Poll: Is it a Doctor's Responsibility to Lecture Their Overweight Patients?

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By: , SparkPeople Blogger
8/15/2009 5:40 AM   :  386 comments   :  16,514 Views

Earlier this week I was reading over some of the message boards when I came across a member who was asking if she should change physicians given that every time she went to the doctor she was told she was obese and needed to lose weight.

How many of us have heard these words, "If you just eat less and move more the weight will come off. I will see you next time." You spent the better part of 10 minutes or less of your appointment being lectured about the obvious, but getting no real help.

For me, I have been on both sides of this issue. I have been to doctors who never once mentioned to me that I was well in the obese category even though I was clearly obese, while others were more than eager to pick apart each and every flaw of mine. With the second scenario, I honestly dreaded going to the doctor. I would literally wait until the last minute before calling for an appointment. My doctor was so condescending. I knew I was overweight, but he did nothing to help guide me except to tell me to eat better and exercise more, then he would look over his glasses and tell me I just needed better discipline. Well, as you can probably guess, that didn't sit well with me considering he was not quite so fit himself. So I did what many of us do and that was to find another doctor or I just didn't go anymore.

Last week I viewed a re-run of Oprah's interview with a woman named Ruby who once weighed 700 pounds. She now has her own reality show chronicling her journey to lose weight and reclaim her life. During the interview, I was surprised to hear her say that even at her heaviest weight her doctor never once said anything about her weight being a health issue. She found that to be so ironic when this same doctor would mention the weight issue to other less obese patients. When asked why--her take, he just didn't know what to say.

So what are we and the health care industry to do?

I believe it is a doctor's obligation to tell their patients what they don't necessarily want to hear but what they need to hear. But doctors also need to provide the resources to their patients. Berating patients about what we already know, at least to me, is wasted energy. That's like telling me there is something wrong with my car because the check engine light is on and then not telling me what the problem could be.

Having a positive relationship with my doctor, as well as an open dialogue, has made a huge difference in how I approach going to my doctor. It took me a few appointments with many doctors to find the right one for me. Five years ago I finally found a physician who spent time with me explaining the consequences of my bad habits. She did not belittle me, but she did not ignore the fact that I was obese either. I feel we are a team working together to keep me as healthy as we can.

Shame and making embarrassing comments about a patient's weight does nothing to change behavior. However, education, compassion, and understanding may be a start to a healthy relationship doctors can develop with their patients . If a doctor doesn't have time and/or knowledge to discuss the changes their patients need to make, then providing them with access to a nutritionist, dietitian or maybe even referring them to SparkPeople is a step in the right direction for both patient and physician.

Do you avoid going to your doctor because you do not want to be berated about your weight? Have you had to switch health care providers because you felt you weren't getting the guidance you needed? Do you believe obesity is a complex issue that requires a multi-prong approach to tackle the issue?


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Comments

  • 386
    I had a woman doctor actually tell me how overweight I was and that my children were going to be fat too right during a "woman's special" exam. She told me I needed to eat less junk food and more Ezekiel bread. I was actually eating that brand of bread at the time, and I wished I had a receipt from my grocery trip with me. I felt so discouraged it took me a while to see another doctor.
    I think that doctors should give their patients the information on what a healthy weight could be for them, and then refer them to a dietitian or another clinic to help. I do think it is wrong to never bring it up, but it is also unhelpful to bring it up and then not want to really discuss solutions. On another note, I hope that doctors are also evaluating people for being underweight, as this also has associated health risks. - 8/5/2011   11:22:12 AM
  • RUSSELL_40
    385
    I have CHF.. and diabetes.. I weighed 361 when diagnose.. and for 8 years they worried about my heart... then I got assigned a nutritionist for 6 months in 2009... have lost 96 total... about 75 since 2009... and no longer take diabetes meds, and half of the heart meds...I believe it is the duty of the doctor to point out that while THEIR concern is the heart,lungs etc.. YOUR focus should be a good diet with exercise... otherwise you are only getting 1/2 the benefits... and yes, they told me I should lose weight a few times.. but they should make it a large focus of your program , not a throw in at the end of your visit - 3/8/2011   10:07:47 AM
  • 384
    When you weigh every time you consult your doc, that tells you something right there. When b/p is taken at every visit, again, that provides info.

    Overweight and obesity should be a frankly acknowledged part of the overall health picture, and noted as a factor in any disease where it is relevant. It is not the physician's job to become a nagger. The physician's job is to advise, prescribe and refer. Once the advice is acknowledged, it is my job and every body's job to set priorities for taking care of his or her own body. Sometimes a physician may have advice about priorities, but ultimately, only one person lives in each body and is responsible for it. In a situation where the overweight or obesity has been clearly recognized and given a designated priority, it need not be mentioned in every visit or even with any frequency. The patient's acknowledgment that, "Naturally I'd like to lose weight but right now X must take priority" is usually enough.

