<p>My daughter’s mother in law hiked 3 miles with the kids and then ate 2 cereal bars and a large sausage and cheese omelet because she “earned” it! Therein lies the problem. </p>
<p>Agree with Bunsen- I always get the “you run so much that you can eat anything you want!” Nope- doesn’t work that way. Unfortunately, I do love food and seem to be making some poor food choices, but I am certainly aware of what I am doing.</p>
<p>A few years back, a coworker went in for an HIV test when he lost 40 lbs in a month. It turns out he had given up Pepsi, which he had been drinking at the rate of up to 30 per day.</p>
<p>For routine healthcare, I see a Family Nurse Practitioner who has been in practice for 35 years. Her yearly physical appointments are 45 minutes to an hour and a routine appt is 20 minutes - concierge service for a routine price. A nice benefit of a long-term relationship with the same person is no need to rehash the issues; we only need to talk about what has changed.</p>
<p>MOWC, the problem is that you and Bunsen just need to exercise more! Clearly, running 26 miles is not enough exercise. You guys should be running 50 miles. And, if that’s not enough, 100 miles. Surely that would be enough, but if it’s not you could always swim to Catalina and back after your run! :)</p>
<p>Or, maybe the fact that running 26 miles isn’t enough shows the folly of the advice to “exercise more” for weight control… advice that overlooks the fact that, when you exercise, the body demands to be fed more.</p>
<p>
</p>
<p>Sabaray, I think what your H doesn’t understand is that he needs to be drinking those beers while on the elliptical. </p>
<p><a href=“http://www.boston.com/sports/other/2014/04/30/dude-crushes-the-beer-mile-record-time/f66YZ3CCfyc4SWzSNReaNL/story.html”>http://www.boston.com/sports/other/2014/04/30/dude-crushes-the-beer-mile-record-time/f66YZ3CCfyc4SWzSNReaNL/story.html</a></p>
<p>Idad, just the opposite happens to me - when I exercise a lot, I am less hungry than I am when I do not. I know - I’m an outlier. :)</p>
<p>Exercising never made me hungry either. It always helps me more than it should to just up the exercise. When I was young I could eat whatever I liked just running about 10 miles a week. I lost 20 pounds one summer just by biking to work.</p>
<p>@ shrinkwrap- </p>
<p>I appreciate the battles doctors have with patients, patients who see an ad for celebrex and think it is going to have them running around like an 18 year old (why they allow prescription drug ads I don’t know…). I also respect a doctor telling a patient who is overweight, especially when they have all kinds of risk factors, what the issues are. What I question is doctors giving nutrition advice, speaking as someone who has fought weight battles for years (not morbidly obese, not diabetic, but still) and being told nutrition advice like “walk away from the table” is not exactly helpful, or telling me to stay away from meat and dairy products because “it clogs the arteries”, I am talking a blanket ban when even the American Heart association at its most stringent is not like that…I respect a doctor that is suggesting talking to a nutritionist, because nutrition is their specialty, as versus what doctors are trained in. I will add that part of the problem is medical training, nutrition is critical to good health, and you as a doctor probably know better than most people that many of the problems you see are lifestyle, that diabetes and heart disease and cancer are often directly tied to lifestyle, and diet is a big portion of that…yet last I checked, only 50% of Medical schools require doctors to take a course in nutrition (as in 1), and that is pretty sad, so much of medicine seems to be in treating things rather than preventing it. We do a good job with innoculations, but a terrible job with other things.</p>
<p>But at least when they refer them to a nutritionist, hopefully they will be up to date with things and can help the person tailor a program for the person. Sorry to say, but a lot of doctors treat obesity or being overweight as some sort of moral failing and come at it that way, rather than as what it is, a health risk. There are a lot of people who won’t go to a doctor when they are sick, who are overweight or obese, because they feel like instead of working with them, they feel like they are being judged, and sadly, more than a few doctors do judge patients (what is ironic is that a lot of doctors you see aren’t in such great shape, either, reminds me of those scenes from Doctor’s offices in “Mad Men” where the doctors are smoking:). </p>
<p>There are a lot of doctors who seem to have picked up on nutrition, integrative doctors like Dr. Weil and others seem to be open to looking at new ideas and such and a lot of mainstream doctors seem to get the idea as well. One of the things that most of the fitness sites get right is that nutrition is 80% of getting healthy and in shape, that all the exercise in the world won’t do it, and they also tend to understand that certain forms of exercise work better. My own cardiologist claimed that the only exercise that is effective in fat loss and losing weight and helping the heart is cardio, but that simply isn’t true, and there is serious research on that, that strength training with or without cardio may be a lot more effective,and what he is saying was conventional wisdom but is no longer true…problem here is he is outside his area of expertise, and is giving advice that may be crap <em>shrug</em>. </p>
