How can some people not get why they are overweight?

[Michie]

For those of you wishing you had a doctor like Steve, would you feel the same if you recognized him from his photo as your doctor, and the patient whose information he was freely sharing on a public message board was you?



I'm sure your doctor cares. He just doesn't publicize your conversations on the DIS message boards.

I think I would be livid! I thought with all the HIPPA hoopla, I thought most people in the medical field were being extra careful. I hope my doctor is not discussing my corns on the internet. Or that I am seeing Brad Pitt.


But on the flip side I agree with you Disney Steve.

 

[Disney1fan2002]

I don't see how Dr. Steve is breaking any confidentiality law. No names have been used. There is no way anyone of us would be able to tell which of Steve's patients he is talking about based on the info he gave.

Maybe, he feels it is safer to vent his frustrations here, than to his wife, where he may give too much info to her.

 

[Caradana]

Can doctors still prescribe appetitie suppressants? I know there is no magic pill for losing weight, but is there a prescription that helps or do doctors just give you a diet and exercise plan to follow? Has there been any medical advancement in this area besides stomach staples and gastric bypass?

Maybe Steve's patient was looking for more than advice.

The most hotly anticipated drug launch next year is Acomplia - a drug that simultaneously treats obsessive behavior, addiction to smoking, and weight. Sanofi-Aventis has already hired thousands of pharma reps for this. I think we'll be hearing a LOT about it. The clinical trial results are tremendous.

 

[momof2inPA]

The most hotly anticipated drug launch next year is Acomplia - a drug that simultaneously treats obsessive behavior, addiction to smoking, and weight. Sanofi-Aventis has already hired thousands of pharma reps for this. I think we'll be hearing a LOT about it. The clinical trial results are tremendous.

Will there be a second round of trials, and how does one apply?

I'm usually fat in the winter, like a bear, and thin down for the summer. This year, it might take a while.

 

[Michie]

I don't see how Dr. Steve is breaking any confidentiality law. No names have been used. There is no way anyone of us would be able to tell which of Steve's patients he is talking about based on the info he gave.

Maybe, he feels it is safer to vent his frustrations here, than to his wife, where he may give too much info to her.

That is a very good point I am sure he knows HIPPA like the back of his hand.

 

[Caradana]

It's through trials and got submitted for FDA approval a couple of weeks ago. It's very likely to pass and I think it'll be on the market within the year. It's so important to Sanofi-Aventis that they mentioned it on their analyst call before they moved onto the topic of Q1 earnings. Ha.

Here's an article about it:
http://www.forbes.com/sciencesandmedicine/2004/01/22/cx_mh_rl_cardiotear_3.html

 

[Jenn Lynn]

Can doctors still prescribe appetitie suppressants? I know there is no magic pill for losing weight, but is there a prescription that helps or do doctors just give you a diet and exercise plan to follow? Has there been any medical advancement in this area besides stomach staples and gastric bypass?

Maybe Steve's patient was looking for more than advice.

I was watching Starting Over this week. They had on a world renowned (sp) nutritionist on the show for one of the ladies. He said that cinnamon was a natural appetite suppressent. He also said that soup is good for women(didn't say anything about men) in helping them to feel full and cut cravings.

I don't remember word for word, but maybe if you did a search you could find some information on these things.

 

[DisneyObsessive]

hmmm... just chiming in. I think yes, we need people to be better educated about nutrition. They need to learn how to read labels right. a 20 oz of soda is NOT meant for one person, though many people can drink the thing in like 10 minutes. its actually 2.5 servings. but no one pays any attention to it. Or they grab a small snack size bag of chips and see "oh its 140 calories". yeah, except theres 3 servings in it. People tend to forget that "serving size" part.

I think what is thrown in the faces of everyone are the ridiculous ways to lose weight, like these weight loss patches and "lose weight while you sleep" schemes, and people are wasting money on this because the ads are everywhere ESPECIALLY online i see banners everywhere. And i think some of these fad diets are crazy, atkins, south beach... i like WW and Jenny Craig, they make SENSE.

