Welcome to Debate Club! Please be aware that this is a space for respectful debate, and that your ideas will be challenged here. Please remember to critique the argument, not the author.

Does your doctor comment on your weight?

1679111221

Replies

  • tbright1965
    tbright1965 Posts: 852 Member
    Zodikosis wrote: »
    Zodikosis wrote: »

    Most people at this point will stop and say "well the patient should've listened, and then it would've been helpful to them". Okay, but they didn't. Now what? Are you gonna throw up your hands and decry human nature? For whatever reason, you made a poor argument to them. You didn't convince them enough that they can or should do this, or they didn't understand what you were saying fully, or perhaps there are roadblocks in their way unbeknownst to you that you didn't address, be it financial, emotional, educational, physical, etc, etc. Whatever it is, you still haven't progressed past Square 1. In the end, you did about as much for them as if they had never gone to see you at all. Maybe you're a doctor in the US and your visits are packed tight and you simply don't have the time to debate this stuff with your patients. Fair enough, personally I think that's reason #34523 this system doesn't work, but in that case why waste any time saying anything at all if you know it won't make a difference?

    You can be right until you're blue in the face and I'm sure it's very satisfying to your own ego, but if what you're telling your patients isn't helping them and you can observe this through your patients' health outcomes, you're not actually doing what you set out to do and need to rethink your approach. This is probably why a lot of doctors don't bother to do this anymore unless it's actually directly related to the condition being discussed -- most of the time, it really does nothing of much good for anybody. Even if it is true.

    Can't really blame the doctor if the patient doesn't follow the advice.

    Just because the patient doesn't follow the advice doesn't mean it's poor advice.

    What roadblocks are in the way of Eat Less, Move More?

    It certainly doesn't take more money to Eat Less. There may be some road blocks for moving more, if there are other issues.

    Yes, I tend to blame people for not following the advice presented.

    We know smoking is bad for you. The best course of action is DON'T START. Yet people choose to smoke.

    It's human nature to help people who seem interested in following the advice and following the plan. If the patient doesn't wish to follow the advice, at what point is it in the best interests of everyone for the doctor to just let them be who they've chosen to be and spend more time on those willing to follow the advice?

    I work in IT service and have customers. They can choose to follow the advice I provide, based in 30 years of education and experience in the field, or they can choose to do their own thing.

    I cannot do it for them, much like the doctor cannot be there to replace the little chocolate donuts with a healthy breakfast.

    I don't doubt there are bad doctors. However, with the sum of human knowledge at the fingertips of most, I have to believe that if someone wanted to eat right and lose weight, the information is there for anyone who is sufficiently motivated to learn and adopt new habits, behaviors and strategies.

    How can people in North America not know that eating more fruits and vegetables and fewer fat and sugar dense processed foods is the better course of action?

    You might as well ask why people ever do things they ought not to, or don't do things they should. There are plenty of roadblocks for plenty of people on a number of fronts, if there weren't then it wouldn't be a problem, it wouldn't be a multi-million dollar industry, and no one would ever be even the least bit impressed that someone lost a substantial amount of weight. Any permanent change of habits and behavior is somewhat to very difficult for the average person. Psychological, environmental, knowledge roadblocks are legitimate roadblocks to achieving this, whether people want to acknowledge it or not. But, this is getting very off-topic. It's not the point of the thread, and I doubt we'll agree if the above doesn't convince you, so I'll leave it at that.

    I mean, you kinda made my point. That's exactly what I'm trying to say. Why should the doctors tell them that if they don't seem interested? They do already know, as you concluded with your post, so why tell them again? What do you think trying for the 1001st time will do that the first 1000 times didn't? This is a tired tactic. I know fat people, smokers, financially irresponsible people, addicts, etc, etc who rationalize and ignore their problems up and down all day. They've got their reasons, I guess, whatever they are, and if I don't think I can say anything that'll actually have any net positive effect, because I don't know what to say or they don't want to hear it, then I don't. What's the point? We can quibble about who's to blame all day as well, but in the end blaming people will probably solve nothing and we have effectively done nothing about the problem.

