I know this is a loaded subject, but here goes: I am a nurse and the physicians I work with often recommend weight loss to thier patients. Some approach this conversation better than others.

As a nurse I understand that losing weight makes patients healthier and the obesity epidemic can not be ignored . . . . BUT as a patient I hated being told to lose weight, in fact I kinda wanted to lash out at the skinny wench. Duh, if it was so easy I wouldn't be fat bc it is SUPER fun not being able to: find clothes that fit, reach my toes, breath while I put on shoes, or fit in a small chair.

So here are my questions for you all:

How should a doctor tell you to lose weight? Or should they just not say anything? Who can you help by ignoring it?

Would it be better if nutrition classes or a healthy lifestyle program was offered at the same time?

Should the conversation only happen with another big person? Would you feel less judged that way?

Or does it seem silly for a fat person to tell another fat person to lose weight? Empathy or irony?

Would it be better or worse if bariatric surgery was mentioned? Would it help if I flashed my scars?

Tell me about times when a medical professional told you to lose weight. How did it feel? What would have made it better?

I can change how this is done where I work, but need input. You can PM me if you want, too.

Second guessing this post, might belong in the rant and rave section.

19 hours ago, GotProlactinoma said:

Let me add another angle to this, for all formerly obese here who had wls. Did a doctor talking about your obesity lead you toward getting the solution you needed??

Because I was the only one who had to get around to deciding this.

No doctor helped me decide. Maybe 2 out of a zillion doctors mentioned my weight, in indirect ways, and I was nothing but offended. For a different problem one doc suggested a pharmaceutical that “people love because they lose weight on it.” The drug had ghastly side effects.

i think that if the patient has a condition or symptom that would be helped by their losing weight, IT MUST BE MENTIONED. As in “here are some of the things you can do for your [knee, blood pressure, whatever]: rest, exercise, lose 10 lbs, ...” etc. Work it in and make it easy. Sure, they need to lose 50-100 lbs. No one can face that. But if you suggest losing 10 lbs, maybe they can do it.

If I were a doc or nurse and I’d HAD wls, I’d sure as poop tell everyone all the time. I talk to people who happen to be obese and DO casually mention I had wls last summer, and move on, but they often do ask me about it, and I RAVE. And I answer their specific questions. I am one of them, I was one of them. I want to share how kind of easy it was to get healthy, how good my experience has been. I used to dream the excess fat would melt away, and now it actually did. So sine you OP had this surgery and had success, you can talk about YOU and maybe you will stimulate more discussion. Not “you might like to hear about weight loss surgery” but “omg, I need to run out and have a bit of my peanuts, running low on protein” and follow it up with how you keep up on your breaks because you had wls and you need Protein every few hours, say. Make it totally about you and see what happens. It works for me, out in the world. Then pretty soon usually we two are “together” as obese only my obesity has recently slipped out. If that makes sense.

no doc or nurse would have had the right affect on me if they’d been heavy handed (whoops pun) with me on losing weight. It was when my blood pressure went sky high for several months that I came around to what I needed to do.

As previously stated, I initiated the discussion with my doctor regarding the referral to the surgeon. I do not think he would have ever brought it up and I am not sure why but I am seeing him next week and asking him. He is about my same age and sometimes I think maybe it is uncomfortable for him to discuss weight with women since many are very sensitive about it.

By the time I saw the surgeon a few weeks later I had already done a lot of research about the options and about the surgeon himself and his level of expertise. I had already decided on the sleeve and he agreed...he told me only if I had severe GE reflux would he recommend the bypass.

Interestingly, I saw my pulmonologist this morning for a routine followup and he was very surprised that I had discontinued all 3 of my asthma/COPD medications about 2 months ago and having no symptoms at all, even when walking 1 1/4 to 1 3/4 miles per day. At our last appt. I did tell him that I was in the process of having VSG surgery done. I have lost 47 pounds since last seeing him. After listening to my lungs, he then sat and asked me a lot of questions about my surgery and how difficult it was for me. I told him it was rough for the first few days but now it is not difficult at all. He then said, "I am going to use your experience and recommend the surgery to some of my other patients who might benefit from weight loss". He is in his 50s and I guess it just surprised me that the recommendation was not more common.

