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Does your doctor comment on your weight?
Replies
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wunderkindking wrote: »Size is not an identity (or, well I suppose some plus sized/health at every size influencers have made it one, but that's not a good thing)
Actually, plus size influencers have been a huge encouragement to me and so good for my mental health. Plus size women have been discriminated against for so long. Women are constantly pressured to look like impossible Photoshopped supermodels who are so skinny it’s unhealthy. No wonder so many girls have body image issues and low self esteem and depression. Even if they eat healthy and live an active lifestyle and are physically fit, they still get labeled “unhealthy” if they have a naturally bigger body size. Yes, I said naturally bigger. Some women eat super healthy and exercise like crazy and have great fitness and they are STILL plus size. Because it’s genetic. And that CAN’T be changed.
I’m not saying that every overweight person is healthy. I know I need to lose weight. But you CAN be overweight by BMI and still be healthy if you have muscle mass and an active lifestyle and good diet. You can also be skinny and very unhealthy if you don’t live a good lifestyle. Healthy doesn’t equal skinny but people think it does because society constantly pushes skinny as the standard and naturally bigger women feel like they can never attain it. Plus size women don’t get equal representation in the media and their bodies are not normalized like skinny people. I am glad we have plus size influencers pushing back against that!!wunderkindking wrote: »Identity is who you are. Inside. Not what you LOOK LIKE, or how heavy you are.
Exactly, and that’s why I don’t identify as “morbidly obese”. I know my body and I know my fitness level and I know that “morbidly obese” doesn’t fit who I am on the inside.
Yes, I’m overweight and I admit that and that’s why I’m here. I am overweight. But I am also a relatively healthy and relatively average woman. ”Morbidly obese” is an awful term and makes it sound like I’m freaking 400 pounds. That’s not me. My weight has actually been pretty average my whole life and I only gained weight recently because of the pandemic. I am chubby but I don’t think anybody would look at me and say “she’s morbidly obese”!
Morbidly obese is a technical term and you are not (although you are close to the lower edge). It means either BMI of 40+ or 100 lbs over your ideal weight (which is not defined subjectively). At 5'5 and 240, you are 39.9 BMI, so at least obese, technically (which just means over 30 BMI). Yeah, muscle mass may make that vary some in reality, but absent an edge case, over 30 BMI (and certainly over 35) has the health risks that go with "obese." It's really not a shaming word, but intended to be a clinical one.
Of course there are multiple classes of obesity and being obese just doesn't mean you are 400 lbs or should feel like you are. I'm only 5'3 and hit "obese" at 170. For me, not overweight = 140. Am I not a weight that would be considered an issue in the current US at over 140? Yeah, although I think I look better closer to 125. Am I unhealthy at, say, 145? Probably not, and I think if I were more stable at that weight than, say, 130, it would be a fine choice, especially if I also were active and ate well. I would hope any discussion of weight with a doctor (and this is true for my doctor, who has always discussed weight) would be broader than this is the number on the scale.11 -
wunderkindking wrote: »Oh, and as icing on the cake? That community tends to viciously turn on anyone who is trying to lose weight, even if it's for a direct health benefit (there's a whole thing with a youtuber named glitterandlasers or something similar). BIG TOXIC hiding under a thin shell of 'positivity'. It's killing people.
What this poster is parroting?
Right out of the 'I watch these videos a lot and need to believe this crap' playbook.
No, I do not oppose weight loss. I oppose the idea that you need to be a certain weight to be attractive or healthy. Weight loss CAN help you get healthier depending on your situation, but there are so many factors that play into a person’s health - it’s not determined by just one number on a scale.
Body positivity isn’t toxic. Decades of society telling young girls that they’re fat and ugly if they’re not a size 0 - that’s what’s toxic. So many girls have gotten body dismorphia and anorexia from those toxic messages.
I’ve been plus size my whole life and despite being only slight overweight for most of my life, I felt SO insecure about my body - I felt like a whale and felt like no boy would ever look at me. I didn’t have the confidence to wear clothes that flattered my figure. I felt invisible and depressed.
Plus size YouTubers have helped me to unlearn that toxicity and see that I’m beautiful and sexy just the way I am and I can dress to show off my assets that super skinny girls don’t have Despite being at ny heaviest weight yet, I feel SO much better about myself now and I’m more confident than I was when I was skinnier.
