How can some people not get why they are overweight?

[shortbun]

I just had to write this b/c I feel so many people on here "judge" others or think they have a motive OTHER than a positive one. Personally, I think this thread is interesting and helpful and a way for fellow DISers to come together to discuss a topic that can be hard to take.

I just had to get that out.

I'm glad you are being helped, I really am. If the DIS community board can help even one obese person lose weight, I support it. I thought the OP was very judgemental and superior in nature. It rubbed me the wrong way. It seemed overly critical and coming from a physician, just didn't sit well. Then it's back and the person bringing it back has a troll count for posts followed immediately by the original poster. I found that suspect and still do but I may be wrong. So, I'm stepping out so you can get the help you desire. Many people like the support of Weight Watchers and you can join them on line now.
Grinders-subs-hoagies...love em all!

 

[disneysteve]

the person bringing it back has a troll count for posts

Can you explain what that means? I've never heard that term before.

 

[disneysteve]

It seemed overly critical and coming from a physician, just didn't sit well.

Physicians need to vent too. I consider this an anonymous enough place to do that here safely. I knew some people might be uncomfortable with it, but lots of people (27 pages now) have been pretty supportive and have shared some great info and personal experiences. Sorry if it offended you.

 

[disneysteve]

Steve...what is your take on Meridia? Do you prescribe that to many patients? If so, what kind of results have you seen with it?

I have prescribed Meridia, Adipex (phentermine), Phen-Fen way back, etc. They all work in that patients do lose weight while they take the pills. But the bottom line doesn't change. If you don't permanently alter your eating habits and increase your exercise, as soon as you stop the pills, or even while you are still on them, the weight all comes back.

 

[deelam]

I have prescribed Meridia, Adipex (phentermine), Phen-Fen way back, etc.

Have you ever recomended a low carb diet? Or were your diets based on the old food pyramid?

 

[disneysteve]

Have you ever recomended a low carb diet? Or were your diets based on the old food pyramid?

Do I tell people to go on Atkins or The Zone or South Beach? No, not specifically. I try to educate patients on healthy food choices - good carbs vs. bad carbs, good fats vs. bad fats. I don't promote any of the fad diets though I've certainly had lots of patients follow all kinds of diets on their own. As a nation, we consume way too much fat, way too many refined carbs and way too little fiber. And, as we've all agreed, portion sizes in general are just too big.

Over the years, I've found that what works best is when I can identify a couple of problem areas and give patients specific alternatives to substitute in their diet rather than trying to reform their whole life at once which is what most commercial diets do. I go for the baby steps approach. Change from white bread to wheat bread. Change from whole milk to 2%. That kind of thing. If I can get people to make a couple of simple changes and see results on the scale, it motivates them to make more simple changes and see more results.

 

[debden]

 

[LuluLovesDisney]

Do I tell people to go on Atkins or The Zone or South Beach? No, not specifically. I try to educate patients on healthy food choices - good carbs vs. bad carbs, good fats vs. bad fats. I don't promote any of the fad diets though I've certainly had lots of patients follow all kinds of diets on their own. As a nation, we consume way too much fat, way too many refined carbs and way too little fiber. And, as we've all agreed, portion sizes in general are just too big.

Over the years, I've found that what works best is when I can identify a couple of problem areas and give patients specific alternatives to substitute in their diet rather than trying to reform their whole life at once which is what most commercial diets do. I go for the baby steps approach. Change from white bread to wheat bread. Change from whole milk to 2%. That kind of thing. If I can get people to make a couple of simple changes and see results on the scale, it motivates them to make more simple changes and see more results.

I do not think that more than one or two patients could truly be so surprised that that is not a healthy diet. I propose to you that there are many people who are educated and have healthy habits, but are overweight anyway. Let me present myself.

I eat 1600-1700 calories a day of extremely healthy foods. I go through 2-3 3 packs of romaine lettuce a week. I have egg whites and steel cut oatmeal or whole grain toast for breakfast. I love veggies burgers or salads with chicken or shrimp for lunch, I love fish and seafood, and I have 5-7 servings of fruits and veggies a day. Admittedly, I could drink more water, as I rather drink a lot of tea- I try to stick with green and white, but I prefer earl gray.