    Where a new level of morbidity has been reached, this may require mention, perhaps with a recognition of the other challenges faced by the patient followed by discussion of priorities and weight loss still may not come in first.

    Exercise, even very moderate exercise has benefits that weight loss alone cannot offer. - 3/6/2011   2:17:28 PM
  • LIVERTRANS
    383
    I have an appointment next week with my family doctor. He can lecture on weight because the man went through University of Toronto as a member of their swim team. He and his wife started the local swim team. He has been a doctor for the Canadian Olympic swim team and his wife was a manager of the team at a later date. I don't think that he has every had an undisciplined moment in his life. Mr .Fitness. Both my parents had been diagnosed with Type 2 Diabetes when I was in my teens. I was an after thought child. I have seen the results of poorly controlled blood sugars with various members of my family. My Dad had two toes amputated because of gangerene. My Mom was legally blind later in life. My brother had a lower leg amputated because of gas gangarene and the other leg was going the same way when he died. All my family smoked, except me, so that is all I have going in my favour. I have fought my weight all of my adult life. Before I was diagnosed with liver failure, several years ago, I kept telling my doctor there was something wrong because I could not eat anything I was so sick. He said, `But look at all of th weight you are losing`. My weight did stay down because of complications, illness, and surgery with complications afterwards. It has finally stabalized to the point that I was taken off of the waiting list for a liver transplant 3 years ago. Only problem now is that I can eat. I have been exhauseted since August. My hemaglobin and thyroid are fine. He blames the weight for all of my problems. I could probably tell him that I had developed an allergy to something and he would blame it on my weight. The big problem , for him and me is that in the last several months my blood sugars have climbed. I have been trying to get them down and have succeded to quite a degree. If I didn't need medicine refills I don't think I would ever see him. At my age and having worked in the health care field for 30 years he really can't tell me anything that I don't already know about the consequences of my weight and blood sugars. I don't need lectures. He actuallly gets on rants if you question him too much when he is in this mood. One of these days I want to stand up and tell him that I will come back when he is in a better mood. I wonder what he would do? Probably kick me out of his practice. There are no doctors taking patients in town so if you don'thave one you are stuck.
    Arrrrrrg! Brenda - 3/18/2010   9:21:51 PM
  • 382
    I was shocked when my doctor mentioned my weight to me. I didn't know what to say. But he handled it perfectly. He treated it like any other issue. He told me it was a health problem and we needed to talk about it, but not right now. Then he let it rest until my next visit. Very non-confrontational but also not letting me pretend it didn't exist. If he'd been pushy or made me feel defensive, I wouldn't have gone back. Not in protest but because I wouldn't have been able to handle the anxiety. Instead, he made me think. - 9/15/2009   2:20:09 PM
  • MSTGREEN
    381
    We are each responsible for ourselves and our actions. Doctors are not here to lecture us. Their job is to advise us on our health and help us get well. Overweight adults and parents with overweight children are fully aware of their situations. It shouldn't take any other person to spark corrective actions for themselves and their loved ones. - 9/7/2009   9:55:10 AM
  • 380
    I have had great doctors who worked with me with weight issued and often solutions that didnt make them a cent. And then I had 2 horrible doctors, one while I was having one of my many miscarriages, the doctored looked at me at look just face it your too fat to have children...What a thing to say to someone who just lost their baby. I wasnt that fat at the time either. The other doctor I went to I told her how I was watching calories and exercising but just wasnt loosing. She told me come on if you were really doing that you would lose weight I do when I am doing what I am suppose to.
    I never went back to either of those doctors again! - 8/24/2009   11:21:07 PM
  • 379
    I have a friend that is constantly going to the doctor for health issues, I personally think if she lost 100 lbs most of those issues would be gone and it is time her doctor told her so, she is costing the system way to much. - 8/24/2009   4:41:19 PM
  • 378
    Obviously, this blog hit a nerve with a lot of people. My doctor never said "boo" to me about my weight (I was just shifting into the "obese" range and out of "overweight" range when I joined SP), but he did compliment me and encourage me when I started losing weight. It would be wonderful if every doctor did what TerrieJo53's doctor did--refer overweight people to a wellness center, to a dietician and a trainer, or simply to something like SparkPeople. It sounds like there are a lot of doctors who aren't doing the proactive things that would really help their patients. - 8/24/2009   3:26:10 PM
  • RUSSELLG1
    377
    People listen to their doctors. If they can nudge someone in th eright direction, then they should. - 8/24/2009   11:08:40 AM
  • 376
    MY DOCTOR IS VERY GOOD ABOUT TALKING ABOUT MY WEIGHT. HE SAID IF HE DIDN'T AND 10 YEARS FROM NOW GOD FOR BID IF SOMETHING WAS TO HAPPEN, HE SAID HE DIDN'T WANT US LOOKING BACK AND SAYING IF I HAD ONLY TALKED TO YOU ABOUT YOUR WEIGHT. SO I THANK GOD FOR MY DOCTOR. WHEN I LOOSE POUNDS HE ALWAYS GIVE ME A HIGH FIVE!!!!!!! HIS FAMOUS WORDS ARE KEEP UP THE GOOD WORK!!!!! IT REALLY HELPS ME AND I DON'T WANT TO LET ME OR GOD DOWN AND NOT MY DOCTOR EITHER. - 8/22/2009   8:32:27 PM
  • 375
    I had a doctor who absolutely said nothing. Years and years went by, as I kept gaining. He never once said that my weight was a concern. I was approximately 100 lbs overweight when I finally decided to leave. I felt that if he wasn't concerned about something so obvious, then what else was he not concerned about. I felt I needed someone who was a little more proactive in my health, rather than just doing what I asked (my annual physical) and nothing more. - 8/22/2009   4:39:40 PM
  • 374
    I remember once, at the university sports med clinic, I had a broken foot and was getting it looked at as well as being fitted for orthotics. Of course it's a university so sometimes there are medical students also checking out whatever the doctors/profs are doing. I still remember him quietly telling half a dozen graduate students to "take into account the subject's mass." I was pretty humiliated. I was on the rugby team, and yeah, I was about 200 pounds, but it was like he was telling *them* I was fat and saying it like I wouldn't notice. On the other hand, there was nothing at all wrong about what he needed to tell his students. I was just, you know, embarrassed. To be the "subject with mass."

