IANA health professional, but my understanding is that the syndrome makes the body very insulin resistant. This means it can’t process food effectively, and lowers the metabolism. This makes the woman gain weight (usually around the midsection, making a “barrel” shape, rather than a pear shape). The weight gain is thought to worsen the PCOS, making the woman gain more weight more easily. Worsening the PCOS … you see where this is going.
So let’s suppose this woman was smoking two packs a day, but so far had no emphysema, cancer, or detectable heart disease. Would the doctor be erring in telling her that she should quit smoking?
Wouldn’t a good doctor tell you to fix things BEFORE the heart attack hits?
Being overweight is really, really bad for you. If you don’t have health problems yet, you will eventually. I’m overweight and I’ve so far avoided any resulting problems, so far as I can tell, but I’m kidding myself if I convince myself this isn’t a problem.
THANK you.
I’ve been overweight all of my life – as in, I was put on a diet as an infant by a doctor. In my experience, doctors tend to treat you like a complete idiot and are completely patronizing when you are overweight.
One doctor I had, as a child, made me write a food diary. I tried to be good for several weeks on the diet. We went on vacation, and I was still good, except for one special occasion family dinner where I had a piece of cake, but was otherwise good that day. We took the diary in to the doctor.
Doctor: Look at this piece of cake in here. Why would you eat like this?
My mom: Well, it was a special occasion…
Doctor: This is exactly the kind of eating that makes a child overweight. She should not be eating cake.
Ok, thanks Doc. So, apparently, as a person who is naturally heavy, I can never eat anything ever again, despite the occasion, which is not diet food. There’s a reasonable plan I could live with!
The doctors were very negative. I remember clearly and it upsets me today because these were adult men who were very insulting and patronizing and I had to put up with it. As an adolescent, I became distant and morose when taken to the doctor again about my weight. As much as I hated being fat, I didn’t want to put up with this nonsense again (for the umpteenth time). I was put in therapy because the doctor said “Something must be seriously wrong if she doesn’t care that she’s fat.”
Eventually, my mom got the hint that I was not going to cooperate with any more of these programs. (My dad was always pretty insulting too, which didn’t help.)
As an adult, I finally worked up the nerves to go to see a doctor again. This doctor was incredibly callous and demeaning – I guess I shouldn’t have been surprised, but I was.
Doctor: “So, I see by your chart that you want to lose weight.”
Me: “Yes, I was looking for some help.”
Doctor: “You definitely need to lose it, looking at your weight it is XXX, that is way too high. You should go on a low calorie diet.”
Me: “Er, I know, I was hoping for some guidance.”
Doctor: “We should also put you on some medication… here I will give you a prescription for this, it is habit forming so come back every month to check on this.”
Me: “Ok, but what else should I do?”
Doctor: “Just eat a low calorie diet.”
Me: “But I was hoping for a little help…”
Doctor: “Well, then set up an appointment with a nutritionist.”
(I do so)
Nutritionist: “Okay, so here’s the diet plan. (Goes through the food pyramid) You should eat some chicken breasts without skin—”
Me: “I’m a vegetarian. That’s why I came in, I wanted to get some help.”
Nutritionist: “Uh, well, here’s the plan. I’m sure you can adapt it.”
Me: “Well I was really interested if my diet was going to meet my needs on the diet or how I could adjust it. I don’t know if I get enough protein or iron.”
Nutritionist: “Well, you could buy a book from the Internet.”
Seriously, that’s what she said. That’s the advice I got!
Long story short, I tried to diet, lost 30 pounds in a month from the pills, but the side effects were really bad. I didn’t go back.
A couple of years later, I am trying to lose weight on my own. It is a struggle but I am experiencing some success. I joined a gym and am using the Weight Watchers plan which is adaptable to vegetarians. I think it’s pretty sad that I could get from a commercial company what is essentially medical advice but I couldn’t get it from a doctor.
Doctors need to wise up and realize that lecturing people isn’t going to help. Do you honestly think that fat people don’t know that they’re fat or that they’re at risk? It’s just that it’s an emotional issue as well as a medical one, and feelings need to be respected. I doubt cosmetic surgeons performing rhinoplasty would find it appropriate to say “Wow, what a conker! Well, we’ll hack a bit off it.”