Granted, its not just what people eat like a lot of people said. My friend is 5'3 and at 147 because she has a thyroid problem so she's just joined WW. My dad has a thyroid problem too but he works out every day and he's a construction worker, so he stays pretty lean because he's incredibly active.

ive never had a problem with being overweight, ever. Im only 18 though so its not like i have many years to go by lol. I actually have the opposite problem, i suffer from anorexia. 5'2 and 95lbs or so, my lowest 92. (but ready to recover and actively searching for a dietician, psych, etc).

THere was a time about 6 or 7 months ago I tried diet pills. Went through 3 different types and man do they have nasty side effects. I realize now how terrible they are and I don't think they should be so readily available over the counter. I mean, you have to be 18 technically, but its not required to ID. I think they should all be prescription for people who need it because man... they are no fun and addictive.

Well.. that was a post that jumped all over the place. Anyway...

*meanders on out*

 

[luv2nascar]

people don't eat to eat or in this case overeat
get to the root of why a person eats and they will be able to control it
putting a fat person on a diet is wrong - I'm talking about really big people they are eating for a reason and a doctor should recognize that. Honestly people eat for emotional reasons.

I am an emotional eater. Oprah is big on this also. For her it was never about the food.

 

[DemonLlama]

Sometimes peoples weight problems are not such a clear cut issue as you state. There are many reasons for being over weight besides diet issues Steve.
For me I was injured in the line of duty and have had three back(lumbar) surgeries. I can still get around somewhat, but have been put out to pasture and retired. Excersizing is a luxury I cannot do. I wish I cud. I really do.
So since being retired and inactive, the weight has been adding up.
I continue with PT, but its to limited and doesnt burn enuf calories.
Any suggestions.......hope I dont regret this.

Just a suggestion:
Any chance you could do some additional PT in a pool, taking the pressure of your back while helping speed recovery as well as burn some additional calories?


One thing that has not been adequately thrown into the mix in all this discussion is the preoccupation our culture has with being thin. The message everywhere is an unnaturally thin look in the magazines, on the TV, etc. And in reaction to this, our obesity rates are skyrocketing. It's the despair that ends up asking, Why bother passing on the ice cream when I stare myself and can still never look like the 5'11, 110 pound model? (This is a hypothetical example, by the way.)

I just watched Supersize Me this past week, which includes that statistic that 1 in 4 children born in 2000 will develop diabetes, and the stats are worse for those living in poverty. The epidemic has appeared so quickly and is so clearly tied to the over-processed foods we consume regularly that it is truly frightening.

 

[Crankyshank]

people don't eat to eat or in this case overeat
get to the root of why a person eats and they will be able to control it
putting a fat person on a diet is wrong - I'm talking about really big people they are eating for a reason and a doctor should recognize that. Honestly people eat for emotional reasons.

I am an emotional eater. Oprah is big on this also. For her it was never about the food.

Yes exactly. I am a big girl. I will always be a big girl. On an average day I eat pretty normal things. I am an emotional eater and after years of therapy I have no problems admitting that I continued my weight gain because it pissed my Mother off and it was my way of asserting control because she was so obsessed with control my food intake.
On a day to day basis I actually eat fairly healthy food and portions, but when under stress out comes the comfort foods. It's not about the food, it's about the comforting feeling I get when I eat certain foods. I have to be constantly mindful of my state of mind before I eat or I will very easily fall off the wagon. I've dropped 33lbs since November thanks to WW. I finally decided it was time to lose the weight.

 

[DisneyObsessive]

I am an emotional eater. Oprah is big on this also. For her it was never about the food.

see thats how i can relate. Its the same thing with me but the opposite way, but in the end, whether a person is too thin or too heavy, much of the time its never about the food. A lot of people cant seem to see that, though.

 

[disneysteve]

Let me throw in a few more comments.

1. Nothing I stated in my OP violates HIPPA rules because no specific personal data was given. You can't identify the patient based on the info given. However, since many of you felt there was too much info, I did modify the OP to be a little more generic.

