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My brother tipped me off to this article in the NY Times about doctors having trouble talking to their fat patients about losing weight. It cites a report presented by the STOP Obesity Alliance (which makes me question the veracity of the report, but anyway...) that says that doctors actually aren't talking to patients about weight loss. The reason? Gee, they just don't know how! Poor doctors. See again, this article gets really close to the actual truth but doesn't quite make the connection. Doctors don't know how to get patients to lose weight and keep it off because nobody does! I do like that the point is made that doctors have a misconception that fat people are weak-willed and self-indulgent, but in the end all this article does is shift some of the blame for fatness from fat people to their doctors. Meh.

Why Gabby VS Hollywood debates annoy me. | HAES Retreat!!

vesta44's picture
vesta44
March 17th, 2010 | Link | Doctors have trouble talking

Doctors have trouble talking to their patients about losing weight? Yeah, but not in the way that article means. Doctors have NO trouble telling their patients they need to lose weight, and no trouble saying it's a matter of calories in/out, no trouble prescribing pills or WLS. Where the real trouble comes in is those doctors actually listening to their patients and believing what their patients tell them with regards to the effects of those diets/pills/WLSs.
Why do they think fat people avoid doctors for routine medical care and only go when it's a crisis and things are so serious that there's no other option? It couldn't be that fat people are tired of being told that they're fat and need to lose lots of weight yesterday, and oh, by the way, you're lying about how much you eat and exercise? It couldn't be that every ailment a fat person has is blamed on their fat (including colds, earaches, sinus infections, the flu, hangnails, etc, not to mention more serious ailments)?
So this article thinks blaming fat people for being fat isn't enough, now they have to blame doctors for not talking to fat people about the necessity for losing weight? Yeah, just what we need, more people pushing doctors to do more blaming/shaming of fat people.
Well, it won't work with my doctor. I don't think she wants me to go off on her again like I did the last time she brought up my weight (she thought a weight gain of 18 lbs over a year was something to be worried about, but that same weight loss over a year was nothing to be concerned over, when my weight can fluctuate by 10 lbs from week to week).

WLS - Sorry, not my preferred way of dying. *glares at doctor recommending it*

Bilt4Cmfrt's picture
Bilt4Cmfrt
March 17th, 2010 | Link | Ok, how about this; Instead

Ok, how about this; Instead of complaining that Dr's keep blaming our sinus infections on obesity and telling us to lose weight, how's about we flip the game completely. Start saying 'Nope. Dr. never said anything about my weight. No diet plans, no WLS recommendations. In fact it was the Doc who told me I should just give up and be as fat as I wanna be.' Then when they deny it or complain that they actually don't know how to 'talk to us about it' we could scapegoat THEM for this 'Obesity Crisis' and start calling THEM liars. Think about it, it's usually just the Dr & the patient. Who's to say otherwise?

Ok, that's pretty immature and probably wouldn't solve a whole lot. But the satisfaction of watching them sputter with indignation as they realize what it's like to have their integrity questioned or flat-out denied while KNOWING that there's not a lot they can do about it. At the, very, least they might know what it's like to walk a mile in a fat persons shoes.

"there's one form of intolerance I'm willing to defend, and that's intolerance of intolerance."
-Carolyn Hax
The Washington Post

Viola's picture
Viola
March 17th, 2010 | Link | My doctor, who recently left

My doctor, who recently left the practice so he could concentrate on Chinese medicine and his acupuncture practice, suggested the South Beach Diet to me several times, and even suggested WLS to my husband.

I was reading the comments and noticed several of them are suggesting that a doctor refer obese people to Overeaters Anonymous. But how much of obesity is actually caused by compulsive overeating? Is an eating disorder now defined as eating enough calories to maintain your weight?

DeeLeigh's picture
DeeLeigh
March 24th, 2010 | Link | Yes. Didn't you know that

Yes. Didn't you know that if you're fat, whatever amount of food you eat is a "binge" - even if you eat less than average? /sarcasm

worrier March 17th, 2010 | Link | I think that the vast

I think that the vast majority of people believe that diets work and that fat people are fat because "they're just lazy, greedy and making excuses". I think any evidence that diets don't work gets filed under the "just making excuses" catagory by these people. I don't think they even want to believe anything different. Unfortunately a lot of doctors also fall into this catagory. In New Zealand we've famously had a professor of nutrition announce in the media that if you put fat people in concentration camps, or tell them you'd shoot them if they didn't lose weight by a set date, then they would lose weight. I think we can take as read that putting all the weight back on again if they did lose weight would be filed under the "they're just lazy, greedy and making excuses" catagory. He also announced in the media that "we're too nice to fat people, we should stop being so nice to them". I think the vast majority of people think fat people should be lectured, bullied, forced into losing weight, because "they're just lazy, greedy and making excuses". This includes quite a lot of doctors. I feel very let down by doctors. Even the ones who do understand that diets don't work and know that we're not "just lazy, greedy and making excuses". Almost the only people who shout from the roof tops that diets don't work are our fellow fat people, and of course everyone knows "they're just lazy, greedy and making excuses". Where are the doctors and professors and academics who get it, and why aren't they shouting from the roof tops?

