Doctors and Weight Talks

[historically accurate]

I'm obese. There, I opened with it. I was a chunky kid, an average teen (held to that weight through some very unhealthy eating habits), and I was obese by age 25. My weight has held pretty steady for almost 20 years. I have weighed within 15-20 pounds of my current weight for those 20 years. I have lost and gained the same 30 pounds many, many, many times over.

I am also very healthy. I take no medications just vitamins that I choose to take. I had breast cancer 10 years ago, but no aftereffects since it was caught early and I had a double mastectomy. I was born with 1 deformed kidney and 1 healthy kidney, but I currently have kidney function to spare. My blood pressure is textbook, and my glucose is well within bounds. 

Today, I was at the nephrologist. I went for the first time in decades last year since I had a new primary doctor who sent me, so I guess it's an annual thing now. I gained 2 pounds since last year. I chuckled and made a joke about "Quarantine weight" when the doctor mentioned the change in my weight. She then said every patient she saw this year has gained 5-10 pounds so she said I was far ahead of the game. 

Seriously, the next words out of her mouth were about not gaining any more weight and getting to and maintaining a healthy BMI and all of the bad things that await my kidneys if I get diabetes or hypertension. They even gave me helpful literature about all of the bad effects of obesity. The kicker? This woman probably has a higher BMI than I do. 

Every time I go to the doctor, they all talk to me about the weight. So far, not a one of them have given my any options beyond eat healthy and exercise. It's one of the reasons I avoided doctors for a couple of years following my breast cancer surgeries. I cannot afford surgery even if I qualified (which I may not since I am not morbidly obese), and diets just really don't work. Really, really tired of every doctor's appointment being an opportunity to scold me. 

I'm stubborn and cranky now and came home and ate a fun sized Reese's. 

[stephanier.1765]

My dh feels the same way. He will put off going to the doctor as long as he can for any complaint because he knows he will get scolded and told the problem (whatever problem) is due to his weight. It's so disheartening and I'm so sorry you are being treated that way as well. DH tells me when he was in the Navy and needed to get his flight physical, he would choose the most overweight doctor on staff because that doctor would be less likely to give him grief. I wish it had worked that way for you today. 😞

[Ditto]

You only ate a fun size Reese's??   That would have sent me straight to the grocery store on the way home and ended with me inhaling at least 30.00 worth of candy and sweets.  The fact that you are maintaining your weight is fantastic.  Stay active, eat as well as you can, and silently tell dr's to stuff it as they lecture. 

[Ditto]

1 minute ago, kand said:

I have a kid with an eating disorder now, and that has a huge impact on my thinking about weight right now.

This is very scary and stressful.   Healing from eating disorders is incredibly hard, I hope they are on the road to recovery very soon.  Also I agree with everything you said.

[ktgrok]

Ugh. I am "obese" as well at a BMI of 31 currently, and my bariatric doctor says there are no real health issues at that BMI other than wear and tear on the joints.  The reason "morbidly obese" is called "morbid" is that it effects your health at that size - eventually if not immediately. But at lower levels of obesity it isn't anywhere as big an issue. (although, surgery isn't just for over 40 BMI - 35 BMI with two or more co-morbidities also qualify - but you don't have those)

And as you figured out, most doctors have no clue about how to treat obesity anyway. 

They should talk to ALL patients, of ALL weights, about diet and exercise. Plenty of skinny people have bad health from not exercising or from eating crap. And take the emphasis off weight. I'm fine with them ASKING if you'd like more info on weight loss, or referring to someone, but not nagging. 

[ktgrok]

And I hear you on everything blamed on weight - doctors love to say my reflux is due to weight...except I had it when I was 120 lbs, and at 220lbs, and every weight in between. So, yeah, losing 5 pounds isn't going to fix it. Thanks anyway. 

[East Coast Sue]

I’m in the same boat but thankful that my doctor has focused on staying active (regular exercise), avoiding weight gain as I age (which he acknowledged us tough), and strength building (he actually focuses a lot on building muscles in my upper body). 

[Bambam]

My personal favorite time was when a PA talked to me about menopause and what to expect. She was in her mid 20s probably. I was in my late 40s and had already done a bunch of research and was already experiencing some issues. I listened attentively, and thought to myself that this talk that she had obviously memorized would surely be different in 25-30 years. 

 

[itsheresomewhere]

My GYN this year walked in and said- “I am just letting it out now,  I am not talking to anyone about weight this year.  We all have too much on our plates now just getting up and attempting to live a somewhat normal life.”  I wanted to hug her.  I hate going to the doctor as they always bring up weight yet most of the time, i weigh less then them and I would bet a lot more active.  DH has a few medical conditions that eliminates a few types of exercise.  He knows he is obese and yet every time he goes to the doctor they tell him to take up those exercises he can’t do.  It just depresses him. 

Edited November 3, 2020 by itsheresomewhere

[bensonduck]

I am recovering from an eating disorder and it’s in my chart that I will be weighed backwards, they don’t tell me the number, and the dr is to only discuss my weight if it’s a medical issue (I.e., my weight drops in a way that looks like I am not eating according to my meal plan needs). I wonder if you could ask your provider to put something like that in your chart as well?

[Ausmumof3]

56 minutes ago, ktgrok said:

And I hear you on everything blamed on weight - doctors love to say my reflux is due to weight...except I had it when I was 120 lbs, and at 220lbs, and every weight in I between. So, yeah, losing 5 pounds isn't going to fix it. Thanks anyway. 

I actually wonder how many times health issues are the cause of the weight gain in the first place.  Reflux can be better when you eat more frequently, joint issues make it harder to exercise etc.  

[Carol in Cal.]

The way I see it, I want to know.  I want my doctor to look at my health comprehensively.  And I want my doctor to treat my illnesses.  

