Everyone knows people who can eat whatever trash they want and remain thin. Why is it so hard to believe that there are people who eat healthfully and have trouble losing weight?
That said, I do think the large majority of overweight people are overweight because they don’t eat healthfully and they don’t exercise. I have coworkers that will drive across the street (literally; I once went to lunch with some of them and they drove and I walked - and I got there first) and then they complain about how they can’t lose weight.
In fairness, it is much more time consuming and requires much more effort to eat healthfully than poorly. I’m beginning to see food manufacturers make more of an effort to push healthful foods, which is great, but I’m afraid a fatty diet of junk food is just too engrained in American society.
IF that’s what he said. There’s telling somebody the truth, and then there’s being hurtful. Granted, there ought to be some leeway in this kind of situation because he’s trying to get her to wake up and realize her problem. The “litany” he described sounds like a little much. Maybe that litany is needed for some people but would just hurt others. A little sensitivity would, one hopes, avoid that problem.
The part that’s funny to me is the idea that anyone would think that a morbidly obese person would need to be told they are fat. Trust me, fat people know they are fat. I’m considered morbidly obese and I know about it every moment of the day. I assume men aren’t attracted to me (that’s part of why I don’t mind being obese) and I assume that all the time too.
That being said, it’s my choice to remain fat (it’s more complicated than that, but that summarizes it) and I don’t need a doctor telling me in any way but a professional clinical way, if at all. I went in for a physical because I would like to know if I have any unhealthy numbers right now, and I don’t. I understand that this might not always be the case, and I would hope to feel comfortable enough to keep going to a doctor periodically to have those numbers checked.
Being told I will die alone and fat wouldn’t make me feel particularly comfortable. I know it’s not the doc’s job to make me comfortable about it, and perhaps they feel obligated to say something, but it’s simply not necessary. We know we’re fat. I don’t need to be told a little walking will help. I’ll just tell you that sounds like a good idea, but I know I won’t do it, so do we need to go through this song and dance?
Board involvement in this case? Sounds like regulatory overkill to me. Boards should be involved when physician practice patterns cause harm, or have a high risk of causing harm (outdated medical practices, practicing impaired, committing fraud, negligence, irrational behavior, etc). IMHO.
Keep in mind, my opinion is coming from many past board interactions, including the experience of having a patient report me to the board for, and I quote him “violating my constitutional right to be completely pain free” by not giving him oxycontin.
So far the board has seen fit to not take me to task over that. And yes, I did evaluate the patient and judged that opiate pain-relievers were not indicated.
Constitutional right? :eek: What was he on? Oh, that’s right, nothing.
I’ve worked in pharmacies in the past, and oxycontin and vicodin were the bane of my existence. I feel even worse for the people who actually need them, and are made to feel like druggies just for asking.
If those two meds disappeared tomorrow, you wouldn’t hear me crying.
A point I think we need to look at in this discussion is the difference between excuses and reasons. An excuse in this case is something someone uses to continue doing what they want to do. A reason is a factor that is contributing to the situation that exists. What burns my butt is fatty haters who don’t know the difference between the two. There are real physical reasons for people to have a hard time with their weight; for example, medications, underactive thyroid, insulin resistance, polycystic ovaries, even food allergies can affect how your body gains/retains/loses weight. People dealing with real reasons for weight problems don’t deserve scorn any more than any people with a medical condition do.
Of course, my butt is also burned by people who make excuses for their bucket of KFC a day and never exercising. Eating 10,000 calories a day is not your hormones, and quit trying to pretend it is.
I’m reluctant to jump into this fray, but I just wanted you to have another voice of confirmation, so I’ll dive in in support of what you’re saying.
After spending 41 years as a size 4 or 6, weighing under 120lbs on a 5’4" frame, I developed Hashimoto’s Thyroiditis that essentially destroyed my thyroid. While I used to be able to eat Kentucky Fried Chicken and Long John Silvers on a weekly basis, never watching or caring about a calorie or fat gram that entered my mouth, and never so much as gaining an ounce, now I can’t even eat an egg white without packing on the pounds because I literally have almost no ability to metabolize food anymore. It is a serious and real condition that, like yours, affects millions of people and is often undiagnosed.
Now, like you, I recognize that changing my diet and getting proper exercise is imperative to controlling my weight. However, if I remained untreated and weren’t replacing the natural thyroid hormones my body is no longer producing, no amount of diet and exercise would be helping. And millions of people go untreated because their doctors are uneducated on the latest qualifiers for hypothyroidism and for whatever reason, don’t seem to want to diagnose it. [Cite.]
However, even with taking replacement hormones, losing the weight I put on when the disease went untreated has been extraordinarily difficult, since my body simply doesn’t metabolize food the same way it used to – it can’t, it’s diseased. And yet I know (again, like you), that diet and exercise are the only way it’s actually going to happen. But how?! And I think that’s the problem you’ve been trying to address and not getting anywhere with.
