# And you wonder why I hate doctors. **URL:** \ **Category:** The BBQ Pit\ **Created:** [March 9, 2014, 6:22pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282 "2014-03-09T18:22:10Z")\ **Posts on this page:** 20\ **Page:** 4
**Author:** ![j666](https://avatars.discourse-cdn.com/v4/letter/j/9de0a6/32.png) [@j666](https://boards.straightdope.com/u/j666)\ **Post date:** [March 12, 2014, 1:29am UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/61 "2014-03-12T01:29:43Z")
What fruits? Yes, it is easier to eat excess calories if you eat breads and roots, but it’s certainly not impossible to do so on other regimens. Congratulations on the new doctor. ---
**Author:** ![Chetumal](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@Chetumal](https://boards.straightdope.com/u/Chetumal)\ **Post date:** [March 12, 2014, 11:08pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/62 "2014-03-12T23:08:51Z")
> [@Saint\_Cad](#): > > My suspicion is that we got a series of doctors that felt she was overweight due to over eating, lying about her food intake and exercise… Still confused…what other way does a person become obese besides eating more calories than their body burns? > [@](#): > > … the diet that she got from the new doctor which is no carbs except certain fruits, she has lost 35 lbs in about 4 months. Maybe it is less calories Um, maybe? But then you backtrack right back to this: > [@](#): > > I’m not convinced it was all about eat less and burn more calories. 😕 ---
**Author:** ![IvoryTowerDenizen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ivorytowerdenizen/32/17937_2.png) [@IvoryTowerDenizen](https://boards.straightdope.com/u/IvoryTowerDenizen)\ **Post date:** [March 12, 2014, 11:10pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/63 "2014-03-12T23:10:48Z")
> [@Chetumal](#): > > Still confused…what other way does a person become obese besides eating more calories than their body burns? Yes, but when you’re low thyroid you could be eating what is a reasonable diet, but due to your metabolism ends up being too many calories. So you could be accurately reporting your intake, but if the doc doesn’t realize you’re low thyroid he’ll think your lying about your intake since you’re gaining weight. Howevre, ultimately it is about calories in and out. ---
**Author:** ![Chetumal](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@Chetumal](https://boards.straightdope.com/u/Chetumal)\ **Post date:** [March 12, 2014, 11:20pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/64 "2014-03-12T23:20:13Z")
> [@IvoryTowerDenizen](#): > > Yes, but when you’re low thyroid you could be eating what is a reasonable diet, but due to your metabolism ends up being too many calories. So you could be accurately reporting your intake, but if the doc doesn’t realize you’re low thyroid he’ll think your lying about your intake since you’re gaining weight. Right but as mentioned upthread, thyroid disorders only account for a very small percentage (I think it was 5 or 10 percent max) of weight gain, the rest is plain old overeating. ---
**Author:** ![IvoryTowerDenizen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ivorytowerdenizen/32/17937_2.png) [@IvoryTowerDenizen](https://boards.straightdope.com/u/IvoryTowerDenizen)\ **Post date:** [March 12, 2014, 11:47pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/65 "2014-03-12T23:47:58Z")
> [@Chetumal](#): > > Right but as mentioned upthread, thyroid disorders only account for a very small percentage (I think it was 5 or 10 percent max) of weight gain, the rest is plain old overeating. Yes, I know. I was responding specifically about the idea that the doctor thought she was “lying” about her food intake and overeating. With low thyroid, you absolutely can be eating what appears to be a normal amount and are not “lying” about it, but it still results in a calorie excess. I have no idea if this is the case with the OPs wife. Frankly, the data about the impact of low thyroid in general is very poor. Plus, it’s thought to be widely under-diagnosed because the normal ranges were determined decades ago before as much was known about was normal actually is. Many doctors refuse to increase the dose in symptomatic people if their TSH are in the so-called normal range, despite recent evidence suggesting that suppressing it further is justified. ---
**Author:** ![Chetumal](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@Chetumal](https://boards.straightdope.com/u/Chetumal)\ **Post date:** [March 13, 2014, 12:32am UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/66 "2014-03-13T00:32:10Z")
> [@IvoryTowerDenizen](#): > > Yes, I know. I was responding specifically about the idea that the doctor thought she was “lying” about her food intake and overeating. With low thyroid, you absolutely can be eating what appears to be a normal amount and are not “lying” about it, but it still results in a calorie excess. True. I guess my point is that, let’s say for example that low thyroid is responsible for 10% of a person’s weight gain. The OP’s posts are a little confusing but it seems that his wife may be somewhere around 50 pounds overweight. Low thyroid then, may be responsible for 5 pounds of that. The other 45 pounds is plain old overeating, something the OP keeps insisting the docs are falsely accusing her of… ---
