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How to you tell someone they need to lose weight?
cathipa
Posts: 2,991 Member
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
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You're probably being too delicate. It wasn't the deciding factor but it was one of the major ones for me when my doctor handed me my first prescription for high blood pressure meds and told me I was morbidly obese. Then she asked me if I knew what that meant, and if I needed help losing weight. Her approach was very straightforward, she simply told me the facts, warned me that if this trend continued that bad things would happen, she even mentioned making sure my life insurance was up to date. It struck a note with me.31
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I'm interested to see what people say. My only experience was kind of useless. I went to the doctor and she weighed me and said my weight was "ok". Except I knew it was a couple lbs over the normal BMI, so I just decided enough was enough and lost some weight after that. I'm not sure why she didn't say something like "Maybe it's a good idea to start watching your weight a bit" or something. Except I guess I was wearing clothes and everything too so maybe she didn't need to.
Of course the next time she weighed me, she looked at the number excitedly and said it was "perfect" lol. So I think she may have tried to go the subtle route. But that was WAY too subtle.
So... yeah... a kind of useless story.0 -
My doctor told me I needed to lose weight...he also told me that with my blood work being what it was (4.5 years ago) that I'd likely be very sick, if not dead by my early 60s...he didn't sugar coat anything...it pretty much got me going.12
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Paramedic here - our providers are always pretty direct about it. Sometimes it's if you keep gaining, this might get worse.. or if you don't lose, this will kill you. I don't think they bring it up unless there's a significant gain or health problem though. I think it's a great idea to bring it with the high-risk topics (eg. smoking, drinking, ect) - something like "I noticed your BMI is XX, that puts you in/close to the overweight/obese category. Studies show increased weight can lead to cardiovascular disease, diabetes, and other problem. Would you like some information on losing weight?" A lot of people don't want to hear it, some won't listen at all or deny help, but there are a few who will take it to heart and do something about it.
ETA - On a side note, if they don't want it, don't push it. They've probably heard it before and they aren't ready to accept it.3 -
my doctor was a pretty big catalyst for me starting to take care of my weight again. i gain when depressed and when i lost my dad it took me a really long time to grieve, when i came out of it i 'knew' i had let myself go a lot, but it was my doctor quantifying it and telling me with no apparent judgment that i had gained 40 pounds in 4 years that shocked me into change. when i replied that i intended to lose it he asked me if i had a plan and what it was. i told him i would be calorie counting and logging in here as well as running because that's how i've always been successful before. he cautioned me about running too much too quickly but let me know that he approved of calorie counting as my method. i really respected that he didn't suggest any elimination diets or lecture me. i'm actually excited for my annual with him so that he can see that i've lost around 20 pounds since that visit.10
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I roll my eyes when a doctor tells me to lose weight. Like I didn't know that going in. Most of us are aware of our flaws. That said, I realize you have to say it. You may just have to accept the eye rolls.7
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GP just told me I was borderline for being taken off the pill (which I take to control acne, do not want to come off!) and was at high risk of further health complications due to my weight. She's a great GP and just said it matter of factly. I wasn't offended, just hearing another person say what I already knew flipped the switched.
I think I started reducing my intake immediately after that, it was a big catalyst because I was damned if my physical health was going to go the way of my mental health! A few months later I got really serious and started tracking here and exercising.3 -
It doesn't matter how delicate you are about it, someone will probably get offended then you'll end up the focus of some viral HuffPo article about "fat-shaming".10
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During my last yearly exam my OB/GYN told me that I needed to lose weight. This didn't surprise me since I already knew that I really did need to focus on my health. I was not offended, upset, or anything...it was something I had already addressed within myself, so hearing it from a medical professional (especially one I trust as much as her) was just the icing on the cake...not that I can have cake right now haha.
Bottom line, when I heard it I was ready to lose weight...it was already something that I felt myself and that I wanted to conquer. There are plenty of people who hear it before they find it on their own, and I think for them it is someone calling them fat vs. what it really is - someone in the medical field voicing their concern about their patient's health. All you can do is make them aware of it, of what could happen, and do your job in looking out for their best interest.1 -
As a fat person, doctors are constantly reminding you how fat you are. I have gone to the doctor for strep throat and got a "yep, you have strep, now lets talk about your weight." I went to get my IUD checked and he brought up my weight before he would even examined me. I went in for a foot injury I had gotten while trying to lose weight and was really excited about my weightloss progress and was feeling really good about myself and the doc made sure to remind met that my progress didnt mean anything since I was still fat. As someone above said, most people are aware of their weight issues and don't want to be constantly reminded of them. I stopped going to doctors and hospitals just so that I didnt have to hear the weight loss lecture. There were plenty of times I needed to go but refused to.