    And another thing -- I don't blame the doctor, in fact I'm trying to point out exactly why many doctors no longer choose to bring this up with their patients unprompted. They have their non-cynical, non-nefarious reasons for no longer pointing this out to people. To them, it's very rational -- the tactic largely doesn't work, it generally doesn't produce better health outcomes, so abandon it. Maybe it could if they had more time or were better at convincing people, but it's certainly not their fault if they're not. Most people are not very good at convincing others of their point of view, and doctors are no exception -- they didn't train to be orators or lawyers, they trained to be doctors. If a patient wants to lose weight, then yeah a doctor should encourage them and provide them resources, but if a doctor doesn't think it makes sense to bring up a patient's weight problem unprompted, I don't blame them.

    I'm not sure you didn't blame the doctor. Sounded like you said the doctor made a poor argument.

    I'm envisioning a doctor saying that it's okay to follow the John Belushi Little Chocolate Donuts diet model.

    I've really stopped asking why people do what they do. It doesn't seem to change things. People do, and that's enough sometimes.

    Getting into the why just invites judgments and I've heard enough "don't judge" so I just let them do.

    Yes, I've seen the same with addicts. To change, the person has to WANT to change. Knowledge doesn't seem to be enough. Heck, I had an unfaithful ex-wife and have had three kids. I've learned that feelings are largely impervious to facts. When a decision is emotional, no amount of data or fact seems to factor into the decision.

    Take smoking. People smoke because it makes them feel good. Or at least they believe it. The facts surrounding smoking don't seem to matter in the decision calculus.

    Unfaithful spouses chase a feeling, facts be damned. Ditto for kids, they want what they want, and reason and logic matter little, and so on.

    I could probably continue to cite examples, but hopefully I've sufficiently made my point.

    So yes, the doctor should make the comment. How far his/she goes after that depends on how the patient responds.
  • Lounmoun
    Lounmoun Posts: 8,427 Member
    I did not get the impression that my doctor was worried about offending me from the things she did ask and talk about.
    Maybe doctor's have given up bringing up weight in general because people do nothing but that seems pretty wrong to not bring it up at all if someone has a medical condition caused or impacted by weight or has a very high risk of developing such a condition.
  • AnvilHead
    AnvilHead Posts: 18,360 Member
    edited July 2018
    Lounmoun wrote: »
    I did not get the impression that my doctor was worried about offending me from the things she did ask and talk about.
    Maybe doctor's have given up bringing up weight in general because people do nothing but that seems pretty wrong to not bring it up at all if someone has a medical condition caused or impacted by weight or has a very high risk of developing such a condition.

    Doctors are people, so their personalities will vary - and will affect if/how they're willing to address it. Some are undoubtedly more timid/reserved about broaching the subject, while others have no problem wading right in and being frank about it.

    I agree that it should be addressed if someone's weight is causing, or could potentially cause, medical issues. But it's not always done.
  • Diatonic12
    Diatonic12 Posts: 32,344 Member
    edited July 2018
    It is very true that many in the medical profession are not taking care of themselves. Do as I say, not as I do... One doc in 2000 recommended to me to eat "more like cavemen did", which I personally feel is sound advice. Avoid process foods, bread, pasta etc., eat meat, veg. He was obese! He says, while rubbing his stomach, something along the lines that he would be thinner if he followed his own advice, but he has too many people bringing in donuts to him! HA![/quote]