    I've had doctors here open the conversation about weight with questions like "how is your weight?" or "are you happy with the amount of activity you're getting?" or things like that. That approach allows me to tell the doctor what I'm doing about it (or to be honest when I'm doing nothing). I'm not going to kid myself that apart from those last "vanity pounds," when I was really overweight, it was a big problem, a health problem both physically and mentally. When I was at my biggest, I couldn't take the "you need to lose weight" from anyone. If a doctor said it I would agree, and want to lose the weight, but I needed more help than "eat less, move more." That message made me leave wondering "how?" I would have needed to talk to a psychologist or a nutritionist or both, and it would have taken more than 15 minutes.

    I think doctors should be able to tell people that for their own health and happiness, they should try to lose weight, but then they've got to go farther than "eat less and move more." It might be the truth, but I think a lot of people need to be asked what kind of support they need. - 8/22/2009   2:32:00 AM
  • MOMS4CHRIST
    373
    My Primary Care doctor refused to listen when I asked him to look a little deeper than "push yourself away from the table" because his labs showed nothing when I kept gaining and gaining and... Even with a STRONG family history of diabetes, he never did more than a fasting glucose - nor told me that other tests were available.

    When my GYNECOLOGIST retired, the first time I went to a new one, she did a complete workup including a fasting glucose AND a fasting insulin. The fasting glucose came back normal (again) but the fasting insulin was WAY off, prompting her to order an A1C. BINGO, I was diabetic (which never did show up in my fasting levels until about 2 years after I was diagnosed).

    When I took this information back to my primary care doctor, he just shrugged and told me to "watch my sugar," not even bothering to explain complex carbs and how they break down into sugars. Nor did he bother to steer me toward someone who knew anything about diabetes. He never examined my feet or told me I needed an eye exam.

