Don't Be Afraid to Talk to Your Doctor about Weight Loss
By: Birdie Varnedore, M.D.,
SparkPeople Blogger
8/16/2011 2:00 PM
: 48 comments
: 15,782 Views
Have you ever felt like your doctor was judging you or made you feel ashamed of your weight? Do you avoid seeing your doctor or postpone seeking medical care because you are embarrassed about your weight or want to avoid a potential lecture about weight loss?
Unfortunately your fears are not entirely unfounded. Many studies have shown that medical professionals do in fact stereotype obese patients. In September 2003, the journal Obesity Research (now called Obesity) published a study that revealed a weight bias among health professionals who work with obese patients. These professionals “significantly endorsed the implicit stereotypes of lazy, stupid, and worthless” using a self-report questionnaire. Not very comforting is it?
Despite studies such as this one, it is important that you do not let your fears interfere with your medical care. Lack of medical care in obese patients is a serious issue and can be harmful to your health. Studies have shown that obese patients are less likely to receive preventative care.
Do you think correcting the perception of health professionals will fix the problem? Yes, it will help, but there is another side to this story. Physicians are faced with the difficult task of potentially insulting a patient. Words must be chosen carefully. Doctors fear that patients may feel insulted by the subject of weight loss even if they did their best to bring up the issue of weight with compassion.
Because of these issues, the topic of weight loss frequently remains the pink elephant in the examination room and is addressed by no one. The obese patient receives inadequate care and the physician may feel like it is a no-win situation to try to encourage weight loss.
Physicians treat obesity-related conditions such as high blood pressure and diabetes on a routine basis. Many of these conditions can be prevented and/or controlled with diet and exercise alone. Often, physicians place their patients on medications to control the disease process without addressing the root cause.
Many Americans see their physicians only when they are unwell. They feel that if you walk out of the office without a prescription you have received inadequate care. For example, if a patient presents with an upper respiratory tract infection (a cold) and you tell your patient that there is no indication for antibiotics because they have a virus (which antibiotics don’t treat) they usually leave unhappy and may even find another physician who is willing to prescribe the antibiotic.
So instead of a lengthy dissertation about how and why antibiotics are prescribed or the risks associated with their overuse, many physicians give in to their patient’s misconceptions and write the prescription anyway. They avoid an argument or disagreement, and they know this patient will feel more satisfied that the visit was a good one.
This fear is only one reason why weight loss and exercise are rarely discussed. To make matters worse, studies show that a significant percentage of physicians actually feel inadequately trained to counsel patients about weight loss--myself included in my days before SparkPeople and my own weight-loss experience.
Still the biggest factor in why physicians aren't counseling patients about weight loss? Time. Your doctor literally does not have the time to teach you about how to change your entire lifestyle. Seasoned SparkPeople members know that just defining what the word calorie means is not going to cause you to change your life. This in no way is a five-minute conversation. Honestly, it is an unrealistic expectation for your doctor to be the main source of information regarding a healthy lifestyle.
So, on one side, we have the patient who feels (and in many cases is) judged and stereotyped by the physician. On the other side is the overworked physician who fears insulting--and possibly losing--the patient.
So, is there anything that you can do to bridge this gap? Yes!
You must take the initiative and tell your doctor your plan to lose weight. Remove the pink elephant from the room by bringing up the subject of your weight first so you and your doctor can have a productive conversation. Only then will you receive complete and adequate care.
Some tips for speaking with your physician about weight loss:
More than likely your physician will be thrilled that you have taken charge of your health. Having a plan and knowing what you need to do will remove the pink elephant in the room. Hopefully, everything that needs to be discussed regarding your health can be done without the fear of judgment on either side.
What if your physician does not seem receptive to your new take-charge attitude? It is vital that you feel your concerns are being heard and met by your doctor. If not, exercise your right to find a new doctor--one who makes you feel comfortable and who puts your health first.
Instead of feeling like, “I knew it! I knew my doctor was judging me!” Rest assured that not all physicians feel this way, but most importantly take charge of your health and get the care that you need and deserve!
Was your doctor supportive of your decision to lose weight? Does he/she tell other patients about SparkPeople? Have you ever had to "break up" with a health-care provider?
Dr. Birdie Varnedore, M.D., is happy to offer her expertise to the SparkPeople community; however, she cannot offer specific medical advice to dailySpark readers. Please do not share confidential medical information here. If you have a personal question or a concern about your health, please contact your health-care provider.
