<p>Personally, the last two places on earth I turn for nutrition advice are:</p>
<p>1) bodybuilders (bro’ science)
2) registered dieticians (no science)</p>
<p>^^^
I like Dr.Andrew Weil for nutritional advice.</p>
<p>I’ve been impressed by this physician. She gives all of her patients a list of foods, portion control assistance, and has a support group. I find nothing wrong with what she is touting. Seems pretty close to Weight Watchers. Probably the only crazy thing she does is incorporate standard medicine with her patients who want to use herbals. I have to admit, I am clueless with most herbals other than the ones that cause severe side effects.</p>
<p>Nutrition is such a new science that the scientists are still working the kinks. What is recommend one decade may be avoided the next. </p>
<p>^^^
What physician are you referring to?</p>
<p>DH lost 25 lbs when he cut out sugared sodas. Unfortunately, he has replaced that with fruit sorbets at 11 pm.</p>
<p>Our insurance only recently began covering nutritionist appointments, and then only $250/year. The one I saw was via my cardiac rehab, and she confirmed what I was doing and mentioned a couple of low-fat cheeses and alternative things to eat that I was craving. (Conclusion: if I’m going to have cheese, it’s going to be the real thing.) My current primary was the first doc who ever really discussed weight openly with me. Everyone else hemmed and hawed – from the sounds of the docs posting here, now I better understand why.</p>
<p>My primary is thrilled with my progress and has asked me openly why DH hasn’t gotten on the bandwagon after my success and Code Blue experience. He’s as befuddled about it as I am. You’d think DH would get the message…</p>
<p>Regarding doctors: I go to a teaching clinic, where I see a very young resident (she’s in her third year now, but I started with her when she was in her first year–when she leaves, I will be assigned a new first-year) who is supervised by the clinic’s doctors. These residents are expected to practice what I think of as “checklist medicine”, which means they need to be able to answer the question “why didn’t you recommend a nutritionist?” with a good answer, if they didn’t recommend one to an overweight or obese patient on the initial very thorough exam (it took more than an hour for her exam when I started with the practice). </p>
<p>The clinic has a set of standard questions that are asked at every single visit:
*what brings you here today?"
“do you feel safe at home?”
“do you have other health concerns you’d like to discuss?”
*what drugs and supplements are you taking, prescribed, over-the-counter, and otherwise?"
“how many alcoholic drinks do you have each week? do you ever have more than three in an evening?”
“your BMI was measured at greater than 30, do you need a referral to a weight-loss program?” (that one got omitted on my last visit–she started to say it, then said “oh my, your BMI has improved a lot!”)
(there are others–it’s about ten or fifteen total–these are the ones I remember.)</p>
<p>These standard procedures mean that the doctor does not have to decide whether or not to ask these potentially embarrassing questions–they are simply SOP, and therefore there’s no judgement implied. </p>
<p>I would argue that such a checklist ensures that when a patient is ready to lose weight (or stop drinking)–the doctor will be in a position to help. Also, I asked once about the “safe at home” question–apparently they find someone who’s being abused almost every day!</p>
<p>Last summer I turned 50 and when I saw the party pictures, I knew I had to do something. I’m very short and carried most of the weight on my midsection and back. I started by cutting out/down on bread, pasta and rice. I also cut my food portions in half.<br>
My breakfast is typically a bowl of cereal w/non fat milk and half banana or a scrambled egg with some veggies and a side of fruit. One cup of coffee.
Lunch is salad with protein or half a sandwich and a side of fruit. If I choose to eat bread or pasta, I eat it at lunch.
Dinner is also a protein, side of veggies and/or fruit. The protein serving is about the size of my palm. I mostly eat clean and rarely cook with canned foods.<br>
I also eat a snack between meals, one in the morning and two in the afternoon. Trail mix, greek yogurt with granola (small serving) or banana with peanut butter.
I drink at least 8 glasses of water throughout the day.<br>
I’ve lost 16 pounds so far and now I’m wondering what my reasonable weight should be.</p>
<p>Okay, I would hate that list of questions and probably would never go back to that place if I could help it. The only problem I want treated is the problem I came in for. Period. And, that has usually been my experience. Thankfully.</p>
<p>Wow, they find a victim of domestic abuse EVERY DAY? How both good and bad. Good that they are finding these people, bad that there are so many.</p>
<p>Well, what do they do with them? It’s a serious question btw.</p>
<p>Are doctors and nurses mandated reporters?</p>
<p>As the weight issue is such a discussion hot point for many heavy folks, and they really need their medical care, it does make sense to deal with the presenting issue, as well as perhaps the diabetes, the cardiac issues, with weight taking a back seat till the practitioner has gained the patient’s trust. </p>
<p>I ask a similar set of questions when admitting people to the hospital. One of the surprise answer questions is whether there has been any thought of self harm. </p>
<p>Doctors and nurses are mandated reporters for minors. </p>
<p>I don’t know what happens when they find someone who feels unsafe; I do know they have a procedure.</p>
<p>It’s a big clinic and serves many people. </p>
<p>Flossy—I have to respectfully disagree with you. I think that it’s a doctor’s job to help her patients be healthy. And I am grateful to this day to the dentist who told my husband to see a doctor about his swollen gland–he hadn’t been to a doctor in many years (five or six), but his non-Hodgkin’s lymphoma was diagnosed and treatment started within a month because of her recommendation. That was fifteen years ago.</p>
<p>It’s one thing to for a dentist to see something unusual and suggest you see a doctor. It’s also one thing for a child with suspicious injuries to be referred to CPS although that one does get a little tricky. Google Justina Pelletier if you want ridiculous extremes. But, a routine question followed by a routine referral to an agency down the street that is most likely no secret to anyone anyway doesn’t make a tremendous amount of sense to me. It’s probably often about as useless as handing everyone a copy of the Paleo Diet. That actually happened to me and I trashed it, immediately. </p>
<p>Well, a doctor’s office is about the last place I would go for diet advice although being overweight is certainly a health issue. How to get in under control is not typically their area of expertise and I think most physicians would agree. As for the rest of it… DV, guns, swimming pool accidents… the questions are getting a little ridiculous. Especially, with no symptoms. And, I agree on referrals… basically not helpful. But, thanks.</p>
<p>Just wanted to add that portion control comes very naturally to some people while not so much for others. We have both in our immediate family so I don’t think it’s nurture as much as nature. Everyone is just different and this is something people have to figure out for themselves. People would consider me thin, but I actually gained weight on Atkins due to the lack of portion control. </p>
<p>The questions are not ridiculous. They are becoming requirements. Do you have an issue with doctors?</p>
<p>Maybe, a little. But, I would prefer they stick to the problem at hand and not attempt to fix a bunch of stuff that’s not broken or that I am not necessarily interested in having them fix, today. Or, that they realistically can’t fix, anyway.</p>
<p>Don’t you think it’s reasonable for doctors to tell parents about things around the house that might kill their children? Pediatricians don’t want their patients to die.</p>
<p>When drowning is the leading cause of death among children under 5, it’s perfectly justified for pediatricians to counsel their patients’ families to secure their swimming pools.</p>
<p>When death by firearm is the second leading cause of death for young people aged 1 to 24, it’s perfectly justified for doctors to counsel families to secure their guns.</p>