<p>That doesn’t mean what every idiot is saying on the net is true, either. A lot of personal trainers knowledge of nutrition makes what I have experienced with doctors look solid gold, some of them are incredibly ill informed. The whole “lots of little meals versus regular meals” , for example, is not universal, it doesn’t work for all people, and can hurt some people, yet they spread it as gospel. Extremely low carb diets like Atkins have terrible drawbacks, and high carb diets loaded with grains can end up increasing LDL in the blood and causes a huge increase in the number of the wrong type of particle (I believe it is the big, fluffy ones as my cardiologist described it) that has been shown now to be the prime cause of buildup, so there is simply a lot of bad advice out there.</p>
<p>And again, my intention was not to denigrate all doctors on all things, when it comes to treating illness and such most doctors I have run across are good at what they do, I just think when it comes to diet and nutrition information medical training and culture doesn’t seem to put an emphasis on it yet at least in my experience, the information doctors are giving on nutrition and diet often is not helpful, handing a patient a 1000 calorie a day diet or telling them to ‘eat less’ or treating meat and dairy as poison is not helpful (and also not true, they aren’t, in moderation), I would prefer doctors note the risks of someone being overweight and referring them to someone who can work with the person to change lifestyle. Someone on here said diets work, they don’t, if you look at the stats on people losing weight on diets, over a period more than a year, most people gain back what they lost and often more, and worse, bounce up and down, dieting, losing weight and gaining it back. The only way to effectively lose weight and keep it off isn’t weight watchers, or Jenny Craig, or nutrisystem, it is changing the way someone eats, and also is in introducing other lifestyle changes, like regular exercise, that will do it. If anything, someone is far better off being overweight and staying steady state with weight, then bouncing up and down. </p>
<p>Doctors cannot assume what a patient or parent of a patient knows. The level of understanding/education of a patient or parent of a patient that walks into a doctors office runs the gamut from very uneducated to very educated to very educated but not knowledgable about health related matters. There ARE people and children who need to hear how and why you should cross the street safely and practice safe swimming.</p>
<br>
<br>
<p>yes! Sadly, today we have admitted a young man 30 years old who has not seen a doctor since he was 12. well, apparently he has suffered from the silent killer, hypertension, for enough years to have now destroyed his kidneys. He will now become a dialysis patient at a very young age and his future now is fairly bleak. He is of an ethnic group in whose male members are majorly hypertensive. I’d be willing to bet his pediatrician/family doctor counseled them about this when he was a child, told them to keep track of his blood pressure, etc. Yet…
So yeah, I can see why doctors tell people all kinds of ways to keep kids safe and healthy. All of us here are simply on a different playing field than many.</p>
<p>I’m 5’2 and a size 4. I have never been a person who owned a scale and watch, rather, how my clothes fit. I, and my whole family, are mesomorphs who like high intensity workouts (like crossfit) and we build muscle very easily. Even at near 50 I get comments on how strong my arms, shoulders and legs etc are. Muscle on me is genetic. BUT lean-ness (as defined here as less fat over the muscle) only comes with either major stress or really careful eating. The first place I really notice if I am getting lean is when my bra cup size goes down. </p>
<p>The major things I do that allow me to be reasonably comfortable in my skin without trying very hard…
<p>I had to give up some of my high intensity workouts due to back problems but am another who has a young hyper dog and we walk about 11/2 hours a day. </p>
<p>Musicprnt, my question was, what is your frame of reference? Is it some study, or your own personal experience? </p>
<p>Sigh…And what is it with the word “idiot”? I know not everone is offended by that, but did you know that (along with imbecile, and moron) was the precursor to the expression mental retardation? When it was used perjoritavely, we moved on to me tal retardation. Now that “■■■■■■” became an insult, we have moved to intellectual disability. </p>
<p>Okay, I’m done.</p>
<p>My lean husbands weight loss plan (when his weight crept up 20 lbs or so over 25 years of marriage)…exercise to the point of sweat dripping everywhere AND eat more. Lots more. It works for him. I, on the other hand, have to do the first, and still watch what I eat. Sometimes I really don’t think I like the man…lol</p>