Unfortunately your fears are not entirely unfounded. Many studies have shown that medical professionals do in fact stereotype obese patients. In September 2003, the journal Obesity Research (now called Obesity) published a study that revealed a weight bias among health professionals who work with obese patients. These professionals “significantly endorsed the implicit stereotypes of lazy, stupid, and worthless” using a self-report questionnaire. Not very comforting is it?
Despite studies such as this one, it is important that you do not let your fears interfere with your medical care. Lack of medical care in obese patients is a serious issue and can be harmful to your health. Studies have shown that obese patients are less likely to receive preventative care.
Do you think correcting the perception of health professionals will fix the problem? Yes, it will help, but there is another side to this story. Physicians are faced with the difficult task of potentially insulting a patient. Words must be chosen carefully. Doctors fear that patients may feel insulted by the subject of weight loss even if they did their best to bring up the issue of weight with compassion.
Because of these issues, the topic of weight loss frequently remains the pink elephant in the examination room and is addressed by no one. The obese patient receives inadequate care and the physician may feel like it is a no-win situation to try to encourage weight loss.
Physicians treat obesity-related conditions such as high blood pressure and diabetes on a routine basis. Many of these conditions can be prevented and/or controlled with diet and exercise alone. Often, physicians place their patients on medications to control the disease process without addressing the root cause.
Many Americans see their physicians only when they are unwell. They feel that if you walk out of the office without a prescription you have received inadequate care. For example, if a patient presents with an upper respiratory tract infection (a cold) and you tell your patient that there is no indication for antibiotics because they have a virus (which antibiotics don’t treat) they usually leave unhappy and may even find another physician who is willing to prescribe the antibiotic.
So instead of a lengthy dissertation about how and why antibiotics are prescribed or the risks associated with their overuse, many physicians give in to their patient’s misconceptions and write the prescription anyway. They avoid an argument or disagreement, and they know this patient will feel more satisfied that the visit was a good one.
This fear is only one reason why weight loss and exercise are rarely discussed. To make matters worse, studies show that a significant percentage of physicians actually feel inadequately trained to counsel patients about weight loss--myself included in my days before SparkPeople and my own weight-loss experience.
Still the biggest factor in why physicians aren't counseling patients about weight loss? Time. Your doctor literally does not have the time to teach you about how to change your entire lifestyle. Seasoned SparkPeople members know that just defining what the word calorie means is not going to cause you to change your life. This in no way is a five-minute conversation. Honestly, it is an unrealistic expectation for your doctor to be the main source of information regarding a healthy lifestyle.
So, on one side, we have the patient who feels (and in many cases is) judged and stereotyped by the physician. On the other side is the overworked physician who fears insulting--and possibly losing--the patient.
So, is there anything that you can do to bridge this gap? Yes!
You must take the initiative and tell your doctor your plan to lose weight. Remove the pink elephant from the room by bringing up the subject of your weight first so you and your doctor can have a productive conversation. Only then will you receive complete and adequate care.
Some tips for speaking with your physician about weight loss:
- Come prepared to discuss how weight loss and the how losing weight will impact your medical conditions. Ask your doctor:
- How will my medications be affected by losing weight?
- Will my doses change?
- Should I come in for more frequent follow ups while I am losing weight so that we can check if it is time to adjust medications?
- SparkPeople. How can SparkPeople play a role? Bring your physician this handout and tell your him/her that this is the plan that you will be following. In the majority of cases, your physician will be supportive and interested in your progress. If you are successful, you physician will more than likely recommend SparkPeople to more patients. How’s that for spreading the spark?
- Get clearance. Make sure you have the green light to participate in the diet and exercise plan you have chosen. Find out if you need to modify your plan due to any restrictions you have been given. Be sure that you are clear on any restrictions given before you leave.
More than likely your physician will be thrilled that you have taken charge of your health. Having a plan and knowing what you need to do will remove the pink elephant in the room. Hopefully, everything that needs to be discussed regarding your health can be done without the fear of judgment on either side.
What if your physician does not seem receptive to your new take-charge attitude? It is vital that you feel your concerns are being heard and met by your doctor. If not, exercise your right to find a new doctor--one who makes you feel comfortable and who puts your health first.
Instead of feeling like, “I knew it! I knew my doctor was judging me!” Rest assured that not all physicians feel this way, but most importantly take charge of your health and get the care that you need and deserve!
Was your doctor supportive of your decision to lose weight? Does he/she tell other patients about SparkPeople? Have you ever had to "break up" with a health-care provider?
Dr. Birdie Varnedore, M.D., is happy to offer her expertise to the SparkPeople community; however, she cannot offer specific medical advice to dailySpark readers. Please do not share confidential medical information here. If you have a personal question or a concern about your health, please contact your health-care provider.
