Woman offended by truthful advice from doctor

The BBQ Pit
208

Please notice that you changed from eating to overeating. We can at least agree that it is the result of taking in more calories than the body can burn. But your claim that they (?) make excuses for the causes of increased appetite (which you put in quotation marks as if it were questionable).

Who are the they that you refer to? The scientists that have done the studies? What reasons would they have to skew the studies and make “excuses”? I would think that in the interest of science, they would want to find reasons.

Do you have a cite pointing to “big bones” as an “excuse” for increased appetite? I’ve never seen one. I think the general principle is that someone with a big frame can generally carry weight better than a person with a small frame.

If you didn’t see obese natives in Liberia, how does that disprove a genetic component?

To the contrary, it is the doctor’s job to do what is best for her or his patient. Any doctor worth his salt should know that undermining the patient’s confidence isn’t going to be helpful. (It was a dumb move on his part, but shouldn’t be actionable.)

Your continued ignorance of compulsive behaviors is deplorable, but not as unexplainable as your need to expound on it.

As for the subject of “will power,” I have been able to find will power for my compulsive eating problems in a pill that I take once a day. It is the same medication that allows some other people to have the “will power” not to have seizures.

(With surgery and the pill, I have maintained a 150 weight loss for 7 years.)

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I’m not saying they’re making excuses for an increased appetite, I’m saying they’re using this alleged gentically increased appetite as an excuse to overeat. Just because you have an increased appetite doesn’t mean you have to indulge it. Addiction has a genetic component too, that doesn’t mean that addicts are absolved of any responsibility for their own conditions.

I never said that “big bones” was an excuse for overeating. I just cited it as one of the common excuses for being fat.

It proves that if you don’t overeat, you don’t get fat.

The patient’s “confidence” could not be less relevant. He’s not her therapist he’s her physician and it would be irresponsible for him to hold back the truth. Her self-esteem is not his concern.

Explain it to me then. Why is it so hard to refrain from eating more calories than you burn? I really don’t get it. Are you saying it’s like a crack addiction or something where you just can’t put down the fork? Enlighten me.

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We’re saying that the human body is anything but simple, and as such, so ‘simple’ equation can account for its behaviour. Yes, calories in must equal or be less than calories burned. But calories in the mouth and energy burned in exercise are far from the only factors to consider. Absorption of nutrients, metabolism, efficiency of energy use in muscles, variants of enzymes involved in metabolism… all of these things and more can, and DO, vary based on genetics and enviroment. And will consequently change (as well as make totally mystifying, in some cases) weight loss and gain rates.

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From what I have read and been told by nutritionists and bariatric specialists and psychiatrists, it is more difficult to deal with (unassisted) than crack addiction. Try to imagine a crack addict that is told that he can have just a little bit of crack three times a day, but no more.

I cannot speak for all people who are overweight, just myself:

When I was restricted to a liquid diet of less that 500 calories, I had no trouble at all staying on that diet for six months. I enjoyed the shakes that I drank, but I sometimes forgot to drink them and wasn’t really interested in food. I would have been content to stay on that plan for the rest of my life.

It was the supervising doctor that made me return to eating because he was afraid of chemical imbalances in “electrolytes” or whatever.

Does that sound to you like a problem with will power or putting down the fork? Does that sound to you like I am some sort of pig or just making excuses for myself?

Yet, when I was forced to return to regular food, because of a compulsion, I was unable to limit my intake.

I hope that you are familiar with obsessive-compulsive disorders and do not blame those people for the compulsions they have that cause havoc in their lives. Mine was no different. I could not concentrate on anything else or proceed with anything else until I had eaten again and then again. (Someone else here compared it to breathing and that is as close as anything that I can think of.) Compulsions are a little different from addictions.

Can you imagine how desperate people have to be to have the surgery that limits their intake for the rest of their lives to a child’s portion? Do you know how horribly painful the surgery was back then (1998) or how dangerous? We were automatically put into intensive care.

Yet you talk about us as if we are a bunch of namby-pambies.

Even after the surgery, the compulsion to eat was still there to the point that I would make myself really sick. After losing 150 pounds, I gained 30 back.

That’s when my shrink told me about the pill for seizures and how it worked for some people who have compulsive eating behaviors. Almost overnight it changed my ability to contol the compulsion because it changed my brain chemistry.. I have now lost what I regained.

There but for a brain glitch go you.

As for the people in Liberia, you have failed to prove your point with any scientific data or even reasonable argument.

This is the lowest level of argument that I have seen you indulge in since I’ve been participating at the Dope. Not your finest hour.

