How would you like your doctor/GP/family physician to help you lose weight?
Replies
-
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
-
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
-
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.
15 -
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.
ITA. This is just my vaguely educated opinion, but it seems like a lack of education in nutrition, exercise science, and weight maintenance leaves PCPs unprepared for these issues, and in the day to day rush they either ignore weight issues to avoid conversational awkwardness, or harp incessantly on weight issues to avoid "wasting time" (sarcasm quotes) on diagnosing something that might be weight related. Or they latch onto a fad that they don't have the education to see through, but give it credence because of their title
It also doesn't help that at least here in the US many people are forced to play musical chairs with their health insurance so often have to switch doctors or go to offices where you see whoever is free. So you don't develop that relationship that fosters more than a hit and run dynamic.
I think a PCP should mention if a patient's weight is a health concern while still treating them as a complex human being with other concerns, and be ready to refer them to an RD or an obesity specialist if they are open to dealing with their weight.8 -
I can vouch for a lot of people who say that nutrition isn't part of medical education...I'm a first year medical student, and though we've had several lectures on nutrition with respect to metabolism and biochemistry, nutrition as a whole isn't integrated into medical curriculum very well. To exacerbate this issue, most doctors forget the biochemistry they learned during first year - practicing physicians are pretty far removed from the world of diet and exercise, even though we are taught to ask about this with each patient. I will say though, that it's out of respect and concern that doctors ask patients about their health goals; it seems like people get offended when asked about this, but we mean no harm or malice in any capacity. We ask because metabolism is a) different in every person, b) a major contributor to microscopic health (not just macroscopically - i.e. BMI), and c) changes quickly and sometimes for unknown reasons. If I wanted nutrition advice, I would not ask my PCP - at the same time, I (and hopefully my peers) recognize that nutrition is out of our scope of practice unless we're certified in some way. Ask your PCP for a nutritionist or dietician consult and see what they say; if they gladly oblige, they're doing their job. If they brush the request off, they are not fulfilling their role as a provider of care and as a patient advocate. A good physician will get to the root of the problem and give you access to as many resources as possible.15
-
I have never had a doctor mention my weight to me. I mentioned it one time to a neurologist (we were trying to figure out why I have syncope). I said something like, “I know I’m overweight,” and he literally told me that my weight was fine. Now I was literally on the low end of obese by the BMI chart, and he literally gave me a hand sweeping motion while brushing off my comment. I expected more of a “yeah, it would be a good idea to get to a more normal weight,” but that never came.
Granted my weight doesn’t cause me any health issues. I have low blood pressure (which causes the syncope) and weight doesn’t affect that at all. I remember that vividly bc that was the day I paid $45 to be told “to eat more salt.” 😒🥴😑0 -
@j_eanie fantastic topic.
Unfortunately, I agree its lack of education, Many medical facility's don't have the money or staff to put together real treatment options. How would I like a DR/GP/FP help me to lose weight? A simple referral to a program offered by my local hospital (My Dr, had no clue this program existed)
Drs diagnose medical issues and give advice on the best route to address weight and nutrition.
People suffering from eating disorders, are referred to a specialized mental health program
Diabetic issues are treated and given education and nutrition to meet their needs
They offer supervised with loss. Appointments with a dietitian. Weight loss diet/nutrition is NOT a one size fits all. They go over your medical history, medications, blood work, hormones and any risk factors to develop a individualized weight loss eating plan.
Exercise - Some classes are offered for people with mobility issues. Insurance company's may cover free gym memberships. Support groups have scheduled days for group fitness.
Group behavior change class facilitated by a psychiatrist
Classes on navigating grocery store for healthy eating and ordering healthy at restaurants.
Cooking classes
Support groups facilitated by nursing staff
Education and treatment for the obesity.
Options for bariatric surgery – Referral to an education seminar that go’s over gastric sleeve, Mini by pass, SIPS, Roux -N – Y bypass (many surgeons don’t do band or balloon procedures) Insurance approval, medical and/physiological pre surgery exams. Pre surgery education with one year dietitian support, five years of check ups. cooking classes, behavior change support groups Etc…
Only my opinion,
We can agree weight gain is food choices and eating over your maintenance calories. But, it so much more than that. age, sex, medical issues, genetics/body physiology, medication, mental health. hormones access to healthy food/income.
7 -
When I went to my previous physician and asked her about weight loss she questioned why, stating that I don’t look fat, despite the fact that I was 20 lbs overweight. When I asked for her advice, her suggestion was phentermine and a 1200 calorie diet.