My mom is a nurse and she sees what I eat in a day. I work at a gym 2-3 days a week from 4-9:15 where I am exercising at a low to moderate intensity at least 3-4 hours of that time. (I am mostly on the gym floor, the rest of the time I'm weighing or measuring people or cleaning, unless I have to stop to answer the phone) I also work out 2 more days a week for 45 minutes at a higher intensity. Occasionally I will add another day to that if I work out on a Saturday morning (depends on my schedule).

Since adopting my healthy lifestyle, I have lost 27 lbs over the past year (though it has been filled with ups and downs) I do not lose more than 1/2 lb a week, even if I cut my calories to 1000. Since I have a history of eating disorders, my doctor has advised me to stick with 1600 calories, and continue to exercise rather than decrease my calories.

I still have 40-50 more lbs. that I need to lose. I am always freezing and I often feel hungry. My doctor tested my thyroid and I was considered normal. My doctor also prescribed me Meridia, since I do have a problem with emotional eating but my insurance won't cover it since I am not morbidly obese and do not have any weight related health problems, so I cannot afford to try it. My cholestorol is normal- in fact my HDL is normal but my LDL's are low. My triglycerides are low. My blood pressure is normal. My heart, joints, etc. are all perfect.

Is it possible that I can be the picture of health at my current weight which is about 60 lbs over what the weight chart for my height says I should be? I have accepted that I will always have curves and it is not reasonable to expect to be a size 6, but since you are a doctor, and are broaching this topic, I would love to know what you think about someone in this situation.

 

[Tiggerlover91]

My highest weight was 250 pounds and my biggest size was about a 24/26. I finally got to the point about 3 years ago, 2003 I believe it was to go on Atkins. I dropped 40 pounds on Atkins and felt so much better. I lost 10 prior making my grand total 50 pounds!
However, over the last year or so I've incorporated A LOT of carbs back into my diet and I put back on 18 of the 40 I lost. I caught myself 2 weeks ago and 6 of it is gone! It's the festival called THE WEEK OF UNLEAVENED BREAD and not having any type of wheat, grain, or what have you has been such a blessing. I'm not big on matzah, but when that desire for bread kicks in, it helps. I call the way I'm eating the "PASSOVER DIET" and it's working beautifully! I can't eat anything unless it has KOSHER FOR PASSOVER somewhere on the packaging. So DH and I have had a lot of eggs, cheese, fruits, veggies, and meat over the last four days. I've had it over the last couple of weeks, because I started my "PASSOVER DIET" early! I've been drinking nothing but water and oj and how amazing I feel. I try to walk a few days a week, but if I don't I'll get out in the yard for about an 1 1/2 hours pulling weeds and such. That really helps too.
I haven't had fast food since August and what a difference that makes. I only eat kosher food, so that eliminates eating out for DH and I since there is only one kosher restaurant in our area. It's over an hour away and the desire has not hit me to eat there anytime soon! However when we hit Atlanta GA, watch out! HUGE Jewish community there with several kosher restaurants!
So anyway, I'm very proud of myself that I was able to catch my weight gain and get it under control again. I've come a loooooooong way and refuse to get back up in the high 200s ever again! My goal is to hit 198 before our anniversary trip and I'm only 13 pounds from that! I've got about one more month to lose it and I think I'll get pretty darn close if I continue staying as close to this Passover Diet as I can when the festival is over.
I was a HORRIBLE eater before eating kosher and was so glad to make the change in my life! Mickey D's, Wendy's, and Hardee's were my best friends on a daily basis! I'm surprised I'm not a diabetic. I thank G-d for that.

Blessings,
Denise

 

[Chicago526]

Wow, talk about digging up an old thread, this was started in May 2005!

Anyway, Lulu, I through those height/weight charts out the window. I'm 5'7" and I think the doctor told me I should weight something like 125 or 130. I laughed in his face. I got down to 135 once, and you could count my ribs, if I'd lost anymore I'd have been hospitalized for an eating disorder! My "right" weight as far as I'm concerned is 145, give or take a pound. So the doc always thinks I'm at least 15 to 20 pounds over weight! It's a good place to start, but not everyone fits the chart (bad pun, I know).

