I’d like to point out that grandma in this case was a psychiatric nurse of many years. No, she wasn’t a doctor, but she had more experience than a lot of young doctors do. I always felt she had an uncanny ability to know when to butt into someone’s head, and when not to.
Guess what. I’m skinny. I always have been.
Please keep that in mind when I tell you that you’re an asshole. A big fat one.
Not only uniquely western, but uniquely modern, with the US currently having twice the number of morbidly obese people it did 30 years ago. That’s some seriously aggressive evolution if it’s a genetic issue.
Love your rant. Every smoking thread on this board has plenty of people who have no problem extolling the stinkiness of smokers without pulling any punches. But to suggest that fat people are unpleasant to look at is one of the biggest sins of the SDMB.
Fighting ignorance indeed.
Well… while I agree that, barring certain specific and not very common medical conditions, losing weight does come down to discipline and dedication and willpower, it isn’t quite as simple as you claim. All I have is anecdotal evidence, but I don’t see much else being presented in this thread, so here we go.
I’ve been overweight all my life. From around sixteen years of age and onwards, I’ve been trying to get rid of the extra weight. I tried many different kinds of exercise and many different diets. I didn’t get any real results until about three months ago, when I managed to move into an apartment building that had its own gym. Eliminating rice/bread/pasta/potatoes from my diet while lowering my fat intake and lifting weights was what finally did the trick, or rather, is doing the trick. I’m not done yet, but for the first time in years - maybe ever - I think I’m fucking hot. I like my new muscles too. It’s amazing the things you can do with them.
Before that, I was a long distance runner for several years. I entered competitions and made good times for an amateur. My heart and leg muscles were in excellent condition, but I just couldn’t get rid of the stomach. I never ate candy, cakes, cookies, crisps or anything of the sort, and I ran 15 kilometres three times a week… but I was still overweight. For some reason it just didn’t do it for me. My current diet and exercise regime are doing it.
So for the longest time I could truthfully say that diet and exercise didn’t work for me, even though it was just a matter of finding the right ones, and the right combination.
Just a thought.
Re: He Said/She Said
Well having worked in a hospital doesn’t make me any expert (not even a novice) but it does make me think about a few things. This doctor’s “standard lecture to women” that they will die alone and unloved reminds me of one real loser doctor I knew in particular. I can’t know that that’s what’s going on but it’s entirely possible IMHO that this doctor enjoyed humiliating overweight women patients. The problem is that a doctor like that will get away with it because the patient can’t really prove that they were trying to humiliate them - even if it would have been obvious to anyone standing in the room. The doctor just says “I was just explaining the consequences of…” blah blah. and it all sounds perfectly reasonable.
On the other hand I’ve seen (more often) patients who are themselves totally (nuts) absurd in their expectations from doctors. They expect doctors to actually be GODS. They expect absolute perfection in manner, demeanor, etc. And if they don’t get it they will scream to everyone in the hospital right up to the board of registration.
Re: Weight Loss
My take - While it’s physically *possible * for a very fat person to return to normal weight permanently without surgery, it’s surprisingly unusual. Quitting highly addictive substances like cigarettes, heroin, etc is much more common. Which suggests there’s something going on in the brain which even the most hostile exhortations to “stop eating and exercise dammit” seems not to be enough to overcome.
My reference for myself is holding my breath. I can hold it easily at first, then it gets somewhat harder but still I can will myself to hold it, then it gets very hard but I can still hang in there, and at a certain point there’s a primitive part of my brain screaming at me and my willpower gives out. That’s the power that the primitive brain is able to exert over the “will” when it feels like it. It’s no joke.
Now with food, obviously you’re rarely if ever at the point which QtM mentioned - like being at the bottom of a lake. But still the model may explain why some people may have a much tougher time losing weight than others - if there are large differences between people in the pressure exerted by the primitive brain to eat. And it may actually be unrealistic in many (or even most) cases to expect willpower to consistently defeat food cravings if they’re pathologically constant and insistent. Maybe as unrealistic as expecting someone to hold their breath until unconsciousness.
On the other hand, the options are pretty limited. Somehow you have to find a way to beat the cravings or stay fat. Or try surgery or drugs. There’s just no getting around that.