Try to look beyond the way things are for you.

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Um, NO. The fact that psychoactive medication may have helped you accomplish a goal does not mean that there was anything wrong with your brain, or that there was anything defective about your brain chemistry.

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I’m sorry, are you from another planet? That has no resemblance to Earth logic.

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One freaking more time. Did you read QtM’s posts and my cites way back on page 2 re: insulin and low blood sugar producing something much stronger than a craving and not merely “increased appetite”? You are being, to use his phrase, willfully ignorant. And please don’t say insulin problems are rare. As my cites show, they aren’t.

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And I’m sorry that you’re a fucking idiot and are incapable of understanding such a simple statement.

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Are child molesters who act on impulses “stronger then a craving” absolved of responsibility for their actions?

If not, why?

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(Not that I think being fat is even in the same league as being a child molester on a moral scale. Let’s just explore this “It’s really hard for some people not to do something so it’s not their fault they do it.”)

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OK I’ll do it. I’ve just learned a lot by actually researching some of this stuff, and I’m ready to question the total efficacy of willpower in weight loss. I like this explanation of how it works with dieting. From Science (click on the link at the bottom to get the full article):

Every single study and guideline I have read in the last two days points out that you shouldn’t try to lose more than 10% of your body weight because it’s not realistic. Why? Because once you top 10% or so innumerable biological mechanisms (both metabolic and behavioral) kick in to defeat you. I refer you again to the Cell article to see all the physiological mechanisms involved in maintaining homeostasis and to this Neuron article on the behavioral controls on feeding.

Since the mechanisms that drives people to eat are partly homeostatic - it’s much trickier to fight than an addiction. With addictions you stop the substance and each day after the first gets easier. But with homeostatic drives the longer and harder you try to move your body away from it’s set point, the harder it fights you - both by making autonomic changes, and by gradually ratcheting up the pressure to eat (or breathe or drink). As a former smoker I am profoundly unimpressed by anyone patting themselves on the back for quitting smoking while bitching about fat people (I’m looking at you Diogenes the Self-congratulatory). I quit smoking too, and frankly it was ridiculously easy compared to maintaining weight loss. A few weeks of cessation starts to extinguish the cravings and by a couple of months out you barely think about it. (For comparison, “food cessation” apparently *increases * cravings over weeks, months and years - imagine, all you ex-smokers, if the longer you’d stopped smoking, the more you wanted to smoke :eek: )

So maybe you respond to me by saying “ok you’ve proved that it’s really HARD” to lose a lot of weight permanently. But you haven’t proved that it’s impossible. No I haven’t. But let’s look at the breathing analogy. When you hold your breath at first it’s easy not to breathe, but gradually it gets harder and harder until eventually your willpower is overcome. That point is different for everyone - some people give up at 30 seconds, others at 60, others at 180. But for everyone it eventually becomes practically impossible - even if it is still theoretically possible -to hold their breath as the CO2 in their blood rises above the body’s set point. There are some freakish people who are able to hold their breath until they pass out - but that doesn’t mean that it’s possible for *you * to do. But how can we determine the point at which willpower is no longer possible (and not that you’re just a weakling)? It seems to me the only way to do it is to look at a lot of people try it and see what the majority of motivated people are able to manage. If you look at a group of people and see that as weight loss increases and the length of time at reduced weight increases, the ability to control diet decreases until you reach a point where virtually nobody’s able to control their food intake over an extended time - you say - ok I’m looking directly at the point where willpower is not sufficient for even the most motivated.

About 4.7% of the U.S. adult population or about 7.3% of all overweight U.S. Adults(cite. You know you can look things up too. It’s getting to be a real pain arguing facts and evidence against people who talk completely out of the butt.) But that’s irrelevant because the cites referred to both obese and severely obese and said basically the same thing - that very few people are able to lose more than about 10% of their initial weight permanently.

So thin people went to the gym and fat people didn’t and that’s the only difference? I’ll just cite another article in Cell:

Of course that doesn’t mean it’s *all * genetics. The cites I saw tended to point to 40%-70% genetics.

And my disclaimer - I’m not saying diet and exercise don’t work. From everything I’ve read they work - but only to a point. A very limited point. Your doctor will still be telling you to diet and exercise (diet especially) because they think you can still reasonably expect to lose 10% or so of your body weight through willpower. And that’s why you see all those articles that say “even a modest weight loss of 5-10% can have important health benefits.” a) because that’s true and b) because you can’t reasonably expect to lose more permanently. But 10% is not going to make a fat person thin.