richie79's picture
richie79
March 17th, 2010 | Link | Heh. This reminds me of UK

Strange isn't it, how many doctors allegedly have a sudden crisis of confidence in their obesity rhetoric when faced with an actual real live fatty. It reminds me of me of UK Chief Body Fascist - sorry Medical Officer Sir Liam Donaldson's complaint that the *mere presence* of a fat audience member (FA infiltrator? Sticking out tongue ) at an obesity conference prevented the other delegates from discussing eradication tactics 'properly', whether for fear of giving offence or sparking the sort of debate that might have made them uncomfortable the article doesn't make clear.

"The patient survey, of over 1,000 adults, found that most obese patients — a definition that would apply to someone who is 5-foot-6, for example, and weighed 190 pounds or more — aren’t even getting the message that they’re obese. Only 39 percent of obese people surveyed had ever been told by a health care provider that they were obese"

Because being told 'you're fat' by a demi-God - sorry, GP is much more liklely to make us sit up and realise 'Oh yes! I am fat aren't I?! Better hit the gym!' than the daily drip-drip-drip of 'You're fat' from the media, schools, peers, family, colleagues, advertising...

Uh, no.

"In New Zealand we've famously had a professor of nutrition announce in the media that if you put fat people in concentration camps, or tell them you'd shoot them if they didn't lose weight by a set date, then they would lose weight"

Said crisis of confidence doesn't seem to stop them trying to get their names in the papers when they don't think they'll be challenged face to face, however, as this shows. Bunch of cowards really. Of course fat people lost weight in the starvation conditions of a Nazi death camp, like everyone else so incarcerated. What those invoking this dark example always neglect to mention however (as it rather undermines their argument) is that those fat people were probably over-represented in the numbers of those still alive at the end of it all, their greater reserves and thrifty gene conferring a survival advantage.

"When people fear the government, there is tyranny; when government fears the people, there is liberty." - Thomas Jefferson

rebelle March 17th, 2010 | Link | The doctor whose piece

The doctor whose piece Newsweek published this week certainly has no problem. In fact, she thinks doctors need to be more vocal about it because "lives are at stake." She also boils down "obesity" to four "Ds," and the first of these, you guessed it, is "denial." We're in denial that we're fat! We're in denial that our kids are fat! The sky, she is a falling. What is "needed," is more involvement from the health, education and media sectors, to tell us we are fat. Does this woman never pick up a newspaper or turn on the TV??? Holy shiz, there's not enough awareness?! Are you kidding me?

wriggle99 March 18th, 2010 | Link | Spare us yakking docs

Oh please with the delusions of grandeur. Because yakking doctors are going to re-route human biology are they? Give me strength.

It never ceases to amaze just how much absurd self aggrandizing can be sold to people- in this case the medical profession-on the back of the obesity crisis.

No wonder they love it so.

Dannan March 21st, 2010 | Link | I had to see a new doctor

I had to see a new doctor the other day, because my normal GP was on maternity leave. I was actually quite worried, because I thought what was coming was the dreaded pointless lecture.. over again. My normal GP gave me the lecture when I first saw her, and then mini-pointless-lectures every visit afterwards.

However, my new GP pleasantly surprised me.. She asked to weigh me 'for the records'. When she got my weight, she said 'Yep! Thats perfectly fine. You can step off the scales now.' and went back to the matter at hand (some pills for an illness I have). She was great! No lecture, no nothing - especially considering that I have put on a good few lbs since my last visit where my weight was recorded.. something my old Doctor would have really gone on about..

Everytime I've been to the Doctors previous, my weight has come up - when I havnt even gone in about anything to do with my weight! So this 'new' Doctor ACTUALLY behaving appropriately, focussing on the matter at hand, was awesome. Needless to say, I will be requesting to change to her permanently. Very efficient, and friendly, lady.

rebelle March 21st, 2010 | Link | It's good to hear that some

It's good to hear that some docs can stick to the topic at hand. I have a pretty good nurse practitioner right now. She does not bring up my weight. It is probably because, after learning the hard way (a doctor who kept exhorting me to lose weight, when I'd come in for an eczema problem!), I sent her office a fax stating they were to mark my file "do not weigh," to treat my complaint rather than attempt to treat my size, and not bring up weight-loss measures unless I asked them for that advice. But, all the same, she and the rest of that office have respected my request for three years and counting. Smiling

Alyssa March 25th, 2010 | Link | Do Doctors Discuss Obesity?