So, if a medical professional says, “Lose some weight and then we can talk about treating this,” that would bug me because if I need treatment, I need it.  But if a medical professional says, “You would be better off thinner for these reasons” I look at it as they did their job.  And it wouldn’t bother me.  I’m obese, too, and I’m just not that sensitive about it.  When I want help with my weight, I will ask for it.  When I don’t, I’m fine with them bringing it up, but not focussing on it as the main reason I’m there.

[Katy]

To my knowledge there are only 3 ways to permanently lose weight, statistically.

1) Surgery.

2) Intermittent fasting.

3) Switching to a religiously strict whole food plant based diet and eating lower on the calorie density food side. 
 

Nothing else works long term. You can choose cleaner foods but sooner or later that always feels like restricting and you bounce back. This isn’t only my experience, it’s pretty much what all the long term studies say too.  Unless you’re prepared to do one of those 3 there’s really no point in stressing about it.  

[rebcoola]

32 minutes ago, Ausmumof3 said:

I actually wonder how many times health issues are the cause of the weight gain in the first place.  Reflux can be better when you eat more frequently, joint issues make it harder to exercise etc.  

I know a lot of my weight gain is because of my hip and back pain making it hard to exercise.  Doctors suck its so hard to find one that listens.  I have had pain since I was 12 but everything is because I'm fat now. 

I remember once DH insisted I go in to urgent care because I could barely walk.  The Doctor said what do you want pills.  No I want to know what is wrong with me and how to fix it if possible!!

[Carol in Cal.]

15 minutes ago, Katy said:

To my knowledge there are only 3 ways to permanently lose weight, statistically.

1) Surgery.

2) Intermittent fasting.

3) Switching to a religiously strict whole food plant based diet and eating lower on the calorie density food side. 
 

Nothing else works long term. You can choose cleaner foods but sooner or later that always feels like restricting and you bounce back. This isn’t only my experience, it’s pretty much what all the long term studies say too.  Unless you’re prepared to do one of those 3 there’s really no point in stressing about it.  

See, I figure the Baby Boomers are ahead of us, and they are going to figure out that fourth way and we will benefit from it eventually.  I’m betting on fecal transplant/bacterial colonization.

[historically accurate]

16 minutes ago, Katy said:

To my knowledge there are only 3 ways to permanently lose weight, statistically.

1) Surgery.

2) Intermittent fasting.

3) Switching to a religiously strict whole food plant based diet and eating lower on the calorie density food side. 
 

Nothing else works long term. You can choose cleaner foods but sooner or later that always feels like restricting and you bounce back. This isn’t only my experience, it’s pretty much what all the long term studies say too.  Unless you’re prepared to do one of those 3 there’s really no point in stressing about it.  

I actually have fallen into somewhat of #2. I eat breakfast around 8-9 and the kitchen is closed by 5:30 pm. So 8-9 hours of an "eating window". Probably have to shave off more hours from the eating time, but I don't care enough to do so.

#3 will not happen here as I have other mouths to feed, and that's just not going to fly. 

[ktgrok]

56 minutes ago, Ausmumof3 said:

I actually wonder how many times health issues are the cause of the weight gain in the first place.  Reflux can be better when you eat more frequently, joint issues make it harder to exercise etc.  

Yes! My regain started after I hurt my back. I started taking muscle relaxers in the evening that triggered massive food cravings (it was like the sterotypical pot munchies - but with flexeril, lol). That messed up my metabolism and then when I stopped taking the pills I still was hungry. Plus pain can trigger food eating just for the endorphins. And I only recently learned that reflux can trigger eating as a way to dilute the acid. 

My mom was skinny - as in underweight no matter what she did - all her life until she got cancer. She underwent surgery that removed a lobe of her lung and was in bed a lot while she healed for a few months. Started gaining weight and has NEVER been able to lose it again no matter what she does, even a decade later. Something changed in her metabolism. 

[TravelingChris]

I don't want doctors chastising about my weight.  Only time I don't care is right now because my weight gain was because of my edema and my doctor wants to monitor that. I do not know why I gain or why sometimes I just suddenly start losing a lot. Nothing I seem to do seems to make a difference.  Anyway, I have serious medical issues going on that aren't related to weight and actually as long as I am not morbidly obese, being slight obese and definitely overweight for sure is much healthier with my conditions.  Blood clots kill skinny people easier and so do strokes. Pneumonia also kills skinnier people easier.  My heat is absolutely fine and I am not a diabetic and am at low risk of getting type 2 diabetes.  

I read medical doctors reviews carefullly and will fire a doctor if they bugged me about weight as some magic cure for my ailments-- it has nothing to do with my factor V Leiden, and the autoimmune stuff all started when I was thin.  So I do not want to hear it.

[DoraBora]

1 hour ago, bensonduck said:

I am recovering from an eating disorder and it’s in my chart that I will be weighed backwards, they don’t tell me the number, and the dr is to only discuss my weight if it’s a medical issue (I.e., my weight drops in a way that looks like I am not eating according to my meal plan needs). I wonder if you could ask your provider to put something like that in your chart as well?

I've refused to be weighed for years now.  I'm not overweight, but even if I was, I don't want to obsess about a number.  The nurse will ask me to step on the scale and I'll politely decline.

[wathe]

1 hour ago, Carol in Cal. said:

The way I see it, I want to know.  I want my doctor to look at my health comprehensively.  And I want my doctor to treat my illnesses.  

So, if a medical professional says, “Lose some weight and then we can talk about treating this,” that would bug me because if I need treatment, I need it.  But if a medical professional says, “You would be better off thinner for these reasons” I look at it as they did their job.  And it wouldn’t bother me.  I’m obese, too, and I’m just not that sensitive about it.  When I want help with my weight, I will ask for it.  When I don’t, I’m fine with them bringing it up, but not focussing on it as the main reason I’m there.

This was not posted as a JAWM post thread, so I will assume that all points of view are welcome.

