# Why Don't Doctors Get It???

**URL:** <https://boards.straightdope.com/t/why-dont-doctors-get-it/523815>\
**Category:** In My Humble Opinion\
**Created:** [January 5, 2010, 11:42pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815 "2010-01-05T23:42:36Z")\
**Posts on this page:** 20\
**Page:** 3

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**Author:** ![msmith537](https://avatars.discourse-cdn.com/v4/letter/m/d9b06d/32.png) [@msmith537](https://boards.straightdope.com/u/msmith537)\
**Post date:** [January 6, 2010, 4:52pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/41 "2010-01-06T16:52:44Z")

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> [@friedo](#):
>
> Maybe they just think you should look at other ways to relieve stress aside from eating, smoking, and drinking.
> 
> How about some yummy brightly-colored pills instead?

The only thing more effective is exercise.😃

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**Author:** ![Dead\_Flowers](https://avatars.discourse-cdn.com/v4/letter/d/ecccb3/32.png) [@Dead\_Flowers](https://boards.straightdope.com/u/Dead_Flowers)\
**Post date:** [January 6, 2010, 5:11pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/42 "2010-01-06T17:11:40Z")

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There is evidence that hearing advice from a doctor does correlate positively with a statistically measurable increase in the likelihood someone will improve their behaviors (one [cite](http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000165/frame.html) of many for smoking cessation). So as annoying as it is, it is likely helping in a big picture sense. Doctors don’t think they have all the answers, but they do have some of them and they’re trying to share them with you.

Also, doctors who work in hospital systems may be required to give lifestyle advice by employers, subject to review and discipline. Many healthcare systems link compliance with counseling guidelines to physician pay and bonus structures. Your doctor may be just as sick of giving the advice as you are of hearing it, but may be doing it because if that little box isn’t checked on the form or documented in patient surveys then they will themselves lose out. Sunshine and lollipops, indeed.

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**Author:** ![Swallowed\_My\_Cellphone](https://avatars.discourse-cdn.com/v4/letter/s/9d8465/32.png) [@Swallowed\_My\_Cellphone](https://boards.straightdope.com/u/Swallowed_My_Cellphone)\
**Post date:** [January 6, 2010, 5:42pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/43 "2010-01-06T17:42:03Z")

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> [@aruvqan](#):
>
> I would absolutly love to lose weight, being a fat diabetic … but - I eat the nutritionist mandated diet, I do the doc mandated drugs. I don’t smoke, drink or binge eat. I _can’t_ do 90% of the forms of exercise out there thanks to arthritis in various forms in essentially every joint from the waist down. .

There are several options for those with mobility issues, which is why an old high school buddy of mine has way better cardio than I do, despite the fact that he’s been in a wheelchair for the past 15+ years.

Heck, you can get a hand cycle for under $200.

Not everyone actually can exercise and you may be one of the exceptions, but _most_ people can take part in light exercise. Most people will also come up with a thousand different excuses why it’s impossible for them to change their lifestyles and do it.

ETA: Also, plain old _hobbies_ can be an alternative stress reduction technique that has more positive effects than eating from boredom and smoking.

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**Author:** ![Machine\_Elf](https://avatars.discourse-cdn.com/v4/letter/m/82dd89/32.png) [@Machine\_Elf](https://boards.straightdope.com/u/Machine_Elf)\
**Post date:** [January 6, 2010, 5:46pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/44 "2010-01-06T17:46:04Z")

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> [@Pazu](#):
>
> I really love OPs like this. They reaffirm my decision to specialize in a field with virtually no patient interaction.

A friend of mine chose anesthesiology for exactly that reason: very little interaction with the patient, basically limited to saying “Hi, I’m your anesthesiologist” right before you put him under.

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**Author:** ![vivalostwages](https://avatars.discourse-cdn.com/v4/letter/v/d07c76/32.png) [@vivalostwages](https://boards.straightdope.com/u/vivalostwages)\
**Post date:** [January 6, 2010, 5:46pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/45 "2010-01-06T17:46:54Z")

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I’d like to see the day when my doctor’s office and the hospitals stop keeping vending machines that loaded with all the crap they say we shouldn’t eat. How about a vending machine that contains only fruits and veggies? 😃

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**Author:** ![Ferret\_Herder](https://avatars.discourse-cdn.com/v4/letter/f/e47774/32.png) [@Ferret\_Herder](https://boards.straightdope.com/u/Ferret_Herder)\
**Post date:** [January 6, 2010, 6:13pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/46 "2010-01-06T18:13:38Z")

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> [@vivalostwages](#):
>
> I’d like to see the day when my doctor’s office and the hospitals stop keeping vending machines that loaded with all the crap they say we shouldn’t eat. How about a vending machine that contains only fruits and veggies? 😃

That’d be lovely (she says, lamenting not having brought any snacks along today, and craving some hummus and carrot sticks). My hospital at least put in a healthy choices selection of hot food (including posted nutritional info) to supplement the other not-so-healthy stuff, but they don’t always have vegetarian fare, which leaves me out. At least there’s the veggie burger or salad bar (ho hum).