    My GYNECOLOGIST sent me to a diabetes educator when she discovered I was pregnant and what I learned there sent me looking for a new primary care doctor who instead of belaboring the obvious (I need to lose weight) discusses what my alternatives are and the best way for me to lose weight. I have lost 130 lbs. so far. I still have 125 to go, but I didn't gain it overnight. I gained it through years of ignorance on my part regarding how to be my own advocate when it came to health care. Diabetes, while a serious condition, has taught me a lot about the importance of going to a doctor who is knowledgable AND willing to discuss your health options. - 8/21/2009   9:55:26 PM
  • 372
    Lots of great and interesting comments here.
    Truthfully? I already know I'm overweight. I already know my family history. I don't need a lecture, though I'd be happy just once to get something a little more helpful than eat right/move more.
    Even with sudden weight gains/losses 50 lbs at a time) over the past few years, none of my doctors, including my endocrinologist that my PCP finally refered me too have ever addressed my weight....other than asking after a sudden 50 lb loss if I was feeling okay. (I said yes, turns out if she'd run some tests she might have caugth the thryoid issues before I went into a thyroid storm.)
    Lately the doctors we see seem to be more interested in whether or not we have guns in the home (none of their business and legal in my state), if we wear seatbelts (not legally required in my state) or if we wear bike/motorcycle helmuts (again not legally required) That bugs me more than a little. Yet they totally overlook discussing side effects of the drugs they prescribe to you or how they might interact with other drugs you take...or even that many of these drugs cause the weight gain that they may be lecturing you about.
    My newest doctor that I've seen only once addressed my weight in a more round-about way. She did ask about my exercise regimen, food habits and seemed happy enough to take what I had to say to her at face value.
    I think most doctors really aren't trained all that well in diet and nutrition...in fact it's a radiculously small part of their overall training, as is dealing with hormonal/metabolic disorders....even with my endocrinologist working out of a "good' teaching hospital, I was pretty much left to puzzle out how to best treat myself, how to take my meds, what to avoid. Thanks to the Thyroid group here on Sparkpeople, I was given the tools to find that out for myself. Never once was I offered nutrional counseling. Never once was exercise addressed. And even once I went Hypo for good and still managed to lose weight...it came as a surprise to him. Seems the weight was no more concern to him than my complaints about losing my hair.
    Should doctors try to address weight issues? Obviously, yes. I just wish they were a little quicker to make referals for this issue that they really don't seem, in general to understand. - 8/21/2009   4:03:51 PM
  • 371
    This has been an on-going issue with me. I think a doctor should talk to you about your health. This means that if you are overweight and have medical issues related to your weight. they shoud discuss it with you. However, I believe that those people who are "fit and fat" should not be lectured every time they go for a check-up. A doctor should encourage you to exercise and lose weight if your lipids and BP are high but not if you are active, and in good health. They should really talk with you to find out if you are having any symptoms related to obesity, but aviod the lecture if you are actually healthy. Also, and this is where I have the most issues with doctors, do not, do not associate every medical complaint to being overweight. I went to a doctor for almost 2 years who discounted my complaints of discomfort in my throat to my having a fat neck. When I finally dumped him and went to a doctor who responded appropriately to my issue, I was diagnosed with stage 3 lymphoma! My discomfort was caused by enlarged lymph nodes in my neck. I think many doctors cannot see the real patient through their obesity. Every issue is related to being fat or they are too uncomfortable to discuss those that are. - 8/21/2009   2:21:42 PM
  • 370
    I remember once going to my doctor because I was afraid I had the flew....so when he asked to lift my shirt to hear my heart rate he grabbed a roll on my stomach and said "Lay off the potatoes and bread". Which to me was pretty harsh...He hadnt weighed me and the reason for my visit had nothing to do with my weight. But all in all if he had bein more genuine and nice about I would have appreciated his advice rather then feeling more like crap!! - 8/21/2009   11:30:50 AM
  • 369
    I am a bit overweight. I am very active, I like natural foods.
    A doctor I went to once insisted I was not healthy, had my cholesterol checked to prove it. I have excellent cholesterol levels, the bad kind twice as low as normal, and the good cholesterol twice as high as normal.
    Looks and appearance are not everything. I see folks in my gym who work out with personal trainers for years and they still are middle aged and far from thin, but I know they are committed to a healthy lifestyle. A few pounds are not a death sentence.
    My point is if a patient is not morbidly obese and active don't try and make them feel bad about themselves, that is counterproductive. If they are very obese don't insult them or they will just avoid going to doctors altogether. There has to be a caring way to get the message across.
    Slender people have health issues also! Are they at risk for doctor's ignoring their issues because they appear healthy? - 8/21/2009   10:26:38 AM
  • FITANNE13
    368
    I absolutely think it is a health professionals job to discuss weight issues with their patients. Being overweight can lead to many different health concerns and disease that could be potentially deadly. However, the approach the Dr. takes should be kind. - 8/21/2009   8:38:09 AM
  • DBOYER30
    367
    I work for a health insurance company. With today's controversy about health care reform, I believe that this very topic is one of the reasons for our troubled healthcare system today. If doctors focused more on the prevention of disease before it sets the system would be different. If a doctor were to address the patient's weight problem before the high blood pressure or diabetes diagnosis, then those could have been adverted with diet and exercise changes, instead of the typical end result, which is expensive drugs. With this said, yes, I do believe that doctors should address their patient's weight issues and not ignore them. Obesity is as much a medical diagnosis as high blood pressure or cholesterol. - 8/20/2009   11:29:51 PM
  • 366
    As a Pediatrician who thinks that my most important goal is to create a population of new Americans who value natural healthy food and reject all the irresponsible garbage that most food processors in this country sell us, this is a no brainer. Of course, those 15 minutes face to face with the parents and their children where I speak to them in easily understandable turns and treat them like intelligent people is invaluable. I find that unfortunately most parents get most of their nutrition information from tv commercials. The two commercials I dislike the most, the orange and V-8 commercials. It is absolutely not true that a glass of OJ is equal to two oranges or that a glass of V-8 is equal to 3 veggies. All of the phytonutrients necessary to health are thrown away when we drink the juice of fruits and vegetables. And, it is much more expensive economically and to the environment when we eat processed food instead of eating foods in their natural state. My 2 cents. - 8/20/2009   3:09:31 PM
  • WILDNCRAZY
    365
    I think a doctor should tell you you need to lose weight, as long as he does it in a nice way! I once had a MALE doctor tell me that I was morbidly obese (given my height and weight- at the time I was only 30 pounds overweight) yet he told a guy who was his patient who was 30 pounds overweight that he was just a little stocky! My regular doctor (who was a female) said I was just overweight. I do know I have to lose weight... But some doctors are very insulting. - 8/20/2009   1:55:16 PM
  • 364
    A physician's JOB is to help their patients be or get healthy. So, absolutely, it is a doctor's responsibility to discuss a patient's weight with them if they are obese, gaining lots of weight, or are heavy enough to be in danger of illness because of their weight.