**Author:** ![IvoryTowerDenizen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ivorytowerdenizen/32/17937_2.png) [@IvoryTowerDenizen](https://boards.straightdope.com/u/IvoryTowerDenizen)\ **Post date:** [March 13, 2014, 12:36am UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/67 "2014-03-13T00:36:09Z")
> [@Chetumal](#): > > True. > > I guess my point is that, let’s say for example that low thyroid is responsible for 10% of a person’s weight gain. The OP’s posts are a little confusing but it seems that his wife may be somewhere around 50 pounds overweight. Low thyroid then, may be responsible for 5 pounds of that. The other 45 pounds is plain old overeating, something the OP keeps insisting the docs are falsely accusing her of… Although it can be cumulative. Gain 5 pounds every year and after 6-7 years that’s a lot of weight. 3-5 lb a year is nothing when your metabolism is suppressed so that it’s just a couple hundred extra calories a week you’re over eating. That’s like an extra couple of slices of bread. 52 weeks \* 200 calories a week = 10400 extra calories, which is 3 lbs. Couple that with low thyroid making you exhausted so you’re moving less, that’s another couple of pounds. ---
**Author:** ![BigT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigt/32/12044_2.png) [@BigT](https://boards.straightdope.com/u/BigT)\ **Post date:** [March 13, 2014, 1:54am UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/68 "2014-03-13T01:54:46Z")
> [@Chetumal](#): > > True. > > I guess my point is that, let’s say for example that low thyroid is responsible for 10% of a person’s weight gain. The OP’s posts are a little confusing but it seems that his wife may be somewhere around 50 pounds overweight. Low thyroid then, may be responsible for 5 pounds of that. The other 45 pounds is plain old overeating, something the OP keeps insisting the docs are falsely accusing her of… No, you’re point it that you’re posting to piss the guy off. You expect us to believe that a brand new poster just popped into this particular thread and innocently brought up the one topic the OP said had caused him so much anguish? I try to give people the benefit of the doubt, but puh-lease. We’ve had these debates before, and you just happen to be bringing up the same points? And, you’re new, yet you happen to perfectly respond in the tenor of this board? Let me guess, long time lurker? If you’re going to do this sort of thing, at least be good at it. ---
**Author:** ![Chetumal](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@Chetumal](https://boards.straightdope.com/u/Chetumal)\ **Post date:** [March 13, 2014, 9:16pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/69 "2014-03-13T21:16:32Z")
> [@BigT](#): > > No, you’re point it My what? ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [March 13, 2014, 9:20pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/70 "2014-03-13T21:20:17Z")
> [@BigT](#): > > If you’re going to do this sort of thing, at least be good at it. From your lips to your ears. ---
**Author:** ![Saint\_Cad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/saint_cad/32/18907_2.png) [@Saint\_Cad](https://boards.straightdope.com/u/Saint_Cad)\ **Post date:** [March 14, 2014, 4:28pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/71 "2014-03-14T16:28:12Z")
I think the issue is that being overweight is treated as the disease and not a symptom. Yes people who eat fast food every meal and never exercise will be overweight. No one is saying that fat is formed ex nihilo and yes it is calories in vs calories out but if there is a medical issue that affects your BMR then the weight gain is a symptom of the illness. When you treat the weight you are not treating the illness. Suppose you have cancer or AIDS and you’re wasting away. Does it make any sense to tell you to eat more and never address the disease? Yet we do that with overweight people all the time by assuming they are overeating viz. substantially more than 2000 cal. per day. When they track their eating they are accused of lying or (as some have on this board claim) are too ignorant to know how much they’re eating. Guess what, if my digital kitchen scale says something is 6oz then give me the benefit of the doubt that I know it’s 6 oz and not 8 or 10. Do you know why Mrs. Cad’s endocrinologist put her on major appetite suppressants? Because she wanted her on a 800 calorie / day diet. Think about that a second. BMR is approximately 2000 calories a day +/- exercise, fat %, sex, etc. If you have to eat less than half of that to lose weight, then why isn’t the question “Why the fuck is your metabolism so slow?” or “Is there a medical reason you need to practically starve yourself to lose weight?” Or I guess the answer to cancer patients should be eat more and you be fine. Oh? You’re eating 2500 calories a day? Fuckin’ liar. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [March 14, 2014, 5:14pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/72 "2014-03-14T17:14:22Z")
