How would you like your doctor/GP/family physician to help you lose weight?
j_eanie
Posts: 1 Member
We are often told, ‘go and see your doctor to help you lose weight’. What things would you like your doctor to help you with specifically? What to eat, how to exercise, alternative ways to lose weight, apps etc?
And what in hindsight do you think your doctor should say and do for other people to help them lose weight? (What worked for you)
And what in hindsight do you think your doctor should say and do for other people to help them lose weight? (What worked for you)
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Replies
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Are you a doctor?
I have a really good doctor who looks me directly in the eye and shoots straight. He gave me the 10 most important words that I could hear from a doctor. They've kept me going and moving for over a year now. I think about them every day and those words are working for me. A good doctor knows that connection matters but they can tell you all you need to know in a nutshell without the whole bushel.8 -
To have an background with nutrition as I've read that General Physicians do not have the proper background in nutrition; it's not part of their medical school curriculum other than a workshop. I would only trust a Registered Dietitian because they have the proper education or if the doctor has taken measures to become certified with learning of the modern science not sponsored by a corporation (for example Coca-Cola funding Pediatric Association). In terms of exercise, I would look at a personal trainer who has worked with clients who are overweight and have know how to accomplish the goal of losing weight long term. In terms of "alternative ways" I would hope they wouldn't just say "just get bypass surgery" or recommending short-term crash diets (I've had a doctor in the pass recommend one so this is why I mentioned this). I want to see a M.D or D.O who has the proper certification, resources to advise, and goes with the science rather than Pseudoscience in their recommendations of nutrition.4
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When I was about 300 lb, I went to my physician to have him fill out paperwork for my insurance company to approve treatment at an eating disorder clinic that I'd already consulted with.
He told me to Google a 1200 calorie diet and just follow it. I had to get the referral elsewhere.
So.....not that. 👍22 -
My GP doesn't listen much, she's more of the lecturing type. That is one of the reasons why I'm not so keen on making appointments unless I actually feel ill.
When my high BP became a concern, she repeatedly told me to cut on the salt - even though I told her I barely use it. Her only advice regarding losing weight was to stop buying sweets at all - even though I tried to explain to her that I'm a moderator, not an abstainer.
It seems like her way is the only way, so frankly I can go without her advice (sorry, doc!). It turns out that doing it MY way, I was able to lose 21kgs so far, going from obese to overweight to normal BMI. So there's that. 8 -
What do you mean by “alternative ways to lose weight”?
I spent many years believing I could not lose weight in part because doctors always made it more complicated than just CICO. When I was able to get rid of those overcomplicated ideas, I successfully lost 100 pounds and have maintained in my optimal BMI range for 2+ years. Therefore, regarding weight loss, I would not want my doctor to tell me what to eat or how to exercise, unless I had a specific issue requiring a particular diet/exercise regimen. Weight loss is caused by a calorie deficit and not by eating specific foods or doing specific exercises.17 -
I have never asked my PCP about weight loss advice. My frustration is that if i do go in for something it gets blamed on my weight. my RHR goes down to 36 (while awake), and i get dizzy when it happens. A few providers ive seen have said its because i exercise. Im 50 pounds over weight, but ok.4
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Our previous GP grow old (as we all do) and his attitude was more in the line of: "you are not going to change, just take some more tablets". It took us years to realize that maybe another GP with a different outlook might just be what we need. So eventually (and we felt very guilty) we made the change - and never looked back. A different approach, a different outlook, always interested in new options - and that's exactly what we need right now.5
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I have never asked my PCP about weight loss advice. My frustration is that if i do go in for something it gets blamed on my weight. my RHR goes down to 36 (while awake), and i get dizzy when it happens. A few providers ive seen have said its because i exercise. Im 50 pounds over weight, but ok.