    Is it a doctor's job to lecture and belittle people? NO. I don't think that is anywhere in the hypcratic oath. It kind of goes back to that old adage: If you don't have something nice to say, don't say anything at all. Well, with doctor's addressing overweight or obese clients, perhaps it should be: If you don't have any constructive advice to give, find it, then give it!

    I have only ever been overweight, probably about 30 lbs, so I have never been told by a doctor I was obese and needed to lose weight. When I was 30 lbs over weight and got pregnant for the 1st time, my OBG/YN merely stated that to stay within a healthy pre-natal weight range, I should try to gain between 20 and 25 lbs with my pregnancy. She didn't say, since you are overweight, be careful not to gain too much weight. She made it constructive and positive. I ended up gaining about 20 lbs (most of it in last 8 weeks when the baby was really growing). By my 6 week post-partum checkup, I had lost ALL the baby weight, plus 6 lbs. Mostly from nursing, but we were also working on painting and cleaning up a house we had just bought.

    Doctor's offices should simply have pamphlets and resource sheet regarding weight loss and weight loss clinics, sites, etc laying around the office. Information is free--it should be readily available! People should be able to go to their doctor's for advice and help without leaving feeling worse than they already did. It takes courage to admit you have a problem and need help (whether it is drugs, alcohol, eating, whatever), so you should be proud for taking that step, and encouraged by your doctor for even making that one small step in the right direction. - 8/20/2009   12:23:50 PM
  • GIANT-STEPS
    363
    Doctors can either be positive or negative in their approach. I find that woman doctors to be much more positive than male; this is one of the reasons I prefer to go to women.

    Anyway, I was taking tennis lessons and was having a lot of knee pain so I went to my male orthopedic surgeon. He is an excellent orthopedist and he told me that tennis is probably not the best activity for me; I can probably play some but I should try to do more of other activies less stressful to the knees. He mentioned that loosing weight would help my knees. I proudly mentioned that I was already working on that and had lost 40 lbs. He gave me a cold stare and told me that I wasn't doing my knees any favors when I weighed 40 lbs more than I do now. He could have been encouraging but instead he had to turn it into a negative that I used to be even fatter than I am now.

    My female family doctor is always positive. If I gain weight since the last visit she encourages me to exercise and eat better and if I loose any weight; even a single pound she mentions it and congratulates me. - 8/20/2009   11:36:59 AM
  • 362
    My experience with my (skinny) doctor has me staying away from his office because I get the same lecture each time I see him. He would skim over the issue I initially made the appointment for and went directly into his lecture about how much protein, how many fruit and vegetables, and how little carbs I should be eating. Eat on a smaller plate blah blah blah.

    Finally he came up with a solution I could work with. He made an appointment at a Weight Management Centre which led me on my internet search for help. That is when I found SparkPeople.

    He kept telling me I was eating too much, but what I have discovered it was the frequency that was my big problem. I am now eating more often and more food than I ever have and I am losing weight.

    Lecturing an over weight (obese) person about eating too much is like telling an alcoholic they drink too much. I know I just shut down. I don't like or need lectures. I beat myself up enough with out having someone else do it as well.

    My doctor has the information for the clinic, my next visit I will bring information about sparkpeople.

    We need tools not lectures. - 8/20/2009   9:22:05 AM
  • UDSNRL2009
    361
    Here is the thing - On the one hand (I weigh just about 125kg), you get given a diet sheet with 1200 calories per day (hello!!), on the other hand, you get an almost disappointed look on the health professional's face, when your cholesteral levels come back within the healthy limits, your blood pressure as 130/70 and resting pulse as 59, and despite being told it will take you a long time, you conceive quickly, have no pregnancy related issues and have not developed diabetes.
    So, I think what I am trying to say is, that my experience over the last few years of health professionals has been, that they look at your size, make assumptions about your health and are almost disappointed when none of it is true.
    So yes, I am big
    Yes I should reduce my weight
    But no, I am not suffering with anything everyone expects me to.

    But then, I walk between 15 - 20 miles a week, use my exercise bike every day for a minimum of 20 - 30 mins, make sure I have a very healthy diet, balanced with my chocolate treats. (some would argue 'spoilt' here....)

    So I think before health professionals make any comments, they should receive life style training, or employ someone who can make proper life style assessments and based on that make better comments and recommendations. - 8/20/2009   7:40:11 AM
  • AMARANTHA2
    360
    This thread really does hit a key point with people and I keep coming back and finding more great thoughts on here. It kind of underlines how important to us our physicians can be and how if they are not providing what we need, we need to keep looking for one who does.