I’m not opposed to weight loss - I WANT to lose weight so I can get in shape and be able to walk further and climb stairs better and do more things without getting out of breath. But I no longer believe I need to lose weight to be sexy. I’m letting go of that toxic mindset. I’m learning to love and flaunt my natural body shape - hence the “curvy” in my username
A lot of strawmen in that post
Nobody was commenting on sexy or beautiful- I hope no doctors are approaching weight loss from those angles.
And nobody was promoting telling anyone they were ugly or promoting weight loss to look or feel sexy.
Nor was anyone saying there are not other health risks or that weight is the only risk factor.
But, yes, you do need to be in a weight range to be healthy - it isn't about looks or sexiness or attractiveness or confidence - being significantly overweight is a health risk.
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It's weird that people accept that the BMI is terrible and inacurrate but also seem to be defending it's use. Being over weight CAN be a major health issue. But since it's that big of a deal, shouldn't we want accurate measurments and guidelines?
What are the accurate measurements in this case you think we are missing?
Re the doctor question, I went to my doctor when I was in the midst of losing and was 26.5 BMI. My dr said "you are technically overweight but I see no issues, tests seem good, you seem healthy, how do you eat and how do you exercise?" I explained I was (a) training for a half marathon, (b) losing weight, and (c) went into details about how I ate. She asked a few more questions to make sure I wasn't doing some unhealthy diet/had unhealthy goals and was fine with my ultimate goal and also liked MFP, which I mentioned. Additional tests done that day came back fine. If I'd not wanted to lose more after that, but kept the healthy behaviors I don't think my dr would hav cared, although she likely would have explained various ways of checking healthy weight (my insurance company recommends such things, like height to waist).7 -
Tweaking_Time wrote: »Has your doc ever suggested you lose weight? If so, were you offended?
I asked my doc if she ever suggested people lose weight, eat better, exercise more, etc. She said that her answer would be mostly "No." When I asked her why she explained that being a doctor is a business and if she would critique each patients weight, she is sure she would lose patients, especially the easily offended ones. She also said if the patient asks her opinion about their weight, should would gladly help them with a diet/exercise plan.
My current GP first met me when I was about 160 and beginning to have problems with my balance. That was just over twelve years ago.
I had been on a weight loss journey then. I was running almost daily, and was in decent shape. Running. And did I mention the unicycle??? My true exercise love since I was a tween?
She watched as I got larger and larger.
Not once did she mention weight. Diet was mentioned. And alcohol. And I could see disbelief when I would say I rarely drink. Or that generally my diet was decent. (Obviously I was eating more than I was expending, but that was because of increasing disability) And a couple times in the early days I had to fight to get my thyroid meds properly adjusted. I also had to fight so much for my ADHD meds that I just stopped taking them and that hasn’t been my best decision either.
She also asked me what kinds of activities I liked. When I said I liked walking on the beach with my partner she told me that was “too dangerous” and that was my last walk on the beach. At the time I was using two canes.
When I told her I enjoyed using my small chainsaw to cut trash trees in my yard? She was absolutely aghast and told me I should not be using a chainsaw. The fact that it was very small, and I was sitting well braced on a firm seat? Meant nothing. So I stopped working in my yard.
I got no diet advice. I got no referral to a nutritionist. I got no advice for exercise I could do And - crucially - when I said something like “well, I feel like kitten all the time so it’s kind of hard to tell…” she didn’t order any blood tests except thyroid.
I developed a fatty liver. My cholesterol went up, which is against my genetics. And my BP went up, also against my genetics. All with no apparent concern from my GP.
Physical therapists I got sent to clearly thought I was faking my balance issues. Completely ignoring the fact that I used to unicycle all the time so my baseline balance is excellent.
Meanwhile I have other issues that the doctors just roll their eyes when I mention because obviously I’m fat. So I must just be looking for attention…. A hypochondriac.
Which is why I can’t feel my toes now. Because the people I trusted to advise me just looked at my size and my mystery balance issue and decided I was fat and stupid and lazy.
Doctors treating fat people as if being fat is their only problem is a very real issue. I was only a bit overweight when my current GP met me. And that was enough for her to mostly dismiss my concerns.
Oh. And she’s one of the better ones in my area.
That said? Body positivity is a good thing at any size. And doctors need to pay attention to their patients of all sizes
They generally don’t. And that likely has some effect on why larger people have worse health outcomes.