Also, you may lose more weight if you increase your calories a little, I know that sounds backwards, but if you're really exercising a lot, your body may think you're "starving" and will refuse to shed pounds, your body just lowers you metabolism to adjust. If you keep your exercise just where it is and add maybe 150 calories a day, see if that helps at all.

And Tigger, glad Atkins worked for you, but personally I could never do a diet that doesn't let me eat whatever I want. I found Weight Watchers to be perfect. I can eat whatever I want, but I still have to stay with in my "points" for the day in order to lose weight. Each food is given a point value, and when you're out of points, you stop eating for the day. Very, very flexable! You can even bank points (within reason) to "save up" for special events like going out to eat, or splurging on your favorite dish. I'm glad Atkins worked out for you though. I don't know how you do it, I could never stop eating bread!

 

[aes74]

I still have 40-50 more lbs. that I need to lose. I am always freezing and I often feel hungry. My doctor tested my thyroid and I was considered normal. .

About your thyroid, I too, tested "normal." but there is a new movement out there about thyroid levels. I go to a holistic doctor and she explained that thyroid should not be evaluated anymore based on the "goalpost theory," in other words, if it makes it in a certain range you are fine, etc. But if you are two points away from one side you are still feeling miserable, so with this new change of thought, they give you a smaller dose. This happened to me, and it has been LIFE CHANGING now that I am on the medicine. Educate yourself, find a new doctor, and that might be a huge help. Try Mary Shomon's page at About.com's thyroid section. That is really helpful.

Also, just my own recommendation, try "The Fat Fallacy" by Dr. Will Clower. Amazing, thought-provoking book, that has made a huge difference. "The Maker's Diet" is also interesting to read. I don't agree with all of it, but it is worth the read.

Good luck! I know this can be frustrating.

 

[Tiggerlover91]

And Tigger, glad Atkins worked for you, but personally I could never do a diet that doesn't let me eat whatever I want. I found Weight Watchers to be perfect. I can eat whatever I want, but I still have to stay with in my "points" for the day in order to lose weight. Each food is given a point value, and when you're out of points, you stop eating for the day. Very, very flexable! You can even bank points (within reason) to "save up" for special events like going out to eat, or splurging on your favorite dish. I'm glad Atkins worked out for you though. I don't know how you do it, I could never stop eating bread!

Now remember I said I was on Atkins, I'm not any longer. I did say that didn't I? But what being on Atkins taught me was discipline. When enough is enough. (Obviously something I've forgotten since I've got to drop 17 pounds again before my anniversary trip in May) For a week, I've given up bread and all other grains for Passover and the Feast of Unleavened Bread, but other than that, I have not given up bread. I was eating a bagel for breakfast at least 4 days a week, and on Friday nights at home and in synagogue we have something called challah. Braided loaves of bread! VERY, VERY GOOD!! Atkins was only restrictive during the first few months and then things got easier when I was allowed to put certain things back into my diet.
I'm glad WW works for you, but it didn't for me. Everyone has something that works for them and right now my PASSOVER DIET is wonderful!

Have a blessed day!

Denise

"The Maker's Diet" is also interesting to read. I don't agree with all of it, but it is worth the read.

Just curious, no flames here, what is it you don't agree with in The Maker's Diet?

 

[FreshTressa]

I was a fat little kid...from the time I was on solid food, I was fat. My mom said I never ate that much or any more than her other kids, but I was always round.

When I hit 14, I realized I could not eat sugars and be thin. Since then, I have been up and down over and over...between 125 and 180. I know it is what I eat, but I honestly think I don't have the same metabolism as other people. When I watch what other people eat, they eat significantly more sweet than I do.

I also think restaurant portions and marketing shows people eating more than is reasonable. On TV or in magazines I see people eating cereal, a glass of juice, toast, coffee etc. I eat one 90cal diet yogurt....I see people eating sandwiches, chips dessert and soda for lunch...I would balloon if I ate that.