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Comments
He said to me that I was only just overweight and that I've probably gained a heap of muscle mass with all the exercise I've been doing. I know my body really well thanks very much and I KNEW it was fat!
He didn't offer any advice and just said that my waist measurement is in a good range to put me in the low risk range for weight related injuries and illnesses, and as far as he was concerned I should be ok with that. Well, thanks doc. That's really helpful. *grumble*. I guess he's just used to seeing the people who are quite overweight but don't want to admit or do anything about it. The idea that someone that's quite fit and isn't really *too* overweight and wants to do something about it is a bit of a novelty. - 11/3/2011 5:18:19 AM
I was rather shocked when she touted a branded weight loss system to me. I won't name them, but this is from their website
"The main objective is to raise Leptin Levels in the body. This consists out of a series of daily injections in conjunction with the taking of supplements and a balanced meal plan. The injections consist of a formula that raises your Leptin Levels which controls hunger and cravings. It helps to mobilise your fat out of the fat cells so that it can be used as energy."
I left and came back to Sparkpeople. Daily injections? Supplements? Not for me. - 11/2/2011 7:02:42 AM
I am very proactive. I am a nurse and I grew up with health issues. I have negotiated the health system for most of my life - as a patient and as a professional. I live in Canada where we are supposed to be very pro-active in health care, yet when it comes to weight it appears this isn't the case. There are still many barriers and prejudgements from professionals when dealing with the issue of weight. Until fat discrimination ends, there will always be issues and barriers when it comes to seeking medical support on this issue. - 9/27/2011 3:33:14 PM
Last time I did see a Dr. she put me on phen-fen for a year until they pulled it off the market.
I gained all the weight back plus much more.
I am down to that lowest weight now doing it the RIGHT and only way. Thanks to SP for the tools to succeed. - 8/18/2011 12:45:21 PM
His reply is always "Well, we won't worry about it right now!"
I'm sure having hypothyroidism is one thing that makes him wary, but is no help to me!
Sue - 8/17/2011 6:50:25 PM
Later, I had hormonal weight gains after I had mirena (google it, others have experienced it). yeah the dr gave me a lecture on NOT drinking my calories - i told her I only drink water or tea with stevia sweetener.
they don't believe you at all. drs don't believe that I eat eggs for breakfast, small amounts of steak, ezekiel bread, tons of veggies. they don't believe it.
they really think that I'm sitting around being lazy. they don't believe me about my back pain or any of it. - 8/17/2011 2:15:57 PM
As far as weight loss and health issues, she is an avid reader of the Times, so she is always very eager to chat about the latest research and methods. She never ever pushes me to do solve a problem using one solution; instead, she offers several solutions and lets me pick what I think is best.
Lastly, what my most favorite thing about my doctor is that she encourages me to ask questions. She's always saying "So what else is going on?" when I get quiet. I only recently learned that a doctor who wants to chat with her patients is unusual. I am very lucky! - 8/17/2011 1:31:17 PM
Through all of the various phases my body has gone through, she has consistently emphasized that, aside than the number on the scale or my appearance in the mirror, what matters is good nutrition, that I'm living an active lifestyle, and that my biochemistry is indicative of health, rather than being full of red flagfs. Although I'm overweight and have at times been borderline obese, I've never had high blood pressure or cholesterol and have always remained active -- I'm so lucky and happy to say that I've never felt judged by my doctor.
Interestingly, recent research shows that there are significant benefits in considering patients obesity in the context of their overall health using the recently developed Edmonton Obesity Staging System (full article at: www.ncbi.nlm.nih.gov/pubmed/2183860
2 ) which ranks obesity into "stages" based on mortality risk, as is already done for conditions like diabetes and cancer. The ranking is based on the persons overall health, rather than just the degree of their obesity, and shows that obese people who are otherwise healthy don't share the disproportionately high risk of mortality that their less healthy counterparts do. Interesting research, which will hopefully help healthcare professionals assess risks and make recommendations for obese patients. For professionals who may be tempted to see their obese patients as "fat" stereotypes, hopefully research like this will also open up their thinking! - 8/17/2011 12:47:14 PM
The doctor I saw most recently was judging me as well.
