How can some people not get why they are overweight?

[disneysteve]

Before you get out the flamethrowers, let me say that I understand many people battle with their weight. Losing weight and keeping it off requires an ongoing effort and isn't a simple task. But you can't turn on the news or open a magazine without seeing stories about the obesity epidemic in this country and what people can change to address their own weight problems. I'd like to think that folks who are obese have at least a general idea of what they are doing wrong, but that simply isn't the case in my experience.

Here is an actual conversation I had recently with a patient who is obese (BMI=34) and has high blood pressure and high cholesterol as well as pre-diabetes.

Me: Your weight is probably a factor in the health problems you have. Tell me about your diet. What do you eat for breakfast?
Patient: I don't know why I'm so heavy. I really don't eat much. All I have for breakfast every day is a bacon, egg and cheese bagel sandwich and coffee.
Me: Well, that's a very high fat, high calorie meal. What about lunch?
Patient: We usually order out. I'll get an Italian hoagie or a cheesesteak or something like that.
Me: Well, how about dinner?
Patient: We'll have steak and potato or fried chicken or fried fish.
Me: What about snacks or desserts during the day?
Patient: I like chips or cookies or ice cream.

This patient seemed shocked when I explained how poor that diet was. As far as this person was concerned, he/she wasn't doing anything wrong and was just unexplainably getting fat. So is this just plain old denial or is the message really not getting out? What can we, as a society, do better to teach the public about proper diet and nutrition? Many times, I've told a parent that her child is significantly overweight - 30 or 50 or 100 pounds so - only to have mom laugh at me. How can I get through to someone who finds that so amusing?

Sorry if I sound frustrated, but it just upsets me to see people suffering from so many medical problems that are all attributable to their weight but, at the same time, making no effort to do anything about it and sometimes even denying that a problem exists.

Curious to hear your thoughts, whether weight is an issue for you or not.

 

[Marseeya]

I find your "story" very far-fetched. Or at the very least, exaggerated to the nth degree.

 

[monkeyboy]

HEY I am working on it

 

[Kimberle]

I find your "story" very far-fetched. Or at the very least, exaggerated to the nth degree.

If I remember correctly, Steve is a Physician.

denial, laziness, wanting "immediate results"..............

 

[mrsltg]

If I remember correctly, Steve is a Physician.

denial, laziness, wanting "immediate results"..............

Yep, Steve is a physician and has relayed cases like this before. It's sad that people can be soooooooo stupid. It must be very frustrating, Steve.

Erin

 

[SherryNC]

Here is my 2 cents as someone who has taught in the public school system. I graduated HS in 87. We were required to have physical ed EVERY day of the week in HS. Where I have taught in an elementary school, they had it once a week. My ds is in kdg and has PE once a week. My dd just finished her freshman year and they are not required to have any physical ed classes at all except for 1 semester during their entire 4 years. True, they offer many extra curricular activities, but many kids will choose not to participate. Our family is active, so I think we're ok, but I really feel like the public schools let our kids down in this regard.

 

[ashjohnson80]

I think a lot of people could control their weight if they wanted to. But I also think that some people try their hardest and people still say that they are fat or whatever. I used to have an eating disorder in high school. I went 2 1/2 weeks without eating once. I only drank water. I never have weighed under 130 lbs. Now I'm on a lot of different medications for depression and anxiety as well as thyroid disease, birth control and others and it has made me gain a lot of weight.

I will ask my doctors what is wrong with me and they tell me to cut my portions. Well I don't drink soft drinks, I only eat two small meals a day that are low fat or low calorie, I count both and no snacks. But of course no one will beleive me. Worrying about my weight is something that I am totally obsessed with and probably spend 90% of my days thinking about it.

But I don't fit into what is "pretty". I must look like I've really "let myself go". I must "not try" Even though I work out at the gym 4-5 days a week. Why don't
"I get" why I am fat? Wow what I loser I must be.

Alright go ahead tell me what is wrong with me, or think that I am lying or whatever. Everyone else does. It's so easy to criticize when you aren't living in this body.

 

[isyne4u]

I know for myself (5' 4" 170lbs) that I don't realize how many calories things have. I will look at it and think that it can't be that bad and when I look at the calories. I know, as an example, I used to get this bluberry muffin from 7/11. I thought it had maybe 250-300 calories and that was all I ate for breakfast. Then I saw that a muffin that was a third the size of the one I was eating was 200 calories :O I almost fell over when I realized that the muffin I was eating had close to 600 calories. That's when I quit eating it.

Anyway, that's my problem.. When i count calories I lose weight pretty quickly...its when I get lazy (like right now) that I have trouble losing weight. I'm afraid to get my cholestrol and such checked until I get to my target weight!!!