Obesity is an independent risk factor for many serious chronic illnesses.  Of course doctors should address it, the same way they should address smoking, hypertension etc.  One wouldn't want ones doctor to ignore any other modifiable risk factor either.  Obesity is also complicated - lots of social and cultural factors, and not at all straightforward to manage.  Doctors should not be "fat-shaming" or treating obesity as a moral issue.  But they certainly should be addressing it.  And that means talking about it with patients during visits when it is relevant.

3 hours ago, historically accurate said:

I'm obese. There, I opened with it. I was a chunky kid, an average teen (held to that weight through some very unhealthy eating habits), and I was obese by age 25. My weight has held pretty steady for almost 20 years. I have weighed within 15-20 pounds of my current weight for those 20 years. I have lost and gained the same 30 pounds many, many, many times over.

I am also very healthy. I take no medications just vitamins that I choose to take. I had breast cancer 10 years ago, but no aftereffects since it was caught early and I had a double mastectomy. I was born with 1 deformed kidney and 1 healthy kidney, but I currently have kidney function to spare. My blood pressure is textbook, and my glucose is well within bounds. 

Today, I was at the nephrologist. I went for the first time in decades last year since I had a new primary doctor who sent me, so I guess it's an annual thing now. I gained 2 pounds since last year. I chuckled and made a joke about "Quarantine weight" when the doctor mentioned the change in my weight. She then said every patient she saw this year has gained 5-10 pounds so she said I was far ahead of the game. 

Seriously, the next words out of her mouth were about not gaining any more weight and getting to and maintaining a healthy BMI and all of the bad things that await my kidneys if I get diabetes or hypertension. They even gave me helpful literature about all of the bad effects of obesity. The kicker? This woman probably has a higher BMI than I do. 

Every time I go to the doctor, they all talk to me about the weight. So far, not a one of them have given my any options beyond eat healthy and exercise. It's one of the reasons I avoided doctors for a couple of years following my breast cancer surgeries. I cannot afford surgery even if I qualified (which I may not since I am not morbidly obese), and diets just really don't work. Really, really tired of every doctor's appointment being an opportunity to scold me. 

I'm stubborn and cranky now and came home and ate a fun sized Reese's. 

Doctors are people.  I think we often to forget that.  People who struggle with all the same life stuff that everyone else does.  Obesity, alcoholism, smoking, family dysfunction.  That doesn't change your doctor's obligation to address modifiable risk factors.

1 hour ago, rebcoola said:

I know a lot of my weight gain is because of my hip and back pain making it hard to exercise.  Doctors suck its so hard to find one that listens.  I have had pain since I was 12 but everything is because I'm fat now. 

I remember once DH insisted I go in to urgent care because I could barely walk.  The Doctor said what do you want pills.  No I want to know what is wrong with me and how to fix it if possible!!

Well thank you.  Some of your fellow boardies are doctors.  Who work hard, often under difficult conditions (particularly this year!), and really do care about their patients. 

Edited November 4, 2020 by wathe

[rebcoola]

6 minutes ago, wathe said:

This was not posted as a JAWM post, so I will assume that all points of view are welcome.

Obesity is an independent risk factor for many serious chronic illnesses.  Of course doctors should address it, the same way they should address smoking, hypertension etc.  One wouldn't want ones doctor to ignore any other modifiable risk factor either.  Obesity is also complicated - lots of social and cultural factors, and not at all straightforward to manage.  Doctors should not be "fat-shaming" or treating obesity as a moral issue.  But they certainly should be addressing it.  And that means talking about it with patients during visits when it is relevant.

Doctors are people.  I think we often to forget that.  People who struggle with all the same life stuff that everyone else does.  Obesity, alcoholism, smoking, family dysfunction.  That doesn't change your doctor's obligation to address modifiable risk factors.

Well thank you.  Some of your fellow boardies are doctors.  Who work hard, often under difficult conditions (particularly this year!), and really do care about their patients. 

Okay the doctors I have had as an adult who general suck.  Sorry but they have been rude, dismissive, and generally unhelpful to a person who has spent 2/3 of their life in f*'king pain!!! Thanks to our even sh*ttier insurance system I can't choose just any doctor nor can I see specialist without a referral from these doctors who don't listen to me.  I'm sure their are great doctors out their that actually try and help but I haven't found them.

Edited November 4, 2020 by rebcoola

[SpecialClassical]

1 hour ago, Katy said:

To my knowledge there are only 3 ways to permanently lose weight, statistically.

1) Surgery.

2) Intermittent fasting.

3) Switching to a religiously strict whole food plant based diet and eating lower on the calorie density food side. 
 

Nothing else works long term. You can choose cleaner foods but sooner or later that always feels like restricting and you bounce back. This isn’t only my experience, it’s pretty much what all the long term studies say too.  Unless you’re prepared to do one of those 3 there’s really no point in stressing about it.  

You should hear the scolding I have gotten from my primary care practitioners for intermittent fasting. One made me quit and the most recent one shamed me and told me it slowed my metabolism.  I’m so tired of working hard and being disciplined.  Sheesh, I just don’t want to get diabetes. 

[Katy]

20 minutes ago, SpecialClassical said:

You should hear the scolding I have gotten from my primary care practitioners for intermittent fasting. One made me quit and the most recent one shamed me and told me it slowed my metabolism.  I’m so tired of working hard and being disciplined.  Sheesh, I just don’t want to get diabetes. 

Next time they scold you, ask to see the studies.  Hint:  It hasn't been widely studied, but the small studies look REALLY good. There was one that is said to be poorly done that showed women have hormonal issues from the stress of intermittent fasting, but I don't think it's been duplicated.