So...I think people think that restaurant portions are "normal" and what you see on TV or a value meal at fast food is a normal meal. They don't get that those foods are not normal and most people can't eat like that.

 

[disneysteve]

thyroid should not be evaluated anymore based on the "goalpost theory," in other words, if it makes it in a certain range you are fine, etc.

I don't have time to fully respond to today's posts right now, but let me comment on this.

The blood test doctors use to monitor thyroid function is called the TSH. The normal range is between 0.5 and 5.0. That's a fairly broad range. It is important to know what you are now, but equally important to know what you were in the past. For example, if a few years ago, your level was 0.9 and it is now 4.8, both are "normal" but clearly something has changed and you may be clinically hypothyroid even though your test isn't quite out of range yet. I have started patients like this on thyroid medication with positive results. So keep that in mind and discuss it with your doctor.

 

[ashjohnson80]

not this thread again....

 

[hiwaygal]

The blood test doctors use to monitor thyroid function is called the TSH. The normal range is between 0.5 and 5.0.

This is some of the problem most thyroid patients have with "regular" doctors, and why most of us who have had to learn to live with thyroid problems suggest seeing an endocrinologist who is familiar with the new TSH guidelines.

From: http://thyroid.about.com/library/howto/htthyroid-test.htm

Note the level of your Thyroid Stimulating Hormone (TSH). At most labs in the U.S., up until late 2002, the normal range is from around 0.5 to 5.5. That range changed to .3 to 3 as of early 2003.

While there may not seem to be a big difference between 3 and 5 (or 0.3 and 0.5) when you are sensitive to the changes in your TSH it is a BIG difference.

I will be very thankful when doctors treat the patients instead of the numbers.

 

[DisneyJules]

I don't think that conversation has been exaggerated or stretched by any means. My aunt thinks in the same way. She just doesn't see it. My grand mother is quite over weight. The other day we were talkinga about my grandmothers health problems and I said, do you think it could be related to her being overweight. And she looked at me very seriously and said "you can't say that she's overweight, she's is NOT overweight." My aunt is over weight as well. I just couldn't believe that her mind was that disorted in thinking she wasn't overweight. It's so obvious, we all know she is! Her diet works much the same as well, she considers "good food" to be food that's homemade, doesn't matter how much fat is in it.
I just don't get it.

 

[disneysteve]

While there may not seem to be a big difference between 3 and 5 (or 0.3 and 0.5) when you are sensitive to the changes in your TSH it is a BIG difference.

I will be very thankful when doctors treat the patients instead of the numbers.

I will check tomorrow to see what normal range the two major national labs (Quest and LabCorp) are using. I'm pretty sure they are still using the older normals.

As for treating the patients instead of the numbers, if you read the rest of my post, you'll see that I said I have started patients on thyroid replacement despite "normal" test results if their were clinical signs and symptoms to back it up. I agree 100% that there is more to practicing medicine than following the numbers.

 

[disneysteve]

I just couldn't believe that her mind was that disorted in thinking she wasn't overweight.

Despite all the posts in this thread that suggested I was exaggerating, I promise you I am not. I saw a young woman recently who was concerned because she had lost some weight recently. She was 5'4" and weighed 186 pounds. At her last visit, a few months ago, she was 192. I wanted to congratulate her but she wanted me to find out what was wrong.

Many many people have lost track of what a normal weight should be. Your aunt is a perfect example, as is this patient.

 

[hiwaygal]

I will check tomorrow to see what normal range the two major national labs (Quest and LabCorp) are using. I'm pretty sure they are still using the older normals.

As for treating the patients instead of the numbers, if you read the rest of my post, you'll see that I said I have started patients on thyroid replacement despite "normal" test results if their were clinical signs and symptoms to back it up. I agree 100% that there is more to practicing medicine than following the numbers.

I'm pretty sure LabCorp still uses the old numbers. I only say that 'cause that's what they use for my tests. I think a lot of people are still suffering needlessly because of a delay in updated information...for whatever reason.

I haven't read this whole thread...but I have read others you have written, and I believe we've talked about this kind of thing before. You do seem to be more of an advocate for your patients than many other doctors.