2. 7thdwarf/dopey said "Sometimes peoples weight problems are not such a clear cut issue as you state. There are many reasons for being over weight besides diet issues." I agree, and said so in some of my subsequent posts. Diet is a major factor but certainly not the only one. Other medical conditions, genetics, physical activity, etc. all play in to how much we weigh. I have many physically handicapped patients in the practice who are very overweight because they simply can't do much of anything to burn calories. I certainly don't have any good answer for that. Wish I did.

3. laurie31 said "it is extrememly likely that a person can have a very high fat, high calorie diet and be totally unaware." This was the basis of my OP. Even though several of you have doubted it, there are many people out there who have absolutely no clue that what they are putting into their bodies is bad for them. I think we as a society have failed to properly educate people about good nutrition. They can revise the food pyramid until it is a dodecahedron and I'm not sure it will make a difference. Many people simply aren't getting the message.

4. DisneyObsessive said "My friend is 5'3 and at 147" That puts her Body Mass Index a hair over 26. 25 and under is considered ideal so she is barely over ideal body weight.

5. momof2inPA asked "I know there is no magic pill for losing weight, but is there a prescription that helps?" Yes, there are a few prescription weight-loss aids. Do they work? Well, yes and no. They can help someone take off some weight but I don't believe they do anything to keep the weight off. i think that still has to be done the old-fashioned way with diet and exercise.

6. Caradana said "Maybe - maybe - for some people - a confrontation akin to the one disneysteve is tempted to have helps matters, similar to an intervention." Even though people may initially be embarrased or offended by me initiating a discussion about their weight, in my 15 years of practice more than a couple of patients have later thanked me for making them face the issue. As a couple of posters have said, their doctors never even mentioned their weight probably because the doctor didn't want to be confrontational, but I think its possible to do it in a diplomatic way. As I keep saying, lots of people really don't see where they are going wrong. If something I say makes a difference or makes them look a little more carefully the next time they go grocery shopping, then I think I've accomplished something.

That's all for now.

 

[momof2inPA]

It's through trials and got submitted for FDA approval a couple of weeks ago. It's very likely to pass and I think it'll be on the market within the year. It's so important to Sanofi-Aventis that they mentioned it on their analyst call before they moved onto the topic of Q1 earnings. Ha.

Dana, look. They just announced another round of clinical trials. Maybe if I move to Iowa, I can get in on them:

http://www.acompliareport.com/News/news-050605.htm

 

[Caradana]

Awesome, go for it It looks like they're exploring to see whether this drug could prevent development of coronary artery disease, ON TOP OF the anti-addictive and weight-loss properties ... that would be incredible, if it checks out to be true. The reps always have samples. I've been working on cementing my friendships with the reps.

 

[donaldsgal]

In all the thousands of people I have treated, I have never, ever treated an elderly person (over 75) who was obese. They just don't make it to old age.

I'm not saying being overweight is good at all, but you cannot make a blanket statement like this. My grandmother just turned 76 and is quite overweight. Additionally, I worked for a patient medication assistance program (as part of a pharmacy) for 8 months, and approximately 50 percent of the elderly members of the program were at least 30 pounds overweight. Be careful about dealing in such generalities.

 

[DawnCt1]

He said "you're fat, it's impacting your health and happiness, you're punishing yourself with your overeating, and you're on the verge of making this a problem that you have to deal with forever." I cried. I was angry at him. But he was right and his words were the straw that broke my back; I couldn't deny it anymore.

Maybe - maybe - for some people - a confrontation akin to the one disneysteve is tempted to have helps matters, similar to an intervention.

Excellent point Dana! I think when physicians attempt to spare feelings they only prolong the agony. Your doc's words were just "right" for you. It may have been too harsh for someone else but for a physician to ignore an issue that is so important these days, is irresponsible.

 

[denisenh]

Why?

Honestly, the reason I said that Doc Steve should hang up his bag and look for a different occupation is because the last thread that I specifically remembered reading is also a doctor rant, frustrated by his patients being "non compliant".
That's the "why".
I see now that he is a helpful Dis'er, so my apology for my sharp and rude thoughts.

Note to tag fairy:

You have to enjoy life, not go around worrying about what other people think

......
unless your definition of enjoying yourself is overeating and under exercising and you are fat and I am your doctor.