I have been seeing doctors and specialists for 3 years and not a one of these pricks will tell me HOW I should modify my diet to help combat this disease. I have asked and asked and BEGGED for information on diet and exercise and not once has any doctor ever offered an answer. After my most recent office visit, my doctor handed me a sheet of paper where one side had all the “good” foods to eat and the other side had all the “bad” foods to avoid. I read it with a fine-toothed comb to see if/where I could make improvements, and guess what I found. I’d already excluded every single thing on the “bad foods” side and already included every single thing on the “good foods” side. We’d already cut out all white rice, bread, pasta and potatoes and replaced them with brown and wild rice, whole wheat pastas and breads (and severely limited our intake of them, too!); already weren’t frying foods, but grilling, broiling, baking and poaching; already making sure to eat breakfast (usually cereal and fruit) and haven’t seen the inside or drive thru of a fast food restaurant in 2 years, amongst a gazillion other changes too numerous to list. I was DOING or NOT doing everything on that fucking list!
And then, when he phoned to tell me my cholesterol is too high and I have to get it lowered, he literally said, “you need to watch your diet and exercise and then see me in 3 months, and if your cholesterol isn’t lower, we’ll put you on some medication.” Click. Fucking bastard, that’s not helpful!!!
I have now resorted to hiring a nutritionist/trainer, who, btw, was very impressed with what I was already doing, but has shown me how to tweak my diet to better suit my condition and health needs. He actually bothered to take the time to research my disease, and although most of the resources he found were ones I was already familiar with, came up with a couple of things that I hadn’t discovered in my own research and added them to my regimen.
Diet and exercise = weight loss, works most of the time for a lot of people.
Treating all weight loss the same, however, doesn’t work.
In my case, I’m actually eating MORE than I was, and would hardly call what I’m doing “dieting,” and I’ve lost 9lbs in the past 4 weeks. It was all about getting the right information – information none of my doctors was ever willing to take the time or make the effort to give me. I was already doing what all the so-called experts say one should do, yet having no success. It’s been my experience that doctors are good at suggesting and demanding weight loss, but they suck at telling their patients how best to go about it. And it’s not always as easy as a simple “math formula.”
In the past 2 years since I was diagnosed, I can’t count how many women I’ve met with this condition who don’t even know the BASICS about how to treat it. And I mean the most basic and most important things, such as taking the thyroid meds on an empty stomach and not within an hour of taking any calcium, as calcium has been shown to prevent the absoption of the thyroid hormone into the system. And it needs to be taken at approximately the same time every day, just like birth control pills, in order to be effectively balanced in your system. One woman was literally wasting her time, because she was taking her pill with a large glass of calcium fortified orange juice every morning!
And no one I’ve talked to has even heard of the term “goitrogen,” let alone limits their intake of raw foods under that heading (like peanuts, cabbage, spinach, broccoli, cauliflower, canola oil and soy). Every bit of research I’ve done on this disease suggests limiting goitrogenic food intake, and cooking such foods to reduce their goitrogenic properties. Yet when I asked my doctor about it, he poo-poo’ed it and brushed me off with a wave of his hand.
I’ve about had my fill of doctors, I can tell you that!
My eldest niece was getting fat. All the women and most of the men in our family are prone to depression and getting fat. But please don’t tell me my family gets fat due to depression or some biochemical imbalance. People in our family eat like pigs. Dinner is a greasy chili-mac thing served on a bed of Fritos, and there is always desert. Ice cream & cake. And if everyone’s in in the mood for it, “hey, let’s go out for more ice cream!”
So my mom, who has been obese almost her entire adult life, knows what she’s talking about. She sees her grand-daughter getting fat way earlier than the women usually do. Normally, they wait 'til they have a kid and then get obese. This one is ahead of the game, thanks to my sister’s cooking. One month my niece is depressed. The next month she’s bi-polar. The next she has ADD, or whatever. You name the popular diagnosis, she has it this month. Meanwhile, she keeps getting fatter.
The niece is over visiting grandma one day and grandma pulls her aside and tells her she’s fat and fat makes you ugly and no one’s going to want you.
Niece is absolutely horrified. Starts dropping weight like crazy. She’s exercising, only eating healthy vegetables & lean meats.
Sister is concerned. She calls me one day and tells me how she was so concerned about her daughter’s weight loss she confronted her and finally found out the horrible thing our mom had said. Niece broke down in tears and admitted grandma said “I was fat and no one would want me. So I’m losing weight.” Sister is livid. Grandma is an evil bitch. How dare she ruin her daughter’s life like this!
Uh, yeah sis, I kinda understand why you’re upset, but your daughter was fat. Now she’s not. She’s healthy. Not anorexic, not bolemic. She just doesn’t want to be fat. She’s 17. She exercises. She eats healthy. Yes, she’s traumatized by the mean thing mom said. She shouldn’t be fat! Yes, mom can seem like an insensitive bitch sometimes, but hello? You feed your family like a herd of cows! Your daughter was like 40 pounds overweight! How the fuck can you let your 17 year old daughter be 40 pounds overweight??
So the doctor was an insensitive prick. Sometimes they are. Sometimes they just don’t feel like listening to bullshit.
Damn, Shayna, that sucks. Good luck to you and a pox on ignorant, condescending doctors who don’t listen.