Cite? And please define “very fat.” Are we talking run-of-the-mill 20-100 lbs overweight, or Gilbert Grape’s mom fat?
So, for everyone saying that there are diseases and conditions that make it nearly impossible to lose weight (and I agree that there are medical conditions that make weigh loss harder), how is the average doctor supposed to know the difference between people who are really trying to lose weight and can’t and the people who claim to be working out and eating right who stopped for a super jumbo slushie on their way from Krispy Kreme to McD’s? Given the realtive rarity of many of the conditions described up thread, I think ordering a bunch of tests and referrals for everyone who is overweight is overkill.
Lord Ashtar, your anecdote reminded me of my mom. One Christmas she told me that she needed to get serious and lose 20 pounds after the holidays. Nobody knows how much she weighs, except maybe her and her doctor, because (wait for it) she broke the bathroom scale using it. I’m guessing that at 5’8" and a size 18/20 with elastic (but the waistband cuts into her flesh) or 2XL she is somewhere between 250 and 300#. Government approved (in the US, YMMV) is between 122 and 165#, I was a 14/16, 1XL (lose and baggy) at around 200# at the same height. That is a healthy dose of denial.
She doesn’t understand portion size at all. A side dish shouldn’t be stacked 3" deep on your plate. (No plate of food is less than 3" deep stacked rim to rim when my mom eats, unless she is eating straight out of the pan) A pound of grapes is not a serving, its four. Subway with chips and soda is not a light lunch, it is half what your daily calorie intake. Why is she overweight? According to her because her fibromyalgia and arthritis (in her left hand) keep her from excercising. Before FM, it was chronic fatigue, before CF, she was a normal weight and could keep up with her very active small children and go on hikes and to zoos and garden and all the other things that normal people do with their families. Then McDonald’s became a bigger part of our family routine. I wish her doctor would sit her down and tell her that she is obese and depressed and if she took care of those problems that she could lead a more healthy and fulfilling life and wouldn’t spend as much of her time worrying about and medically treating her blood pressure and cholesterol.
Or maybe if she led a more healthy and fulfillling life she wouldn’t be depressed and eat a lot.
Extreme morbid obesity is usually well over three hundred pounds. I would say Gilbert Grape’s mother qualified.
I wonder if there’s anyone who’s overweight/obese without any excuses or apology. It can’t be that rare as Gigi seems to be like that. I mean, I just think that people just don’t want to change their lifestyle either now or ever. If they’re happy(or content) that way, who gives a shit? Why see the need to pick on them? Is it so hard to leave them alone? I guess that takes too much willpower. Heh.
Given that this thread, and the subsequent arguments, aren’t about such people I’d say that it doesn’t take much willpower at all.
The article linked in the OP gives very little information about the situation, but it sounds to me like the woman who filed the complaint against the doctor might be one. The doctor might have given his stupid lecture about obesity impacting love lives to a lot of patients, but this time he delivered it to someone who would call him on his bullshit.
It’s not bullshit.
It is bullshit. Unless a patient specifically brings it up, the love lives of a doctor’s patients are none of his business. I don’t care if he does justify his bullshit with “I was only trying to save her life.” It’s her life, and she can do whatever she wants with it even if it offends his sensibilities.
The well-being of a patient is the doctors business; being too overweight to find a significant other–for those that desire them–can be detrimental to ones well-being, in addition to all the other health effects.
But it is scientifically proven that people who have happy love lives with their significant other live longer, healthier lives and a doctors role should be to help us lead longer healthier lives. Doctors who just treat a symptom or a complaint are not treating the patient, they are treating a disease.
I never understood what the deal with treating diseases vs. patients was until I got into an HMO that treated patients. They meet with you for at least 30 minutes any time you are there. They explain what your condition is, what the ramifications are, what the treatment options are, what they recommend, what to do if it doesn’t get better or gets worse, how to prevent it in the future, what the most current research shows, what else you should be doing to keep healthy, what resources are available through the HMO and elsewhere in the community, etc.
I’m not sure if you are agreeing or arguing, but your absolutely right. The real problems are mental health and weight. But her doctor gives her an Rx for every symptom of her physical health problems instead of counseling her to lose weight, eat better, excercise, and see a counselor. As a result, she was on pain meds that were recently pulled for causing heart damage, cholesterol meds that damaged her liver, blood pressure meds that make her bleed for hours with any little scratch, sleeping meds that interfere with her blood pressure meds, and Og only know what else, since she hides her meds from the family.
