I have a friend who is a retired medical school dean. She supervised residents who were training to be PCPs. She said she spent a great deal of time teaching her students about the ways they could encourage their patients to do what was needed for a healthier lifestyle, i.e., providing patients with resources to succeed in instead of just telling them to do lose weight, exercise more, or quit drinking. With respect to the discussion above on doctors telling folks they are obese and at greater risk for COVID. It’s probably going to have a greater impact if a doctor offers resources for the individual who needs begin a healthier lifestyle. I’m pretty sure that the way in which a doctor presents this info to a patient can make a difference in how the patient reacts.
I am obese, though my BMI doesn’t touch near 40, the apparent cutoff for COVID complications. Doctors don’t avoid telling overweight patients about their weight- in fact it’s far more likely to be deemed the cause of everything. I’ve had doctors suggest losing weight for everything from anxiety to anemia. I lost a lot of weight once- made it practically to underweight in fact- but I was surviving on less than 500 calories a day with daily cardio and weight exercises. It wasn’t sustainable long-term and lasted about a year and a half. I can look back at pics and go wow, I was skinny… and that’s the extent of it. My apnea, gerd, allergies, anxiety, and anemia (amongst other things) didn’t improve in the least. I just wore smaller clothes.
Hey - finally something I (sort of) know something about! I used to work for a group of healthcare analysts who studied the impact of workplace wellness programs (you know, Weight Watchers at work, smoking cessation programs, etc.) on the employer’s health care and disability costs.
So, if my employees lose weight, do I save any money? Short answer was no, not really. On average, people who lost weight didn’t keep it off long-term. (No surprise there.) And surveys of overweight employees revealed that an overwhelming majority of respondents had been told they were overweight by their doctors and that their doctors’ advice to lose weight had no bearing on the respondents motivation to lose weight (or success in doing so.)
Discouraging. Of course, when the economy tanked in 2008-2009, many of the large company workplace wellness programs folded, so that was discouraging, too.
If doctors telling patients they’re overweight and should lose weight worked there wouldn’t be any overweight patients.
I don’t think telling someone they are fat and need to lose weight is going to be any more productive than my telling a student they are bad at math and need to improve their skills. Sure there might be a small percentage who take that info and figure out what to do, then do it, but most are going to go home and tell everyone they are bad at math. Then they’ll do something else more fulfilling. It’s probably not anything academically related, after all, they’re bad at that.
But should doctors stay silent? Nah. I’d suggest they have some ready made connection material and say something to the effect of, “Mr/Ms Jones I’m sure you know that the added weight you carry isn’t doing anything for your health. A lot of people have this problem, esp as they get older and our bodies change. If you want to try to lose some there are several new discoveries medically that might help. I can have my staff make an appointment with a specialist for you if you like (or we can work on it - whatever fits the situation). It’s easier to do when you have a supportive group helping out. I think it’d be worth a try.”
It’s not terribly different when I approach the student and say, “I see you’re missing some concepts with math. You know that’s not going to help down the road with your classes. How about we get you set up with a tutor (or I help you) to catch up. I know you’re quite capable. A lot of people don’t understand something the first time around. Your brain is just not quite getting it on a couple of things, but when it clicks and you understand it, it’ll be a lot better.”
I weigh about 10 pounds more than I’d like. My PCP actually told me NOT to lose weight. She says that as you get older, a few extra pounds are expected, and my BMI is very much within the range of OK.
So, I think I’ll compromise with my PCP and lose 5 pounds.
My doctor asks me what I think are the issues holding me back from improving weight/blood sugar etc., and what am I doing to overcome those issues. She asks what could help me. We both know the situation and the reasons for improvement; no surprises.
I got inspired years ago right here on Weight Loss for Dummies, made a number of lifestyle changes, and lost close to 50 pounds in 18 months. Then I broke my ankle, was laid up for three months, and over time slowly gained back half the weight. The rest has stayed off but it’s a struggle every day. Before my lifestyle changes I was obese, but now I am staying overweight. For a brief time I was normal.
So I know I’m higher risk due to age and underlying conditions and realize that I need to continue higher caution behaviors for quite a long time. Losing weight will not eliminate my age or other conditions! But keeping it under control will help.
This isn’t much different than the doctors telling me all of my health issues are stress related. My family line is genetically weird health-wise (with symptoms) and then there’s an added radiation X factor that probably comes into play for me. Since nothing fit their tests for the basics, it all has to be due to stress.
I fixed the stress. I quit the dr appts. No more stress. Now I just live with the issues figuring que sera, sera.