Edited July 11, 20188 yr by MIZ60

I love this question! From my personal experience, I don't think primary care doctors are qualified to address this issue. They are not trained in nutrition, they are not bariatric doctors and frankly, they have nothing to offer except to refer you to a specialist or information you can find online. I had to change my primary care doctor because he advised against wls. No health issues except being 290 lbs. Some issues were definitely coming though. Then the doctor I was referred to from the wls program I was going through told me (I kid you not) that "at least it's not bariatric surgery".....I had vsg. Yes. yes it is bariatric surgery and she looked at me and said, no it isn't. I wrote a letter to my wls program person who referred me to this very uninformed doctor. She said it is very difficult to educate doctors who are not in the bariatric circle. She said they offer information and try, but it is always a struggle.

For years I would ask my original doctor if there was anything new that might help me. He just said nothing except diet and exercise. Which obviously I was already trying over and over and over. Yes, we know we're fat. And because there is so much misinformation out there, I don't take advice from anyone who is not HIGHLY qualified to dispense advice on weight loss or someone who has been successful at loosing a LOT of weight in a healthy way. The ignorance is real.

One assistant tried to give me weight loss advice. She said, I bring a water bottle with me and drink lots of water all day, and I walk to work. She was overweight also. I said, that's great. I have some recipes I can give you on my next visit. I think that ticked her off. But I took offense for sure. She knew NOTHING about me and what I had done over how many years and how many times I had heard drink more water and exercise more. Did she really think I was 290 lbs and never even thought of water or exercise?? It's highly insulting to be spoken to as if you have no brain and have just emerged from a dessert ed island where there was no internet access. Give me a little credit please.

My obgyn (physician's assistant) said my weight loss was impressive. I told her all about it then she looked at me and said "I see you have found something that works for you FOR NOW". For now! Ok, so I guess there is some other method for weight loss out there that I missed that works FOREVER? Sorry, what is that, cause I'd love to know. Any method of weight loss is for now. You don't just say, I'm done now, and the weight loss struggle is over. It's ongoing for life.

It is great that you want to help people . I don't mean to take away from that. If you were to try to help your patients, personally, I would want to see statistics and research. Maybe ask them if they would like information for proven weight loss methods. And provide a pamphlet with websites where they can start researching to find their answer. Or ask them if they would like to attend a bariatric meeting and provide information. Ask if they have considered seeing a registered dietitian who specializes in morbidly obese patients.

Great question!

I live in a high percentage obesity county in Ohio. It is hard not say something,to,people I meet about the hopeful future they could have with Bariatrics. I want,to jump,on a soapbox and start preaching,like a street corner evangelist. It is sad to see people my age and younger with the,problems it produces but the worst are the amount of teenagers and little children I see.
6 and 8 year olds shouldn't weight 150-175 lbs yet I have seen them just this week and it breaks,my ?

1 minute ago, Frustr8 said:

I live in a high percentage obesity county in Ohio. It is hard not say something,to,people I meet about the hopeful future they could have with Bariatrics. I want,to jump,on a soapbox and start preaching,like a street corner evangelist. It is sad to see people my age and younger with the,problems it produces but the worst are the amount of teenagers and little children I see.
6 and 8 year olds shouldn't weight 150-175 lbs yet I have seen them just this week and it breaks,my ?

I hear you and I felt the same way a year ago. I was ready to have before and after tshirts made and rent a billboard with my picture on it. But after sharing to anyone who would listen for the past 28 months, I now feel that most people don't get it and never will. Maybe it takes a certain desperation to get to the point where we actually put in the time and do the work to understand what wls really is and does. And if you're not at that point, it just doesn't register. I hope you do reach some people and make a difference for them. So many people could benefit from this surgery.

