How can some people not get why they are overweight?

[Michie]

I'm sorry, I understood your original post but I got side-tracked too.
I don't know how to get people to understand. My MIL knows all the men on her dh's side of the family have died of heart disease, as did her parents. When my Dad had heart surgery she told me over and over how he's have to watch his salt intake. Yet she still insists on salting EVERYTHING she cooks.

My MIL does the same thing I just don't get it My FIL is obese, has diabetes, high blood pressure, as well as my DH's siblings but she continues to cook fried foods, foods with high salt contents, and sweets.

This really saddened me. My DD school, they usually have the Jump Rope for Heart day; this year they did not. The school board decided not to. it was too big of a liability risk because of the number of obese kids in the school.

 

[grlpwrd]

I think a few people are joining the thread late and missed the point of the original topic. My original point was discussing how best for a physician to interact with people who are obese but don't seem to have any concept of how or why they got that way even though they freely admit to eating a high fat, high calorie diet. I suggested that we, as a society, have failed in getting the word out to everyone about what constitutes a healthy diet and good nutrition.

Yes, there are varied reasons for gaining excess weight, which I've already said. And yes, most people who are overweight have at least a basic idea of how they got that way. That doesn't mean its easy to change old habits or lose weight - I never suggested that at all.

I don't think this is a lack of compassion issue. In fact, just the opposite. The fact that I'm trying to find new ways to help my patients get healthier is kind of the point. I know there are many people here at DIS who have struggled with their weight over the years and I thought it might be helpful to hear what kinds of strategies have worked for others. I thought I might get some insight into better counseling my patients. At no time did I say, or hopefully even imply, that I was criticizing anyone for being obese or making fun of people who have weight problems.

I'm glad this thread has grown so long but I think some of the message has gotten lost in the process.

IIRC you're an osteopathic physician, right? Excuse me if I am in error - I thought you mentioned it a while back.

I can totally understand your approach as you are dealing with the "whole person" approach to medicine which is in contrast to an allopathic physician (MD). As a DO your focus is on preventative healthcare, too... right?

Lots of tangents taken on this thread, but at least you got everyone discussing health and fitness issues!

 

[donaldsgal]

I think a few people are joining the thread late and missed the point of the original topic. My original point was discussing how best for a physician to interact with people who are obese but don't seem to have any concept of how or why they got that way even though they freely admit to eating a high fat, high calorie diet. I suggested that we, as a society, have failed in getting the word out to everyone about what constitutes a healthy diet and good nutrition.

Yes, there are varied reasons for gaining excess weight, which I've already said. And yes, most people who are overweight have at least a basic idea of how they got that way. That doesn't mean its easy to change old habits or lose weight - I never suggested that at all.

I don't think this is a lack of compassion issue. In fact, just the opposite. The fact that I'm trying to find new ways to help my patients get healthier is kind of the point. I know there are many people here at DIS who have struggled with their weight over the years and I thought it might be helpful to hear what kinds of strategies have worked for others. I thought I might get some insight into better counseling my patients. At no time did I say, or hopefully even imply, that I was criticizing anyone for being obese or making fun of people who have weight problems.

I'm glad this thread has grown so long but I think some of the message has gotten lost in the process.

I think this is a very thought-provoking subject, so it was a good idea to post the issue (and yes everyone, I remember that I disagreed and apparently went on a self-induced HIPAA binge in response to the ethical implications of his OP ). I think it's only natural that, with such a controversial and heated subject, the original point may be lost while other, more secondary issues are temporarily snatched on to by some of us. I hope you don't take what some have shouted at you about "lacking compassion" personally; you know your heart and know the reasons why you practice. You know, at the end of the day, despite what some people who read your remarks here may think, that you take action and confront your patients for their own good. It certainly hasn't made you look like a saint in the eyes of everyone here, right? So to me, the fact that you're willing to do it - put yourself out on a limb and then let us all KNOW you did that - proves you care.

I hope you can forgive us while we digress on points here and there that interest us. I didn't think you were being a bully in your last post, so I don't mean this as a sarcastic response. This conversation has certainly taken unexpected turns here and there, but it has been my impression that your concern for your patient supercedes any other reason that may be thrown out as an explanation for your OP.

Jenny

 

[FINFAN]

Just thinking of the patient in the OP....What the heck would they think if this was printed out and given this to read? After the got over the shock of being made an example of on the boards, the suggestions and theories here might be helpful...after all, isn't that what the OP was after? A way to get thru to a patient who does not get why he/she is overweight? I still think it was wrong to use an "actual" doctor/patient conversation w/out the patients permission, however, many folks here have great thoughts on the matter and one of them may just be helpful.

 

[chobie]

I really think that genetics play a large part in it also. My grandmother was obese most of her 105 years on this planet. She was 4'9" and weighed about 150 pounds until the last few years when she started to lose it. She walked everyday, she never had a problem with diabetes, blood pressure, never broke a bone, never needed a hip replacement. She was an incredible healthy obese woman.

 

[Zippa D Doodah]

I haven't read anywhere NEAR the whole thread, but am I the only one who would be livid if my doctor was on here posting about my medical issues? Is thsi covered under HIPAA?

