything on fire with a candle
Another Fact: If I put a candle near something flammable and leave it would watching it or have some caution it could catch fire and burn my house down - even though I have no history of that right now.
Wouldn't you rather someone mention it than your house burn down? Me? I'm gonna move the dang candle!10 -
WeepingAngel81 wrote: »When I go to my doctor, I expect him to be straight up with me about health issues I may be facing. I don't want him to sugar coat or be nice. I want clear cut answers that I can understand, the pretain to why I am there. I also expect him to walk me through any questions I may have. Not everyone is like that. My ex-husband saw this as the doctor being cocky or opinionated, and he stopped going to him and went somewhere else. When it comes down to it, you may hurt some feelings, you may upset some people, but you are very capable of having great bedside manner while still being direct. Better to know you did what you could do to inform, than not inform at all.
I am the same way. I want a doctor who is completely clear and doesn't try to pad the info. No BS. My favorite doctor once told me that a woman's uterus should be like a lush lawn and mine was more like a field of weeds. My husband was horrified but I was thankful for the bluntness. My second favorite doctor was used less colorful language but was very clear that losing weight would help immensely with my sleep apnea. I appreciate his candor as well.
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My doctors (2 of them now) are completely USELESS! I am obese. When I decided I needed to do something about it, it was me that brought it up and I asked them if they would refer me to a nutritionist. "Sure, we we can do that." 5 more visits and 8 phone calls and over a year later REMINDING them I asked for this and they promised to deliver, I still have NOT been referred. They acted like it was a huge favor and showed little interest in my concern. I WANT to see more doctors take a more concerned active role in their patients. I decided I don't need their help (since I'm not going to get it anyways) and that's why I joined MFP. If I can't ask a nutritionist, I will ask here.5
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From the age of 9, I was told by every doctor at every appointment to lose weight. It became annoying. It became the standard prescription: ear infection? sore throat? pneumonia? car accident? second degree burns? "lose weight". Had anyone ever made a suggestion as to how to lose weight or offered some sort of help, I might have done something. I rarely go to the doctor unless it's for an annual physical or I'm sick and need medicine. I don't have medical issues that losing weight would/did solve. I have HBP (BP average 135/90 since childhood) and lost 181#. Guess what? Still have HBP. The only reason I decided to lose weight was that I couldn't find clothes in my size. The prospect of wearing the same pair of khaki jeans for 40 years was the kicker.
IMO, unless you can a) give reasonable proof that losing weight will solve/cure/fix/help with a person's health problems, and b) give assistance on how to lose weight (eating plan, exercise plan, etc.), don't say anything. Since you sound (read) like the type of person who will tell someone to lose weight regardless, go ahead, but don't expect many of your patients to be grateful about it.
No weight loss isn't the golden ticket. Can't do much about genetics so there's that to compete with as well. But limiting your modifiable risks are advised.
I have given advice and even help build plans, but guess what...in follow up most haven't started the plan. And its pretty simple : Recommend using myfitnesspal.com or similar program for weight reduction. Diet should be rich in fresh fruits, vegetables, beans, lean meats (limiting red meat), dairy (as tolerated) and whole grains. Limit prepackaged/processed foods. Drink at least 64oz water daily. Exercise 20-30min 4-5 days a week.
I've even given custom macros, but its all for not.
Guess I'm not the person you say I read like.
ETA: and no I don't advise using pills or shots or some of the crazy money making weight loss gimmicks I read about.
Then what is it you're asking exactly? It sounds like you're already telling them they're overweight/obese and giving them an action plan. Just because you think they need to lose weight doesn't mean they're ready or feel able to take those steps.3 -
Pose weight loss as a solution to applicable ailments.
I had put on some weight over about 2 years, wasn't obese, but overweight by about 20lbs. I had gone to the doc for my breathing issues and mentioned some abdominal pain I had been having intermittently. Turns out it was my gallbladder. Doc explained how the body processes fats and that the pain will be directly correlated to my eating habits. She posed a few options: the first being a better diet and another, medication. I try to avoid medications unless it is dire. It was the SLAP IN THE FACE I needed to get my eating habits under control. Realized my eating habits were putting myself in pain.1 -
When I was 16/17 I went for my yearly check up with the pediatrician and she told me straight up youre bordering on the line for morbidly obese at a young age (I was about 5'6, 196lbs). She said you're going to be at a higher risk for diabetes, blood pressure everything scary. I was scared and I lost 30 or so pounds in a year. I regained that weight though and a little more during college but I'm fixing to now get it off and keep it off.