A Seventh-Day Adventist-run hospital near my house has nutritional info posted for all of the choices in their cafeteria, which about bowled me over when I saw it. Their religion promotes vegetarianism, and though not all of their cafeteria selections are veg, that institution really walks the walk on trying to help people be healthy.

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**Author:** ![nashiitashii](https://avatars.discourse-cdn.com/v4/letter/n/7c8e57/32.png) [@nashiitashii](https://boards.straightdope.com/u/nashiitashii)\
**Post date:** [January 6, 2010, 6:18pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/47 "2010-01-06T18:18:00Z")

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> [@Dead\_Flowers](#):
>
> Also, doctors who work in hospital systems may be required to give lifestyle advice by employers, subject to review and discipline. Many healthcare systems link compliance with counseling guidelines to physician pay and bonus structures. Your doctor may be just as sick of giving the advice as you are of hearing it, but may be doing it because if that little box isn’t checked on the form or documented in patient surveys then they will themselves lose out. Sunshine and lollipops, indeed.

Also, if they’re working for corporate doc-in-the-box locations, it’s part of the whole setup. I recall the last time I had to go to the doctor, I was diagnosed with bronchitis. Based on the numbers generated from that visit, I received a computer printout for losing weight in addition to one on treating bronchitis; this wasn’t something that the doctor or any of the nurses discussed with me, but they did mention the treatment procedures for bronchitis. I’m guessing that the computer automatically prints out these types of things based on a patient’s information, but it was still a little bizarre. I realize I have to lose weight and am actively working on it, but to the average person, I don’t look like what my height-to-weight ratio makes me seem like. If I had gotten a lecture from the doctor about the issue (whom I’d likely not be seeing again, since it is a walk-in clinic), I would have informed him of my dietary choices and fitness efforts and left it at that.

Having been one of those people who’d get very intense cravings for food that was bad for me, it took a long time to readjust to a healthier food regimen and for my tastes to consequently change. I still like and sometimes overindulge in fatty and rich foods, but it’s increasingly common for me to want more vegetable-heavy dishes and lighter preparations than before. It’s \*not \*impossible to change a craving or to change a binge cycle into a healthier pattern of eating, but it’s damned hard and requires some vigilance on the part of the person who binge eats.

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**Author:** ![LouisB](https://avatars.discourse-cdn.com/v4/letter/l/dfb087/32.png) [@LouisB](https://boards.straightdope.com/u/LouisB)\
**Post date:** [January 6, 2010, 6:43pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/48 "2010-01-06T18:43:50Z")

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Why do doctors insist on jacking around with medications that work? I’m damn near 70 years old; I’ve had migraines since I was about twelve years old; I KNOW what medicine works for me; I should know as I’ve tried bushels that don’t. WHY IN THE HELL DOES A DOCTOR WHO HAS NEVER MET ME WANT TO CHANGE MY DAMNED HEADACHE MEDICINE WITHIN TEN MINUTES OF OUR FIRST MEETING? I DON’T CARE if it is some “new and improved” BS; I DON’T WANT another migraine headache as long as I live: Don’t mess with my headache medicine; rubber hammers to the back of the skull have worked for many years.

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**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\
**Post date:** [January 6, 2010, 6:59pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/49 "2010-01-06T18:59:21Z")

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> [@shiftless](#):
>
> It seems a little dishonest to me for doctors to charge the amounts they do if they are only dispensing the same advise everybody else gives.

But why is “everybody else” dispensing that advice? They learned it from doctors.

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**Author:** ![Kelby](https://avatars.discourse-cdn.com/v4/letter/k/a587f6/32.png) [@Kelby](https://boards.straightdope.com/u/Kelby)\
**Post date:** [January 6, 2010, 7:20pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/50 "2010-01-06T19:20:54Z")

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(Slight hijack, sorry)

I’m new here and was curious: Anyone have an estimate of the number of physicians that frequent these boards?

