My Doctor is an idiot!

He must be related to my last doc. The one that tried to take my blood pressure reading manually, and put the cuff on inside out ( with the gauge against my arm). Twice.

I fired his *kitten* on the spot.

I went to the doctors (OB/GYN) today to get my test results. The results were perfect. I asked him what he would reccomend for diet. I was being tested for PCOS, cysts, ect. He asked me what I was currently eating. I told him that I was eating 1500 calories a day, working out 5-6 days week. I assured him that I made sure I netted 1200 calories and that I recently dropped my carb intake to 100g sticking to mostly clean eating.

He then went on to tell me that I could easily eat 1000 calories and work out. I told him that I believed that would make me net 500-600 calories most days. He that was fine. He then went on to ask me how often I weigh myself. I told him probably 2x/week. He then reccommends that I weigh myself everyday to see the gains/losses. He told me that when he sees a gain from the day before he will not allow himself a treat such as ice cream that night.

What the eff!! I think I was just perscribed anorexia!! I have 40 pounds to lose, not that much. The medical student behind him was stunned and shaking her head, "no" to me as he was speaking.

I am horrifed. Not just for me, but what about a younger, less knowledgable girl? He just green lighted an eating disorder. I think I am going to call the office manager on Monday. I had just switched OB's as my private practice provider retired.
The search is on again.

Is this crazy? What would you do?

This is the third story I've heard in the past few days stemming from a PCOS consult and diagnosis. Nutrition is important in woman with PCOS and an OBGYN should be able to give appropriate and correct advice to patients with the condition. In a word... Yes! Find another doctor if you've been diagnosed cause it's important to get great medical advice and treatment. Good luck to you!

When you think about it, asking a Gyn about nutrition is like asking a tire salesman how to replace a head gasket. (Though I'm not trying to dissuade you from putting in a complaint if you feel it's the right thing to do.)

We've been lied to and conditioned for such a long time in the thinking that and corn oil and supposed "good carbs" such as whole grains are good for us and that animal fats are bad. Many people (including some doctors) are not ready to hear that it's been incorrect information all along and that the nutritional pyramid is upside-down. As long as your doctor is qualified to take care of the gyn subjects, leave him to that and continue to do exactly what you're doing. I know it's frustrating to know that he may be giving bad nutritional advice to expectant moms, but when you think about it, so are the rest of the...ehem.... "nutritional experts".

I agree. But who are the nutritional experts? It seems if there is not an underying condition (diabetes/PCOS/obesity/HBP) than there really isn't an authorrityThe RD I went to didn't seem concerned with my extra weight as I am otherwise very healthy. It seems that I need to find a RD with a specialty in vanity. lol.. I have no medical issues that I know of, I really want to lose 40lbs, it's really not budging, can you help me? The answer seems to be "no" in the medical world. It's no wonder Jenny Craig, Nutrisystem, ect are so damn popular.

Seriously... it must have just been that woman you went to. I know plenty of RDs who do weight loss counseling without any other medical conditions present. Overweight should be and IS a medical issue in my opinion. If it's not controlled it can lead to heart disease, diabetes, hyperlipidemia, etc. Is it possible you could find another dietitian to consult with?

he should have referred you to a dietician or specialist. I personally think you're over reacting, you don't have to follow his advice on weight loss, but I doubt hes going to kill you during a pap smear.

I'd trust any MD over any dietitian or nutritionist.

I've never in many years of reading about weight loss heard of 'net calories', before landing here last month. Sorry but I agree with your doctors. 1000 calories plus exercise really is nothing extreme or dangerous.

I sometimes wonder what all the WLS patients who must read here and are on doctor supervised low-cal diets must be thinking of all the eating disorder/starvation fears here, based on diets much less aggressive than their own.

I know, here comes the pile-on of the internet dieters who know more than the medical profession, thanks to all the great stuff they've read on MFP.

That is seriously messed up. regarding what everyone says about him being OBGYN and not knowing nutrition -- that may be true, but it doesn't stop him from spewing b*llsh*t to his patients. I would also worry about any impressionable person or someone recovering from ED.

I've had unsolicited advice from doctors. What I've done is say thanks but no thanks or politely shift the conversation toward the concerns I came to see them for. I want to be more firm and direct next time, though.

I would book an appointment with the medical student.

I am actually also in the helping field, though not medical...more counselling. If I am "not qualified" to deal with a person with PTS, or TRAUMA...i need to refer the client to someone who does have the proper knowledge and qualifications to help effectively. SOME people (including doctors..believe it or not)...pretend to know more than they actually do. I think the idea that "drs know everything" is bs - and people need to realize that.

He really should have referred you to a qualified person. We all like to act like know-it-alls at times, which can be incredibly unhealthy and damaging to people who don't have the mental capacity to apply critical thinking.