It’s the new Hitler argument. These days no thread is complete until someone’s sent in the child molesters.

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great post, uglybeech. Disheartening, but informative.

It cracks me up that we provide cites and science and they counter with the same old crap.

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Instead of calling me names, why don’t you explain how you came to that conclusion. Or is your argument too weak for that?

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I concur; that was a great post, beech. Thank you for that information. It makes a lot of sense.

It occurs to me that the people participating in this thread who are being dismissive and outright hostile to overweight people are not directing their anger at those of us participating in this thread who are overweight and struggling with it. I believe that the haters in this thread are actually angry and hostile to people they know in real life who eat tons of food and don’t walk further than from the couch to the car, and blame their weight on everything but their eating and exercise habits, and are projecting their frustration and anger onto us here, and for some reason we’re identifying with and accepting it.

I don’t think any of us overweight people in this thread are trying to make excuses and say that we’re not responsible for our weight; the point we are trying so hard to make that it doesn’t matter how you got to where you are, it is not easy to lose weight, and there are real, varied factors coming into play in people’s lives that make it even more difficult, but we’re still not making excuses.

I have a hard time losing weight; I have had a hard time losing weight for 26 years now (since puberty, basically). I am still not making excuses or not taking responsibility for my weight. 26 years later, I am still making an effort, and trying to find a healthy way to lose my extra weight permanently. 26 freaking years I have been working at this, and you don’t think I have willpower?

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Part of my frustration with a couple of the posters here is that they are otherwise open to scientific data and depend on it.

Then what caused the change?

I wonder if this medication is classified as “psychoactive” when it is given to prevent seizures. Is there something wrong with the brain of people who have seizures? Is it possible the compulsions arise from something wrong with the brain? Why are you so insistent that that can’t be so? Just a hunch?

Should we be fighting ignorance with your hunches?

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I am sorry, but I have to disagree with you. Not only does obesity run in my family, it is a multiple gold medal winner, but the fact that nobody in my family is obese at the moment, due mostly to self-restraint and a minimally active lifestyle leads me to believe that it can be done.

BTW, I am fresh out of pregnancy and I have a good 20 - 25 lbs to lose. Trust me, I know it is difficult (I can’t diet now) but I think it would be easier for me to lose those 20 lbs than to gain the 80 that would put me in the morbidly obese category.

Obviously YMMV.

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And to put things into perspective, I am 5’1".

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I haven’t read all the posts in this thread but note that there seems to be some dispute as to the economic consequences of obesity (for the non-obese taxpayer and health plan contributor).

In fact, there are many, many papers documenting the increased societal economic burden due to obesity. Unfortunately, I am ubale to provide links to most of them. In any case, here is the abstract of one. And here is another (click on RED rectangle for full text for free).

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there are a lot of obese people in my family. i personally have had a weight problem for most of my life. i have pcos and a host of other physical issues that i am sure contribute to my weight and lack of weight loss.

i rarely eat more than 1,500 or 1,600 calories a day. i’m almost always hungry. on a 1 to 10 scale, my willpower rates a 9.

most people have no idea what it is like to crave food like i do.

and i tried the insulin resistant thing too. didn’t work.

i’m 5’ 4" and i weighed 248 this past May.

at the very beginning of the summer, i started walking the 2.41 miles (according to Mapquest) from my job to my home on a daily basis. at first i had to stop and rest every two blocks. now i only stop once to rest if it is really hot out. if it’s not, i keep going.

an amazing thing happened. i lost weight.

not a lot, but that 11 pound loss was enough to take me from a bursting at the seams size 20 to a comfortably snug size 18.

there are people who have a much harder time losing weight than others. i am one of them.

but that just means it’s harder, not impossible.

227

No shit you binged after a starvation diet of 500 calories a day. That’s not a matter of will power, it’s a matter of your body’s desire to survive. That’s not a compulsion - that’s the way your body is supposed to work, the same tactics that allowed all our ancestors to survive through years of bad harvests and famines.

If you were really starving, you would be grateful your body reacts like it does to famine/perceived famine. Our highly efficient metabolisms are a legacy of a human history without big, stocked supermarkets or 24 hour drive-through burger places.

Overly restrictive diets are doomed to failure, the body reacts poorly to starvation - jacks with the metabolism, reduces lean muscle mass, leads to binging. In my experiences after extreme restriction - as soon as I started eating “normally” I gained all the lost weight back very quickly AND more.

500 calories a day - your doctor should have his license to practice medicine revoked.