Then I got a doctor who didn't focus on my weight. She focused on my health and explained how weight loss would help certain things I was dealing with. I appreciated that. But ultimately nothing a doctor said would make me decide to lose weight, that is a decision that i needed to make.
This is literally how I feel every time I go to a doctor's appointment.
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Most people are clueless. Some need to be scared. Some just need someone to GUIDE them/"hold their hand"... (me).
What I WISH my doctor(s) did: Refer me to a nutritionist, and while waiting for the appointment- give me a shopping list & calorie goal, and tell me to get fitted for decent shoes and a HRM- then USE them and/or if not tell me where to go for a fitness plan (my gym gave me a regimen which I could not realistically do without a trainer!)
What they said: You need to lose weight. (I had high cholesterol, fatty liver, triglycerides were incredibly high; blood sugar, pressure, everything else was "normal")... so I "dieted for 2 weeks. And quit. Every time.
So when I lost ~65 lbs (seeing nutritionist, C25K app, lift some weights- nothing crazy)... they were ASTONISHED. Begged to know what I was doing. Wished all their overweight patients would do it. I told them I used MFP (with nutritionist), someone to talk to (nutritionist), exercise a few times a week, and finally had the INFORMATION I needed; not just eat less, move more. How much less? How much more? (Surely, walking for 10 min when you're that overweight feels like a lot of "work", but doesn't count for much when you can't figure out a meal strategy :-/)9 -
Both times that I've lost weight, I did it myself; no one told me I was overweight, including my GP. I think it was because she'd known me for so long, though, that she felt uncomfortable pointing out my weight gain. I don't know if it would have made a difference or not because I knew I was overweight.
That being said, I did roll my eyes at the MA who tried to fat shame me when I had high blood pressure at an urgent care clinic while waiting to be seen for a sinus infection. She gave me a snide, "Is your blood pressure always this high?" when it was barely over the normal range. Fun fact: Sinus infections can cause higher than normal blood pressure in some people.2 -
I would expect a medical professional to be very up front and straight when talking to a patient about being overweight or obese. "You are obese. Obesity is not an aesthetics issue. It is a health issue. The health implications are XYZ." If the patient wants to be eye roll-y, so be it. Let their friends and family coddle them. It's not your place to do that. Your job is to address health issues, and being overweight or obese does have a negative effect on health.9
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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.10 -
I think if a patient is being seen for an issue that can be directly attributed to their weight, then counsel. Bloodwork came back and it's all out of whack? Counsel and set a goal with the patient for their next draw. Required physical for health insurance? It's a reasonable discussion to have. If someone is coming in with Pinkeye or something, there's no need to bring up their weight, as I'm sure they're not oblivious to it.13
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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.2
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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.
This!! It's always lose weight but we aren't going to give you any guidance on how to start. Even the 2 times I went in and said, "I want to lose weight but i need help," I still got no guidance. A referral to a nutritionist would have gone a long way to help.4 -
Great question, difficult to answer because what strikes a chord with one person may not with another. I had a doctor tell me 'it would help your health to lose a few kilos'. She did this in a nice way. I also saw a podiatrist when I was still obese who was pretty blunt who told me that my weight put me at risk of diabetes and that she saw diabetics who needed to have limbs amputated which was pretty scary!
The most important things in life to people are their families- people they love. Focusing on that aspect 'if you don't lose weight, you are at risk of these diseases. These diseases will shorten your life, and mean you have less time with people you love. You won't be there for your children' etc.
Asking people if they have seen or known someone (especially someone they love) suffering with a disease that is common amongst someone who is overweight or obese. Asking: do you want to go through that same suffering? Do you want your family to have to watch you suffer?2 -
"Diabetes" usually means to most people you need to check your blood sugar (needles), take insulin (needles)/meds (pills). True. But wait, there's more!! STRONG words ahead...
If more people KNEW what diabetes actually does- the relentless nerve pain- so bad you can't walk or sleep through the night; the infections that never go away, that rot your limbs until the amputations start (so no need to worry about walking!); that you can only eat green vegetables and lean protein (not even fruit or milk or cereal) if you get really out of control glucose (because you're in denial); dependence on others to cook, clean, bathe, feed you; endless hospitalizations; you lose your friends; you lose your cognition; your body is actively dying. You waited too long.6 -
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.3 -
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
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