Let me just mention: please do not send in another physician to give this talk if you are too busy...she asked first and I said ok so it is partly my fault but I didn’t really know we were going into the weight , this guy came in, got my name wrong, and once I corrected him proceeded to give me the speech on being obese. Then she popped in and they both lectured me with her even telling me I should eat like a rabbit, carrots and veggies... they did not ask what my diet or exercise was and only assumed I came home and ate cakes all day or something. I never went back to them and did not get a new doctor for years. I admit I was sensitive as well but I have a new doctor now and while she doesn’t bs me she isn’t condescending. I have high cholesterol so when she wanted me to get on medication and I wanted to try to lose weight on my own first she encouraged me but also explained the risk And I appreciated that

10 hours ago, sestewart17 said:

I never went back to them and did not get a new doctor for years.

That's me as well. I think it had been 5-7 years since I'd had a well-woman check because I was so disgusted. I didn't start going to the dr. again until I had decided I was going to have this surgery and I wouldn't take no for an answer.

23 minutes ago, Orchids&Dragons said:

That's me as well. I think it had been 5-7 years since I'd had a well-woman check because I was so disgusted. I didn't start going to the dr. again until I had decided I was going to have this surgery and I wouldn't take no for an answer.

I've done my share of avoiding doctors, too. It is stunning to me how misinformed physicians can be, judging from the shared stories here. I guess we all can be ambassadors and try to shine an educational light on things just by being ourselves. I know the surgical practice I'm working with is getting more and more clients -- very busy, and having to hire more coordinators to manage the influx.

I honestly think the thing that tickles and offends me the most about this topic is the title from a medical professional:

"Help!!! Need advice on telling people they are fat..."

When I first read this my knee-jerk response to this was, "Well, my honest opinion is that none of us need to be told this--Newsflash! We already have very personal knowledge and awareness of our fatness." Like, what a strange way to broach a subject to a room full of people in various stages of trying to change their personal reality.

But @nibble and @Orchids&Dragons I know this avoidance so well. I also ducked my well-woman's exam for years--only going to my GP when I had severe infections. I almost died from BC because of the shame of my own personal knowledge of being fat and my embarrassment to have a gyno exam while super morbidly obese.

2 minutes ago, FluffyChix said:

I honestly think the thing that tickles and offends me the most about this topic is the title from a medical professional:

"Help!!! Need advice on telling people they are fat..."

When I first read this my knee-jerk response to this was, "Well, my honest opinion is that none of us need to be told this--Newsflash! We already have very personal knowledge and awareness of our fatness." Like, what a strange way to broach a subject to a room full of people in various stages of trying to change their personal reality.

But @nibble and @Orchids&Dragons I know this avoidance so well. I also ducked my well-woman's exam for years--only going to my GP when I had severe infections. I almost died from BC because of the shame of my own personal knowledge of being fat and my embarrassment to have a gyno exam while super morbidly obese.

And we're all super glad that you bit the bullet and had your checkup. I do realize (and did at the time) that the only person I was hurting was me, but I did it anyway. Never said I was particularly bright

First off i love this post. And i totally get your concerns. I also love that you care enough about someone else’s feelings.

To be honest, i would be that patient that lashes out at someone because obviously we already know we’re fat and don’t need to hear for the millionth time lol.

I would say wait until an opportunity presents itself like if the patient has other co morbidies. Then you can casually share your experience with them. It’s a lot less intimidating for a lot of people if they know you went through their struggle too.

I will say this though- still be prepared for people getting upset or plain ignorance. Because most people will still be slightly defensive. And you also have to remember that it is mental too. So for example, i have two very large best friends and all they do is complain about their weight. They know i had the sleeve and that i’m super tiny now, and im sure it makes them uncomfortable. But reality is, they are not mentally ready to make any sort of change. They still swear by excuses and drown their feelings in food. So that may also be the case for some of your patients. It’s different if they’re frustrated and genuinely trying to figure out how to keep the weight off. But if they’re still in a negative miserable frame of mind, there’s nothing you can do about that either. And pushing may only make things worse.