 

[Marseeya]

If I remember correctly, Steve is a Physician.

denial, laziness, wanting "immediate results"..............

Add stupidity to the list.

Patient Moron: I don't know why I'm so dang fat! I don't eat much!
Doc Wonderful: What does your daily diet consist of?
Patient Moron: Great big gobs of greasy grimy gopher guts! Mutilated monkey meat & contaminated birdy feet. Oh yeah, and french fried eyeballs swimming in a poopy doop. It ain't much, doc, I swear! Duhhhh... I just don't get it.
Doc Wonderful: There's no hope for you, then. The fat is deeply imbedded in your brain.


I'm overweight and I know tons (put intended) of fat people. Not a single one of them would have such a ridiculous conversation as what he posted.

 

[Royalbear]

While I agree with you in this particular patient's story, I see something slightly different with my patients. Most of my patients know what healthy eating is, they just somehow can't be satisfied with that lifesytle. Some of my skinny patients are truly health nuts who eat as healthy as can be, but I also see the very skinny patients whose diets are no better than anyone else's and they don't gain weight.

I also find it very interesting to watch a group of children at a party. The skinny kids can take or leave food, but the heavy kids are drawn to the food--they seem to really be drawn into eating. These are young kids, so I know that little secondary gains are gotten from eating, but there is something in their make up that makes them need food more than other children.

When I talk to patients about how they lost weight, they always talk about how somehow a switch was turned on that enabled them to stop eating, (it is hoped that they trained themselves while the switch was turned on so that they could choose healthier foods for life), but I believe that the switch has to be on in order for the weight loss to begin, and when I figure out how to manipulate that switch, I will be 3 sizes smaller and millions of dollars richer.

 

[Dan Murphy]

I have fought the battle of the bulge for 45 or more years. Several times I have made a good faith effort and succeeded in losing. Most currently, for about 2 years now, I have followed the low carb methos and have knocked off, and kept off, about 45 pounds. I would like to do another 15, knowing if I were more active (less DIS'ing, LOL and more walking) I would do it, just takes the discipline. That or go to WDW more often and walk there.

 

[HayGan]

I have a few extra pounds (~20) but nothing that is harmful to my health (tests are all excellent!) I know my excess pounds are due to poor food choices and lack of exercise. I'm working on losing the weight and adding more excercise into my daily life. It is highly unlikely that I would ever be an obese person but I will have to work at keeping off extra weight all my life. I lost 25 lbs 2 years ago but unfortunately I put it back on after a very stressful 2 years. No one else put that junk in my mouth, McDonald's didn't force a Big Mac down my throat. It was my choice and now I have to do the work to reduce the effects!

I also don't understand why alot of people don't want to take responsibility for their physical conditions. I guess it is just another symptom of our society's general lack of personal responsibility - it is always someone else's fault not mine.

 

[CEDmom]

I think it's a combination of things. These being ignorance about nutrition, denial about actual consumption, lack of physical activity and inability/unwillingness to make lifetime changes. There is no quick fix. The weight didn't come on overnight so it's not going to come off quick either.

Before anyone flames me, I was heavy until my mid 20's but then I finally made some big changes and have pretty much maintained my weight for the last 15+ years. It's still something I have to focus on because a few pounds will creep back on if I don't.

Being a mom with a DD has made me even more aware of portraying a positive image to her. That includes healthy eating for the most part and maintaining a healthy strong body.

 

[btass]

I am going to preface this with a fact:

I am 5 foot 5 inches and wiegh 260 (or so) Yes, I am fat and I know it. Yes, I have been to a Nutritionist and am trying to follow the guide that I was given.

Now for my comment:

Most people are taught what to eat by thier parents. I have heard this a lot "It is the parents responsibility to teach the child how to eat." Well, if the parents have no idea what is nutritionally sound, the children will never learn. That leads to an epidemic of obese children turning into obese adults with health problems from the obesity.

There are so many different advertisements and specialists and whatevers that are shoving different information down peoples throats these days that it gets very confusing. Am I supposed to eat meat am I not supposed to eat meat? What the heck is a carb anyway? Etc. Etc.

I personally think that every person in the world should find a nutritionist and follow what they say to eat before going to Wieght Watchers or something like it. Most of the time the Health Insurance will cover the cost of a nutritionist so that should not be a factor. They teach people what portions are and what is good to eat with what so that your waistline does not grow too fat. And of course the most important of all is:

Losing wieght is a lifestyle change, not a diet.

You will never ever be able to not eat a certain type of food for a while, lose wieght, eat that food again and maintain your wieght loss, it is not possible.

Well, that is my very long 2 cents worth!