So to answer your post I'd say be straightforward with them. Pull out charts, tell them whats up. They can choose to either listen to you or just not care, but you at least know you gave them as much information as you could as to where they were headed.0 -
In UK here and the only person who mentioned weight once was my athsma nurse. Found out I was obese due to wanting to scuba dive and beING quered on bmi. . Knew the weight had crept up but was oblivious to how heavy I was. In my case I started to sort it. Would like to add that after losing weight haven't suffered with athsma.
However most people I know fall into three categories. The yep heard it all before not going to listen categories. The totally oblivious that weight can be a problem category,(probably got the overly tactful doctors as a couple are in terrible shape) thirdly the oh no wasn't aware there was problem must sort it out. categories.
Thing is for last two categories how can they do anything if not aware. Doesn't mean they will change but at least they have option too.
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My doctors (2 of them now) are completely USELESS! I am obese. When I decided I needed to do something about it, it was me that brought it up and I asked them if they would refer me to a nutritionist. "Sure, we we can do that." 5 more visits and 8 phone calls and over a year later REMINDING them I asked for this and they promised to deliver, I still have NOT been referred. They acted like it was a huge favor and showed little interest in my concern. I WANT to see more doctors take a more concerned active role in their patients. I decided I don't need their help (since I'm not going to get it anyways) and that's why I joined MFP. If I can't ask a nutritionist, I will ask here.
Does your insurance require a referral? Because mine didn't, but since there are only 2 locally, accepting new patients (and how quickly) in another problem. Maybe you can call a nutritionist in your area, explain the problem, and maybe they can guide you? Or call your insurance company? Don't give up :-) And MFP is great, either way!1 -
You didn't specifically say what you do, so I have a few thoughts on this. I equate a medical professional that I don't have an expectation to see for follow-up care telling me to lose weight to my dental hygienist telling me to floss - I assume you say it to almost everyone. I also pay considerably less attention to someone I'm never going to see again than I do someone I'm going to have to go to for follow-up care (sorry, but it's true). And I don't want to hear about my weight every time I go in for issues that are completely unrelated... what zyxst said is 100% true in my case "It became the standard prescription: ear infection? sore throat? pneumonia? car accident? second degree burns? "lose weight".
If you only see patients once or twice, offer them some information to someone who can help if they want it. Keep those numbers handy. If you can made a referral, do it if they want one.
If you're in a position where you're working with the same patients over and over again, you can approach it like a previous commenter said and say "I noticed your BMI is XX, that puts you in/close to the overweight/obese category." Then, I would add this... "Combined with your medical history/family medical history, that puts you at an increased rate for x, y and z. Is there something I can do to help you with this?" - this approach makes it personal, and it's supportive.
If the answer is no, then follow up with "When you're ready, please come to me and I will (insert whatever you can or are willing to do for the patient)".
My GP brought up my weight every visit. It would be irresponsible as my doctor for her not to. But she brought it up, and she accepted that I was "working on it" even though we both knew I wasn't working on it that hard. When I was ready and willing to get help, we talked about my options and what I was doing. When I've done well, she acknowledges that I've done well and how I've done it and we talk about more options if I want them. But the most important thing she's ever done for me is that she didn't waste my time or hers talking about something I wasn't ready to deal with, she treated me like a person who deserved good medical care in spite of an issue I didn't want to work on and spent time working with me on the reason I was there. She's always been straight-forward with me and supportive.6 -
I work in the medical field and at least 50% of my patients are overweight if not obese. It is a crisis in the US and most of the Westernized countries. We counsel them on smoking and alcohol, but what about weight? What is your reaction to someone or a medical practitioner telling you to lose weight? Most of the responses I get are eye rolls (and I'm very delicate about how I address it), but what would cause someone to wake up and understand that its more than just aesthetics and more about health in general. The majority of the ailments I see can be directly correlated with being overweight or obese. Any thoughts? Any one who has had this happen and actually take the advice and be a success story? TIA
Ultimately it comes down to the patients willingness/want to change and them having the right tools to make the change. There seems to be a wide range of people on here and their desire to want this information thrown at them. Why not ask your patients before going on about it? "I notices that at your weight and height you fall in the morbidly obese category which increases your health risks. Would you be open to learning how we can change that?" If they say yes, explain the health risks, give them a plan, be blunt with them, etc. If they say no, just say that if they change their mind they can come to you for information. I wouldn't even bring it up at all if it is not related to what they are at the doctor's for. I dont need a weight lecture to fix my ear infection. Again, they need to decide if they want to lose weight, you can't decide for them.