Thanks for sharing this article, and thanks for everyone's responses. I particularly like the idea of faxing my doctor(s) to place a "do not weigh" note in my file. Myself, I have had very mixed experiences with doctors on this issue over the years. My current peeve is specialists, like an allergist, whose office insists on taking my weight every visit. WTF? How is that relevant? When I refuse, the nurse gets huffy. Too bad.

About ten years ago, I had a primary care doctor PCP who suggested gastric bypass surgery. It was not a coincidence that the hosptial where she practiced had just opened a new "bariatric center" that specialized in WLS. I asked her if she was aware of the risks of WLS and high mortality rates and cited the stats. That shut her up. She had not done her homework. This was just a sales call.

My crrent PCP is a mixed bag. Ironically, she is fat herself, but she uses the technique " a 5% to 10% weight loss will improve your health." Yeah, right. I think this is a passive aggressive approach. I fully expect if I lost 5% to 10%, she would then tell me to lose 5% to 10% more and so forth and so forth.

I like to think fewer doctors bring up obesity and weight loss because they have read the statistics that 98% of those who diet lose weight gain it back, and secondly the medical establishment has no real "solution" for obesity other than lecturing and shaming, but I might be overly optimistic.

DeeLeigh's picture
DeeLeigh
March 25th, 2010 | Link | There is actually good

There is actually good evidence that being 5-10% below your maximum weight reduces health risks.

However, I've never had a doctor ask about my maximum weight before telling me lose 5-10%. I was told to lose 5-10% when I was maintaining a weight 20% below my maximum. They also don't ask how active you are before they tell you to exercise more, and they don't ask how much or how you eat before they start making assumptions and recommendations about diet.

The complete lack of logical thinking often makes me wonder how they made it through medical school. I find that I have less respect for the medical profession because of this kind of thing.

Beanietude's picture
Beanietude
March 25th, 2010 | Link | I hear that. I usually go

I hear that. I usually go into new doctor situations with a laundry list of stuff I do/don't do... I do exercise fairly regularly, I do cook everything from scratch, I don't eat out a lot or takeaways or ready-meals because I prefer cooking and, most notably, I don't drink alcohol... because I am highly allergic and it would, quite literally, kill me. So there I am with a consultant GYN, trying to get on the list for an endometrial ablation because I'm dangerously anaemic. She proceeds to tell me I can't possibly have the procedure under general anaesthetic because I'm too heavy... by 2-3 whopping great kg no less (shock and/or horror!). If I could just lose that small amount, I'd be cleared for surgery and, you know, there are easy changes I could make... like exercising, cooking from scratch and, my favourite, cut down on alcohol consumption. I let loose on the last suggestion, particularly as ALCOHOL ALLERGY was written in big red letters on the top of my file. "I can only assume you know how to read.." was my opener.

In the end, I went to a different hospital with more competent staff and had a pleasant (as pleasant as surgery can be, anyway) experience.

CastingPearls's picture
CastingPearls
April 6th, 2010 | Link | My sister's HMO doctor whom

My sister's HMO doctor whom she'd never seen before gave her a cursory exam, then informed her he was referring her to a nutritionist. She said, 'What for?" He said, "For your weight-problem" She said, "I don't have a problem with my weight. You do. You see the nutritionist."

All levity aside, since statistically around 80% of American are now at least 'overweight' that would include most of our doctors and other medical professionals. Although I am obese, I do observe nutrition information on nearly everything I consume and maintain as healthy a lifestyle as my condition allows.

In my case, my own doctor who says she weighs 50 lbs. more than she'd like asks ME for nutritional advice so how are we supposed to seriously consider medical suggestions when so many of them are as fat as we?

This same doctor, whom I trust and respect, has repeatedly stated that according to medical journals, a person of my size just doesn't 'exist' because my history, current health, and lifestyle defies all known data .

Also, I have to be extremely proactive and vigilant when I meet a new doctor or visit a hospital because BY APPEARANCES I should have diabetes and hypertension. However, in my case it's the exact opposite. I've had to nearly wrestle a hypodermic of insulin from a nurse who hadn't bothered to read my chart and would only read it after asking me if I was 'officially' refusing it and also having my bp checked and rechecked excessively because they'd rather assume their equipment was faulty than I might have HYPOtension.

This continued for two days until I demanded to see the patient advocate.

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