    It is sad how so many people in our obesity burdened society feel that diets don't work and everyone knows it. Personally and just my opinion from the perspective of having lost more than 100 pounds and kept it more or less off for years, I do think diets work in the sense that a diet is just a way of eating and in the weight loss sense it is a planned, rational way of eating that is targeted to weight loss. A healthy, weight loss targeted diet is part of the healthy lifestyle changes that need to be made to permanently get out of the obese category and a doctor can so help with that if it is the right doctor.

    I think so many people feel frustrated with the weight loss process in general and feel, fed by the media and online chatter and the weight loss industry, etc., that permanent healthy weight change is not possible and that is a myth, in my opinion and experience.

    I think it IS a doctor's responsibility to address this. - 8/20/2009   7:34:16 AM
  • MEMERE2*2
    359
    I don't think a doctor needs to tell us we're obese, I think we all know that! But it is their obligation to remind us of the damage we are doing the future we face if we don't do something about it. But this all needs to be done with compassion and understanding. When I went for my physical in 2008 and my doctor gently mentioned that I had gained 20 pounds that year and added "oh, Denise, what happened?" I could have cried. She wasn't blaming me, she was looking for what was happening in my head and heart that allowed me to let myself continue putting weight on. It was her compassion along with several other big factors that got me here to Spark People. I have dropped 70 pounds so far and have another 50 to go but I KNOW I'll do it!
    If your doctor lectures and berates you, it's time to find another doctor! - 8/20/2009   7:04:43 AM
  • 358
    I have a very close relationship with my OB/GYN...I know how strange that sounds. Long story short, my mom used to work for him when I was a kid and my sister is his RN now. When I had my son there were major non-delivery problems shortly after his birth and my doctor was very supportive and there for me like a family member would be, not cold like some doctors. He has mentioned my weight to me a few times...always in a gentle way and always with suggestions on how to lose the weight.

    I am still looking for a family doctor that I like. The last one I went to because my blood pressure was really out of control. I came in and weighed in at almost 300 pounds. When he came in he said "What seems to be the problem? You seem like a pretty healthy young lady"...UHHH...300 pounds is NOT healthy. I told him I was concerned about my BP, he prescriped a pill and did a chest x-ray. Bing Bang Boom...out the door. I was left feeling like...wait a second...he didnt give me any useful information at all. What calorie range should I be in? Should I watch my sodium?