I know it absolutely was a factor in why I have neuropathy right now. If my doctor had encouraged exercise instead of shutting me down when I mentioned the things I liked to do even with my balance disorder? Or had encouraged me to find an assistive device that would make those activities safer in her eyes? Or had sent me to a nutritionist? Or done a simple fasting blood sugar???? I would have been able to reverse the diabetes in the early stages. I know this because my diet was already not that bad. And I was already exercising some. I just needed to be told to step it up a notch.
I am diabetic in some part because my doctor chose not to encourage me to exercise. Chose to only look at my fat and not my symptoms And that’s a big problem for a lot of overweight people.
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Hi everyone,
Reading through this thread has been really interesting and eye-opening for me, in particular the debate/discussion that has come up about body size and health.
I have to say, I think a lot of the discussion becomes confused as people mean different things when they write, and others assume a shared meaning where actually these aren't shared due to life experience.
Health is a good example: some argue that any mass above 1 standard deviation above the mean (or whatever arbitrary line you want to set) is unhealthy, and some argue that they are healthy at a weight higher than that. But the issue here is what health and unhealthy means.
People argue that being overweight by its nature is unhealthy I take it to mean that, as a lot of evidence shows, the risk of cardiovascular disease, diabetes, osteoarthritis etc increase with increasing weight. The studies which showed this did not often look at more complex metrics than BMI, and have many confounders (such as socioeconomic status which is highly correlated to weight) but have been done on huge populations. The sheer number of people studied gives strong evidence that on average being heavier increases the risk of specific diseases, although each disease risk is somewhat independent. Specific evidence of an impairment in general wellbeing is harder to come by: although I believe there are some studies which also support this and it can be inferred from the higher rates of physical health problems (and concomitant other life/mental health issues) in overweight populations.
What others are saying is different: that it is possible to be healthy and be overweight. The studies do not preclude this. They talk about the mean risk of cardiovascular disease, but if we evaluate that in more depth, the actual risk of a heart attack or stroke (particularly as a result of athersclerosis and essential hypertension) for a young woman is really very small. And, as they get older and continue to carry extra weight, that risk increases, but it is by no means 100% - many people who are older and larger do not have consequences of being overweight or obese. For one reason or another they do not have the occurrence of the actual illness that can be associated with obesity. Now, of course, a large number of people will be (to all intents and purposes) lucky. Some people will statistically just not get heart attacks or strokes or joint issues. But there's more: taking cardiovascular risk into consideration, physical activity is more closely associated with heart attack risk than BMI. Of course, BMI and physical activity are closely associated, but not actually dependent on each other. Studies to tease this out show that physical activity is more important than BMI, but BMI is also an independent risk factor. These details are likely to be true for several conditions: people who are overweight are more likely to both eat processed meat and get bowel cancer: there is probably some independent effect of BMI, but many studies which demonstrate the association were not designed to control in high resolution for dietary features.
So an overweight person who exercises regularly, has a good exercise tolerance, maintains a diet which is balanced, doesn't smoke and is lucky with their genes may have an individual risk of cardiovascular disease than many other people who have a lower BMI. Does that mean that they couldn't lower their cardiovascular risk further - no. Does that mean they are healthy? Who knows... depends on what you mean by healthy.
A further issue is that when you use the word healthy a bunch of other stuff comes in. There's really solid evidence that obese people are discriminated against, and that words which are associated with obesity and being overweight are viewed more negatively than those describing people who are not that. In fact the terminology is pretty vulnerable to prejudice: as someone pointed out "normal" weight is a statistical measurement of the population and could in theory change over time as people get taller and larger. "Healthy" weight is also challenging, as there is probably a range in which people can be "healthy" in a medical sense. Furthermore, the word healthy also kinda means attractive, or at least attractive adjacent. So when someone brings up that the word obese is offensive, or that they are put out by being called unhealthy they are telling you that their experience is that the word is offensive, or that unhealthy has been used as a euphemism for ugly in their life. It doesn't too much matter that they are medical terms, or in your view don't relate to attractiveness: they have become offensive, just like a bunch of other medical terms.
In the end what do we want? we want each other to live long, happy lives. And in this case both sides are right. Overall a population should have a lower BMI, eat less processed food, exercise more and the mean age of death will likely increase. If we look at individuals though, telling them they are fat, telling them they are by their nature unhealthy and treating them poorly for that will not help. It will not help them change their lifestyle to become more healthy regardless of weight, and it will contribute to the feelings of inadequacy which burden many people who have a high BMI.