Ditto ditto ditto. I’m hypoglycemic too and my doctor gave me similar, although not identical, advice (he told me to have snacks of fruit and yogurt between meals). One of my biggest problems was when I was trying to lose weight, I would avoid snacking…and when my blood sugar started falling, I’d grab the first thing I could to bring it up again, which was usually candy. And then I’d be hyped up and bouncing off the walls. I would often cycle through several highs and lows in a day.
I’ve just been noticing how cheerful and upbeat I’ve been feeling the last few days, and it only occurred to me yesterday that it’s probably because I haven’t had any candy, cookies, or chocolate in about a week and a half now. OTOH, my fruit intake is way up. And I’ve lost 4.5 lbs. Rock!
Rock indeed, Kyla. 
Where’s the high-five smiley when you need it?
My hypoglycemia is reactive, meaning my body over-produces insulin in response to sugars (even fructose). This means that fruit by itself is usually out as a snack. I usually have to pair my fruit with a protein (like apples and cheese or peanut butter- yum). Eating this way has decreased my cravings for junk food.
My understanding is that eating more frequently keeps your metabolism “revved up”. I’m a grazer by nature, so this was a pretty easy diet for me to go on.
Thanks for the info, stufflikethatthere. I had no idea.
Well to paraphrase Jerry Seinfeld, they do call it a rhinoplasty 
As to the rest of your post- I think that your experience happens more often than health care professionals would like to admit. I’m glad that you didn’t give up, though. Just wondering, what did you think of this thread a few months ago?
You make some good points but for most fat/been fat people NOTHING short of a heart attack is going to initiate a real change in eating behaviors until a person commits to making the change, so I can understand how some docs become frustrated. I’m also stuck by the number of stories here about clueless dietians and nutritionists. The bottom line for 99.9% of weight loss scenarios is calorie control relative to metabolism, but many people including professionals don’t seem to recognize that even small variations off the metabolic norm can cause massive amounts of weight to stack up. Few modern adult people (esp overweight people) understand how (relatively) little food they really need to be healthy.
As a serious question, out of curiosity how is it possible to be an overweight vegetarian? To control my diet I eats lots of salads & vegetables and they are usually enormously filling relative to their calorie load. Unless I was eating massive amounts of breads, beans, avocados, nuts and dried fruits I would think (apparently erroneously) that being a vegetarian would be a sure route to significant weight loss.
That’s much easier said than done for many people. I suffer from recurrent bouts of depression which can last for years and is resistant to antidepressant drugs. I’ve tried most of them by now.
Unlike many people, when I’m depressed I eat compulsively and gain weight. In fact I eat so much that my stomach hurts from being over stretched and yet I still then eat more. And it really is a matter of I cannot control my appetite at these times.
When the depression eventually subsides I eat normally and can get some exercise. Then I lose the weight, until the next time.
So it really is unfair to assume that it is a simple matter for someone who is overweight to eat less and exercise more.
Candy and chocolate and cookies and cake are all vegetarian. I’m not speaking for anyone but myself here, but I’m a vegetarian and I have a serious sweet tooth. Sure, I don’t eat Big Macs, but I love me some cookies.
And cheese! Man, I looove cheese. I’m going to Wisconsin this weekend and I am gonna get me some CHEESE. It is high fat and it is delicious.
Reminds me: several years ago, I was chatting with a cab driver and we were talking about food. I mentioned that I was a vegetarian, and he said “No! You’re too fat to be a vegetarian!” Heh.
(FTR: I’m not overweight. I weighed more than I do now when that anecdote occurred, but even then I wasn’t actually overweight. I’m normal-sized. Not skinny, just ordinary.)