Also, doctors use fasting all the time on people who are sick enough to be hospitalized.  Pancreatitis patients are routinely fasted until they're in remission. Other patients with un-diagnosed pain who may need surgery are also fasted at a hospital. Now, hospital supervision, with someone constantly monitoring your blood and vital signs, and giving IV saline & nutrition if necessary is worlds apart from the sorts of "supervised fasting centers" where people routinely drop dead from hitting their head when passing out, but you're not going to have a dangerous blood pressure drop by pushing back breakfast a few hours (or even two days assuming you're not in dangerous heat) and not snacking after supper.

[Kassia]

1 hour ago, rebcoola said:

Okay the doctors I have had as an adult who general suck.  Sorry but they have been rude, dismissive, and generally unhelpful to a person who has spent 2/3 of their life in f*'king pain!!! Thanks to our even sh*ttier insurance system I can't choose just any doctor nor can I see specialist without a referral from these doctors who don't listen to me.  I'm sure their are great doctors out their that actually try and help but I haven't found them.

I've had terrible experiences with doctors, too.  It makes me so angry that I waste time and money on bad medical advice and being misdiagnosed.  I was just billed $400 for a consult with a specialist who told me to eat BANANAS as a good source of protein.  BANANAS!  I wish I could pay her in bunches of bananas.  I had a doctor tell me at an office visit to take Tums when he didn't believe me that I had an intestinal obstruction.  My family doctor recommends exercise for everything even though I've told her over and over again that I am a compulsive exerciser.  I absolutely should not be exercising more than I do (or even as much as I do now).  I could go on and on...

As far as weight, most doctors don't look at the whole patient - they see the BMI and that's all they care about.  I've been healthy and obese, and I've been at a low weight with eating disorders.  My doctors were always delighted by my low BMI and never asked if I was okay, but they always recommended weight loss when I was overweight - even the ones who knew I had a history of eating disorders.  

[Scarlett]

I feel bad for people who struggle with their weight.  I do think a doctor has an obligation to address it.  Obesity is a serious health problem and it makes every other health problem worse.

There are success stories. Even without surgery.  I have so many friends who struggle with their weight.  The one thing that stands out to me in observing my friends is that food seems to hold too high of a priority in their life.  I remember reading a story where an accountant had embezzled a bunch of money and disappeared.  He was very overweight and just hid out in a cheap motel and lost the weight before re emerging with a new fake identity.  It described his thought process....he just completely disassociated his mind from food beyond basic life sustaining. 
 

I am sure y’all are rolling your eyes at me and saying that is how eating disorders come about....but isn't obesity an eating disorder too?  
 

I have a friend who is very strict with her diet and working out.  She ‘eats to live’ with the exception of rare times where she is ‘off’ her program.  
 

 

[Scarlett]

2 hours ago, Katy said:

Next time they scold you, ask to see the studies.  Hint:  It hasn't been widely studied, but the small studies look REALLY good. There was one that is said to be poorly done that showed women have hormonal issues from the stress of intermittent fasting, but I don't think it's been duplicated.

Also, doctors use fasting all the time on people who are sick enough to be hospitalized.  Pancreatitis patients are routinely fasted until they're in remission. Other patients with un-diagnosed pain who may need surgery are also fasted at a hospital. Now, hospital supervision, with someone constantly monitoring your blood and vital signs, and giving IV saline & nutrition if necessary is worlds apart from the sorts of "supervised fasting centers" where people routinely drop dead from hitting their head when passing out, but you're not going to have a dangerous blood pressure drop by pushing back breakfast a few hours (or even two days assuming you're not in dangerous heat) and not snacking after supper.

What is the intermittent fasting?

[ktgrok]

3 minutes ago, Scarlett said:

 I have so many friends who struggle with their weight.  The one thing that stands out to me in observing my friends is that food seems to hold too high of a priority in their life.

Well, and people with anxiety make worries too high a priority, and people with alcoholism make alcohol too high a priority in their life, etc. Saying obese people think about food too much sort of is a description, not a cause. People who are obese have been proven to have a biochemical difference that makes them actually hungrier than other people - despite eating a lot more. There is almost always a reason - a chemical one - that they think about food all the time. And the horrid thing is that losing weight makes that WORSE in most cases - they lose and the body fights back and sends MORE hunger signals, and LESS signals of fullness. 

[Scarlett]

4 minutes ago, ktgrok said:

Well, and people with anxiety make worries too high a priority, and people with alcoholism make alcohol too high a priority in their life, etc. Saying obese people think about food too much sort of is a description, not a cause. People who are obese have been proven to have a biochemical difference that makes them actually hungrier than other people - despite eating a lot more. There is almost always a reason - a chemical one - that they think about food all the time. And the horrid thing is that losing weight makes that WORSE in most cases - they lose and the body fights back and sends MORE hunger signals, and LESS signals of fullness. 

  It is there never a reset? For instance I am what I feel like is a carb addict.  Sometimes all I want to do is eat chip and dip. So I force myself to do a reset where I do t put a chip in my mouth for weeks....then I am better.  I don’t crave chips constantly. 
 

And is every obese person suffering from a chemical imbalance? Or could some just retrain their brain?

I don’t know.....just asking.  

[ktgrok]

9 minutes ago, Scarlett said:

  It is there never a reset? For instance I am what I feel like is a carb addict.  Sometimes all I want to do is eat chip and dip. So I force myself to do a reset where I do t put a chip in my mouth for weeks....then I am better.  I don’t crave chips constantly. 
 

And is every obese person suffering from a chemical imbalance? Or could some just retrain their brain?

I don’t know.....just asking.  

Sure, there are certain things that help some - cutting processed food, for instance. But plenty of obese peopl have tried keto for months, or whole foods only, or vegan, etc...but continue to overeat even those foods. And yes, by definitions, obese people have a metobolic, biochemical, generally progressive disease. Fat is biologically active, and secretes hormones that effect appetite, metabolism, etc. 