In response to the question: I was told by a doctor when I was 18 that I was fat and needed to lose weight as a throwaway at the end of a consultation. Literally those words. The first part was true - I knew it before I went in, I knew it when I was 12, and when I was 8, and I know it now that I am 33 years old. As for the second part: how could he know what I needed? And in every moment of self-loathing and weakness I would think back to that doctor with a prideful grin - shows what he knew! Here I am and I didn't NEED to lose weight. Of course, I know, and, I think knew then, that what he meant to say was "We should have a further consultation to create a supportive environment and carry out a holistic assessment of your general health and consider how your long-term health goals may be supported by a plan of increased activity and active consideration of your diet, balancing sustainability with calorie limitation in order to meet predefined activity and weight loss goals and maintenance." j/k, lol.
P.S. Just starting my current plans for a healthy future: happy to chat with folk to keep motivation going!9 -
MargaretYakoda wrote: »Tweaking_Time wrote: »Has your doc ever suggested you lose weight? If so, were you offended?
I asked my doc if she ever suggested people lose weight, eat better, exercise more, etc. She said that her answer would be mostly "No." When I asked her why she explained that being a doctor is a business and if she would critique each patients weight, she is sure she would lose patients, especially the easily offended ones. She also said if the patient asks her opinion about their weight, should would gladly help them with a diet/exercise plan.
My current GP first met me when I was about 160 and beginning to have problems with my balance. That was just over twelve years ago.
I had been on a weight loss journey then. I was running almost daily, and was in decent shape. Running. And did I mention the unicycle??? My true exercise love since I was a tween?
She watched as I got larger and larger.
Not once did she mention weight. Diet was mentioned. And alcohol. And I could see disbelief when I would say I rarely drink. Or that generally my diet was decent. (Obviously I was eating more than I was expending, but that was because of increasing disability) And a couple times in the early days I had to fight to get my thyroid meds properly adjusted. I also had to fight so much for my ADHD meds that I just stopped taking them and that hasn’t been my best decision either.
She also asked me what kinds of activities I liked. When I said I liked walking on the beach with my partner she told me that was “too dangerous” and that was my last walk on the beach. At the time I was using two canes.
When I told her I enjoyed using my small chainsaw to cut trash trees in my yard? She was absolutely aghast and told me I should not be using a chainsaw. The fact that it was very small, and I was sitting well braced on a firm seat? Meant nothing. So I stopped working in my yard.
I got no diet advice. I got no referral to a nutritionist. I got no advice for exercise I could do And - crucially - when I said something like “well, I feel like kitten all the time so it’s kind of hard to tell…” she didn’t order any blood tests except thyroid.
I developed a fatty liver. My cholesterol went up, which is against my genetics. And my BP went up, also against my genetics. All with no apparent concern from my GP.
Physical therapists I got sent to clearly thought I was faking my balance issues. Completely ignoring the fact that I used to unicycle all the time so my baseline balance is excellent.
Meanwhile I have other issues that the doctors just roll their eyes when I mention because obviously I’m fat. So I must just be looking for attention…. A hypochondriac.
Which is why I can’t feel my toes now. Because the people I trusted to advise me just looked at my size and my mystery balance issue and decided I was fat and stupid and lazy.
Doctors treating fat people as if being fat is their only problem is a very real issue. I was only a bit overweight when my current GP met me. And that was enough for her to mostly dismiss my concerns.
Oh. And she’s one of the better ones in my area.
That said? Body positivity is a good thing at any size. And doctors need to pay attention to their patients of all sizes
They generally don’t. And that likely has some effect on why larger people have worse health outcomes.
I know it absolutely was a factor in why I have neuropathy right now. If my doctor had encouraged exercise instead of shutting me down when I mentioned the things I liked to do even with my balance disorder? Or had encouraged me to find an assistive device that would make those activities safer in her eyes? Or had sent me to a nutritionist? Or done a simple fasting blood sugar???? I would have been able to reverse the diabetes in the early stages. I know this because my diet was already not that bad. And I was already exercising some. I just needed to be told to step it up a notch.
I am diabetic in some part because my doctor chose not to encourage me to exercise. Chose to only look at my fat and not my symptoms And that’s a big problem for a lot of overweight people.
Oh, this is a terrible story, I’m so sorry. There’s no excuse for not running a regular a1c, yet my doctor didn’t do it either.