The seems like a pretty learned place. I’m impressed.

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**Author:** ![ShelliBean](https://avatars.discourse-cdn.com/v4/letter/s/f9ae1b/32.png) [@ShelliBean](https://boards.straightdope.com/u/ShelliBean)\
**Post date:** [January 6, 2010, 7:39pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/51 "2010-01-06T19:39:43Z")

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Just want you guys to know I almost ate some nasty overprocessed crap for lunch but read this threat and really just wanted to go get my cup 0’yogurt with wheat germ and big ass bottle of water. So thanks for that.

aruqvan - is home health a possibility? I would go to one PT and tell them “I won’t be able to come back, can you refer me to home health?” - the lack of transportation should be enough to at least get a referral to home PT. Also tell them that transportation is an issue so you need some specific PT that you can do on your own at home.

Sleeps - thx for the tip on carrot sticks in water. My son and I love fresh carrots but they look like ashy old man legs by the time we get to the bottom of the bag. I’ll def. put some in water for him for school!

Remember people: carrot sticks are better than chips!! They even make chip-shaped carrot slices that are fabulous.

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**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:** [January 6, 2010, 7:41pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/52 "2010-01-06T19:41:39Z")

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> [@Kelby](#):
>
> I’m new here and was curious: Anyone have an estimate of the number of physicians that frequent these boards?

I think we only have 3-5 who are openly physician-y. **Quadgop the Mercotan** is one. I forget who the others are.

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**Author:** ![Green\_Bean](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/green_bean/32/1760_2.png) [@Green\_Bean](https://boards.straightdope.com/u/Green_Bean)\
**Post date:** [January 6, 2010, 8:06pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/53 "2010-01-06T20:06:03Z")

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> [@tumbleddown](#):
>
> Because binge eating, true binge eating, isn’t about having an occupied mouth, or a full stomach. It’s not about nutrition. Nor is it about weight loss, as binge eaters don’t have to be overweight. It’s a psychological problem with a physical manifestation. **Suggesting ice chips or carrot sticks to combat binge eating is like suggesting an anorexic buy some pretty clothes and smile more. It misses the point so immensely, it’s not even in the same universe**.
> 
> A _good_ doctor, upon hearing the word “binge” should have stopped and asked more questions, and investigated further and made a recommendation for someone _qualified_ to treat _ **eating disorders** _. Glib recommendations of carrot sticks are about as useful as telling the person with a compound tib-fib fracture to just not walk around for a while until they feel better.

(Bolding mine)

True binge eating is an eating disorder. Like anorexia and bulimia. Binge eaters have already tried all those great tips about carrot sticks and such. Doesn’t work for them. And it’s not about willpower, either. Binge eating disorder has to be addressed from a different angle.

> [@LurkerInNJ](#):
>
> Did you explain that this was/is a psychological problem and that you weren’t talking about sneaking back to the fridge for a few spoonfuls of leftovers ?

A good doctor should be aware of binge eating disorder. When she heard “night-time bingeing,” she should have asked some follow-up questions and possibly referred **panache** to the correct specialist. Of course **panache** also should have tried to make sure she understood the extent of the problem. But maybe he wasn’t aware that binge eating disorder even exists. Maybe he’ll look into it because of this thread and see if it might apply to him.

> [@Sleeps\_With\_Butterflies](#):
>
> Ha! I would suggest the carrot sticks. I keep a bowl of veggies all cut up and ready to go in a little tupperware container full of water so that when I need something to munch on… there it is.
> 
> Also: air popped popcorn with a few sprays of zero calorie dressing and your favorite spice sprinkled on top.
> 
> I could go on and on 😉
> 
> Although your comment does make me ask something that I’ve experienced both online and off (and I swear I’m not accusing you, it’s just the right time for me to ask): why do a lot of people seem to discount the advice of people who are thin? I’ve gotten “you wouldn’t understand!” from overweight people who are looking for diet/exercise tips. Why wouldn’t I understand? It works!
> 
> PS: I would also suggest not visiting the fridge in the middle of the night for pie 😉

It’s not because you’re thin, sweetheart. If someone does have binge eating disorder or compulsive overeating disorder or even just other issues with food, then you definitely don’t understand.