And that's just a small piece of it. We are still learning so much about the science behind it. For instance, after bariatric surgery diabetics can often come off their insulin within HOURS of surgery - before they have lost any weight. Their metabolism changes, and we dont' know why, exactly. 

Just the other day I was listening to a podcast where they had recently discovered that bile acids, secreted by the liver, seem to have an effect on appetite. It's all so intriguing, but very complex. And none of it is helped by a society where we are bombarded with images, videos, smells, etc of food 24/7. 

[Hunter]

Diets are no more effective than spelling curricula.

Shaming fixes nothing.

We all need to be careful about addressing things that we do not have a solution, including and maybe especially doctors addressing weights. Weights are complicated. One of my children was overweight. He did not know he was overweight until he was 14 and a physicians assistant addressed it with him. At 14, he was confused why I had not talked to him about weight, and only healthy eating. Later, he thanked me for that. His weight after 14 has been up and down, but never because of attempts to change his weight. Other factors that had nothing to do with an attempt to change his weight were what changed his weight.

My mom had anorexia and pressured me to remain underweight as a child in ways that confused me then and set me up for a lifetime of mucked up thoughts about my body. I was determined that my kid would have the healthiest relationship with food possible. He says there was NOTHING more I could have done that was in my power.

Medical staff are only human and only know what they know. And will get sued if they do not follow "best practice" no matter what they think of "best practice." They training is what their training is. To just do what they are trained to do, is what keeps them sane and financially solvent and able to have a life.

But that doesn't mean that what they are trained to do doesn't harm you. You are harmed by this. I'm sorry this is happening to you. Many of us avoid doctors to prevent being harmed. Sometimes "treatment" is more harmful than medical neglect.

[Scarlett]

7 minutes ago, ktgrok said:

Sure, there are certain things that help some - cutting processed food, for instance. But plenty of obese peopl have tried keto for months, or whole foods only, or vegan, etc...but continue to overeat even those foods. And yes, by definitions, obese people have a metobolic, biochemical, generally progressive disease. Fat is biologically active, and secretes hormones that effect appetite, metabolism, etc. 

And that's just a small piece of it. We are still learning so much about the science behind it. For instance, after bariatric surgery diabetics can often come off their insulin within HOURS of surgery - before they have lost any weight. Their metabolism changes, and we dont' know why, exactly. 

Just the other day I was listening to a podcast where they had recently discovered that bile acids, secreted by the liver, seem to have an effect on appetite. It's all so intriguing, but very complex. And none of it is helped by a society where we are bombarded with images, videos, smells, etc of food 24/7. 

As in decrease?  My co worker has been sick for well over a year....bad gallbladder.  Lost a lot of weight which was not exactly a bad gall bladder symptom.  Turns out he has a raging case of H pylori.....is that the right word?  And it affects the absorption of food and nutrients and appetite.  

[ktgrok]

Just now, Scarlett said:

As in decrease?  My co worker has been sick for well over a year....bad gallbladder.  Lost a lot of weight which was not exactly a bad gall bladder symptom.  Turns out he has a raging case of H pylori.....is that the right word?  And it affects the absorption of food and nutrients and appetite.  

I may be remembering wrong, but I think it was that higher levels of bile acid in the blood led to weight decrease. It was cutting edge stuff. 

And yes - the balance of bacteria in our bodies has a huge effect on weight. Some people have a microbiome that is not efficient, and lets a lot of the calories eaten pass right through. others have very efficient bacteria that convert most calories to usable energy. So two people eating the same food, burning the same amount of calories, could have differences simply from gut biome. This has been demonstrated in mice using fecal transplants. Thin mice given a fecal transplant from obese mice then became obese themselves. It isn't like their will power changed, or their psychological background. Just their microbiome. It's fascinating. 

[Jean in Newcastle]

33 minutes ago, Scarlett said:

I feel bad for people who struggle with their weight.  I do think a doctor has an obligation to address it.  Obesity is a serious health problem and it makes every other health problem worse.

There are success stories. Even without surgery.  I have so many friends who struggle with their weight.  The one thing that stands out to me in observing my friends is that food seems to hold too high of a priority in their life.  I remember reading a story where an accountant had embezzled a bunch of money and disappeared.  He was very overweight and just hid out in a cheap motel and lost the weight before re emerging with a new fake identity.  It described his thought process....he just completely disassociated his mind from food beyond basic life sustaining. 
 

I am sure y’all are rolling your eyes at me and saying that is how eating disorders come about....but isn't obesity an eating disorder too?  
 

I have a friend who is very strict with her diet and working out.  She ‘eats to live’ with the exception of rare times where she is ‘off’ her program.  
 

 

And here’s the obligatory “obese people have no self control “ post. I track every single morsel that goes into my mouth. I track water. I track carbs and poke my fingers six times a day to test my blood sugars. I exercise daily using exercises monitored and assigned by my physical therapist. I have met with four? five? nutritionists. I eat well within (actually under) my recommended calorie range. I have clawed my way to 25 pounds lost but I literally can only lose a pound or two a month- if I am lucky. So you can bet my eyes are rolling so hard they are about to roll out of my head. I don’t know why people who admit that they have no actual experience actually living with this feel like they have to chime in to give us dumb obese people their “wisdom”. 

[Scarlett]

5 minutes ago, Hunter said:

Diets are no more effective than spelling curricula.

Shaming fixes nothing.

We all need to be careful about addressing things that we do not have a solution, including and maybe especially doctors addressing weights. Weights are complicated. One of my children was overweight. He did not know he was overweight until he was 14 and a physicians assistant addressed it with him. At 14, he was confused why I had not talked to him about weight, and only healthy eating. Later, he thanked me for that. His weight after 14 has been up and down, but never because of attempts to change his weight. Other factors that had nothing to do with an attempt to change his weight were what changed his weight.