Did your neuropathy improve at all with good glucose control? I ask because I used to have neuropathy in my hands and it mostly disappeared after a year or so with good control.5 -
Doesn't mean it never happened, but I can't remember a doctor ever telling me I should lose weight. Not my:
* GP (who was urging me to take a statin for high cholesterol, when I also had high triglycerides, borderline to high blood pressure at the time);
* Oncology team (treating me for a stage III locally advanced cancer that's statistically more likely among the overweight);
* Orthopedist (treating me for torn meniscus, more likely with excess weight), nor the follow-on physical therapists;
* OB/Gyn.
(FWIW, most of my doctors have been at or at least close to normal weight, based on my amateur visual assessment. Only one oncologist was obviously overweight, possibly lower end of obese?) To me, that doesn't matter. Sure, maybe an overweight doctor mentioning weight to an overweight patient is a hypocrite. But *not* mentioning it, when relevant, is borderline incompetent performance, maybe even malpractice. The latter is worse.
That my doctors weren't harping on my weight seems odd in retrospect, so maybe the problem is my memory? 🤷♀️
I do remember talking about my weight with doctors, i.e., I remember saying "I know it would be better if I lost some weight", in multiple cases - i.e., I brought it up. I even remember telling an oncology PA that I was obese (my BMI was above 30 at the time), and having her dispute that. I told her to run the BMI calculation, and when she did, she admitted I was right. Maybe I just brought up my weight before the doctors did: I knew I was overweight/obese, and that it was a health risk (even before I experienced other health and test consequences later in life).
"Obese" is a technical term in a medical setting, based on weight and height. It's not a value judgement about good looks, sexiness, value as a human, or anything else. It's just a health metric, and a screening metric at that - i.e., an easy statistic that helps identify people who probably need a more individualized assessment. I was obese, by that definition, at 5'5", 183 pounds.
I was also super active, working out hard 6 days most weeks, even training and competing in a short-endurance sport (rowing), and not always unsuccessfully either. I suspect that's why I didn't look obese to the oncology PA: I wasn't as soft-looking, especially in my upper body, as most women of my height/weight whom she saw.
I'm pretty sure I have more than average muscle mass for my demographic, as a woman, though far from bodybuilder level. (That's me, in my profile photo, so y'all can judge for yourselves . . . and I haven't added muscle mass since weight loss, to my knowledge.)
At 183, my body fat percent was too high. I don't have a good estimate, but probably over 35% at the most optimistic bare minimum. Even in the mid-150s, when I joined MFP, I was still visibly fat, in terms of central-body fat . . . even though that was about the point where friends who were used to fat me had started saying "you don't need to lose more weight, you should stop".
When I lost weight, my GP and his assistant acted . . . astounded, even gobsmacked. I visit them every 6 months, because I'm hypothyroid, and had dropped from 165 to 129 pounds (after an 18 pound drop the previous 6 months, which didn’t gather any reaction that I remember). My inference from their stunned reaction was that this pretty much never happens, when someone – after much urging to take a drug for a related condition – says she wants to try improving the situation without medication. (Yes, my cholesterol, triglycerides, blood pressure had all become solidly normal - actually everything except HDL - the one that should be higher - had normalized with that first 18 pound drop, and it was only 1 point below normal then (has nearly doubled since).)
Now, I do hear about my weight from the GP, more like "don't need to lose weight". Well, yeah, at around 125 pounds at 5'5", BMI 20-point-something, no, I don't need to lose weight.
I think the way the doc phrased it at my recent visit was something like "most women need to lose weight, but you don't". Almost makes a person think that most people are overweight or higher, that average is not "BMI normal". (That'd be consistent with what I see in the community . . . and generally it seems like doctors' offices of various specialties seem to have an even higher fraction of higher-bodyweight people compared to say, grocery stores, though the average here most anywhere is for people to be overweight, especially among folks my age).
I don't think anyone should be shamed for their bodyweight, or discriminated against. I liked myself, liked my body, even when I was obese: My body could do cool things, and what the heck would I do without it? I 100% agree that the culture does implicitly and explicitly criticize and discriminate against people who are heavier than would be optimal for health. That's inappropriate, unfair. A doctor telling me I had an obese BMI, when I had an obese BMI, is not shaming, it's just a fact.
I especially disliked that, when overweight and obese, it was super difficult to find plus-size activewear, especially specialized active wear (things like wetsuits/drysuits, bike shorts, rowing gear, etc.). Believe me, I looked. I saw those things being more available for overweight men, less so for overweight women. (I get that availability is demand-driven, and that many women who are overweight are not active, so not helping create demand for those specialized products: Still, it's frustrating for those of us who want the gear, and I'm not the only woman who was active but overweight/obese.)