> [@Mr.Nylock](#): > > Thanks for the info, I REALLY need to get more updated econ textbooks. I think the idea in the examples I was originally referring to are about accreditation and the ability to limit the supply of doctors(the only thing I remember for certain is the worker supply limitation) in the same way some craft unions can limit the supply of workers and thus professional standards and pay are influenced by the reduced supply. They _do_ still do that; our current physician shortage is the result of a terrible miscalculation in the 80s about a looming physician glut. ---
**Author:** ![Chetumal](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@Chetumal](https://boards.straightdope.com/u/Chetumal)\ **Post date:** [March 14, 2014, 7:39pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/73 "2014-03-14T19:39:29Z")
> [@Saint\_Cad](#): > > Do you know why Mrs. Cad’s endocrinologist put her on major appetite suppressants? Because she wanted her on a 800 calorie / day diet. Think about that a second. BMR is approximately 2000 calories a day +/- exercise, fat %, sex, etc. If you have to eat less than half of that to lose weight, then why isn’t the question “Why the fuck is your metabolism so slow?” So you’re claiming that her thyroid imbalance is causing her to only require 800 calories a day, instead of 2,000? And on 800 calories a day she either maintains or even gains weight? One thing I’ve never understood about the whole “thyroid imbalances create huge decreases in BMR” and also the belief in “starvation mode” is this: The United Nations Food and Agriculture Organization estimates that nearly 870 million people of the 7.1 billion people in the world, or one in eight, were suffering from chronic undernourishment in 2010-2012\*. If there were a way to simply adjust thyroid function in a starving population so that they suddenly only need less than half the calories to maintain their body weight, million and millions of lives could be saved. So why aren’t we airdropping care packages of thyroid meds into famine-affected areas? Cite: [World Hunger, Poverty Facts, Statistics 2018 - World Hunger News](http://www.worldhunger.org/articles/Learn/world%20hunger%20facts%202002.htm#Number_of_hungry_people_in_the_world) ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [March 14, 2014, 7:46pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/74 "2014-03-14T19:46:28Z")
> [@Chetumal](#): > > The United Nations Food and Agriculture Organization estimates that nearly 870 million people of the 7.1 billion people in the world, or one in eight, were suffering from chronic undernourishment in 2010-2012\*. If there were a way to simply adjust thyroid function in a starving population so that they suddenly only need less than half the calories to maintain their body weight, million and millions of lives could be saved. So why aren’t we airdropping care packages of thyroid meds into famine-affected areas? > > Cite: [World Hunger, Poverty Facts, Statistics 2018 - World Hunger News](http://www.worldhunger.org/articles/Learn/world%20hunger%20facts%202002.htm#Number_of_hungry_people_in_the_world) So, you wonder why we don’t suppress people’s thyroid in order to allow them to live on fewer calories? Hey, if we chop off some limbs, they’ll need fewer yet! ---
**Author:** ![IvoryTowerDenizen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ivorytowerdenizen/32/17937_2.png) [@IvoryTowerDenizen](https://boards.straightdope.com/u/IvoryTowerDenizen)\ **Post date:** [March 14, 2014, 7:55pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/75 "2014-03-14T19:55:39Z")
> [@Chetumal](#): > > So you’re claiming that her thyroid imbalance is causing her to only require 800 calories a day, instead of 2,000? And on 800 calories a day she either maintains or even gains weight? > > One thing I’ve never understood about the whole “thyroid imbalances create huge decreases in BMR” and also the belief in “starvation mode” is this: > > The United Nations Food and Agriculture Organization estimates that nearly 870 million people of the 7.1 billion people in the world, or one in eight, were suffering from chronic undernourishment in 2010-2012\*. If there were a way to simply adjust thyroid function in a starving population so that they suddenly only need less than half the calories to maintain their body weight, million and millions of lives could be saved. So why aren’t we airdropping care packages of thyroid meds into famine-affected areas? > > Cite: [World Hunger, Poverty Facts, Statistics 2018 - World Hunger News](http://www.worldhunger.org/articles/Learn/world%20hunger%20facts%202002.htm#Number_of_hungry_people_in_the_world) What? Being low thyroid just doesn’t make you need fewer calories, it has a whole of detrimental symptoms, like cold intolerance, pervasive fatigue, brittle hair and nails. Even people with thyroid cancer, who are on meds to suppress their TSH, are given replacement hormone because physiologically we need it. ---