If you are eating a lot of processed grains, simple sugars, and starches, you can gain weight pretty quickly. A diet high in white rice, potatoes, etc, would be fattening. I only know because those types of foods are comfort foods for me, but now I have to sing a variation of Cookie Monster’s song, “Grits are a sometimes food”
Well, I think the doctor was out of line. Not about cautioning the woman wrt health problems (he was totally right to do that), but because he said all that stuff about how she’ll never find a mate or keep a man (I suppose he assumed she is heterosexual as well). The doctor is not a therapist, it is not his place to speculate on her love life. I don’t know if he should be sued for that (then again, maybe he should… none of us know how insulting or demeaning that part of the conversation might have been), but I think it was a definite error in judgment, and if this spot of bad publicity prevents him or other doctors from saying similar things then that’s a good thing.
What if someone going to a dermatologist for acne was told the same thing? Doctors should treat the disease or condition, not cast aspersions on the personal lives of their patients. (Except psychologists, because like, that’s their area.)
Not really. It’s hard for everyone. If it was easy, their wouldn’t be so many overweight people.
It is a simple matter. It being harder for some people to muster up the will power to do so does not make it complicated. It just makes it harder for some then for others.
I think it’s ridiculous. The stigma of being overweight is crushing for a child; as an adult, social mores make it easier to cope because it’s not acceptable to criticize someone’s appearance in their presence, but as a child you deal with being mocked and ostracized daily. It becomes the central part of your life, and the defining factor in how others see you. This leads to depression and ultimately poor self-esteem, and a self-destructiveness that only continues the problem. As a kid, people tell you that you’re worthless if you’re fat; if you’re worthless, why bother trying to change?
I think we need to find some sort of positive encouragement that reaches people, especially children. Frantic fear-mongering and labeling just makes things worse.
Sure, but this sort of behavior is counterproductive. I can see saying “I’m concerned about your health, and I’d like to discuss some ways to become more physically fit with you. Would that be okay?” Telling women that their husbands will die from obesity and they’ll be all alone – well, not so much.
Yes, this is a problem. I know that for me it actually got easier for a time after I had gotten used to this.
Nonetheless, dieting sucks. It sucks less than being overweight, and ultimately there is a huge emotional surge in seeing success, but it sucks. I hate thinking about it all the time, and I hate getting the shakes and getting dizzy when I’ve not balanced things out just right, but I can’t eat more unless I don’t want dinner. It’s not a pleasant feeling and it’s hard to put up with it. If you have a slow metabolism (and I do – this was what the prescription was for), you have to put in a lot of effort to change. Sadly, many people just say “put down the fork, fatties” because it’s easy for them.
I don’t want to make obesity socially acceptable – I want it to be considered with some acceptance, though, and that people would be supportive rather than cruel. I’ve been told by many people that the only reason they were cruel to me was to get me to change (family members included). This doesn’t work and we need to take a hard look at obesity in this country as it is becoming a real problem. It’s not just a medical problem, it’s an emotional and a social one.
I’ve been vegetarian for 10 years (I’m 26). Due to my slow metabolism and (hopefully formerly) sedentary lifestyle, even eating healthily caused me to gain weight. When I started my weight loss program, I actually started eating more (though I did cut back on few unhealthy things, especially eating out, for the most part I was OK). I was just very conscious of balancing everything out, and cutting out depressive eating which I did once in a while. Exercising, for me, makes all the difference because of the metabolism boosting.
It was also a gradual weight gain over many years.
Until you have walked a mile in everyone else’s shoes you not not assume to know how things are for them. What is easy for you may be overwhelmingly difficult for someone else.
While the physical function of losing weight is, at root, a metabolic heat equation, losing weight by controlling intake and managing appetite is a hell of a lot more lot more complicated that just telling someone to “use willpower”. Appetite is tightly wound in the fabric of your brain and your life. It’s like telling someone they can stop being a drug addict by “using willpower”.
Successfuly losing weight or maintaining weight loss in the midst of a social abundance of relatively cheap calories involves numerous strategies, including meal planning, portion control, high levels of awareness of caloric content, and keeping fairly precise track of your intake. The automatic appetite control mechanisms of the body and brain that most non-seriously overweight people rely on and take for granted, are constantly having to be fought and negotiated with if you are overweight. You have to constanly be aware of your intake, and quite frankly it can be an enormous pain in the ass.