My mom had anorexia and pressured me to remain underweight as a child in ways that confused me then and set me up for a lifetime of mucked up thoughts about my body. I was determined that my kid would have the healthiest relationship with food possible. He says there was NOTHING more I could have done that was in my power.

Medical staff are only human and only know what they know. And will get sued if they do not follow "best practice" no matter what they think of "best practice." They training is what their training is. To just do what they are trained to do, is what keeps them sane and financially solvent and able to have a life.

But that doesn't mean that what they are trained to do doesn't harm you. You are harmed by this. I'm sorry this is happening to you. Many of us avoid doctors to prevent being harmed. Sometimes "treatment" is more harmful than medical neglect.

I can definitely see how the pendulum swings on this.....the way your mom handles weight issues made you do the opposite with your son.  I on the other hand, could not stand by and say nothing when one of my kid was morbidly obese.  

[Starr]

5 hours ago, ktgrok said:

Yes! My regain started after I hurt my back. I started taking muscle relaxers in the evening that triggered massive food cravings (it was like the sterotypical pot munchies - but with flexeril, lol). That messed up my metabolism and then when I stopped taking the pills I still was hungry. Plus pain can trigger food eating just for the endorphins. And I only recently learned that reflux can trigger eating as a way to dilute the acid. 

My mom was skinny - as in underweight no matter what she did - all her life until she got cancer. She underwent surgery that removed a lobe of her lung and was in bed a lot while she healed for a few months. Started gaining weight and has NEVER been able to lose it again no matter what she does, even a decade later. Something changed in her metabolism. 

Flexeril lol I remember when we first started giving that instead of valium as a muscle relaxer. Some people were so high. 

[Scarlett]

3 minutes ago, Jean in Newcastle said:

And here’s the obligatory “obese people have no self control “ post. I track every single morsel that goes into my mouth. I track water. I track carbs and poke my fingers six times a day to test my blood sugars. I exercise daily using exercises monitored and assigned by my physical therapist. I have met with four? five? nutritionists. I eat well within (actually under) my recommended calorie range. I have clawed my way to 25 pounds lost but I literally can only lose a pound or two a month- if I am lucky. So you can bet my eyes are rolling so hard they are about to roll out of my head. I don’t know why people who admit that they have no actual experience actually living with this feel like they have to chime in to give us dumb obese people their “wisdom”. 

Well, I know how you feel about it.  Maybe not every obese person on the board feels the same way.  
 

I do have experience not being obese.  Is that worth nothing?

[Scarlett]

6 minutes ago, Starr said:

Flexeril lol I remember when we first started giving that instead of valium as a muscle relaxer. Some people were so high. 

I was prescribed flexeril for TMJ issues.  I think I have taken 3 in 15 years.  I can’t function until at least noon the next day.  

[kbutton]

6 hours ago, Ausmumof3 said:

I actually wonder how many times health issues are the cause of the weight gain in the first place.  

I suspect this happens a lot.

I tried to get help from my doctor to address issues that I knew were going to get worse, and she didn't care. At all. 

I have very bad luck with family doctors. Specialists are better, and thankfully, I've had insurance plans that didn't always require a referral.

My DH is in healthcare, and he gets frustrated on my behalf. 

I tend to read up on things, and my doctor seems to be more bothered by that than if I were totally ignorant; however, I have caught health issues of friends and relatives because I read up, some of which were rare and were not on the doctor's radar. 

Right now, I am staying on top of hunger by monitoring blood sugar. Guess what I asked my doctor about years ago? My blood sugar. I truly think that if I had been helped back then, I might not be as fat as I am now. (I got the idea to monitor it myself via the forums.) My blood sugar was only ever barely normal, even when I thin and in good shape. As I've aged and gotten fatter, I have improved my diet quite a lot--when I was younger and thinner I ate a lot of carbs because that was the thing to do at the time. For me, low-carb eating makes a really big difference, but I don't know that it will be enough. But it bothers me that my doctor just didn't care. I kept changing my diet, and my blood sugar kept creeping up, but it wasn't like I had stellar blood sugar when I was thin. It was always barely normal, or slightly into the pre-diabetic range.

I also suspect that there are people on one side of my family that were diagnosed with Type 2 diabetes that might've actually had LADA. There are some autoimmune things that show up in that family, and I have a cousin that was diagnosed with Type 1 at a very young age.

[Jean in Newcastle]

27 minutes ago, Eliana said:

I hate food.  I eat far below the recommended calories & I am morbidly obese. Food is only a priority to me in the sense that it is hard to find foods that do not cause me serious pain and other digestive issues, it is certainly not something I find pleasurable to interact with or that I enjoy thinking about.

The times when I have lost weight have been when I have been able to cobble together enough foods that don't cause pain & inflamation & am thus eating a large enough number of calories for my absurdly efficient metabolism to get out of starvation mode.  (Increasing exercise too much flares my fibro and has actually caused weight gain for me.)

(And no, I didn't have weight issues as a teen or young adult - it was clearly tied to the emergence of other health issues.)

(And to push back on another stereotype: I don't eat junk food or dessert.)

Weight is complicated & simplistic assumptions are really not helpful or kind.

And, no, I don't think your experience being not obese is helpful at all.  (it might be if you had been obese in the past and weren't now, but only to those with similar causes.)

My experience exactly.  Twinsies. 

[Scarlett]

31 minutes ago, Eliana said:

I hate food.  I eat far below the recommended calories & I am morbidly obese. Food is only a priority to me in the sense that it is hard to find foods that do not cause me serious pain and other digestive issues, it is certainly not something I find pleasurable to interact with or that I enjoy thinking about.

The times when I have lost weight have been when I have been able to cobble together enough foods that don't cause pain & inflamation & am thus eating a large enough number of calories for my absurdly efficient metabolism to get out of starvation mode.  (Increasing exercise too much flares my fibro and has actually caused weight gain for me.)