And frankly, your P.S. with the winky is offensive. Do you really think that fat people don’t _know_ that they shouldn’t eat pie in the middle of the night? Do you think that fat people are so stupid that they can’t think of any low-calorie snacks without your handy dandy tips? Sure, some people are lazy and/or ignorant and/or have no willpower and/or just don’t give a shit, but gimme a fucking break! Do you really think that you’re going to make a dent in the obesity epidemic with your perky but unsolicited advice? Are you expecting people to say “Oh, wow! I never thought of eating carrot sticks instead of potato chips while I’m watching Desperate Housewives!! Thanks, **SWB**!”

And no, I’m not making excuses for why people are fat, so please don’t accuse me of that. And I’m not saying that people who have compulsive or binge eating disorders can’t lose weight. Like I said above, they need to approach it differently. They can diet until the cows come home, but it ain’t gonna work unless they deal with the underlying disorder.

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**Author:** ![GargoyleWB](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gargoylewb/32/199_2.png) [@GargoyleWB](https://boards.straightdope.com/u/GargoyleWB)\
**Post date:** [January 6, 2010, 8:09pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/54 "2010-01-06T20:09:13Z")

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IME, what doctors simply don’t get is money. In my lean min-wage temping years, when I’ve had to explain that I could not find the time for an appt during their hours, that missing half a day of work literally meant the difference of paying rent or not or getting fired, they looked at me like I was speaking Klingon.

Doc: “So if we schedule you for next week…”  
Me: “No, I really can’t, I have to be at work. Besides it’s just a follow-up”  
Doc: “Later in the week?”  
Me: “I have to work, I don’t make much money and I can’t afford to miss the time. Can’t you just call me?”  
Doc: “What if it’s early, like 9:30?”

Arrghh!!!

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**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:** [January 6, 2010, 8:25pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/55 "2010-01-06T20:25:00Z")

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> [@Green\_Bean](#):
>
> It’s not because you’re thin, sweetheart. If someone does have binge eating disorder or compulsive overeating disorder or even just other issues with food, then you definitely don’t understand.
> 
> And frankly, your P.S. with the winky is offensive. Do you really think that fat people don’t _know_ that they shouldn’t eat pie in the middle of the night? Do you think that fat people are so stupid that they can’t think of any low-calorie snacks without your handy dandy tips? Sure, some people are lazy and/or ignorant and/or have no willpower and/or just don’t give a shit, but gimme a fucking break! Do you really think that you’re going to make a dent in the obesity epidemic with your perky but unsolicited advice? Are you expecting people to say “Oh, wow! I never thought of eating carrot sticks instead of potato chips while I’m watching Desperate Housewives!! Thanks, **SWB**!”

She wasn’t referring specifically to binge eaters, but to anyone who wants to lose weight. She’s got a point, too - fat people never ask skinny people how they got skinny. They just assume that we all started that way and we always stay that way no matter what.

Now, for some people, that _is_ true - I’m skinny despite a horrible diet and infrequent exercise, but **SWB** has mentioned before that she eats like a rabbit and works out constantly to stay in shape. So why _not_ listen to her?

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**Author:** ![Green\_Bean](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/green_bean/32/1760_2.png) [@Green\_Bean](https://boards.straightdope.com/u/Green_Bean)\
**Post date:** [January 6, 2010, 8:49pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/56 "2010-01-06T20:49:03Z")

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> [@Really\_Not\_All\_That\_Bright](#):
>
> She wasn’t referring specifically to binge eaters, but to anyone who wants to lose weight. She’s got a point, too - fat people never ask skinny people how they got skinny. They just assume that we all started that way and we always stay that way no matter what.

I hear what you’re saying, and I agree that many overweight people just assume that thin people don’t have to work at it.

But she was specifically responding to **panache45** who said that he had a problem with nighttime bingeing. **LurkerInNJ** had already made the same point about how he could “binge” on healthy low-cal foods, and **tumbleddown** had already addressed that. **LurkerInNJ** obviously got the point. **SWB** just parroted the old party line, which is apparently made out of carrot sticks.

If we were all able to follow her advice, then nobody would be fat unless they wanted to be. But the fact is that many people have extreme trouble doing what she suggests. The question, then, is why? And how should they fix that problem?

Her post was condescending as hell, though I’m sure that she didn’t intend for it to be so.