I went to the doctors (OB/GYN) today to get my test results. The results were perfect. I asked him what he would reccomend for diet. I was being tested for PCOS, cysts, ect. He asked me what I was currently eating. I told him that I was eating 1500 calories a day, working out 5-6 days week. I assured him that I made sure I netted 1200 calories and that I recently dropped my carb intake to 100g sticking to mostly clean eating.

He then went on to tell me that I could easily eat 1000 calories and work out. I told him that I believed that would make me net 500-600 calories most days. He that was fine. He then went on to ask me how often I weigh myself. I told him probably 2x/week. He then reccommends that I weigh myself everyday to see the gains/losses. He told me that when he sees a gain from the day before he will not allow himself a treat such as ice cream that night.

What the eff!! I think I was just perscribed anorexia!! I have 40 pounds to lose, not that much. The medical student behind him was stunned and shaking her head, "no" to me as he was speaking.

I am horrifed. Not just for me, but what about a younger, less knowledgable girl? He just green lighted an eating disorder. I think I am going to call the office manager on Monday. I had just switched OB's as my private practice provider retired.
The search is on again.

Is this crazy? What would you do?

Okay, let me try and be constructive here. I am not an OBGYN but I am a physician and I have some nutrition background.
The only thing you should probably ask your OBGYN (who is not a registered dietician - do you know there was not one book on nutrition in an entire Medical Book Store I looked in) is what foods are off limits in PCOS (see below).

http://www.3fatchicks.com/living-with-pcos-4-foods-to-avoid/

Otherwise you should speak to a RD. I'm not going to get into the 1200 calorie limit (which is set mainly to make sure most people get the macro and micro nutrients they need). I have patients that will not lose weight unless they get a diet of 900 calories a day becasue their RMR (resting metabolic rate) is so slow (quadraplegic). You're RMR can slow to 30 percent of what it should be when you get your calorie counts down to 900 (in the average person) but you still lose weight, just at a much slower pace.

IF you don't have PCOS then I based on available knowledge and scientific study you are taking in too few carbs. There are specific requirements for the average athelete - women and men - but diet plans need to be taylored to your build (how much muscle you have, etc).

The general recommendations (see Sports Nutrition: A Manual for professionals 5th edition for a summary) as follows:

Protein 1.0 grams per kilo per day (kilo = 2.2 lbs - ie 22 lbs = 10 kilos), moderately active aerobic 1.2 - 1.4 grams per kilo, resistance training 1.4 - 1.7 grams per kilo per day with some bodybuilders doing 2.0 grams protein per kilo per day. There is no evidence that numbers over this amount are useful).

Carbs: Less than 60 min of activity a day - 2 grams per kilo per day.
60 minutes of moderate activity 3-5 grams of carbs per kilo per day
1-3 hours of exercise per day 5-7 grams of carbs per kilo per day
4-5 hours of exercise per day (ie training for tour de France) - 8-12 grams of carbs per kilo per day.

The problem with consuming less carbs than this is that you will not be able to optimize performance or endurance at lower levels. The "percentage" of your diet that is made up of carbs is not as important as the absolute number.

Having said this...you can see why dieting and exercising for prolonged periods can cause a perceived problem - especially amoung women atheletes trying to maintain lean body mass while gaining stength and stamina.

Remember: Eat too many carbs and you get fat stored. However, this is about optimizing the right amount of carb for you so that you can exercise hard, get stronger, but still lose weight. Muscular builds have higher requirements than lean. So keep this in mind. The reason your question is too vague to answer appropriately is I'd have to know a lot of specifics such as what your diet consists of, not just how many calories. I'd tell you to eat heart healthy fats high in Omega 3/low in omega 6 and after exercise make sure to take in carbs with both high and low GI (Glycemic Index / and glycemic loads). I'd also need to know what kind of exercise you do and how long.

It gets more complicated too. Just as an example...rebuilding glycogen stores is what helps you recover. To do that you need carbs and protein. Did you know that Fructose (sugar found in fruit) is the least effective at helping rebuilding glycogen stores? In addition it helps to have a mix (ie sucrose, maltose, fructose, glucose) because the "carriers" that help carry these building blocks into the cell are speciific for each type of sugar. So if you take in a lot of glucose you can't use it all because the carrier is full like too many people trying to get into the elevator. If you add three different sugars they get carried in by three different carriers and that helps get glycogen synthesis done quicker aiding in recovery.

Sports drinks that combine carbs and protein and different kinds of carb sugars are preferred and convienent...but not always necessary. If you are exercising less than 90 min a day you might not need to know any of this.

For the OP or any of you that might have questions, feel free to ask. If I don't know the answer, I'll try to find out from a licensed source. These are not specific recommendations for anyone out there....just general knowledge in sports medicine. You should ask your physician and a dietician for specific advice that pertains to you!








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