(And no, I didn't have weight issues as a teen or young adult - it was clearly tied to the emergence of other health issues.)

(And to push back on another stereotype: I don't eat junk food or dessert.)

Weight is complicated & simplistic assumptions are really not helpful or kind.

And, no, I don't think your experience being not obese is helpful at all.  (it might be if you had been obese in the past and weren't now, but only to those with similar causes.)

Well, I have thoughts based upon my observation and experience. I didn’t think my thoughts were especially simplistic. Certainly not unkind.  Seems to me, in all my years on this board, no one who is obese really wants anyone to tell them anything.  No suggestion will work for them. They have tried it all. And God forbid a non obese person have a thought about the subject at all. I just find that strange.

Just because I am not obese doesn’t mean I don’t have struggles.  Or that I don’t have a brain. 

Edited November 4, 2020 by Scarlett

[Scarlett]

28 minutes ago, Eliana said:

I hate food.  I eat far below the recommended calories & I am morbidly obese. Food is only a priority to me in the sense that it is hard to find foods that do not cause me serious pain and other digestive issues, it is certainly not something I find pleasurable to interact with or that I enjoy thinking about.

The times when I have lost weight have been when I have been able to cobble together enough foods that don't cause pain & inflamation & am thus eating a large enough number of calories for my absurdly efficient metabolism to get out of starvation mode.  (Increasing exercise too much flares my fibro and has actually caused weight gain for me.)

(And no, I didn't have weight issues as a teen or young adult - it was clearly tied to the emergence of other health issues.)

(And to push back on another stereotype: I don't eat junk food or dessert.)

Weight is complicated & simplistic assumptions are really not helpful or kind.

And, no, I don't think your experience being not obese is helpful at all.  (it might be if you had been obese in the past and weren't now, but only to those with similar causes.)

But to the bolded.....surely you understand that there are obese people who do love food. Who do eat sweets....and huge portions.  And think of food night and day.  

[Jean in Newcastle]

15 minutes ago, Scarlett said:

Well, I have thoughts based upon my observation and experience. I didn’t think my thoughts were especially simplistic. Certainly not unkind.  Seems to me, in all my years on this board, no one who is obese really wants anyone to tell them anything.  No suggestion will work for them. They have tried it all. And God forbid a non obese person have a thought about the subject at all. I just find that strange.

Just because I am not obese doesn’t mean I don’t have struggles.  Or that I don’t have a brain. 

With that logic I should find some threads on cancer because I have never had cancer and surely I can tell them how not to get it too. 

[Jean in Newcastle]

14 minutes ago, Scarlett said:

But to the bolded.....surely you understand that there are obese people who do love food. Who do eat sweets....and huge portions.  And think of food night and day.  

And there are thin people who love food.  And who eat sweets and huge portions.  And think of food night and day.  And who still stay thin.

 

And many obese people might crave food because of imbalances and hormonal problems.  Telling them that they lack self control is no help at all. 

[Laura Corin]

The only time I can see it making sense as a topic is if there is a very targeted health reason: my brother was asked to try to lose weight before an operation because it would significantly increase the likelihood of a good outcome.

Otherwise, for people of whatever shape or size, I wish doctors would talk instead about activity and healthy eating.  Most doctors are not well trained in exercise and nutrition.  For example, no doctor has ever advised me to make sure to take weight-bearing exercise and eat adequate protein as I age, to protect my muscle mass.  Presumably if I had a fall they would then tell me that I should have been doing this.  This organisation in the UK is interesting

https://culinarymedicineuk.org/

https://culinarymedicineuk.org/who-we-are

Edited November 4, 2020 by Laura Corin

[Hunter]

3 hours ago, Scarlett said:

I can definitely see how the pendulum swings on this.....the way your mom handles weight issues made you do the opposite with your son.  I on the other hand, could not stand by and say nothing when one of my kid was morbidly obese.  

You can help a child be healthier and even thinner without ever mentioning their weight.

My son just mentioned recently how I used to refuse to allow a thirsty child to drink a beverage with sugar or even milk, and insisted that "thirsty" required water not food. Food was for hungry. Water was for thirsty.

I said fruit was healthier than treats. Whole grain was healthier than white flour. Etc. etc. ect.

Healthy and skinny are not synonyms. 

Some people are never going to be thin, and they deserve to have a good life. I was not an obese child, but I was reared to believe that I was obese. To this day, my siblings will insist that I was "fat" even though they can not produce a single picture of me fat. I was reared to believe that fat was bad and that I was bad, and my weight was the reason that I was treated differently than my underweight siblings. I lived the life of an overweight child despite not being overweight. I did not know it was all a lie until I was 15 and singled out as the smallest student in a gym class of 100 girls and placed at the top of a pyramid. I looked down at the stronger girls holding me up, and realized I could not be both the smallest and obese.

Overweight people are not different than lower-weight people. Rearing ALL children to eat healthy is enough, without discussing weight. If healthy eating doesn't make a child thin, then teaching them unhealthy habits in the hope they will be thin probably isn't going to end well. I believe in the right of all children to be reared to be healthy as the goal and to be told they are beautiful and moral and equal to their thinner peers and siblings.

I did not stand by. I did not say nothing. I just did not ever use the word "weight". I just did not ever tell my child that he was different. I just never told him that he was inferior in any way. He failed to choose wheat bread over white bread, maybe, when he had the chance to make that choice despite my teaching, but he did not fail at being thinner, because that was never the narrow goal. We stuck to a wider goal of healthy. He was able to be successful at that most of the time. He was a healthy child. And a mentally healthy one. He got to be a child, something that I never experienced. I did not stand by. I fought for my kids with every resource AVAILABLE to ME.

No regrets about this. NONE! 

[Hunter]

2 hours ago, kand said:

Given the choice between someone having an eating disorder or being obese, it is far, far, far safer and healthier for them to be obese. Eating disorders have the highest death rate of any mental disorder.