Something else I hear and read, that I also think constitutes criticism (though I don't personally feel ashamed): "Stick thin", "a skeleton", "real women have curves", etc.
Some women do have curves, some have a more squared-off or sporty build, some are narrow, and there's everything in between, and beyond. Though I don't feel shamed, as one of those sporty-build women, how should I - as a post-bilateral-mastectomies cancer survivor who didn't have reconstruction - react to "real women have curves"? In practice, I just laugh and shake my head.
Real women know who they are. It's not a function of body type.
No one should be shamed for their body type, nor feel ashamed of it. There are folks in every body size camp who use shaming, critical language. It's inappropriate.10 -
Nope, I have had to ask. I was having trouble losing weight (always have) so asked about it and despite having my weight in the chart, she always looked at me and said I don’t look overweight. All of my doctors have said this even though my weight has hovered around 140 lbs at 5’0” tall for years. I was 125 lbs for a while and she said I was a bit too slim. My previous doctor offered me phentermine which I refused.
As a medical provider myself (P.A.), I sometimes mention weight if it relevant to the patient’s condition in the emergency room but most patients don’t want to hear it no matter how kindly and tactfully I broach the subject. I believe this is why many doctors don’t bother. This is a topic that should be addressed in primary care more, for sure.
A lot of patients will blow the doctor off though. I have 300-400 lbs patients wondering why their knees or backs hurt at age 30 despite having normal imaging or why their diabetes is out of control and if you mention the extra weight they get mad. I know when I am 20 lbs heavier, I feel more pain in my body, so I can only imagine 100 to 200 extra pounds.10 -
paperpudding wrote: »Nobody (barring obvious outliers like people with dwarfism or born with missing limbs) has a 'natural shape' that is far out of healthy BMI range
I’ve been outside of the “healthy” BMI range my whole life DESPITE a relatively healthy lifestyle. I know lots of women in the same boat. Some people are just naturally heavier!
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
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It's weird that people accept that the BMI is terrible and inacurrate but also seem to be defending it's use. Being over weight CAN be a major health issue. But since it's that big of a deal, shouldn't we want accurate measurments and guidelines?
I would prefer if we had BODY FAT PERCENTAGE measured accurately as a more usable standard. Lol, but could you imagine how some people would flip out over that? Finding out they could be 40% body fat and still think they aren't unhealthy?
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
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It's weird that people accept that the BMI is terrible and inacurrate but also seem to be defending it's use. Being over weight CAN be a major health issue. But since it's that big of a deal, shouldn't we want accurate measurments and guidelines?
I would prefer if we had BODY FAT PERCENTAGE measured accurately as a more usable standard. Lol, but could you imagine how some people would flip out over that? Finding out they could be 40% body fat and still think they aren't unhealthy?
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
Prediction: if we went to that system, we'd quickly have people telling us that body fat wasn't a reliable indicator, that it didn't tell you how fit someone was, etc etc.
Many of the people who are critical of BMI would be equally opposed to any sort of metric because the goal isn't to introduce a more accurate system of measurement, the idea is to attack and discredit the idea that there should be ANY system that's identifying people who are at risk due to weight/body composition.17 -
janejellyroll wrote: »It's weird that people accept that the BMI is terrible and inacurrate but also seem to be defending it's use. Being over weight CAN be a major health issue. But since it's that big of a deal, shouldn't we want accurate measurments and guidelines?
I would prefer if we had BODY FAT PERCENTAGE measured accurately as a more usable standard. Lol, but could you imagine how some people would flip out over that? Finding out they could be 40% body fat and still think they aren't unhealthy?
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
Prediction: if we went to that system, we'd quickly have people telling us that body fat wasn't a reliable indicator, that it didn't tell you how fit someone was, etc etc.
Many of the people who are critical of BMI would be equally opposed to any sort of metric because the goal isn't to introduce a more accurate system of measurement, the idea is to attack and discredit the idea that there should be ANY system that's identifying people who are at risk due to weight/body composition.
I do have clients that state they want to get to say 10%-15% body fat and super fit with abs. And when I take their age and current health into consideration, I let them know that while possible, the amount of change in their life may be quite drastic to achieve it. Especially if they are near the obese category on BMI.
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
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rheddmobile wrote: »MargaretYakoda wrote: »Tweaking_Time wrote: »Has your doc ever suggested you lose weight? If so, were you offended?