Being overweight in and of itself doesn’t mean you can’t have strong cardiovascular fitness, BUT a pulse rate that low combined with dizziness warrants a second opinion. I’m a distance runner and my normal RHR is about 40-45; my doctor is only okay with that after I explain my training regimen AND that I have no dizziness. Because you do have symptoms, I would encourage looking for a new doctor who will take you seriously.6 -
My doctor is overweight (maybe obese -- he has a potbelly). He doesn't listen. When he told me to stop losing weight, I told him I was still medically overweight by 5 pounds and his stupid response -- a grin.
I can't stand my doctor. I go there because his practice takes my insurance and the next place is about an hour away. I don't ask him for weight loss advice. I go to MFP and track my calories and exercise.13 -
I'm not sure I've ever heard "go see a doctor to lose weight". It's not part of their job description. They are not registered dieticians. I think the best thing a PCP can do is recognize their own limitations with regards to this area and keep a network of well regarded dieticians for referral purposes for their patients.18
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What does one expect for advice except to eat less and/or move more (absent some specific physical or mental health issue)?8
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The one thing that irks me about my former weight and my doctor was that I had a whole bunch of related health issues and she never one time said, "Ya know, weight loss would be a good thing for you to do to help with these issues."
Knee problems
Back pain
Reflux
Sleep apnea/trouble staying asleep
Anxiety
High blood pressure
High cholesterol
ALL made better/now gone with weight loss. Yeah, her solution was surgery and pills. So many pills.
I now take zero meds (except thyroid.)18 -
cmriverside wrote: »The one thing that irks me about my former weight and my doctor was that I had a whole bunch of related health issues and she never one time said, "Ya know, weight loss would be a good thing for you to do to help with these issues."
Knee problems
Back pain
Reflux
Sleep apnea/trouble staying asleep
Anxiety
High blood pressure
High cholesterol
ALL made better/now gone with weight loss. Yeah, her solution was surgery and pills. So many pills.
I now take zero meds (except thyroid.)
I think this is something that should be focused on more, as well. It seems most doctors assume patients won't lose weight, so they just treat the symptoms. I asked the nurse at my gastroenterologist office (there for testing related to low iron, not weight) why she was so surprised by my weight loss after looking at my medical records (a relatively modest 55 pounds, btw). She said they simply don't see many people who succeed at losing weight. I find that very unfortunate.
Since those of us who are dedicated and successful tend to want to surround ourselves with similarly like-minded people (such as are found here), it's easy to forget we're not representative of the population as a whole.14 -
@pinuplove
Yeah, or they don't want to "offend" people in this Trophy For Showing Up Special Snowflake society.
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If I needed special dietary advice, I'd ask my PCP for a referral to a registered dietitian. But I didn't need that kind of help, so I didn't ask.
PCP never told me I should lose weight, that I can recall, even at an obese BMI, with high cholesterol, triglycerides, blood pressure, when he was urging me to consider taking statins (didn't wanna; gave up enough cognitive bandwidth to chemotherapy, don't want another brain-fuzz side-effect med).
His only role was that, once I confirmed that the reason I was losing weight was because I was trying**, was to pull out a paper twirly device and say it would be fine for me weigh something between 111 and 149 pounds (normal BMI range for my height). This was useful when friends said - even when I was just in the 140s - "you're getting too thin". I could truthfully say "My doctor is fine with my weight loss and goals".
Eventually, I accidentally lost down to 116 (overshot goal while trying to dial in maintenance calories), and showed up again in his office for my normal 6-month thyroid status review. (I've been hypo for almost 20 years). A slightly higher weight than 116 would've shown up on the office scale, because clothes and breakfast. He kind of freaked out, and said I'd lost too much. (I did not tell my friends this part! ).
Now, I weigh something in the mid-130s (overshot goal in the other direction), have consistently good health markers, and we never talk about my weight at the 6-month visits. I'd prefer to weigh a bit less than this, and am working on super-slow loss. Haven't asked his opinion about goals.