**Author:** ![Chetumal](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@Chetumal](https://boards.straightdope.com/u/Chetumal)\ **Post date:** [March 14, 2014, 8:14pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/76 "2014-03-14T20:14:55Z")
> [@IvoryTowerDenizen](#): > > What? Being low thyroid just doesn’t make you need fewer calories, it has a whole of detrimental symptoms, like cold intolerance, pervasive fatigue, brittle hair and nails. I would think people in imminent danger of starving to death would prefer those symptoms over, y’know… dying. ---
**Author:** ![IvoryTowerDenizen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ivorytowerdenizen/32/17937_2.png) [@IvoryTowerDenizen](https://boards.straightdope.com/u/IvoryTowerDenizen)\ **Post date:** [March 14, 2014, 8:17pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/77 "2014-03-14T20:17:15Z")
> [@Chetumal](#): > > I would think people in imminent danger of starving to death would prefer those symptoms over, y’know… dying. If they had the resources to send thyroid suppressing meds, monitor the dose, and ensure everyone was getting it, I think dropping off food would be doable as well. Minus the side effects of being hypothyroid. Not too mention that low thyroid in children causes mental retardation. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [March 14, 2014, 8:30pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/78 "2014-03-14T20:30:30Z")
> [@Chetumal](#): > > I would think people in imminent danger of starving to death would prefer those symptoms over, y’know… dying. Words I never thought I’d say: You really should take BigT’s advice. Maybe take a class on trolling or something. ---
**Author:** ![Saint\_Cad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/saint_cad/32/18907_2.png) [@Saint\_Cad](https://boards.straightdope.com/u/Saint_Cad)\ **Post date:** [March 14, 2014, 9:26pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/79 "2014-03-14T21:26:09Z")
> [@Chetumal](#): > > So you’re claiming that her thyroid imbalance is causing her to only require 800 calories a day, instead of 2,000? And on 800 calories a day she either maintains or even gains weight? No. I said her endocrinologist recommended 800 cal a day to lose weight which probably is true. My point was where is the followup of WHY she needed such a radical diet to lose weight. Wouldn’t such a restrictive diet indicate a medical condition that should be treated as well? ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [March 14, 2014, 9:53pm UTC](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282/80 "2014-03-14T21:53:06Z")
> [@Saint\_Cad](#): > > No. I said her endocrinologist recommended 800 cal a day to lose weight which probably is true. My point was where is the followup of WHY she needed such a radical diet to lose weight. Wouldn’t such a restrictive diet indicate a medical condition that should be treated as well? It appears that if she needed such a low-calorie diet to lose weight it is because she has low thyroid levels. Which she was being treated for. It seems if they thought she was just lying, they wouldn’t have thought she needed to go so low. If they thought she was eating 3000 calories a day, wouldn’t they would have suggested she needed to go to 2000, or 1800, or 1500, or 1200? “Normal” calorie requirements for women to lose weight? It’s only if they believed that she was being honest in her calorie reports that saying “she must need an 800 calorie/day diet to lose weight” makes any sense. Most women don’t need an 800 calorie diet to lose weight, as you said, so most doctors are not likely to say “Oh, I think you’re lying about how much you eat, so that means you only need 800 calories a day.” Again, maybe your story is just getting a bit mangled in the telling. I get that people might not have been as nice as they should be (and that’s bad). I get that they may not have communicated as well as they should (and that’s bad). And I get that they may not have done as aggressive treatment as they could. But where it’s all falling apart is where you are claiming that they are horrid bastards for not diagnosing her and disbelieving her, when from what you are saying she WAS diagnosed and she WAS believed. (There’s also the temporal possibility that she developed hypothyroid after this entire journey started. There’s no guarantee that someone’s thyroid levels will stay constant over 6 years.) [Previous page](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282.md?page=3) [Next page](https://boards.straightdope.com/t/and-you-wonder-why-i-hate-doctors/683282.md?page=5)