Off topic in a small way but I feel like typing and ventilating

I'm not overweight, but I do have a cholesterol problem. I think that I am my own worst enemy in that regard. I've always been able to eat whatever I wanted to and stay the same weight. Therefore, I think that I indulged in waaaay too many of the foods that were bad for my cholesterol. I've never eaten fast food, don't drink soda, only eat organic, etc., but you'd be surprised at how I can do all of that and still manage to take in plenty of junk. I'm making a concerted effort to eat better, because I don't want to be the thin person who dies of a heart attack at 35.

My mother, very aware and educated about diet and exercise and actually led a very healthy life style,(she may continue to lead a healthy life style but she doesn't like me and has given me the boot, so I am not sure about that She may have died by now) maintained a healthy weight, has primary hypertension.

A female colleague / friend of mine is late 40ish trim, really physically active and consumes a healthy diet has significantly high cholesterol and is on a statin drug.

A 30 something friend of mine who is very fit, exercises regularly was dx'd with breast ca shortly after giving birth to her 3rd child.

And I am not picking and choosing people..these are folks in a small circle of people that I consider friends, with the exception of my mother.

My overweight friends do not have medical issues....at all.

I could stand to lose a few pounds but my blood fats are all at good levels. I don't worry too much about what I eat but I do not like things like chips, bolony hot dogs, bacon and red meat. I do eat them, but not often.
I consider myself an emotional eater...I have caught myself trying to swallow my need to cry, by eating something. I actually tried to get rid of a lump in my throat by eating.
My weakness is dairy products, and not the low fat kind (except milk I like 1% but compensate for this by using half and half in my coffee) and corn flakes. I like scrambled eggs. My favorite lunch is peanut butter and strawberry jelly on whole wheat. I love diet caffeine free coke but I will drink plain water as an alternate. I like plain seltzer water better.

PS And I like cake and have put entire cakes into the garbage disposal so that I wouldn't eat them.

 

[Caradana]

My overweight friends do not have medical issues....at all.

Denisenh: step back and rethink it. Do you really think that's true? Do you honestly think that there's no correlation between health and weight?
Are there exceptions? Sure. But generally speaking? There's a correlation. We know that to be absolutely true.
Life isn't fair, and sometimes the marathoner drops dead at 30 while women like my grandmother, who just passed at 86, enjoy a lifetime of cigarettes and red wine gallon jugs. But don't think in terms of exceptions, think in terms of generalities, because statistically speaking, your overweight friends are going to die early.

 

[donaldsgal]

I don't think there's a fat person alive who would say, "I know I'm fat but it can't be because of the cookies, candy, and chips."

We aren't stupid. I think 99% of us know what we should be eating. I'd also say a good 50% of fat people avoid the doctor because of condescending attitudes and the notion that many doctors have that every issue we face is because of our weight. Sometimes it is, but sometimes it isn't and it would be nice to just once have a cold and not be told that my resistance is lower because of my weight.

I also think it is in very poor taste for a doctor to in effect make fun of a patient on a public forum.

ITA agree with what you say here. However, I didn't think disneySteve was trying to make fun of his patient. I think he was confused and didn't know how to move forward. Unfortunately, as you say here, it's very easy for a doctor to attribute all problems to weight.

I'm 25 and 270. I went to my nurse practioner, who said, "I'll refer you for a gastric bypass if you want." Um, WHAT? You're telling a 25 year old healthy (yes, healthy -tests all concur) that I should just jump in for such an invasive surgery? I agree it's helpful when it's negatively impacting your healthy, and no doubt my weight will in the (probably near rather than far) future. However, I've never made consistent, dedicated effort to lose the weight. So why should I just be referred to for surgery? I much prefered my doc and OBGYN's approach: "It wouldn't hurt to lose weight. As you get older, I'll get on you more and more. But right now, surgery is not the only option, so it shouldn't be the first option." For me, FOR ME, not anyone else, that would be the easy way out. For my NP to advocate this surgery was offensive and inappropriate. I appreciate her concern, but come on.