I'm coming late to the party here, but I'd really like to jump in, because this is a very real issue to me.
I don't see anything wrong with the posting of this anecdote. Doctors are entitled to shop talk like anyone else. The information was general enough that it was just like reading a case study in a journal.
I never envied my doctor having to do the "fat talk". Unlike many of my counterparts, who have shied away from medical care, I see my GP for an annual physical and for other visits throughout the year. Luckily I have a good GP, and the "fat talk" only comes up annually unless I'm visiting her for a reason that has something specifc to do with my weight or metabolism. I do know folks who have doctors who address their weight at every visit--even if it's for an ear infection. In my opinion the only thing that accomplishes is to make them less likely to seek medical care.
With that being said, I appreciate my doctor's willingess to do the "fat talk", awkward as it usually is. In fact, I would consider her derelict in her duties if she didn't address my weight as part of a comprehensive annual exam. My weight, and anyone's really, is a health issue. She usually starts by asking if my weight has fluctuated at all over the past year. Then she reviews my BMI and other test results and asks me about my diet/exercise habits and how I'm managing my weight. She reminds me of the various treatment options--nutritionists, perscription medications, weight loss programs, and wraps up by saying she's available to discuss the issue again at any time. I really appreciate her approach--I find it to be helpful, respectful, and non-judgemental.
I am not at all surprised at the idea that someone could be eating that poorly and think nothing of it. I used to work with a girl who would eat a Dunkin Donuts bran muffin every morning because "bran is OK". I went to lunch with a guy just last month who ate a salad topped with cheese, bacon, fried chicken, and french dressing because salads are "light" and "healthy". There is a lot of ignorance and a lot of denial. No one wants to be told that they can't have what they want.
For others, the truth about their weight is just too painful and the problem seems too big. To achieve a healthy BMI, I still to lose over 150 pounds, but I just can't face thinking about it that way. It seems like Everest. I do much better when I think of it in smaller chunks, which is why you'll see my ticker below shows a 30 pound goal. Perhaps an effective way to address those people who seem so clueless is to just focus on one tiny goal at a time. Instead of completely correcting their weight problem, suggest 5 or 10 pounds. Instead of trying to overhaul their entire day of eating patterns, try just for breakfast. A small measure of success is empowering and confidence-building.
I think I understand why I'm overweight, and I'm doing the best I can to live a healthier lifestyle, though it is a stuggle. Like anyone, my overweight can be attributed to many factors, but I firmly believe the first and most important is the fact that I have made poor lifestyle choices. When you eat 5,000 calories a day and only walk from your desk to the cafeteria, there's only really one outcome. I can see where an upbringing in a "fat" culture, both in my family and in the US in general have had an effect, and I have PCOS, which makes managing my weight a challenge, but in the end the food did not force its way into my mouth. I put it there and I take responsibility for that.
I'm not sure how much I believe that there are certain people who are just "meant to be fat". I was struck by an early poster's description of kids at a birthday party because I recognized myself. I was that kid. At age 6 I was jockeying for position to be as close as possible to the cake. Nothing was more important to me. By age 8 I learned how to get extra food and hide it from people, and eat it in secret. I guess I can agree that there are people who have an altered relationship with food--I certainly feel I'm one of them. I don't know first hand, but by my best guess my relationship with food is not unlike an addict's relationship with alcohol. But I can't accept the idea that I'm destined to be like this always, and that there's nothing I can do about it. I still think personal choices are 80-90% of the battle.
