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Does your doctor comment on your weight?

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  • ninerbuff
    ninerbuff Posts: 48,964 Member
    ninerbuff wrote: »
    EyeOTS 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 agree with you to a point. I hate BMI as a standard because for me it COSTS me more money. How? Well my life insurance policy is higher due to me being "very overweight and bordeline obese" based on BMI. And there's NO WAY if you saw in me real life that you'd say that.
    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

    9285851.png

    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.
    Agree with you completely.
    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

    9285851.png


  • MargaretYakoda
    MargaretYakoda Posts: 2,985 Member
    edited July 2021
    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.
  • ninerbuff
    ninerbuff Posts: 48,964 Member
    ccrdragon wrote: »
    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.
    Well at least that's one thing you'll get from me. No *kitten* footing about weight and how it can affect their long term health when I speak to a possible client. I do intros all the time and sometimes you need to let them know where they really stand because it's been dismissed for a long time and they hadn't had concerns until they come in.


    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

    9285851.png

  • AnnPT77
    AnnPT77 Posts: 34,133 Member
    edited July 2021
    NVM - wrong thread.
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
    lokihen wrote: »
    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.

    Yay!
  • autobahn66
    autobahn66 Posts: 59 Member
    When I got hired for my job, I had to have a physical done. The doctor that was performing the physical said that I was 2.2 LBS away from being what he considers overweight. I am 5'6" and was 130 lbs at the time. I also had a very low body fat. I don't know if there is something that i am missing when it comes to what classifies as overweight but i did not consider myself such. I have recently bulked up to 175. I am still only around 16% bodyfat but i do feel the affects of being heavier. Is there a reason that the doctors standard always feels so much lower than mine% is it because i spend to much time in the "bodybuilding" community?

    A doctor doing a routine company physical has a box to tick: BMI normal, overweight, obese. They may be paid or contracted based on giving dietary or weight related advice. Those few words are enough for the doc to write down: "Discussed weight, noted BMI in normal range but close to overweight category." The issue is that BMI is a gross calculation that is useful on a population level and sometimes for an individual to track weight over time, and as a screening tool. As a tool for determining an individual's actual health though, it has significant limitations.


    As for lower standards? A decent majority of people a doctor sees are overweight or obese, and I would venture most to far less than the recommended level of physical activity. So when confronted with someone who is generally around the upper limit of a normal BMI, who clearly exercises, their input is limited. They are going for the low hanging fruit of encouraging a person who does nothing to do literally anything active...
  • autobahn66
    autobahn66 Posts: 59 Member
    lemurcat2 wrote: »
    autobahn66 wrote: »
    When I got hired for my job, I had to have a physical done. The doctor that was performing the physical said that I was 2.2 LBS away from being what he considers overweight. I am 5'6" and was 130 lbs at the time. I also had a very low body fat. I don't know if there is something that i am missing when it comes to what classifies as overweight but i did not consider myself such. I have recently bulked up to 175. I am still only around 16% bodyfat but i do feel the affects of being heavier. Is there a reason that the doctors standard always feels so much lower than mine% is it because i spend to much time in the "bodybuilding" community?

    A doctor doing a routine company physical has a box to tick: BMI normal, overweight, obese. They may be paid or contracted based on giving dietary or weight related advice. Those few words are enough for the doc to write down: "Discussed weight, noted BMI in normal range but close to overweight category." The issue is that BMI is a gross calculation that is useful on a population level and sometimes for an individual to track weight over time, and as a screening tool. As a tool for determining an individual's actual health though, it has significant limitations.


    As for lower standards? A decent majority of people a doctor sees are overweight or obese, and I would venture most to far less than the recommended level of physical activity. So when confronted with someone who is generally around the upper limit of a normal BMI, who clearly exercises, their input is limited. They are going for the low hanging fruit of encouraging a person who does nothing to do literally anything active...

    Just for the record, I think this is way too much of a generalization about doctors. A doctor who relied on assumptions like that and didn't have an actual conversation and assessment about fitness is IMO a bad doctor. Also, it can't be just relying on BMI, since the BMI was nowhere near overweight. If the doctor was used to dealing with overweight/obese and inactive people (which seems likely enough), they should be immediately able to see the difference.

    I'll be honest: I didn't redo the calculation myself and I work in cm and kg, so didn't catch the the calculation was out!