Im a P.A. now and would never give that advice. Tbh, most patients get offended if you mention their excess weight as the probable cause of their disease or pain, no matter how nice and tactful you are. This is probably why so many probably don’t bother to address it. Tbh, most just want an immediate fix, a pill, etc. It is the minority of patients that actually are willing to make a lifestyle change.
If someone asks for my advice about weight loss, I will encourage them to change their diet, move more, and I suggest MFP to help them count calories. If they ask for my advice on what to eat for health, my advice will be different.3 -
In general I don't expect doctors to comment on weight loss unless a patient is obese and then gently. If there are health issues that can be resolved I think it's great to bring it up. For example when I was diagnosed as diabetic I was given medication and a meter, no dietitian or counseling covered by insurance. The majority of my older family members are diabetic including some who work out daily. I started losing for my health, I never thought I'd be able to go off medication with my family history but my A1C is down to 4.5 and I'm slightly hypoglycemic instead when I wake. I found what to eat and do from my own research and n=1. My doctor was happy for me and wanted to know what I'd done.2
-
My weight got to the point where I needed to be put on blood pressure meds. I hate having to remember to take pills. My GP is a second-generation Iranian guy who gives no *kitten* and told me flat out, "Lose the weight and you'll be able to get off the pills." He introduced me to MFP - I'm a numbers person and I was motivated. He gave me gentle encouragement and if I had questions he would point me toward an authoritative reference or email me something. I held up my end of the bargain, lost the weight, and he held up his. I've been off the pills for a year.13
-
My weight got to the point where I needed to be put on blood pressure meds. I hate having to remember to take pills. My GP is a second-generation Iranian guy who gives no *kitten* and told me flat out, "Lose the weight and you'll be able to get off the pills." He introduced me to MFP - I'm a numbers person and I was motivated. He gave me gentle encouragement and if I had questions he would point me toward an authoritative reference or email me something. I held up my end of the bargain, lost the weight, and he held up his. I've been off the pills for a year.
That’s excellent! It is so motivating and inspiring when patients make positive changes for their health!
0 -
I have EDS and my doctor essentially told me "you're best shot for a healthy life is to get as light and as strong as possible. Do that however you want"0
-
When I was a child, our family doctor would not stop talking about my weight. He made me feel like an animal and not a person. He wouldn't look at me or speak to me, but used words like fat and cow (seriously). This began around age 7-8 and continued until I was 13 and my parents finally switched doctors. At one point he sent me to a psychologist AND a dietitian. The psychologist helped with my anxiety but the dietitian basically said I was a healthy preteen and needed to drink more milk. I was around 5'4" and around 140 lb when I was 10 years old...which is strange for an elementary school aged child, certainly very tall and big for that age and on the way to weight issues, but not dangerously obese or anything. I was active, rode bikes & swam and didn't have any other health problems.
Because of that (and other issues with same physician) I developed a fear & mistrust of doctors that lasted well into my thirties.
When I finally went to a doctor in my 30s, he told me I really needed to lose about 10% of my body weight to avoid becoming prediabetic and other issues. I was morbidly obese at the time and needed lose much more than 10%. BUT...that worked for me...I took his concerns very seriously and I liked and trusted him much more because he didn't seem to write me off for being too fat. I knew a lot of other people around my size who were basically told that any health issue they had was due to weight and they needed to get various surgeries such as the sleeve, lap band, etc. That doctor wound up retiring but I liked and trusted him all the more due to his realistic suggestion. It felt doable and I got serious about exercising more and eating less.
Now that I'm at a healthy weight or technically about 12-15 lb overweight (on the charts) as a 5'8", 43 year old...my doctor thinks I'm at a great weight and it's amazing that I've maintained a major loss for 6.5 years.
I would be 100% open to any suggestions if I began to have any type of health problem that could be exacerbated by excess weight.
I think PCPs need to be frank about weight affecting certain body systems and making certain conditions worse. But shaming and berating patients is usually not effective.
15
Categories
- All Categories
- 1.4M Health, Wellness and Goals
- 391.2K Introduce Yourself
- 43.4K Getting Started
- 259.7K Health and Weight Loss
- 175.6K Food and Nutrition
- 47.3K Recipes
- 232.3K Fitness and Exercise
- 385 Sleep, Mindfulness and Overall Wellness
- 6.4K Goal: Maintaining Weight
- 8.5K Goal: Gaining Weight and Body Building
- 152.7K Motivation and Support
- 7.8K Challenges
- 1.3K Debate Club
- 96.4K Chit-Chat
- 2.5K Fun and Games
- 3.2K MyFitnessPal Information
- 22 News and Announcements
- 895 Feature Suggestions and Ideas
- 2.2K MyFitnessPal Tech Support Questions