I asked my doc if she ever suggested people lose weight, eat better, exercise more, etc. She said that her answer would be mostly "No." When I asked her why she explained that being a doctor is a business and if she would critique each patients weight, she is sure she would lose patients, especially the easily offended ones. She also said if the patient asks her opinion about their weight, should would gladly help them with a diet/exercise plan.
My current GP first met me when I was about 160 and beginning to have problems with my balance. That was just over twelve years ago.
I had been on a weight loss journey then. I was running almost daily, and was in decent shape. Running. And did I mention the unicycle??? My true exercise love since I was a tween?
She watched as I got larger and larger.
Not once did she mention weight. Diet was mentioned. And alcohol. And I could see disbelief when I would say I rarely drink. Or that generally my diet was decent. (Obviously I was eating more than I was expending, but that was because of increasing disability) And a couple times in the early days I had to fight to get my thyroid meds properly adjusted. I also had to fight so much for my ADHD meds that I just stopped taking them and that hasn’t been my best decision either.
She also asked me what kinds of activities I liked. When I said I liked walking on the beach with my partner she told me that was “too dangerous” and that was my last walk on the beach. At the time I was using two canes.
When I told her I enjoyed using my small chainsaw to cut trash trees in my yard? She was absolutely aghast and told me I should not be using a chainsaw. The fact that it was very small, and I was sitting well braced on a firm seat? Meant nothing. So I stopped working in my yard.
I got no diet advice. I got no referral to a nutritionist. I got no advice for exercise I could do And - crucially - when I said something like “well, I feel like kitten all the time so it’s kind of hard to tell…” she didn’t order any blood tests except thyroid.
I developed a fatty liver. My cholesterol went up, which is against my genetics. And my BP went up, also against my genetics. All with no apparent concern from my GP.
Physical therapists I got sent to clearly thought I was faking my balance issues. Completely ignoring the fact that I used to unicycle all the time so my baseline balance is excellent.
Meanwhile I have other issues that the doctors just roll their eyes when I mention because obviously I’m fat. So I must just be looking for attention…. A hypochondriac.
Which is why I can’t feel my toes now. Because the people I trusted to advise me just looked at my size and my mystery balance issue and decided I was fat and stupid and lazy.
Doctors treating fat people as if being fat is their only problem is a very real issue. I was only a bit overweight when my current GP met me. And that was enough for her to mostly dismiss my concerns.
Oh. And she’s one of the better ones in my area.
That said? Body positivity is a good thing at any size. And doctors need to pay attention to their patients of all sizes
They generally don’t. And that likely has some effect on why larger people have worse health outcomes.
I know it absolutely was a factor in why I have neuropathy right now. If my doctor had encouraged exercise instead of shutting me down when I mentioned the things I liked to do even with my balance disorder? Or had encouraged me to find an assistive device that would make those activities safer in her eyes? Or had sent me to a nutritionist? Or done a simple fasting blood sugar???? I would have been able to reverse the diabetes in the early stages. I know this because my diet was already not that bad. And I was already exercising some. I just needed to be told to step it up a notch.
I am diabetic in some part because my doctor chose not to encourage me to exercise. Chose to only look at my fat and not my symptoms And that’s a big problem for a lot of overweight people.
Oh, this is a terrible story, I’m so sorry. There’s no excuse for not running a regular a1c, yet my doctor didn’t do it either.
Did your neuropathy improve at all with good glucose control? I ask because I used to have neuropathy in my hands and it mostly disappeared after a year or so with good control.
Off topic. I would love to explore in a different discussion if you need more information. But the answer is at this point is my control is super tight, has been since the diagnosis, and I’m only 4 months past diagnosis. AND the neuropathy may be caused by whatever is causing the balance issue and exacerbated by the diabetes but it’s still really too early to tell. But to me it felt as if it came on suddenly, and my glucose was never in the astronomical range. (A1C was 9.2 at diagnosis) and my doctor did change my chart from “diabetic neuropathy” to “idiopathic neuropathy” at my 3 month checkup. Without me mentioning it. And then she attempted to define “idiopathic” for me even though I didn’t ask and didn’t show any confusion when she used the word. I just smiled and said yes, I know.
Ha ha classism ….
There’s a type 2 diabetes group here. https://community.myfitnesspal.com/en/group/1772-type-2-diabetes-support-group We can discuss neuropathy there.1 -
I am late to the conversation here, but it just amazes me that people (both doctors and patients) have such an issue with the concept of the doctor mentioning the patient's weight. I am paying the doctor good money to help me manage my health in the best way possible, and as it has been well demonstrated and determined that excess weight is detrimental to my health, I EXPECT my doctor to mention it and then help me manage it - whether that be thru referrals to specialists or to simply schedule regular progress check-points to help keep me on top of the issue.