 

[kasar]

As frustrating as it must be for you Steve, you have no idea how strong denial can be! Deep in their hearts they KNOW. They just don't want to face what needs to be done. I've avoided mirrors for years and yet I'm still surprised at myself everytime I walk by a glass window or see a picture of myself. Why? I have no idea - it's not like I don't know my weight or size.

I know exactly why I'm overweight. I've been living like I'm 18 not like I'm almost 40. It's hard to face but like monkeyboy, I'm working on it! Keep on preaching to your patients - you really are helping them even if you take a lot of flack in the process. Thanks for caring.

 

[disneysteve]

I find your "story" very far-fetched. Or at the very least, exaggerated to the nth degree.

Sadly, it isn't exaggerated at all. And yes, I am a physician and could tell you dozens of stories just like this. I had a patient a few years ago who insisted that all she ate every day was a can of tuna fish, plain right from the can, at lunchtime. She denied eating breakfast or dinner or any other snacks during the day. Her husband even was in the room and agreed with her. I tried to explain that she couldn't possibly be surviving and continuing to gain weight if she was only consuming 500 calories per day and there was really no helpful advice I could give her. Denial is an incredibly powerful thing.

 

[Rachie0507]

Okay, I'm unsure about getting into these thread, but I'll try!

I didn't understand what good eating habits were until I joined Weight Watchers for the first time. I grew up with overweight parents who constantly surrounded all of us with unhealthy foods. I think our biggest issue was portion control. My attempts to diet before Weight Watchers always failed because I thought dieting meant not eating much, but I didn't understand that I was eating bad foods. Since I have become a Weight Watcher, I understand a lot more about what eating healthy means. I must admit I have not always been willing to eat in healthy ways and I have come to terms with the fact that I will always be someone who struggles with my weight. I would say that 98% of the time I am eating a healthy diet.

Seeing that I was an adult before I realized all of this, I would guess that there wasn't much education out there for my generation (25-35 yr old) to learn about good eating habits. I was a great student and I don't remember learning much about it in school. My parents were certainly no help. I don't ever remember my doctor saying anything about it when I was younger. So that would be my guess as to why overweight people just don't get it--kind of like, you can't teach an old dog new tricks. If we just didn't know for all these years, it is hard to change.

(I never get involved in these threads that may become debates, so please don't get mad at me. That would be my opinion from someone who has been there.)

 

[DisMN]

I find it distressing that everyone has bought into blaming the "fat" for having high blood pressure and high cholesterol. It's just not true IMHO.

I know several very thin people who eat the most healthy diets you could imagine. They're all plagued by high cholesterol and one recently and suddenly died from a heart attack.
I know several other people who are thin who struggle very much with high blood pressure......in fact when I was at my lowest weight (#112 5'2") I had high bp as well.....

Currently I weigh a full 40 pounds more than the woman you mentioned Steve and my cholesterol is 154.

I've known many fit, rail thin people who have diabetes as well. I'm just not buying that the fat as why people get these illnesses.

I've seen too many variations to blame fat for the ailments human beings suffer with.

I'm glad you care about your patients but personally I stopped going to one of my doctors who's only concern was that my broken ankle hadn't healed because I was fat. Turns out he was wrong and they should have put a pin in the ankle......the healing had nothing to do with my weight but that's all he could focus on. That's an obsession on his part and it wasn't helpful to the patient at all.

 

[isyne4u]

Add stupidity to the list.

Patient Moron: I don't know why I'm so dang fat! I don't eat much!
Doc Wonderful: What does your daily diet consist of?
Patient Moron: Great big gobs of greasy grimy gopher guts! Mutilated monkey meat & contaminated birdy feet. Oh yeah, and french fried eyeballs swimming in a poopy doop. It ain't much, doc, I swear! Duhhhh... I just don't get it.
Doc Wonderful: There's no hope for you, then. The fat is deeply imbedded in your brain.


I'm overweight and I know tons (put intended) of fat people. Not a single one of them would have such a ridiculous conversation as what he posted.

It may sound far fetched but if the patient doesn't realize that what she eats is bad then she will be honest.

Just for my information....do you think that instead of saying the truth that a person would lie to the doctor? I would hope that this is an honest response from a patient that truly needs someone to guide her onto the right path of eating responsibly. Maybe, as another poster said, she needs to see a nutritionist who would help her understand the fat and calories and the effects on her health.

just my .02

 

[Mom2Ashli]

I know at my DD school the PE department is big on promoting exercise. They have a coupon that the kids can fill out and enter for a drawing. They have to do 30 mins of fitness outside of the outside. Bike Riding, skating, yard work etc. They are trying to start them off right. Not to sit in front of the TV and eat junk food.

I honestly feel for the people who are very overweight. There was a lady this past week at WDW that was using a scooter to get around because her legs just wouldn't hold her for that amount of walking. She was talking to us on the bus. She is capable of walking and stand just for not a long period of time.