This. And more patients die of suicide after "treatment" than die of starvation or other physical complications of the disorder.

Edited November 4, 2020 by Hunter
grammar

[ktgrok]

7 hours ago, Scarlett said:

Well, I know how you feel about it.  Maybe not every obese person on the board feels the same way.  
 

I do have experience not being obese.  Is that worth nothing?

It would be as if you went to a blind person and said you had experience with having sight, so you could help them learn to see as well. 

Losing weight after becoming seriously obese is NOTHING like naturally not being obese. Nothing. Your body chemistry and metabolism are different from that of an obese person. 

6 hours ago, Eliana said:

I hate food.  I eat far below the recommended calories & I am morbidly obese. Food is only a priority to me in the sense that it is hard to find foods that do not cause me serious pain and other digestive issues, it is certainly not something I find pleasurable to interact with or that I enjoy thinking about.

 

This is my mother. She was always SO skinny - to the point she was teased about it growing up. She was 130 pounds when 9 months pregnant. All long legs and gangly. She hates sweets. She LOVES vegetables. Her idea of a yummy meal is a serving of squash or brussel sprouts and a small piece of good cheese. Only person I know who actually dislikes both pizza and ice cream. I've never even seen her eat a french fry or potato chip. 

She had surgery, and her metabolism changed in some fundamental way. This is NOT uncommon. She went from unable to gain weight to unable to lose weight. She was obviously less active while recovering, but that was for a month and during that time she ate less as well. Then when she was healed she was active as ever - constantly on the go, the type of person that never sits still. Also did daily pilates, walked, etc. MORE exercise than before surgery...and continued to gain. 

6 hours ago, Scarlett said:

Well, I have thoughts based upon my observation and experience. I didn’t think my thoughts were especially simplistic. Certainly not unkind.  Seems to me, in all my years on this board, no one who is obese really wants anyone to tell them anything.  No suggestion will work for them. They have tried it all. And God forbid a non obese person have a thought about the subject at all. I just find that strange.

Just because I am not obese doesn’t mean I don’t have struggles.  Or that I don’t have a brain. 

They don't want you to tell them how to manage obesity because you have zero training or experience in that area. I am not going to go tell a person with MS how to manage that. Because I don't have MS, and I have no scientific training in that area. 

Hell, even the scientists will tell you we are barely touching the surface of how obesity works. There are epigenitc issues, biochemical issues, environmental factors like chemicals in the environment, etc. There is not one cause of obesity, there are a multitude. Sort of like autism. It's hugely complex. Heck, they have found that women who experience certain kinds of stress while pregnant produce children who grow up to have more heart disease as an adult. Whatever biochemical or epigenetic thing that triggers that in them happened while they were in the womb! It's crazy!

[Scarlett]

6 hours ago, kand said:

No, obesity is not an eating disorder. Eating disorders involve distorted thoughts about food and body and cause an actual change in the brain. Given the choice between someone having an eating disorder or being obese, it is far, far, far safer and healthier for them to be obese. Eating disorders have the highest death rate of any mental disorder.

She didn't say he was morbidly obese. If you ever had a kid with an eating disorder, you would wish they would just be overweight instead. No contest.

I have experience not being obese as well--I've always been thin and I don't have to do anything special to be that way. I'm not morally superior and I don't exercise better will power than other poeple. I used to think people who were overweight could just change their habits if they cared to. That was because I didn't understand it's not that simple. I'm not saying people can't lose weight and get healthier, but my view was way overly simplistic. My experience not being obese was not the least bit relevant to me understanding what it is like for someone who is.

I was referring to my son.

[teachermom2834]

I haven’t been to a doctor for five years. I have gotten mammograms but that is it. 
 

I have a BMI around 30-31 and I fight to keep it there. I am 46 years old. I have never had any health problems at all found on bloodwork up until 5 years ago when I quit going. The last time I went my dr gave me advice about eating small meals all day long to keep my metabolism going. That is totally wrong for me and I know it. Fighting to stay around 30 BMI means I know a lot about my body and how it works and eating a granola bar as soon as my feet hit the floor in the morning is only going to make things worse.

Ugh. I should go back. My mom started having all kinds of health problems when she was just a couple years older than I am now. But I’m just sick of dealing with the weight. I feel bad about it on a daily basis and I work at it on a daily basis. Being told to eat every two hours and skip the drive thru (haven’t eaten from a drive thru in at least five years maybe more) is just so insulting. 

[Scarlett]

I at no time in any of my posts have said or implied that obesity is a moral failing or lack of willpower.  
 

And like most people on this board I am not medically trained. I agree with what Katie just said that once a person becomes obese to a certain point losing weight is nearly impossible. I am sure there is a portion of people with weight problems who are unable to do anything that works.  My point is that is not always the case.

 I have the up close experience of my step son who was morbidly obese and put on blood pressure meds at age 16.  That scared me.  And then by 17 his med had to be increased.  There was nothing his dad or I could do....he had to do it.  But you can bet we didn’t stand by and say nothing about it.

When he was 18 he made some changes. A lot of changes. And the weight just began to come off. The changes were all things that his doctor and his parents had suggested and encouraged many times.  He has so far lost 70 pounds. I don’t think he will ever be thin, but he will be able to keep control of it. We are very proud of him and so is his doctor.  Ds was able to come off his blood pressure meds completely which is what the doctor told him would happen all along.  

He can’t be the only one like that.  And that is all I am saying. That we do a disservice to people by assuming it is all some mysterious chemical imbalance that they can’t help.  And although I have never been obese I do struggle with cravings and other things that can start to add on weight and my way of dealing with that might help a person somewhere . And if a person hears me make a suggestion and they have already tried that and it didn’t work, well no reason to hate on me or chastise me for my ‘ignorance.’