I don't think the doc should be a total *kitten* about my weight and to be totally dismissive about any health concerns I currently have (you know - 'lose the weight and it will all go away'), but seriously, I ditched my previous doctor for the one I am now seeing because he would rather manage the symptoms (high blood pressure, sugar and cholesterol) than try and get rid of the cause of those symptoms. The doctor I am now seeing has been absolutely supportive and one of my best cheerleaders in actually losing the weight to solve the issues.8 -
I am late to the conversation here, but it just amazes me that people (both doctors and patients) have such an issue with the concept of the doctor mentioning the patient's weight. I am paying the doctor good money to help me manage my health in the best way possible, and as it has been well demonstrated and determined that excess weight is detrimental to my health, I EXPECT my doctor to mention it and then help me manage it - whether that be thru referrals to specialists or to simply schedule regular progress check-points to help keep me on top of the issue.
I don't think the doc should be a total *kitten* about my weight and to be totally dismissive about any health concerns I currently have (you know - 'lose the weight and it will all go away'), but seriously, I ditched my previous doctor for the one I am now seeing because he would rather manage the symptoms (high blood pressure, sugar and cholesterol) than try and get rid of the cause of those symptoms. The doctor I am now seeing has been absolutely supportive and one of my best cheerleaders in actually losing the weight to solve the issues.
A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition
1 -
NVM - wrong thread.1
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Yes. My doctor mentioned my weight at my last physical and suggested I consider weight loss surgery. I love my doctor. He's direct and to the point. I told him "no" on weight loss surgery and jumped back here to MFP and organized a small group of friends to begin our weight loss journey. I am "morbidly obese" on the charts. It is what it is. I know it and just needed a push to get back to focusing on my health. I have a long way to go and while I'd love to be in the "normal" BMI category some day, the lower end of "obese" is still way better than "morbidly obese". So just like I step on the scale every day to see my progress, the BMI chart gives me an idea of progress and where I'd like to be. It's one marker of many that I'll be using as I move forward.12
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Yes I gained weight during the pandemic, as did many people. But I’ve been overweight (according to the crappy BMI system) my whole life DESPITE eating healthy for years.
I know MANY women who eat healthy and are relatively active but they are STILL overweight according to BMI.
In any population you are going to have some individuals who are naturally thinner and some that are naturally heavier. It’s called genetic diversity. Even if every individual “ate within the calorie allotment they’re supposed to” guess what? You are STILL going to see a range of weights among the population - some lighter, some heavier. Caloric intake is only ONE factor that influences an individual’s weight. Genetics also plays a major role. Not everyone is genetically predisposed to be in the “healthy” BMI range, which is a completely arbitrary range. Case in point: in the U.S. the “overweight” BMI range starts at 25, but in Asia, it starts at 23. It modified to fit that population, which is genetically predisposed toward lower weight.
There are plenty of women who are predisposed to higher weight. They eat right and exercise regularly and are STILL labeled as “overweight” according to BMI… even though they are at their natural body weight that genetics has predisposed them to, and would need to starve themselves with an unhealthily low caloric intake in order to get their weight any lower. No thank you!
Anyone who thinks an overweight person is automatically an overeater is just uneducated. There is so much more that influences a person’s weight than caloric intake alone.
[edited by MFP Moderators]5 -
Eating healthy and being 'relatively active' doesn't mean you cannot be eating more calories than you burn - which will lead to weight gain.
Yes, different racial groups ( and genders and ages) can have slightly different best BMI ranges - that is the sort of thing we mean by context.
Quite possible an older Asian woman will be healthy slightly under the standard BMI lower limit, quite possible a young muscular causcian man will be healthy at slightly over the standard BMI upper limit.
And of course you are going to see a range of weights, even amongst people who are a healthy weight.thats why healthy BMI is a range, not a single figure
But nobody is healthy far out of it.
You seem in a lot of denial.18 -
I saw my doctor today and was disappointed that he didn't mention my weight. I've lost 30+ pounds since my last appointment. Although I did get a 'good for you' for exercising. Lol
I normally don't pay attention to BMI so it was nice to see I've dropped out of Stage 3 obesity and am firmly in Stage 2. Another 25 pounds will put me in Stage 1. That's a good goal.17
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