I don't plan to share my weight loss journey with a doctor! - 8/17/2011 11:09:24 AM
Finally now I'm with and MD/Nurse Practioner duo who are completely supportive of the healthy changes I've made. Every time I see one of them they just gush over how great I look, how great my lab results are and keep up the great work! The nurse even wrote down SP's web address and taped it on a cupboard door, saying she was going to reccomend SP the next time someone asked about weight loss! - 8/17/2011 11:05:18 AM
My current doctor is supportive but happy to remain in the background unless I have specific questions. Her view is that anything I'm doing which is more than I did for the 20 previous years (which was nothing) is a huge improvement, and that small steps will lead to great strides. The difference is that I leave her office knowing I'm moving in the right direction, and not feeling like a failure. - 8/17/2011 9:08:59 AM
Don't be afraid to talk to the doc, but have lots of support and skills to cope if it doesn't go well. - 8/17/2011 7:28:25 AM
I just need to get over my sensitivity, and realize some things he just is simply wrong. Additionally, he absolutely doesn't understand about muscle gain, and to him all fat is equal. - 8/17/2011 4:00:38 AM
RIGHT!
I know I have Metabolic Syndrome/Insulin Resistance and my Triglycerdies was 550 (normal is under 150), so I found Sparks on-line and did something about losing weight for myself. - 8/16/2011 11:50:06 PM
What I find absolutely appalling is the doctors who don't treat conditions when a patient has a lot of weight to lose. Two family members have been totally dismissed, told only to lose weight, as if that'd cure the problems. One went ahead on her own, with dietary changes, OTC diet pills, exercise, and lost 100+ pounds, only to have her symptoms continue with the same severity. PFFTTTT.
My doctors have been startled by my test results, standard blood tests, stress test, etc... as if they could not believe I had completely healthy levels despite being quite a bit heavier than I "should" be. When one doc scheduled my test, he didn't say we'd see if I had a problem; he actually said the test will show us how severe the problem is... and there was absolutely none. Then I couldn't get his office to send those test results to my family doctor. What, did he think the test was in error??
I miss my dearest doctor, who closed her practice to move out of the country to join her grown children. Otherwise, I have little faith or respect for doctors I have encountered and go only when I absolutely positively need to do so. If your doctor is supportive, go ahead, and discuss your nutritional plans etc. I think it should be patient intiated, as one commenter wrote. - 8/16/2011 6:48:44 PM
I for one, honestly, and I do mean honestly, AM NOT AN OVEREATER, NOR AM I LAZY. But there are a few people that view many, as such. I have a wonderful doctor now, and work with her very well. I am already scheduled for my annual checkup in September (before I leave any office, I make my next appt, mark my calendar, and follow through) and I have already copied my SPARKPEOPLE letter for my doctor and Spark cards! I can't wait to go...spread the SPARK!
- 8/16/2011 6:37:31 PM
I'm not talking about the care-nothings, but the good ones who are up against it with intransigent, or simply stuck, patients.
I LOVE the letter/handout. If I were changing doctors I would definitely take that with. - 8/16/2011 5:14:09 PM
He has also been teaching me to listen to my body about how fast to go,what foods to eat, etc. When I eat, I should write down how I feel afterwards. That'll help me stay away from things I should not be eating.
The bad part to me is that these preventative type appointments are not covered by my insurance. They will pay the fee if I go there for a "problem" but not if I am going to talk about weight loss. That part really bums me out, but I go and pay the fee. The system is messed up. If people are trying t get healthy, they should not have to pay more. We'll be costing the insurance company less in the long run. Sorry for the rant.
I think discussing your weight loss goals with your doctor is one of the best things you can do. When mine tells me that I'm doing a great job, I just beam with pride and excitment! - 8/16/2011 3:53:39 PM
I have printed the handout from above and have printed off my nutritional report as well as my fitness reports for the past month. I see my doctor this Friday and am looking forward to it.
I had bloodwork done a few weeks ago and it came back very good, which suprised my doctor because I am 112 pounds overweight. Being overweight doesn't always mean that your bloodwork will be bad, but it is still unhealthy. It is hard on my joints and I'm sure it's hard on my heart and other organs. Now is the time to get my body in tune with my bloodwork and get everything healthy.
My doctor is learning, through me, that some people do want to take the next step to a healthy lifestyle and not to judge people by thier size. - 8/16/2011 3:38:52 PM
On the other hand nothing will work until the person is ready to do it for themselves!
My doctor would mention my weight and I did dread going to him because I hated to hear "the talk". But when I was finally ready to do something -- watch out! Now my doctor likes to use me as a "good example" -- he once told me "Its a pleasure to have you visit...for every person like you there are 9 more out there that just give me excuses." And to be fair I told him "Remember, it wasn't that long ago that I was one of the nine!"
And obesity CAN affect issues like the flu... before I lost weight I would get bronchitis and other such infections at LEAST once or twice in the cold weather.. since I've lost weight... I don't get sick as easily or for nearly as long. - 8/16/2011 2:36:37 PM
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