** If you're a cancer survivor like I am, they rationally worry that unexplained weight loss might be . . . something else.15 -
My doctor always would comment on my weight. Not in a mean way, but it actually led to me avoiding the doctor (irresponsibly) for some years when I knew I was too heavy. When I decided to lose I also decided to get the heck over that and see her anyway. She told me I had an obese BMI and that it could lead to health issues (although my tests were all fine as it turned out), and I told her I knew and was working on it. She asked a bit about what I was doing and thought it all seemed sensible.
At another time I saw her when I was just over the normal BMI (26), and she said I was a bit over but that it probably wasn't a big deal given my overall tests. She did also ask about diet and exercise, and at the time I was exercising quite a bit and said I was actually planning to lose more so that I would be in the healthy range and she asked what I was aiming for and said it seemed like a good weight goal. At that time I actually mentioned to her that I was using MFP and she said she was a fan of using MFP to log.
I don't think I would want a doctor more involved, like telling me what to eat or not or a calorie goal, since it's very important to me to figure stuff like that out for myself, vs. feeling like it is imposed. However, in some cases, as with specific health issues needing diet advice, I'm a huge fan of getting a referral to a dietitian (my mom could have used much better and clearer advice when she was struggling with an illness in the last few years of her life), and I do think some people might do well with basic advice about weight loss.
(I tend to take being told things that I think everyone should know as implying that the person telling me it for some reason is assuming I'm ignorant and thus a bit insulting, so it's hard to know the best approach given how people are different. When I was fat this caused me to joke about how I was fat so people wouldn't assume I was too stupid to realize it, and also why with my doctor I was avoidant until I actually had a plan and some evidence that it was working since I'd lost some weight -- neither of these are healthy behaviors, I admit.)
One thing I would STRONGLY recommend is not assuming the person cannot properly count cals so recommending super low cals to compensate and not assuming anything about the diet (oh, must be too many carbs, or the person must not cook and eats lots of fast food and drinks loads of soda, person must be a total couch potato). May be true, may not, but if it's not you've started by alienating the person with "fat person must do X" assumptions.9 -
I think it'd depend on the relationship I had with the medical professional. I went to a PCP years ago, very depressed and overweight at 200+. Her advice was "just eat carrots instead of brownies". Wow thanks.
But my current PCP recommended this place to me back in July when I was singing the blues about having no self control whatsoever. I love the lady.
She also gave me a therapist's name to meet with, who was also not much help because she equated trying to lose her baby fat with what I was going through. 
So I think it comes down to your relationship and what kind of advice they give you. But I also think it should be more in the offer of referring you to someone else that is more specialized to your needs.7 -
cmriverside wrote: »The one thing that irks me about my former weight and my doctor was that I had a whole bunch of related health issues and she never one time said, "Ya know, weight loss would be a good thing for you to do to help with these issues."
Knee problems
Back pain
Reflux
Sleep apnea/trouble staying asleep
Anxiety
High blood pressure
High cholesterol
ALL made better/now gone with weight loss. Yeah, her solution was surgery and pills. So many pills.
I now take zero meds (except thyroid.)
It's interesting I've heard the other side of this as well. Patients who are obese and their doctors are so obsessed with their weight that they don't bother to look into other causes and diagnosises that could be causing their health issues and just hit them with "you need to lose weight", even if there way be other factors causing the health issue.8 -
cmriverside wrote: »The one thing that irks me about my former weight and my doctor was that I had a whole bunch of related health issues and she never one time said, "Ya know, weight loss would be a good thing for you to do to help with these issues."
Knee problems
Back pain
Reflux
Sleep apnea/trouble staying asleep
Anxiety
High blood pressure
High cholesterol
ALL made better/now gone with weight loss. Yeah, her solution was surgery and pills. So many pills.
I now take zero meds (except thyroid.)
While I gained 60 pounds because of pain, I was going to a Dr. who suggested plastic surgery. He said a face lift would give me a whole new attitude. Perhaps help with the pain would have helped.