    I know. You have to be there to experience it... working nightshifts in the hospital and waiting for patients to go to sleep so they can eat the candy out of their boxes while they're sleeping. It's a tough job with a high amount of stress. Stress eating is real. They're dog tired on their feet.
  • jlsmith4439
    jlsmith4439 Posts: 53 Member
    Yup each time and when I was pregnant they made me feel like I was a monster for putting her through a high risk pregnancy . My pregnancy was easy so lucky me but I’m glade they said things I needed that wake up call :)
  • KrazyKrissyy
    KrazyKrissyy Posts: 322 Member
    Yes. A couple of years ago, my GI doctor thought their scale was broken because I'm a small size (2) and was 25 pounds overweight. It was an intestinal blockage (that ended up bring removed).
  • NadNight
    NadNight Posts: 794 Member
    My weight is never mentioned by the doctors which is kind of odd because I'm quite underweight (105 lbs 5ft6) but I suppose I don't look gaunt or unhealthy
  • midlomel1971
    midlomel1971 Posts: 1,282 Member
    In my 47 years, NEVER has a doctor ever mentioned my weight. Even at my heaviest when I was obviously overweight by a good 40 pounds. I always found that odd.
  • Packerjohn
    Packerjohn Posts: 4,855 Member
    AnvilHead wrote: »
    Being overweight isn't as much of a concern for me as the consequences of being overweight, such as hypertension, type II diabetes, high cholesterol, etc. If my A1C is high and is a risk factor for heart disease, then I want to know how to respond. I expect my doctor to look the data at and help me understand risk factors. If losing weight helps, great, I need to know that. What I want is the truth. My doctor is helpful in that regard.

    My wife is obese. She recently went to the doctor and was diagnosed with all three of those things (T2D, hypertension, high cholesterol). I asked her if the doctor addressed her weight, or mentioned that losing weight would help with those conditions. She said her weight was never once brought into the conversation in any context - the doc just wrote a 'script for meds and sent her on her way to the pharmacy. When I told her about the discussion in this thread, my wife's comment was "I guess they're afraid they're going to offend somebody."

    Better to offend someone a bit and see them a year later 50 pounds lighter than see them at their visitation.
  • TonyB0588
    TonyB0588 Posts: 9,520 Member
    Candyspun wrote: »
    Yes. I would be happy if everyone was weighed at each visit, with a quick chat about whether or not it's a healthy weight. If more people were aware on a regular basis, things wouldn't get so far out of control.

    This makes good sense. There are some lifestyle diseases which can be prevented by being at an appropriate weight. Any good doctor would want to let you know how you're tracking in a weight range that would or would not predispose you to those diseases.
  • CarrieA140
    CarrieA140 Posts: 20 Member
    Yes and I'm certainly glad that he does. He has explained that many of my health problems would be greatly reduced or eliminated with a 30 lb loss. I believe what he says and that's why I'm working so hard to lose weight. I may even be able to stop my metformin.
  • tbright1965
    tbright1965 Posts: 852 Member
    CarrieA140 wrote: »
    Yes and I'm certainly glad that he does. He has explained that many of my health problems would be greatly reduced or eliminated with a 30 lb loss. I believe what he says and that's why I'm working so hard to lose weight. I may even be able to stop my metformin.

    That is entirely possible. I was prescribed 500mg/day of Metformin after showing up with a fasting BG of 180 and an A1C of 7.3%

    Three months following that DR visit, I was getting fasting BG readings of between 90 and 105 and had an A1C of 5.4%

    I had lost over 30 pounds going from over 265 to 235. A couple months later and I'm down to 225.

    The DR said I could stop it. I suggested I stay on it, but only take it on those mornings when I was over 100 mg/dL and he agreed. It does give a bit of advantage in the weight loss goal. I think I've taken it once or twice this week. Once the day after the local Tour de Donut bike race where I ate 6 donuts as part of a 34 mile bike ride. The next day my fasting BG was 103. Wednesday morning as well as I had been travelling the past two days and spent more time in the car which is less time to work out, walk, etc.

    I would like to get down to 200# which would match my weight leaving the Army in 1992. I don't think my stretch goal of 175 is possible, my high school graduation weight. I only had a 42" chest at that time, and grew to a 48" chest during college and my time on active duty.

    But my point is that it may be possible to get off the metformin and control your BG with diet and exercise.

    But take advice from your doctor, not our N=1 anecdotes.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,468 Member
    CarrieA140 wrote: »
    Yes and I'm certainly glad that he does. He has explained that many of my health problems would be greatly reduced or eliminated with a 30 lb loss. I believe what he says and that's why I'm working so hard to lose weight. I may even be able to stop my metformin.