    But as to the second part: it depends very much on the specific role of the doctor. A full evaluation of diet and fitness takes way more than even a single appointment. It takes anthropometric and functional tests. Review appointments to assess food diaries and weight change over time. It is a massive investment of time for a doctor (which is why most of these things are done by dieticians or nurses in a multidisciplinary appointment)

    This will happen in a weight management clinic, definitely should happen in metabolic/diabetes clinics and would be of great benefit in a general clinic. But the reality is, unless you are specifically there to discuss weight management, at least in the part of the world I am, there is virtually no chance of a full and proper assessment of weight or weight management. I guess YMMV depending on location and other factors, but the reality is that a doctor who is not being paid to specifically care about your weight and activity levels probably just wants to know where you fall on a BMI chart and whether you do 30 mins of activity every day. And even if you are overweight or obese, or completely inactive, the intervention that will be offered is almost certainly going to be "lose weight, do more activity".

  • claireychn074
    claireychn074 Posts: 1,590 Member
    @lemurcat2 i think it depends on where you’re based. In the UK doctors (GPs) have on average 10 mins per person, and they need c3mins to write up notes so you basically get 7 mins to discuss issues. I get weighed regularly owing to endocrine issues and they will always go through the “BMI tick box”. I did have a v short conversation when I’d put on nearly 2kgs over one year but they usually just want to move onto other stuff. It’s not ideal, but the NHS is massively overstretched. I rarely get asked about my exercise or diet as they just don’t have time 🤷‍♂️
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
    edited July 2021
    autobahn66 wrote: »
    But as to the second part: it depends very much on the specific role of the doctor. A full evaluation of diet and fitness takes way more than even a single appointment. It takes anthropometric and functional tests. Review appointments to assess food diaries and weight change over time. It is a massive investment of time for a doctor (which is why most of these things are done by dieticians or nurses in a multidisciplinary appointment)

    It really doesn't (and I would expect a referral to a dietitian if that kind of diet evaluation was needed or if I'd wanted weight loss help).

    Example of what my doctor does is in the thread already, but I'll repeat. Doctor: technically you are a bit over the healthy BMI (I was around 26.5) but seem fit, your blood pressure is good, tests are good (I forget what the doctor had at that point, but also I got other usual tests that were reported later) so it's probably not an issue. How's your diet/exercise? Me: training for a half marathon, and I know I'm a bit over, I'm actually losing weight right now, blah, blah on general diet. Doctor: what's your goal weight and process for losing? (Checking to make sure I wasn't crash dieting or have an unreasonable goal, I assume.) Me: 120, I'm just using MFP, losing about a lb/week. Doctor: that seems great, not too aggressive, that's a healthy weight for you. This was overall a super short conversation.

    If I'd thought BMI was not reflective of my actual risk due to BF% or waist to height (which my doctor was already ready to believe), I would have expected her to maybe do the waist measurement as a backup.
  • glassyo
    glassyo Posts: 7,733 Member
    Awwwww my post got delete. Probably for the best because I did end up with low key posters remorse but do you know how long it took to write that??? How I salivated all over my tablet remembering the good old days? 😀
  • paperpudding
    paperpudding Posts: 9,265 Member
    autobahn66 wrote: »
    lemurcat2 wrote: »
    autobahn66 wrote: »
    When I got hired for my job, I had to have a physical done. The doctor that was performing the physical said that I was 2.2 LBS away from being what he considers overweight. I am 5'6" and was 130 lbs at the time. I also had a very low body fat. I don't know if there is something that i am missing when it comes to what classifies as overweight but i did not consider myself such. I have recently bulked up to 175. I am still only around 16% bodyfat but i do feel the affects of being heavier. Is there a reason that the doctors standard always feels so much lower than mine% is it because i spend to much time in the "bodybuilding" community?

    A doctor doing a routine company physical has a box to tick: BMI normal, overweight, obese. They may be paid or contracted based on giving dietary or weight related advice. Those few words are enough for the doc to write down: "Discussed weight, noted BMI in normal range but close to overweight category." The issue is that BMI is a gross calculation that is useful on a population level and sometimes for an individual to track weight over time, and as a screening tool. As a tool for determining an individual's actual health though, it has significant limitations.