    So....basically, I feel like you doctor absolutely should bring up the issue IF they are willing to take the 5 minutes out of their busy schedules to actually have a discussion...not just state the obvious "Eat less...move more". DUH. - 8/19/2009   9:16:16 PM
  • MLADYBUGMCH
    357
    Yes I do think it is the doctors responsibility to tell you, You are over weight, and this is what you need to be doing. If not, this is what is going to happen. You need to get the worse case scenario. I know I needed that PUSH. and still do at times. - 8/19/2009   7:00:11 PM
  • 356
    The only person in the medical field who ever pointed out my weight to me was when I was at my heaviest. It also happens to be the day I joined sparkpeople. The nurse who weighed me and took my bp and all of that treated me like I was stupid. She asked if I knew I was overweight. I said yes. Then she asked if I was doing anything about it. I said no. Instead of giving me some resources she just said that if my weight was still an issue and my bp was still up that I wouldn't be able to be on the medication they were prescribing me. She told me "you need to eat healthier" and that was the end of it. All in a very condescending tone. That very night I went home and looked stuff up and found spark. I didn't do it because she motivated me in a positive way, I did it to prove to her that I wasn't the "fat dumb idiot" she treated me like. So it was a blessing in disguise I guess. - 8/19/2009   4:32:33 PM
  • 355
    I think it's a physician's obligation to make suggestions on how to improve the health and well being of the patients in their care. They must do with in a respectful and helpful manner. I have been blessed to have been treated by 3 of the most wonderful docs through the course of my lifetime. If your doc isn't working for you, find another....They are out there! - 8/19/2009   3:57:17 PM
  • 354
    I don't think they should nag, but they should certainly mention it.
    I'm at a healthy weight and exercise...and I don't drink at all. But I smoke. Everytime I see the doc, I get the same lecture. More people die each year from obesity related illness than smoking....why can't they get lectured too? (ha-ha) - 8/19/2009   12:34:41 PM
  • 353
    I think it's the doctor's responsibility not to nag or put down their patients, but to keep them informed. I would love to have my doctor say "Well, according to your BMI you need to lose some weight, do you feel as though you're struggling with your weight, or do you have any concerns?", or something along those lines. My last doctor I practically begged for help to get my BMI out of the obese range, asking if it could be a side effect of other medication, trying to tell him what I was doing and he interrupted me. He stopped me. He didn't want to hear what I was doing. He looked me in the eyes and said "there are no reliable weight loss drugs". I told him I didn't want drugs, but at that point he wasn't listening and left the room. As a doctor he should be looking at me as a whole, and providing suggestions. Be it a change in antidepressants, re-testing my thyroid, or giving me a referral to a nutritionist. My insurance has a special program for helping people lose weight that is covered 100%, but your doctor has to refer you to it. I can't even learn about it, because despite being obese, my doctor won't talk to me about it. I wanted to know if because of my thyroid there were certain diets that worked better, or anything. I know there is no quick and easy way out. Your doctor should listen. But they should definitely bring it up, tactfully. Sometimes when you start seeing it as a health concern, losing weight become more of a priority in your life. - 8/19/2009   11:15:09 AM
  • 352
    I really liked the car engine analogy. If someone is overweight, the doctor is not doing any favors by nagging and belittling or by just prescribing a pill to treat a symptom and not giving the patient helpful information. We may not all be ready to take the advice, but after enough consistent reminders, it might help get us thinking about taking more responsibility for our own health, at least. - 8/19/2009   9:46:49 AM
  • FOURNINES
    351
    // - 8/19/2009   12:18:39 AM
  • TEDDIANGEL
    350
    I believe a doctor should let you know if you're overweight--especially if it's enough to affect your health. Maybe, discuss why the patient is gaining ..... If the patient is interested, he should point out ways to control it. But, he should never, never "nag" or act derogatory about it. - 8/18/2009   11:41:47 PM
  • SLEEPBEAUTYROSE
    349
    I think that a good doctor should tell their patients if they are under weight, over weight, and even when they are healthy. I also think that just telling them to eat better and walk more is not a way to guide that person (I mean, if that person knew what to do, they wouldn't be too skinny or over weight in the first place, right?). I think that a doctor should tell their patient if they need to gain/loose weight, but also show them how/where they can go/what they can do. Not every one wants to go to the doctor every month, but maybe the doctor can have the patient start a food journal and every about 5 to 6 months then the patient can go in for a check up and bring their journal. Then the doctor can see why the patient has been successful/unsuccessful and then give further guidence. Afterall, shouldn't doctors want to help people become healthy? - 8/18/2009   7:37:27 PM
  • 348
    I think it would be highly unnerving if a doctor did not discuss weight with their patients. Whether they be overweight or underweight. I think if you do not have a doctor that has your health in mind then you need to find a new doctor. They should be able to lead you in the right direction to what a healthy weight for you is. It would be unorthodox for them to just say oh yeah your fat so lose weight but they should be concerned if you are not at a healthy weight, or if suddenly you gained or lost a bunch very quickly. Also it is your responsibility to bring weight up with your doctor. - 8/18/2009   4:40:05 PM
  • NIGHTSTAR777
    347
    Sorry but I do know that I have extra pounds, so there is no one reason to doctor to tell me about benefits of being fit. This sounds that when I come to doctor he/she tells me that being healthy is better then being sick. Funny. Is that really true that ill people do not know about benefits being healthy?

    I took off four doctors just because every time I come to office they told me I have to lose weight, and I gained weight one pound after another. They told that I WILL HAVE DIABETES IF I DO NOT LOSE WEIGHT. Funny, I already had diabetes, and really needed med support., but I got only lectures. Really in this case why do I need doctor? Just put DVD and tune it. Lecture 24 hours a day 7 days a week. It will give more motivation, at least to turn that DVD off.

    Interesting , just right now I read article about exercise, that it does not help to lose weight. There were studies about exercising. Also a few years ago I was told to forget about any physical activity. Now I have to go to gym club more then four days a week.

    Every one of us tried diets, and we all know it does not work, but we still use it. Why? Just take it for granted it is not what you need. I do, I do not use dieting, go to gym club but do not stay there more then hour, and do not go every day.



    - 8/18/2009   4:16:40 PM
  • BOBITA12
    346
    As a physical therapist, I see a lot of patients with back and knee problems and a lot of times they tell me the doctor doesn't know what is wrong and just tells them to lose weight. This is the case for people even only 10-20 pounds overweight. Granted any extra weight is putting extra stress on the joints, but sometimes I think it is a copout for doctors to deny further testing. - 8/18/2009   4:04:14 PM
  • 345
    I think it's irresponsible for doctor to skirt the issue or prescribe medications to treat obesity related health issues. While we may not like to hear it, someone has to tell us that our weight is shortening our life span and certainly interfering with our quality of life. - 8/18/2009   3:56:00 PM
  • 344
    I think a doctor should help their patients learn to lose weight just like any other medical condition. Many medical conditions are caused or made worse by overweight.
    I am so aggravated at my husband's doctor because he will not tell him to lose weight. He is diabetic and that had caused him to lose quite a bit of weight which was a good thing but then he retired and only wants to sit around and gained 40 lbs in 4 months and his blood sugar went way up again. I mentioned to the doctor that his weight gain might have something to do with less exercise because he had had an active job but he just brushed me off and gave him a second medication.
    He did send him to a dietician when he was first diagnosed as diabetic but she just went through the nutrition stuff which I already knew and then wanted him to keep track of food and come back every few weeks. But it was $150 for a 15 minute session and our insurance wouldn't pay it so he never went back.
    He does have another doctor for another condition who did agree with me that he needed to lose weight and should do more exercise.
    I have high blood pressure and am close to being diabetic which is why I am trying to lose some pounds. My doctor did tell me to watch my diet and exercise every day but never mentioned losing weight although I am not much overweight so she might not have thought it was that important.
    Doctors need to be more helpful in helping a patient try to cut back on food and finding exercises that they can do. Just reminding them to get out and walk a few minutes evry day would help. - 8/18/2009   3:32:17 PM
  • 343
    I think that doctors need to say something, when people are leading unhealthy lives. I know that it gets annoying, especially when it comes to long-term problems like obesity, but it is their job to look out for the health of their patients. They need to say something, when the health of the patient is compromised. Still, I agree, just saying something isn't enough, the doctor needs to also give the patient resources, and also needs to be honest and tell them what the actions of or inaction on the part of the patient could mean for their future health and well-being.