:rolleyes:
If doctors are so fucking concerned about patients’ love lives as part of their overall well-being, are they justified in suggesting rhinoplasty, a new haircut and some medication to plane off some personality traits that might scare off potential suitors? So long as they’re telling patients they’re unattractive, they might as well go whole hog, right?
BTW, the article makes no indication of the woman’s relationship status. She might very well have been in a satisfying relationship.
First, the doctor in this case wan’t picking on her, he was giving her medical advice and information as per his fucking job.
Second, if it’s not ok to pick on happy fatties, then why is ok to pick on happy smokers? What’s the difference?
It’s not bullshit if it’s true, and he didn’t tell her anything that wasn’t true. He was trying to apprise her of all the potential consequences of her unhealthy choices. Would you think it was bullshit if a physician told an alcoholic that his drinking could hurt his personal relationships?
Hmmm…actually, I rather think I would. I’ve never seen a medical doctor who knew anything about the relationships in my life, and so they wouldn’t be qualified to comment on them.
My objection to doctors lecturing patients about relationship risks as opposed to health risks are two-fold:
- Assuming the patient has even a modicum of self-awareness, the doctor is wasting his time hectoring them with information they already know.
Like a previous poster pointed out, fat people know they’re fat. You can’t live as a typical member of our society without being bombarded with messages about how being fat is horrible. People do shit to fat people that they wouldn’t dream of doing to anyone else, and they tend to justify as “giving them what they need to hear.”
I’m not sure how alcoholics compare in self-awareness, but I would wager that, by the time your doctor is commenting on it, some friends, family members, coworkers or law enforcement personnel have brought your drinking issues to your attention at least once or twice.
- It risks triggering patients’ defenses. If it does that, it’s not effective means of bringing about the change doctors want. If a patient doesn’t see themselves as unattractively overweight or an alcoholic, this isn’t going to change their mind.
Does anyone think the woman filed the complaint has started to lose weight because of the doctor? If she hasn’t, he’s risking disciplinary action for something that had no net benefit to anyone.
Hard to say. I’m between 5’9" and 5’10", 300#, and wear a 22 (3XL). All that is less important than the fact that she is experiencing so many health problems. I’m not (yet, I know) except for discomfort that I weigh (heh) against the discomfort of taking steps to change my body.
And Dio, I don’t think it is OK to berate a happy smoker. They know it’s an unhealthy habit but they still might want to see a doctor for other issues without being harassed about smoking.
And I agree with the idea of a reason vs. an excuse. I believe I am a food addict, but I don’t use that as an excuse, but a reason. I know there are treatment options out there but I weigh the cost/benefit of them and I haven’t opted for them yet. I go through the conversation enough times in my head that something a doctor says is not going to be a revelation to me.
Everyone has to be ready to lose weight in order for it to work for them. For years I tried to lose weight, as I mentioned, but failed primarily due to depression and low self-esteem. This is why calling people “fatties” and bleating “it’s all your fault” is harmful and counterproductive. If people have no sense of self-worth (and, believe me, it’s often hard in our society when you’re overweight to have a healthy self-esteem) then they’re not going to lose weight. Being overweight is a way of being self-destructive.
It’s not just a matter of willpower. There is a large emotional factor involved and, for people like myself, it’s a matter of breaking habits you’ve had your whole life. It finally took me cutting out people in my life completely who were nasty and abusive about the matter and taking some time to really find my own personal sense of self-worth. Now that I feel better about myself, I’m losing weight. It’s not rapid this time, either, because I want to find good habits that I can keep up for a lifetime, and going down to 600 calories a day is just going to make me yo-yo back to where I was.
I’ve had some successes and some failures, but the important part is that I weight significantly less than where I started, and I’m trying to find more ways to be successful. I’m staying with it after 6 months of struggle. Do you think that I would do this just to please other people, because I’ve been broken down into thinking that I’m horrible and ugly?
I can only hope that when I reach my goal weight, I don’t become a sanctimonious asshole about it. I guess I’ll just have to use some willpower to avoid that, won’t I?