<p>lol shellz… I get that! My fiance can behave for a week and drop 10lbs. It would take me 6 months to a year on an even more strict diet than him to accomplish that. It is so much easier for him. And then he wants to “celebrate” his weight loss by going out to eat, which he can get away with, I absolutely CANNOT! I CANNOT go off book with my diet unless I am okay with being up and having to be extra strict for 2-3 weeks afterward to make it up. I just remind myself that at least I can indulge without going hog wild (usually), he can’t have any snacks in the house at all or he will eat all of them in one sitting… if I couldn’t have the high metabolism, at least I got better self control. </p>
<p>I am realizing my body only wants to be so lean. My torso has gotten so lean you can easily see my abdominal muscles and any thinner it would not look healthy, and this is the only place I seem to be able to lose fat anymore. My bra is still the same 32DD it was 40lbs ago and I still probably have a good 5lbs+ of excess fat on my thighs, but that is not going anywhere. My body wants to be VERY hourglass shaped, not just a little, but VERY. FINE, I give in! I wonder if over time some of that fat will redistribute itself and maybe I’ll look a little different. Who knows. The important thing to remember is that your body works the way it works, and it will do what it wants to do, and if you eat well you will be healthier and you will be smaller, that is the only way to look at it. Getting too specific an idea in your head of what you want to look like is a recipe for frustration and failure. You can’t control everything.</p>
<p>@ Shrinkrap- </p>
<p>The term idiot was used in a sardonic way, as when someone refers to a group of people he is part of as ‘the gang of idiots’ or some such, it is meant sardonically. My main point was in this case at doctors dispensing advice in areas where they haven’t kept up. For example, I am in the age group where heart issues start becoming a focus, and I still hear doctors telling patients that the big thing is to eat a diet low in saturated fat and cholesterol, because that is the contributing factor to heart disease (which major studies now say basically is bs, which was first shown decades ago in the Framingham study, or telling patients that their LDL/HDL ratio is off and take niacin, both of which have been shown to be false (niacin does change the ratio, brings it into the good range, but apparently doesn’t help heart health, not surprisingly, just read a piece by an MD who is also a fitness expert who said that LDL particles are the real factor, that HDL/LDL ratio sometimes reflects the particles, other times doesn’t; an oh, yeah, cited several big studies that said high carb diets cause the particle count to skyrocket…). </p>
<p>I understand doctors can’t know everything, and I understand that, any more than I understand every facet of the financial industry, I don’t, what bothers me is the doctors giving advice without having checked up on what is going on. I understand how pig headed patients are, and I think a doctor has a duty to try and get patients who are in serious danger of diabetes and heart risk and such, to change their lifestyle, and I think it is wonderful that doctors are referring patients to nutritionists, whom I may personally not agree with, but are professionals. I have a lot of respect for integrative doctors like Andrew Weill, because they seem a lot more open minded then standard practitioners (example, integrative doctors have been telling their patients on statins to take Coq10, because statins wipe out coq10 levels, last time I went to my cardiologist last year, he said “Coq10 is not standard protocol”…um, the heart needs coq10, the vitamin package he recommended I take has…ta da, coq10 in it…)…</p>
<p>In terms of where I am getting this, I tend to read when studies come out and are written up, plus for nutrition stuff I am fond of Dr. John Berardi up at Precision Nutrition, he is a Phd in Nutrition who reads the literature, and among other things, is pragmatic and willing to talk about when things change and his own views change, and why…among other things, he promotes the idea that there is not one diet or fitness plan that works for everyone, as opposed to someone telling patients that the only way to lose fat and weight is to do an hour of cardio a day or to go on a 1000 calorie a day diet, both of which are dubious to say the least…Like I said, I respect experts and I respect the training that goes into that, what I don’t respect is rigid thinking or clinging to any one orthodoxy, or giving advice as if they know when they should say “you know, I think you may benefit from talking to a nutritionist about finding a dietary plan that works for youi”. And yeah, I know, I give advice, but I am also very, very careful to say I am not an expert, that what I know is either because it worked for me or because of what I have read, I don’t claim to be an expert, which is different than when someone relies on a doctor. </p>