    As for lower standards? A decent majority of people a doctor sees are overweight or obese, and I would venture most to far less than the recommended level of physical activity. So when confronted with someone who is generally around the upper limit of a normal BMI, who clearly exercises, their input is limited. They are going for the low hanging fruit of encouraging a person who does nothing to do literally anything active...

    Just for the record, I think this is way too much of a generalization about doctors. A doctor who relied on assumptions like that and didn't have an actual conversation and assessment about fitness is IMO a bad doctor. Also, it can't be just relying on BMI, since the BMI was nowhere near overweight. If the doctor was used to dealing with overweight/obese and inactive people (which seems likely enough), they should be immediately able to see the difference.

    I'll be honest: I didn't redo the calculation myself and I work in cm and kg, so didn't catch the the calculation was out!

    But as to the second part: it depends very much on the specific role of the doctor. A full evaluation of diet and fitness takes way more than even a single appointment. It takes anthropometric and functional tests. Review appointments to assess food diaries and weight change over time. It is a massive investment of time for a doctor (which is why most of these things are done by dieticians or nurses in a multidisciplinary appointment)

    This will happen in a weight management clinic, definitely should happen in metabolic/diabetes clinics and would be of great benefit in a general clinic. But the reality is, unless you are specifically there to discuss weight management, at least in the part of the world I am, there is virtually no chance of a full and proper assessment of weight or weight management. I guess YMMV depending on location and other factors, but the reality is that a doctor who is not being paid to specifically care about your weight and activity levels probably just wants to know where you fall on a BMI chart and whether you do 30 mins of activity every day. And even if you are overweight or obese, or completely inactive, the intervention that will be offered is almost certainly going to be "lose weight, do more activity".


    there seems a bit of confusion here - the poster you quoted was getting a pre employment medical - of course the doctor wasn't going to discuss weight management in detail or do a referral or anything else , he/sh e isnt even the patient's treating doctor, it is a company paid pre employment assessment, not a medical consultation

    How/why the doctor made a comment about poster being overweight is unclear - certainly nothing to do with 'healthy but over the upper BMI limit" - if her BMI was 21 :*

  • LGreenfield7
    LGreenfield7 Posts: 75 Member
    lemurcat2 wrote: »
    autobahn66 wrote: »
    When I got hired for my job, I had to have a physical done. The doctor that was performing the physical said that I was 2.2 LBS away from being what he considers overweight. I am 5'6" and was 130 lbs at the time. I also had a very low body fat. I don't know if there is something that i am missing when it comes to what classifies as overweight but i did not consider myself such. I have recently bulked up to 175. I am still only around 16% bodyfat but i do feel the affects of being heavier. Is there a reason that the doctors standard always feels so much lower than mine% is it because i spend to much time in the "bodybuilding" community?

    A doctor doing a routine company physical has a box to tick: BMI normal, overweight, obese. They may be paid or contracted based on giving dietary or weight related advice. Those few words are enough for the doc to write down: "Discussed weight, noted BMI in normal range but close to overweight category." The issue is that BMI is a gross calculation that is useful on a population level and sometimes for an individual to track weight over time, and as a screening tool. As a tool for determining an individual's actual health though, it has significant limitations.


    As for lower standards? A decent majority of people a doctor sees are overweight or obese, and I would venture most to far less than the recommended level of physical activity. So when confronted with someone who is generally around the upper limit of a normal BMI, who clearly exercises, their input is limited. They are going for the low hanging fruit of encouraging a person who does nothing to do literally anything active...

    Just for the record, I think this is way too much of a generalization about doctors. A doctor who relied on assumptions like that and didn't have an actual conversation and assessment about fitness is IMO a bad doctor. Also, it can't be just relying on BMI, since the BMI was nowhere near overweight. If the doctor was used to dealing with overweight/obese and inactive people (which seems likely enough), they should be immediately able to see the difference.

    I found the doctors comments interesting. My Physio therapist always told me that I looked incredibly healthy around 130 and that he was jealous. While donating blood the nurses would always suggest that I put on a little more bodyfat due to the fact that I had veins very close to the surface and it would make hitting the vein difficult. I wonder if he had to come up with something to note for my employer. I was a swimmer so my lung health was phenomenal, I had recently had laser eye surgery so sight couldn't have been a problem, and I hear well beyond the average person. IF this is the case.... is this really the level of politics that are involved in our workplaces and medical fields... Curious as to how you guys all feel.