 

[chadfromdallas]

I haven't read anywhere NEAR the whole thread, but am I the only one who would be livid if my doctor was on here posting about my medical issues? Is thsi covered under HIPAA?

Read the thread...already been addressed....

 

[babar]

Me thinks a lot of people don't understand HIPAA.

 

[Miss Jasmine]

I haven't read anywhere NEAR the whole thread, but am I the only one who would be livid if my doctor was on here posting about my medical issues? Is thsi covered under HIPAA?

I love all the supposed HIPAA experts. In a word...NO.

 

[snoopy]

I really think that genetics play a large part in it also. My grandmother was obese most of her 105 years on this planet. She was 4'9" and weighed about 150 pounds until the last few years when she started to lose it. She walked everyday, she never had a problem with diabetes, blood pressure, never broke a bone, never needed a hip replacement. She was an incredible healthy obese woman.

I've been saying that all along, but its yet to be addressed. I mean, just like there are short people and tall people, aren't there just some people who are born to be fat?

Back when I was young, in my parent's generation, that was just a fact of life -- some people were fat. It certainly wasn't boiled down to having emotional issues or whatever or something wrong with the character of the person who was genetically predisposed to being fat.

 

[pumba]

I am one with high BP ......high CHolesterol....pre diabetic......let me think of all the other stuff going wrong.......cholesterol is 20 percent diet and 80 percent genetics......my bp was just a fluke.....I do not eat alot of stuff.....that is wrong..but loved my carbs and pasta ...no fat in my diet but there it was.....I am also the weight and bmi that I should be at....so this does throw that reasoning out the window........I am just the one with the problems........My Nana ws the obese person in the family......my mother is small and half of my siblings are good size and the other half are skinny runts......

 

[bicker]

It looks like someone was absent on the day they taught compassion, empathy & understanding.

It looks like someone was absent the day they taught reading.

It looks like some folks were absent on the day our hosts here on The DIS asked ... that everyone conduct himself or herself with respect when speaking to other people. It is okay to disagree, as long as the discussion remains respectful of the feelings of others.

 

[JennyMominRI]

I've been saying that all along, but its yet to be addressed. I mean, just like there are short people and tall people, aren't there just some people who are born to be fat?

Back when I was young, in my parent's generation, that was just a fact of life -- some people were fat. It certainly wasn't boiled down to having emotional issues or whatever or something wrong with the character of the person who was genetically predisposed to being fat.

I think a lot of it has to do with metabolism...Hence some of the predisposition.. I can eat.. I mean REALLY eat and although I have weighed a bit more than I should at times,I've never ben fat and yet,I know people that are taller than me,and eat much less,but weigh a lot more.
I know that my mental status effects my eating habits..Last winter ,when I was going through a very rough time,I barely ate and lost some weight..On the other hand ,often If I'm bored or sad ,I eat. I know I'm not alone

 

[bicker]

It's sad that we can't just be who we are and people can't accept that

I don't think that lack of acceptance is anywhere near as critical of an issue as the health concerns that surround obesity. While clearly there is some relationship between the two, as well as one-sides concerns with respect to acceptance, the risks associated with obesity are still sufficiently more pressing to warrant the kind of concern folks are raising in this thread.

In my circle, I don't see *anyone* starving themselves at all, although I hear that eating disorders are on the rise. I don't see it.

And, if I understand you correctly, you're not saying that they're not out there, but rather that the number of folks facing the risks of obesity is far higher than the number of folks facing the risks of anorexia and bulimia. To be fair, making an assertion like that is practically a "sucker-punch" -- more than half of American adults face the risks of obesity, so there is no way that there could be anywhere near as many facing the risks of the starvation scenarios.

 

[disneysteve]

One of those charts someone had up here a few pages back....I typed in my 5'10", 170 pounds, and got told I was obese.

Nope. That gives you a BMI of 24.3898. 25 and under is considered the desirable range. To be obese (BMI>30), you would have to weigh about 210.

 

[MeetingMickeyin2006]

I agree. People know what makes them fat, but they eat it anyway. What gets me is the people you see in the stores who are clearly upwards of 4 or 500 pounds, riding in the motorized carts, with their carts FULL of cookies, candy, chips, cakes, etc. We make our own beds and must lie in them. It isn't McDonald's fault that we are fat. It is our fault for eating at McDonald's.

Just my 2 cents.

 

[bicker]

One of the complain I have seen mention onthe thread is that eatin healthy is more expensive... Good health has no price !!!

Of course. I took those statements, though, not so much as saying that eating healthfully wasn't worth it (pardon the double-negative), but rather that some folks actually didn't have the financial resources to be able to eat as healthfully as they perhaps should. I know my wife was in that situation for many years before we were married. She didn't devalue eating healthfully, but just couldn't afford it.

For those who complain about the price of eating healty , two little thoughts: with the price of doctors in the states , you could actually be saving some money by heating healthy !

And here's where controversy starts: Who pays for the food? Who pays for the doctor? In the United States, in many cases, the answers are not the same.