    People, when they get vague comments from doctors about weight and other unhealthy behaviors, also need to be ready to ask questions. "I need more determination and follow through? How do I get it, what tools are out there for me?" "I need to exercise more? I am having difficulty getting myself out to do that, what kinds of things do people do to help themselves? Where can I go to get help with this?" I think part of our problems with doctors is that our system doesn't always support doctors having good "relationships" with their patients. They have to rush from room to room, quickly look over some data, and give the patient an answer. If the doctors are not giving us useful answers, we need to make sure that we are asking the right questions to get the information we need. If we ask the right question, and the doctor seems unwilling or unable to answer it, we need to move on and find someone who knows how to help us. - 8/18/2009   3:32:02 PM
  • 342
    ARTHUR AGATSTON, M.D. gives a great lecture in "THE SOUTH BEACH HEART HEALTH PROGRAM" book on WHY we need to lose weight and exercise to prevent heart disease. All doctors should do the same. - 8/18/2009   3:28:19 PM
  • 341
    My weight never got to the point of obese. I never had a doctor tell me I needed to lose weight though I clearly did. It was obvious that I had rolls and no energy. When I asked about doing tests to make sure I could start an exercise program. She, who is rail thin, made sure I knew the good, bad and ugly of what was out there, what would work and what wouldn't. - 8/18/2009   3:13:06 PM
  • 340
    I've been there a lot of times, and it makes me angry when the REAL issue gets ignored.

    I've been to the doctor for a badly infected ingrown toenail and was told to lose weight... Uhm... right. I've been to the doctor for birth control, I was told to lose weight.. is it me or is that complete irrelevant to why I came to them?

    A doctor before that was even worse. She was maybe 120-140 lbs, skinny as a rail and a MARATHON runner. I was 13 and she told me to eat like she does. The nutrition needs of a growing teen and a marathon runner in her early forties are NOT the same.

    I've been to a dietitian who tried to get me into inline skating, which I tried once, fell and just hated it. She asked me if I ever ate a whole bag of licorice, I said no .. but I don't like licorice. Now if she asked if I ever ate a whole box of cookies, I would have said yes. *laugh* It's like they never looked at me as an individual. Who puts a growing teen on a 1200 calorie diet? I was biking to school every day for 20 minutes and back for another 20.. Full-time school days. Call me crazy, but 1200 calories was NEVER going to work.

    With all the ups and downs in my weight loss, it's funny to see that the LESS drastic approach worked far better. I lost 75+ lbs by eating 1800 calories.. as an ADULT. If only they ever truly looked at me as an individual and looked at what worked for ME, I wouldn't have been an overweight adult.

    I'm glad some doctors now give people the tools (such as sparkpeople) and teach you how to lose weight. Rather than try to force some cookie cutter meal plan upon you. Every individual is different, they need to see that.

    So I guess I'm middle of the road. I want doctors to care about our weight, but not go so extreme as to ignore what you came for and try to brainwash you. - 8/18/2009   1:27:41 PM
  • 339
    I think doctors should push their patients to lead healthier lives. Absolutely! - 8/18/2009   12:45:01 PM
  • 338
    Actually, my doctor has been great; however, it did take several visits to several different doctors to find her! She suggested I join SparkPeople, she took the time to listen to my concerns and challenges and she gave me sample menus and suggestions on how I can increase my exercise to challenge myself. I agree doctors should be obligated to tell patients they are obese. I just believe that doctors are also obligated to take the time to listen...it makes a difference! - 8/18/2009   12:40:30 PM
  • 337
    "Frankly, Marjorie, your fat is going to kill you if you don't get rid of it"... I guess he knew what he meant...and now, he says..."You are still classified as 'obese' but progress slow and sure is a good way to go!" Sigh - 8/18/2009   12:21:50 PM

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