So yes it takes “willpower”, but that’s not all it takes by a long shot, and people who don’t have serious appetite control issues and make glib statements about “willpower” are utterly clueless about this fact.
The woman is an idiot. It reminds me of the time my girlfriend, drunk, almost walked out in front of a car on our way home from a party. She started one of the worst fights we’ve ever had because I pulled her out of the road. She was pissed that I didn’t trust her to know what she was doing. The next morning, when she sobered up, she apologized though. This woman has yet to do that. I think it’s absolutely ridiculous that the doctor might be barred from practicing medicine because of her complaint.
A lot of people focus on the food, but they also need to think about the exercise. Aerobic exercise alone doesn’t do as much as weight training and aerobics. About a year ago I finally got fed up enough with my fat ass to get into the gym and lose 3 years accumulation of fat. I was a formerly fit individual who had strayed from the Way and I had some catching up to do. In my pre-plan research, one of the things that lots and lots of people agreed on was that resistance training and aerobic training offer synergistic benefits, particularly in losing weight.
After a few weeks of progressive light training, I was fit enough to start lifting challenging weights. My aerobic exercise didn’t change, nor did my diet, but I lost more weight in the two weeks following the introduction of heavy weights than I’d lost in the two months prior to that. That made me a real believer in weight training. If you want to lose some fat, start lifting weights. Diet and aerobic exercise are very important, but weight training, calisthenics, or some other resistance training is extremely helpful for getting rid of fat.
That’s how I eat - 5 or 6 small meals per day, and protein with every snack and meal to keep my blood glucose more level. The dietician agreed with this - her only tweak was for me to eat less protein - I didn’t realize how small a serving of protein was needed to keep my blood glucose level.
My point in talking about my weight and my struggles with it and my medical conditions is simply that weight and weight loss are nowhere near as simple as telling a fat person to lose weight or use your willpower. I suspect that most “normal” people eating as I eat and exercising like I do would not be overweight, but I am, so I need to find a way to deal with this that works for me.
I noticed an “I lost a bunch of weight” thread within the last week where posters were congratulating the OP on having the willpower to do so. Where was your righteous indignation at that sentiment?
Seriously, if it’s not about willpower, are you saying that people who do lose weight aren’t using willpower? Everyone else is just lucky I guess, eh?
Agreed. With no multiplier at all, I get 2100+ calories. With the minimum multiplier, I get 2500+. That’s off by a goodly amount.
I typically consume significantly fewer than 2000 calories a day. On days where I find the motivation to eat a lot, I’m still under 2000.
But it is a simple matter of eating less and exercising more. It’s just as simple as quitting smoking. (Don’t smoke! See? Simple.)
Whining about how hard it is is mainly self-indulgent self-sabotage. Alcoholics need a 12 step program because there entire life turns to complete shit very quickly without extreme intervention. Smokers and fatties? Not so much. All we need to do is exert sustained willpower to affect lifestyle changes. Quite simple, actually.
I think the doc in question employed a halfway decent strategy. Pointing out to a fat chick that being fat is unattractive might not be such a bad idea. It’s tougher to dismiss a doctor as “just being mean” than joe asshole on the street, but I see some of the posters in this thread have developed even that amazing capacity for rationalization.
Smoking is bad for you, smoking makes you less attractive, and quitting will require longterm, sustained willpower, and it will be very difficult to do, but is quite simple to attempt. Nobody would dispute this, right? Certainly not the smokers. Yet the fatties go batshit crazy when hearing the same thing about weight loss. It boggles the mind.
Quick question here, how does one get into a whole body exercise regimen without involving at least calesthenics? I’d always thought that aerobic exercise was most beneficial when it was a target for a whole body workout. When I worked on my weight, I was doing about 15-20 minutes of calesthenics (jumping jacks, push-ups, sit-ups, squat thrusts, and a few other tortures) then following with a 1.5 mile jog. A nice workout that, with strict diet, kept me losing weight. Do people really just jog, or bike, or something?
My point was that the recipe for losing weight is extremely simple: eat less, eat better, and exercise. That’s it. Having the discipline & self control to do it is another matter entirely…