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**Author:** ![Sleeps\_With\_Butterflies](https://avatars.discourse-cdn.com/v4/letter/s/bb73d2/32.png) [@Sleeps\_With\_Butterflies](https://boards.straightdope.com/u/Sleeps_With_Butterflies)\
**Post date:** [January 6, 2010, 8:51pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/57 "2010-01-06T20:51:16Z")

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> [@Green\_Bean](#):
>
> It’s not because you’re thin, sweetheart. If someone does have binge eating disorder or compulsive overeating disorder or even just other issues with food, then you definitely don’t understand.
> 
> And frankly, your P.S. with the winky is offensive. Do you really think that fat people don’t _know_ that they shouldn’t eat pie in the middle of the night? Do you think that fat people are so stupid that they can’t think of any low-calorie snacks without your handy dandy tips? Sure, some people are lazy and/or ignorant and/or have no willpower and/or just don’t give a shit, but gimme a fucking break! Do you really think that you’re going to make a dent in the obesity epidemic with your perky but unsolicited advice? Are you expecting people to say “Oh, wow! I never thought of eating carrot sticks instead of potato chips while I’m watching Desperate Housewives!! Thanks, **SWB**!”
> 
> And no, I’m not making excuses for why people are fat, so please don’t accuse me of that. And I’m not saying that people who have compulsive or binge eating disorders can’t lose weight. Like I said above, they need to approach it differently. They can diet until the cows come home, but it ain’t gonna work unless they deal with the underlying disorder.

I’m sure that chip on your shoulder would free up about five pounds or so if you lost it. That’d be a starter!

The PS was a nod to the bruhaha that erupted between Lynn and another member about midnight pie, not an actual suggestion… _sweetheart_. Laughing helps boost your metabolic rate according to a Vanderbilt University study, so you might try a sense of humor. Just an FYI.

I actually have professional experience working with morbidly obese patients as a registered nurse so it’s a little more than “Let me halp u get thin!!!111one!” so your wild ranting about unsolicited advice doesn’t really work. I get _paid_ to help people lose weight. I was simply mentioning an observation that I’ve experienced that I’ve often had my advice dismissed simply because I’m thin.

> [@Really\_Not\_All\_That\_Bright](#):
>
> She wasn’t referring specifically to binge eaters, but to anyone who wants to lose weight. She’s got a point, too - fat people never ask skinny people how they got skinny. They just assume that we all started that way and we always stay that way no matter what.
> 
> Now, for some people, that _is_ true - I’m skinny despite a horrible diet and infrequent exercise, but **SWB** has mentioned before that she eats like a rabbit and works out constantly to stay in shape. So why _not_ listen to her?

Thank you. To be fair, I don’t always eat like a rabbit. Sometimes I eat crap just like everybody else.

But you’re right, a lot of people see a thin person and assume they can eat whatever they want and won some kind of genetic lottery. There are plenty of people in my family who are obese and I have to work at it just like everyone else does.

But hey, who knew you could get such an over-the-top reaction from a throw away question and a joke?

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**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:** [January 6, 2010, 8:55pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/58 "2010-01-06T20:55:46Z")

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Er… anyone who’s posted on this board before?

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**Author:** ![Sleeps\_With\_Butterflies](https://avatars.discourse-cdn.com/v4/letter/s/bb73d2/32.png) [@Sleeps\_With\_Butterflies](https://boards.straightdope.com/u/Sleeps_With_Butterflies)\
**Post date:** [January 6, 2010, 8:59pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/59 "2010-01-06T20:59:02Z")

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> [@Really\_Not\_All\_That\_Bright](#):
>
> Er… anyone who’s posted on this board before?

True. Maybe I should talk about tipping next?

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**Author:** ![aruvqan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aruvqan/32/2891_2.png) [@aruvqan](https://boards.straightdope.com/u/aruvqan)\
**Post date:** [January 6, 2010, 9:00pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/60 "2010-01-06T21:00:25Z")

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> [@Ferret\_Herder](#):
>
> Yeah, they stay fresh and crisp. Cut-up veggies will go limp faster than whole veggies due to surface evaporation issues and the exposed surfaces/cut-through plant cells leaking water faster. Putting them in water is like putting cut flowers in water; both will suck up water and stay nice for longer.

A little dash of lemon juice is also good in the water, the acid in it helps protect against oxidation that can change the flavor of the veggies and in itself doesnt do much to change the flavor. You also can buy precut veggies in the veggie section, but htey tend to be more expensive than doing it yourself, but the little individual packets are good to stick in a linch to take to work for snacks.

Also, might I suggest jicama as a snack, a really nice crunch, and though it is a starchy veggie like a cross between a radish and a potato texture wise [rob says it reminds him of a giant water chestnut]

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