To the OP, in my case, help with my general health would have the best help with my weight loss(stopping my weight gain), and was what I really, really wanted.
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Funnily enough, I was never offered diet advice or any kind of weight talk during the many years I was 320+ pounds. During that time, friends who'd seen the same doctors, who were either not overweight or just slightly overweight, told me the doctors would ask about their nutrition and exercise and make all sorts of recommendations. Once I got my weight down to 260, bam!, I spent half my annual exam getting unsolicited food, BMI, and exercise advice. The only thing I can think is that at some weight level they just consider you a Lost Cause and don't bother. Or, there might be some legal thing in this touchy era of ours - if someone implies they noticed you are fat, they're open to some discrimination thing, because when I was at my peak weight of 331 a doctor said to me, straight faced, while making perfect, uninterrupted eye contact and never looking at my body, "Do you have any conditions that you think might limit your flexibility?" I almost laughed out loud. Maybe they flat-out aren't allowed to discuss weight anymore.
By the time I'd whittled my way down to 260, I'd learned everything I needed to know about what, when, and how much to eat. So when all of a sudden doctors were all about discussing my weight and such, it was kind of like a bank finally being willing to make you a loan after you've established yourself and don't need a loan anymore.
So, my experience is, doctors are basically useless about nutrition - but of course, very valuable when it comes to things in their wheelhouse - blood pressure, glucose, metabolic syndrome, etc.11 -
cmriverside wrote: »The one thing that irks me about my former weight and my doctor was that I had a whole bunch of related health issues and she never one time said, "Ya know, weight loss would be a good thing for you to do to help with these issues."
Knee problems
Back pain
Reflux
Sleep apnea/trouble staying asleep
Anxiety
High blood pressure
High cholesterol
ALL made better/now gone with weight loss. Yeah, her solution was surgery and pills. So many pills.
I now take zero meds (except thyroid.)
It's interesting I've heard the other side of this as well. Patients who are obese and their doctors are so obsessed with their weight that they don't bother to look into other causes and diagnosises that could be causing their health issues and just hit them with "you need to lose weight", even if there way be other factors causing the health issue.
To my disagreers... I didn't just make this up https://www.nytimes.com/2016/09/26/health/obese-patients-health-care.html9 -
I think PCPs can’t win in this situation. Either they mention the weight as a possible cause for issues and are told they are focusing on the wrong thing, or they don’t mention it and they are not helping.
I can understand why they either get stuck in the loop of blaming everything on weight or just ignoring it.5 -
Lobsterboxtops wrote: »I think PCPs can’t win in this situation. Either they mention the weight as a possible cause for issues and are told they are focusing on the wrong thing, or they don’t mention it and they are not helping.
I can understand why they either get stuck in the loop of blaming everything on weight or just ignoring it.
I never even had a doctor MENTION my weight, though.
I'm one of these people who got up to a size 18 and thought I didn't look that bad and that I was healthy.
Someone needed to sit me down...3 -
Lobsterboxtops wrote: »I think PCPs can’t win in this situation. Either they mention the weight as a possible cause for issues and are told they are focusing on the wrong thing, or they don’t mention it and they are not helping.
I can understand why they either get stuck in the loop of blaming everything on weight or just ignoring it.
A PCP once told me flat-out that 80-90 % of obese patients who say they're going to go on a big weight loss journey never do it or just gain it back right after, and that is why they try to offer helpful tips on how to lose some weight if asked, but otherwise don't get too involved. Because then the doctor ends up becoming a weigh-in cop and the failed dieter skips their subsequent appointments, which is the worst outcome for them of all - a doctor can only do some good if people show up to their appointments. Such is what I was told, when I was 330 pounds and after discussing my upcoming weight loss journey. Which didn't happen that year or the next. That was 5 or 6 years ago. So in a way he was correct in all his assumptions, as I would've definitely skipped my next batch of appointments, although now I am actually losing the weight.8 -
cmriverside wrote: »Lobsterboxtops wrote: »I think PCPs can’t win in this situation. Either they mention the weight as a possible cause for issues and are told they are focusing on the wrong thing, or they don’t mention it and they are not helping.