They at least checked heart and lungs - the biggies that would have fit the symptoms. They wouldn’t check for cancer even though cancer killed my mom. Some days when the issues are nagging I wish I would have pressed more, but the stress of hearing doctors tell me it’s all stress wasn’t worth it.
FWIW, they told my mom her issues were all stress too. That stress ended up being Stage IV cancer. For me, if it’s cancer it’s at least not a quick one. It could be like my brain tumor and just something benign.
Que sera, sera.
If doctors want to help they need to actually help. Med school lad and I discuss that a bit because he saw everything that happened and still shakes his head. He tells me differences in what he sees and experiences too. Like teachers, there’s a wide variety of doctors out there (personality and how they handle things). At least he’s learning from it all.
@katliamom i do believe that there is some pushback from our medical community, however, we have a governor who only focuses on one region in the state. I do know our mayor is petitioning the governor to allow our area to allow more opening including increases medical services, although no one around here believes the governor will budge. Medical is our largest employer here and vital to our community both in the medical care of our citizens as well as in the wellbeing of our economy.
No, but realizing that a personal characteristic that is unlikely to change increases risk may cause the person to incorporate that in personal risk assessment with respect to activities that may result in exposure to the virus. (Although, for men specifically, this may not override men commonly being more risk-seeking generally.)
Of course, the social stigma surrounding obesity is so great these days that it is nearly impossible to mention without backlash even when trying to do so in a neutral medical way, unlike other aspects like gender, age, blood type, pre-existing conditions like diabetes, hypertension, asthma, etc…
Note that weight or BMI is not necessarily the best measure of obesity on an individual basis. For example, if you have two people of similar height and weight, but one has a waist circumference of 46% of height, while the other has a waist circumference of 54% of height, are they likely to be the same level of body fat?
doctor loves to virtue signal about weight>>>>>>
Really, most GPs don't do this, because >50% of family practitioners are themselves overweight or obese. Nurses with obesity and overweight are in the majority. They simply are not virtue signalling enough. People even here believe that being told they are obese is a value judgement. It is ridiculous.
If simply put, the sickest covid pts are victims of their own immune systems, obesity is part of that system overdrive, but all the time, not just in infection.
Information cannot be withheld lest one offend the sensibilities of the customer. Clothing manufacturers pander to this market by actually obfuscating size labels, do people really want that from their drs?
With all this talk about obesity, has anyone seen any real data regarding this issue? I keep seeing vague mentions in articles that obesity is linked to worse outcomes, but no studies or detailed data. The CDC says that BMI > 40 is a problem; other places I’ve seen BMI > 35 or BMI > 30. I’ve seen a few articles saying things like “X% of hospitalized patients were obese”, but nothing comparing that to the percentage of obesity in the general population. Please share if you’ve seen any studies on this issue.
I suggest everyone google BMI calculator and enter their info. It can be eye opening, though not necessarily accurate.
BMI is a very imperfect measure of weighing too much for your frame. Your doctor still should caution you if your weight is a health risk.
That would be really frustrating, bhs1978… I live in Colorado where larger numbers of Covid cases were also mostly a regional problem, and the more remote/rural areas were allowed to reopen sooner. I find the whole concept of medical personnel being furloughed/laid off during an unprecedented pandemic really bizarre. But what do we know in the peanut gallery, sigh.
Please explain what good it does for doctors to tell their patients they are fat.
Not what good it would do in some idealized world. Not what good it ought to do, if weight loss worked the way you want it to work. Explain to me in simple words what good it actually accomplishes in this world. Do doctors who tell their patients they are fat get their patients to lose weight, more than doctors who don’t tell their patients they are fat? Is this a successful intervention?
Do you want a doctor to tell a person they’re ugly and ugly people have worse health outcomes? It’s true that ugly people have worse health outcomes. Does that make it a useful comment, or do you think it would be counterproductive for the doctor to say it?
I’m finding this discussion very bizarre. It DOESN’T MATTER if the doctor’s admonition does any good. MANY things a medical professional tells a patient fall on deaf ears. I’ve been told before not to run with a certain injury and I haven’t listened. It still needs to be said. Have we really reached this level of snow-flakeness where we can’t handle honest medical advice?
Being ugly is not a medical condition and ,therefore, should not be mentioned by a doctor. Being obese is a medical condition and ,therefore, should absolutely be mentioned by a doctor.
Yes, I have gained the Covid 10. Because of my work traveling, I actually did well with my weight. I would walk through all those airports, and places. I do go outside to walk, but being indoors for most of 2 months and working from home (and near the stocked kitchen) has not been good for me. Luckily I am not quite overweight yet.
But on another note, I really really really need our TAG/TAX office to open. I need to get a title in my name. Not until next monday and I bet the lines will be out the door. Sigh. If I could take care of it online I would.