Poly Cystic Ovarian Syndrome? This is quite common in a lot of women

There is no question that PCOS is a major contributor to obesity. However, it is important to point out that many women with PCOS do successfully manage to maintain a healthy weight, and are fit. Also, remember that only about 5% of women suffer from PCOS (depending on the research -- this number comes from research presented at the 86th Annual Meeting of The Endocrine Society). I have seen a lot of folks online (not on this board, of course <grin>) assume that they have PCOS without consulting a physician: I caution against that on two counts: (1) chances are you don't have PCOS, and (2) if you do, you need a doctor to get it treated.

don't believe it for a minute, but I guess you're officially a part of the obesity epidemic that's sweeping the country and alarming the world. [I think the chart is wrong.]

Most of the charts out there are wrong: They actually are using old information. However, the later research indicated that the healthy weight ranges are actually lower than they used to be. Ten years ago I was supposedly healthy below 175... now I'm healthy only below 170. Furthermore, recent research indicates clearly that even the new healthy weight ranges are actually higher than they should be, if the balance between day-to-day health and longevity was shifted a bit in favor of longevity. People who are below the healthy weight ranges live longer than those above the range or even in the range.

I'm not in my healthy weight range right now. Having been there, relatively recently, I can say with assurance that I was indeed healthier then than I am now. The charts don't lie. They're reflections of our best research on what is a very complicated subject. In my weight-loss support group, we helped each other fight the obstacles to getting fit, rather than fighting the prospect of getting fit.

I imagine the population on one there looks a lot different than that of Lynn, MA, so give me a break. The people around me don't look a whole lot bigger than they ever did, collectively, but the weight standards seem to be more stringent, for sure.

Two things. First, we in Masschusetts are the healthiest people in the Northeast. We're in the top 10 nationwide. Obesity is much lower here than elsewhere around the country. Second, the standard have indeed become more stringent; as I mentioned above, that's because later research indicated that the older healthy weight ranges were too high. The older ranges were based on actuarial tables that were related to a certain financial risk appetite on the part of insurers. The newer ranges are based to a greater extent on health.

I think a few people are joining the thread late and missed the point of the original topic.

Well, of course, these discussions tend to branch out as they go along.

aren't there just some people who are born to be fat?

I mentioned before that we're all born to be fat. I believe the issue here is what to do to avoid the inevitable obesity.

 

[snoopy]

Nope. That gives you a BMI of 24.3898. 25 and under is considered the desirable range. To be obese (BMI>30), you would have to weigh about 210.

Yup, you are right. I think it had me listed as "overweight". I stand corrected.

 

[disneysteve]

just like there are short people and tall people, aren't there just some people who are born to be fat?

Here’s the problem with that line of thinking:

Our genetic makeup has not changed in the past 10 or 20 or 30 years. But the obesity rates in this country have risen dramatically. Genetics doesn’t explain why people born and raised in countries with low obesity rates (like Japan) move to the US and have their obesity rates rise to match folks born and raised in this country. Same goes for their diabetes and heart disease rates. Their genes didn’t change when they came to the US. Only their diet, activity level and lifestyle changed.

 

[swilphil]

Gotta tell you, I see Lindsay Lohan on the news or whatever, but I don't see an anorexia epidemic around me at nearly the rate that I see a binging epidemic. I don't see an effect where "society is increasingly fat-phobic, so more people are starving themselves." This isn't true. The average weight of women is climbing, and the main drivers of anorexia are not usually related to "society wants me to be skinny" as much as they are "I want to be able to control something in my out-of-control life."
There was a really heartfelt post a few pages back from a woman who talked about binging, planning her day around food ... I think that's incredibly common and it brings with it painful shame. I expect that somewhere around half of the women who've read this thread are food-hiders who binge late at night or in the car. I'm not sure what the main drivers of that behavior, and the obesity it yields, are. It might be something like "I give my whole life to other people and this is the comfort I give to myself." It might be "it is futile for me to even try to maintain a moderate weight, screw society's expectations." It might be "I'm fat but it's not my fault and I am ANGRY." I'm not sure what it is, but it's far more pervasive than anorexia at this point.

I wouldn't dismiss the problem of anorexia. It is very prevalent with high school, and even younger, girls. It has gotten a little better in recent years because there has been more awareness about it. Oddly enough, I have met a few women in their 30s who had anorexia or bulimia as a teen and now are overweight.

There are two things happening in our society that are contributing to both these problems. One is the obsession with the female body image having to be perfect. Obviously that leads more to anorexia, which may be not be as common but is a more immediate danger to young girls. The other is the situation that has arisen in recent years that lends itself to less movement and the consumption of more calories. The car, the computer, the suburbs, even the conveniences of housework, allow us to sit on our behinds more instead of moving it. On the food front, it's much easier to buy and prepare foods with refined flour and sugar. The grocery stores push them more, as well the commercials you see on tv. We also have the typical American mindset that bigger is better, even when it comes to food portions. I remember my grandparents having those little bitty orange juice glasses in the '60s that held about 4 oz. That's how much oj we had at breakfast. Now you can buy a 20 oz. bottle of oj out of the vending machine and that's the "healthy" offering.