I can understand why they either get stuck in the loop of blaming everything on weight or just ignoring it.
I never even had a doctor MENTION my weight, though.
I'm one of these people who got up to a size 18 and thought I didn't look that bad and that I was healthy.
Someone needed to sit me down...
Understood, but for every person like you there is one who would react the total opposite “OMG, the first thing my doctor said was that I’m overweight don’t they think I know that! “ and then shut down to anything else they said.
Like I said..can’t win.6 -
The only thing that is going to really help someone lose weight is lasting behavioral change. If the person is not committed to making significant behavior changes-it’s a futile effort.
I don’t mean significant dietary/lifestyle changes (small changes there can add up to significant results).
I mean is the person willing to go for a walk instead of watching The Bachelor? Or swap fruit for cookies? Address mental health issues that may be leading to overeating/binging/emotional eating? Really understand that while McDonald’s (or anything) can fit into an overall healthy diet, it’s unlikely to include a supersize Big Mac meal with 2 apple pies and a chocolate shake every week?
The best “help” is to find ways to manifest lasting behavior change. Otherwise, it’s no different than all the people here on mfp asking what they can tell their Spouse/SO/parent/friend/etc to convince them to lose weight/get healthy.
My doc said and did everything for years. Even up to referring me for WLS. It was a random occurrence on a walk with my dog in the park that sparked my desire to actually change my behaviors.6 -
Lobsterboxtops wrote: »cmriverside wrote: »Lobsterboxtops wrote: »I think PCPs can’t win in this situation. Either they mention the weight as a possible cause for issues and are told they are focusing on the wrong thing, or they don’t mention it and they are not helping.
I can understand why they either get stuck in the loop of blaming everything on weight or just ignoring it.
I never even had a doctor MENTION my weight, though.
I'm one of these people who got up to a size 18 and thought I didn't look that bad and that I was healthy.
Someone needed to sit me down...
Understood, but for every person like you there is one who would react the total opposite “OMG, the first thing my doctor said was that I’m overweight don’t they think I know that! “ and then shut down to anything else they said.
Like I said..can’t win.
Those are not the only two options. It IS possible for doctors to both properly educate their patients about the risks of obesity while also doing proper diagnostics and investigation into the causes of health issues and not simply assume it's from obesity.8 -
I’m not saying there aren’t more than 2 options, but it seems like doctors generally come down to one of the two approaches, or they are perceived to. And that I can understand why they do.3
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My doctor was instrumental in my weight loss because he gave it to me straight, not as a judgment statement, but as a game plan. When I started having blood sugar and triglyceride issues he basically told me: this most likely has to do with your weight. There are a few things we could do about this and a few medications we could try, but weight loss may be your best bet. There is a chance your numbers will improve without medications if you lose weight, how would you like to proceed? My doctor working with me instead of working "at me" gave me that push to do my part. I told him I want to try to lose weight, he asked if I needed a referral to a weight loss specialist, I told him I will figure it out on my own, and that was that.13
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I have a great doctor who brought it up by asking me questions about it...the conversation went something like this...
DOC: How do you feel about where your weight is right now?
ME: I know I've gained some, and I'm not too happy about it.
DOC: What do you think would be a good weight goal for you?
ME: I think around 140?
DOC: That sounds good. How do you want to go about getting there?
Etc...etc...it was all questions from her.
She made me come to my own conclusions about it, and just affirmed that I had a good plan. She said to let her know if I wanted a referral to a dietician or any other resources. It wasn't a lecture, which I think can turn people off.
A year later, when I came back below the goal I had set, she just said "Yay!", confirmed that I was now at a healthy weight, and encouraged me to maintain.
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