Everyone talks about “eat less, and exercise more”, but it’s so much more complicated. I think the problem isn’t eating less, it’s eating RIGHT. People are frighteningly ignorant about what’s really healthy, and with all the fad diets around, and conflicting information, it’s no wonder some of us just throw up our hands and give up.
Everyone’s body is different. Everyone has different metabolisms, different health issues, different trigger foods, etc. And some people are being told they’re fat when they’re NOT (look at girls as young as eight developing eating disorders). And even weight isn’t always an indicator-doesn’t muscle weigh more than fat?
A grandma is not a doctor. Grandmas have the right to comment on your weight and be nasty about it. Doctors are supposed to treat your physical health and then stay the hell away from you.
But don’t doctors have an obligation to tell you to quit doing whatever it is that’s making you sick?
I know they overdo it sometimes. I smoke. I get really tired of doctors telling me to quit smoking when I’ve come to them with the primary complaint that I have a rattlesnake attached to my ass.
Yes, they do. The doctor was totally right to scare her about what she’s doing to her health as a result of the weight. I hate the tendency to sugar(heh)coat everything under a glaze (double heh) of body acceptance as much as anyone.
However, I do NOT believe that doctors have the right to extrapolate from your health condition and cast aspersions on your personal life. For instance, if a doctor told you that your smoking gives you X% risk of dying from cancer and causes such-and-such damage to your teeth and makes you X% less physically fit, then that’s all fine and professional and good. Doctors are supposed to say that kind of stuff. But if a doctor said “smoking is disgusting, and no person will ever want to be with you while you’re a smoker, with your teeth all yellow and your hair all smelly,” then that is unprofessional. God knows there’s enough danger associated with smoking, it’s not like the “kissing an ashtray” memo is necessary.
Barring a genuine, diagnosed physical medical explanation… It’s not any more complicated then that.
Not really. Eating more healthy food will certainly help other aspects of your health, but you can loose weight even if your reduced-calorie diet consists entirely of crap.
That’s not always the case. When I worked as a personal trainer I’d get people like the 5’3" woman who was 220. When I asked her what her long term goals were, she said she just needed to drop 10-20 pounds. When I told her that 200 pounds was not a normal weight for a woman of her size (it might be if she’d been a foot taller), she waved it off telling me that “all the women in [her] family are big-boned”.
I didn’t see her after two weeks because she wouldn’t do what I suggested. She prefered to get on the treadmill and walk for 15 minutes at 1.5 mph and yak on her cellphone. She wouldn’t modify her diet, eating a Big Mac or two after her workout because she had “just burned off all those calories, so it’s okay”. She wouldn’t even put on sweats, preferring to wear her jeans and silk blouse.
I already know all fat people are not like this, but enough are.
I honestly don’t know if the medical cons of eating a “bad”, yet calorie-aproporiate, diet outweigh the medical pros of eating a “good”, yet overly caloric diet. I suspect it’s somewhat complicated, and depends a great deal on how bad the bad diet is and how overly caloric the good diet is.
Regardless of that question, I think the social aspect of the two different diets grossly favor being skinny (people typically don’t find fat attractive, and gross obesity can be viewed negatively from even a non-sexual perspective) and I’m not at all convinced that a “bad” yet calorie-apropriate diet would make one “feel like shit” after you’d adjusted to the different type of food (if you needed to adjust in the first place). People seem to be pretty adaptable, diet-wise, new-age’ish “preservatives harm your yoni, man!” type comments aside.
I think that sometimes doctors try to say whatever they believe will shock a patient into listening to them. If the buffalo in question would not listen to warnings about her health, maybe some hard truth about how it could negatively affect her interpersonal relationships could penetrate her skull. I don’t see it as any different than warning an alcoholic or a drug addict that their disease could ruin their relationships. I think this doctor was doing his job and trying to save the woman’s life and was reaching for whatever he thought would be effective. It wasn’t like he told her anything that wasn’t statistically true.
Her complaint is ridiculous. I don’t understand why it’s considered rude to say that obesity is unhealthy and unattractive when those things are both undeniably true. No one thinks it’s rude to tell smokers that they’re doing something unhealthy or even to tell them that it makes them smell bad. Compulsive overeaters are, if anything, more unhealthy and more unattractive than smokers (hey, if Angelina Jolie wants to smoke Camel unfiltereds, I can get past that, you know what I mean?) but for some reason we’ve decided that it’s unforgivably impolitic to say that. This is one issue on which I just can’t toe the PC line. Fat people are fat because they choose to be. I don’t necessarily mean people that are merely over their ideal weight or are a little bit soft in the middle (I’m in that category), I’m talking about FATTIES. Any talk about genetics or “big bones” or “glands” or any of the other typical excuses just ring completely hollow to me. If it’s genetic, it seems to be a uniquely western gene. I lived for two years in Liberia and never saw any genetically obese natives.
It’s pretty simple. If you take in more calories than you burn, you get fat. If you burn more calories than you take in you don’t get fat. It’s basic math. Fatness is correctible for most people…at least the ones who haven’t yet reached the “I wash myself with a rag on a stick” stage.