Well speaking as an pretty damn overweight all my life Med student, I’ve been on both sides of this coin.
All my life I felt the way you did, I enjoyed my Doctor’s visits and all, but I hated the checkups and the inevitable conversations that would always occur- “You need to consider loosing some weight…”- EVERY visit. As a kid, I always ignored it, or I said I’d try, or even had a few doctors just give up on me for it. I hated it and I hated them for it.
Now in med school, it kinda sucks- because the one telling me I should lose some weight is myself pretty much. And the textbooks- well they pretty much all spell out the same thing. Diabetes lowers your life span, and has plenty of complications. Hypertension is a killer in the long term- the big three irreversible organs to go are Kidneys, Heart and the Brain. Acute MI’s, Heart Attacks, aortic stenosis, clogged arteries, pulmonary HTN (hypertension), reversible steatosis (for the drinkers out there) that progresses to fibrosis and then irreversible cirrhosis. Getting to read about Wernicke-Korsakoff syndromeand the crushing toll it can take on family members, to learn about the costs of medications, the strokes, the MI’s, the feel of cutting into a Cadaver and feeling a person’s yellow fatty tissue…
It really really brought it all home to me. It was and is graphic and on going. So many problems are created in the long term with these and many other pathological conditions which all list common causes that can lead up to them: being overweight and all the complications that arise from it pretty much lead up to a TON of crazy things that can do you in, or if not even that, can REALLY make the end stages of life not a happy place to be.
So I feel for you, Sir/ma’am. Because I know had I not gone to med school I never would have cared about these things, I was stubborn about it, and I believed that sure I might be cutting a few years off my life, but why sweat it, when I could enjoy the now?
And now, I have to be on the other side of the coin, being an overweight doctor trying to explain to his patients to do the very same things that I myself can obviously been seen as not having done? Not cool. It feels hypocritical. But in the end, the Doctor-patient relationship should be FOR the patient. The patient comes first. Their health should be #1, that’s why they’re here to see us, and we’ve got to do the best we can to take care of their current problems. If they’re sick, medical professionals should do their best to help solve their problems or if not that, then to improve their quality of life the best we can with our knowledge, our training, and our tools.
But should we as health care professionals stop there? Would you want us to?
I believe now that health care professionals should also try to do some measure of preventative measures as well- if we can advise or advocate to the patient ways that can help THEM out in the long run from hitting more severe or complicated illnesses, I think that doctors and other health care providers have an obligation to try to prevent that.
We cannot force you to change, nor do I believe that is the role of a doctor.
But if there’s a bad end down an unhealthy path, I feel I should try to educate and advise my patient the best I can on ways they can avoid that end. Life is certainly stressful and terrible right now, but if we only focus on a patients’ CURRENT medical health, then I think I would be doing you a grave disservice.
If a patient came in with a growth or suspicious lump, the doctor would be doing them a terrible disservice if they merely stated “well, it’s not bothering you right now, we shouldn’t worry about it right now. Let’s wait and if it gets worse, THEN think about coming in” (yes, I know this does still happen though- it’s not a perfect world).
That’s my idealistic views as a medical student. And I know how much a 15 year old me would have hated the current me saying these things. But… I still think it’s the right thing to do. Dieting isn’t fun, cutting back on alcohol isn’t fun, and I certainly don’t blame anyone for feeling frustrated at all- I know what it’s like to constantly have doctors remind me about it over and over. And I also know what it’s like to go to the doctor, and have them look at my weight and simply not say anything, even though they knew it was out of control. That one hurt more- when it hit me that he had nothing left to say and he’d given up on me. I don’t want to do that to my patients. You’re not alone though.
And I’m sorry I don’t have all the answers at all.
The only thing they give me is the fact that I get to learn all the various ways I can die, all the various ways my life can slow down, and watch others who’re currently suffering through those problems.
All the books tell us is “it could have been prevented.”
As to HOW to get someone to cut back? How to explain to someone for the 400 and first time that he’s got to cut back or else it could kill him but to do it in a way that connects and makes sense- there’s nothing on that. How to get someone to figure out that they’ve got to take a look in their life and see what’s more important to them their current lifestyles or the ability to have a similar one in 5 or 10 years- nothing on that either.
I don’t think it’s something that’s teachable really- they just teach us that to prevent these problems it’s best to prevent them from starting in the first place, and to recognize the unhealthy behaviors when they’ve got a fighting chance to not go down an even worse road.
But getting someone to MAKE an important lifestyle change just because a doctor has pointed out it’s got an unhealthy consequence? That’s not something that they can teach us. That’s where the doctor-patient relationship now requires help form the other side. The doctor can only point out the bad outcomes, and he can only be an advocate and warn the other half that it’s not a fun road… :shrug: The doctor can only give forth the knowledge, and perhaps (if they’re really knowledgeable) some ways to help or places to turn to for support and help, but the rest? The rest is up to us patients to deal with.
Bummer on the bad news, but good luck to you in your journey. We each have our own to bear and it’s not a fun or easy path. But I certainly do wish you the best.
A journey of a thousand miles begins with a single step. - **Confucius **