    That is entirely possible. I was prescribed 500mg/day of Metformin after showing up with a fasting BG of 180 and an A1C of 7.3%

    Three months following that DR visit, I was getting fasting BG readings of between 90 and 105 and had an A1C of 5.4%

    I had lost over 30 pounds going from over 265 to 235. A couple months later and I'm down to 225.

    The DR said I could stop it. I suggested I stay on it, but only take it on those mornings when I was over 100 mg/dL and he agreed. It does give a bit of advantage in the weight loss goal. I think I've taken it once or twice this week. Once the day after the local Tour de Donut bike race where I ate 6 donuts as part of a 34 mile bike ride. The next day my fasting BG was 103. Wednesday morning as well as I had been travelling the past two days and spent more time in the car which is less time to work out, walk, etc.

    I would like to get down to 200# which would match my weight leaving the Army in 1992. I don't think my stretch goal of 175 is possible, my high school graduation weight. I only had a 42" chest at that time, and grew to a 48" chest during college and my time on active duty.

    But my point is that it may be possible to get off the metformin and control your BG with diet and exercise.

    But take advice from your doctor, not our N=1 anecdotes.

    I agree that weight loss will help most all type 2 diabetics to be able to eventually stop all medications.

    But your comment about taking metformin only on certain days is odd. I wonder... is this an endocrinologist or a GP? I ask because a GP may not be aware that metformin builds up in your system. It takes a couple weeks to wear off after you stop taking it. Yes, there will be a greater concentration in your body if you took a dose that morning after not having any for a few days prior. But it isn't just as simple as that if you took no metformin that day, you have none in your system.
  • urloved33
    urloved33 Posts: 3,361 Member
    I always bring all that up first...to the doctor. its my health and those are the things I want to talk about. even if its to hear her say...you're good.
  • tbright1965
    tbright1965 Posts: 852 Member
    CarrieA140 wrote: »
    Yes and I'm certainly glad that he does. He has explained that many of my health problems would be greatly reduced or eliminated with a 30 lb loss. I believe what he says and that's why I'm working so hard to lose weight. I may even be able to stop my metformin.

    That is entirely possible. I was prescribed 500mg/day of Metformin after showing up with a fasting BG of 180 and an A1C of 7.3%

    Three months following that DR visit, I was getting fasting BG readings of between 90 and 105 and had an A1C of 5.4%

    I had lost over 30 pounds going from over 265 to 235. A couple months later and I'm down to 225.

    The DR said I could stop it. I suggested I stay on it, but only take it on those mornings when I was over 100 mg/dL and he agreed. It does give a bit of advantage in the weight loss goal. I think I've taken it once or twice this week. Once the day after the local Tour de Donut bike race where I ate 6 donuts as part of a 34 mile bike ride. The next day my fasting BG was 103. Wednesday morning as well as I had been travelling the past two days and spent more time in the car which is less time to work out, walk, etc.

    I would like to get down to 200# which would match my weight leaving the Army in 1992. I don't think my stretch goal of 175 is possible, my high school graduation weight. I only had a 42" chest at that time, and grew to a 48" chest during college and my time on active duty.

    But my point is that it may be possible to get off the metformin and control your BG with diet and exercise.

    But take advice from your doctor, not our N=1 anecdotes.

    I agree that weight loss will help most all type 2 diabetics to be able to eventually stop all medications.

    But your comment about taking metformin only on certain days is odd. I wonder... is this an endocrinologist or a GP? I ask because a GP may not be aware that metformin builds up in your system. It takes a couple weeks to wear off after you stop taking it. Yes, there will be a greater concentration in your body if you took a dose that morning after not having any for a few days prior. But it isn't just as simple as that if you took no metformin that day, you have none in your system.

    I don’t know. He was ok with me going off of it totally. Like I said, I’ve only taken it twice this week. So maybe it’s more about me managing my diet and exercise.

    As I get slimmer, I need less. I could split pills or go to every other day...