When I decided to go see a nutritionist (on my own since the doctors were not very helpful), I was given a small booklet full of health, diet, and exercise information that was extremely helpful and was able to get me started. I wish that doctors had something like that available for patients that show interest in losing weight.2 -
When I see my dr, which is rare and never for 'weight issues', he quite often tells me I should lose weight - no matter what the scales say. If I wasn't healthy (cholesterol and BP are fine, no diabetes) I might believe him. But you know, 'advice' coming from someone who is battling the bulge isn't going to inspire me. The dr is about 40kgs overweight himself. Of course, I'm probably not likely to listen to a trim fit person either because I'll hear them being 'nasty'. The dr was really surprised when I told him at the last visit I'd lost 37 kgs, but had put some back on because I felt like crap at the lower weight. He wanted me to go back to feeling like that.
My best push to 'do something' was my BIL dying of a heart attack. He was younger than me and about 80kgs overweight. My best friend was also 'doing something' and he supported me. Life caught up with him and he isn't 'there' as much as before. Without that support, the weight is creeping back on. I know it is, and I don't like it, but..no drive to change anything again.1 -
OP: I've been seeing the same doctor since 1992. He has always told me the same thing: stop smoking, lose weight, stop drinking, eat better, get some exercise. Ironically, my blood numbers have always been well within normal ranges. It took me most of the past 25 years to make the necessary changes, but as of 2016, I am a non-smoker, I've lost a total of 66 pounds from my heaviest weight, I only drink occasionally and moderately when I do, I follow a Paleo diet, generally, and I do 2 strength, 2 cardio and 1 stretch session every week.
It takes what it takes. So don't sugar-coat it. Just put it out there.2 -
I work in the medical field and at least 50% of my patients are overweight if not obese. It is a crisis in the US and most of the Westernized countries. We counsel them on smoking and alcohol, but what about weight? What is your reaction to someone or a medical practitioner telling you to lose weight? Most of the responses I get are eye rolls (and I'm very delicate about how I address it), but what would cause someone to wake up and understand that its more than just aesthetics and more about health in general. The majority of the ailments I see can be directly correlated with being overweight or obese. Any thoughts? Any one who has had this happen and actually take the advice and be a success story? TIA
If it is relevant to the medical condition you are treating and you have helpful advice then you should bring it up.
"Bob, I see your weight is higher than the healthy range for your height. Excess weight makes your specific health condition worse. Losing weight can improve your condition, reduce your need for medication, etc. Weight loss is about calories. Using this calculator, XYZ is the amount of calories you would need to consume daily to maintain your current weight if you are sedentary. Reducing your calorie intake by 250-1,000 calories daily would result in weight loss. Would you like to talk more about a healthy weight loss plan for you or a referral to a dietician to help you figure out a plan?"
If it is not relevant to what you are treating or you don't have time to say anything other than "You weigh too much. Lose weight." then don't bring it up.
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What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.1
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DrifterBear wrote: »What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.
I don't know, I've met a lot of doctors who could use a few lessons on how to speak to their patients. Listening would be a good skill for some as well.4 -
DrifterBear wrote: »What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.
Let's call it continuing education. I'm a PA and no we (as well as MDs/DOs/NPs) are taught minimal information on weight loss let alone how to counsel someone. Can someone ask a question to see how it may have encouraged others to change? Just trying to be a better practitioner.6 -
Let's call it continuing education. I'm a PA and no we (as well as MDs/DOs/NPs) are taught minimal information on weight loss let alone how to counsel someone. Can someone ask a question to see how it may have encouraged others to change? Just trying to be a better practitioner.
I heart you, Internet Stranger, for this right here. I've had some amazing Dr's and PA's over the years and appreciate that you're trying.
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DrifterBear wrote: »What does "in the medical field mean"? Are you a doctor? I don't understand why a doctor would need to ask people on a forum how to tell people to lose weight, that's your job.
Let's call it continuing education. I'm a PA and no we (as well as MDs/DOs/NPs) are taught minimal information on weight loss let alone how to counsel someone. Can someone ask a question to see how it may have encouraged others to change? Just trying to be a better practitioner.
Just my experience but my current GP focuses more on encouraging me to get some exercise and actually listens to my issues and is able to help me come up with some alternative ideas. She also listens when I tell her the problems I'm having implementing certain things. I've had providers in the past that see the extra weight and my care with them begins and ends with that. I work for a teaching hospital so that is where some of my experience comes from. Then there are the ones that talk to each other over you, like you're a biology lesson. Not saying you do that, though.
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