Don't Be Afraid to Talk to Your Doctor about Weight Loss

By , SparkPeople Blogger
Have you ever felt like your doctor was judging you or made you feel ashamed of your weight? Do you avoid seeing your doctor or postpone seeking medical care because you are embarrassed about your weight or want to avoid a potential lecture about weight loss? 
 
Unfortunately your fears are not entirely unfounded.  Many studies have shown that medical professionals do in fact stereotype obese patients.  In September 2003, the journal Obesity Research (now called Obesity) published a study that revealed a weight bias among health professionals who work with obese patients.  These professionals “significantly endorsed the implicit stereotypes of lazy, stupid, and worthless” using a self-report questionnaire.  Not very comforting is it? 
 
Despite studies such as this one, it is important that you do not let your fears interfere with your medical care.  Lack of medical care in obese patients is a serious issue and can be harmful to your health.  Studies have shown that obese patients are less likely to receive preventative care.
 
Do you think correcting the perception of health professionals will fix the problem? Yes, it will help, but there is another side to this story.  Physicians are faced with the difficult task of potentially insulting a patient.  Words must be chosen carefully. Doctors fear that patients may feel insulted by the subject of weight loss even if they did their best to bring up the issue of weight with compassion. 
 
Because of these issues, the topic of weight loss frequently remains the pink elephant in the examination room and is addressed by no one.  The obese patient receives inadequate care and the physician may feel like it is a no-win situation to try to encourage weight loss. 
 
Physicians treat obesity-related conditions such as high blood pressure and diabetes on a routine basis.  Many of these conditions can be prevented and/or controlled with diet and exercise alone.  Often, physicians place their patients on medications to control the disease process without addressing the root cause.
 
Many Americans see their physicians only when they are unwell.  They feel that if you walk out of the office without a prescription you have received inadequate care.  For example, if a patient presents with an upper respiratory tract infection (a cold) and you tell your patient that there is no indication for antibiotics because they have a virus (which antibiotics don’t treat) they usually leave unhappy and may even find another physician who is willing to prescribe the antibiotic. 
 
So instead of a lengthy dissertation about how and why antibiotics are prescribed or the risks associated with their overuse, many physicians give in to their patient’s misconceptions and write the prescription anyway.  They avoid an argument or disagreement, and they know this patient will feel more satisfied that the visit was a good one.
 
This fear is only one reason why weight loss and exercise are rarely discussed.  To make matters worse, studies show that a significant percentage of physicians actually feel inadequately trained to counsel patients about weight loss--myself included in my days before SparkPeople and my own weight-loss experience.
 
Still the biggest factor in why physicians aren't counseling patients about weight loss? Time. Your doctor literally does not have the time to teach you about how to change your entire lifestyle.  Seasoned SparkPeople members know that just defining what the word calorie means is not going to cause you to change your life.  This in no way is a five-minute conversation. Honestly, it is an unrealistic expectation for your doctor to be the main source of information regarding a healthy lifestyle. 
 
So, on one side, we have the patient who feels (and in many cases is) judged and stereotyped by the physician.  On the other side is the overworked physician who fears insulting--and possibly losing--the patient. 
 
So, is there anything that you can do to bridge this gap? Yes!
 
You must take the initiative and tell your doctor your plan to lose weight. Remove the pink elephant from the room by bringing up the subject of your weight first so you and your doctor can have a productive conversation.  Only then will you receive complete and adequate care.
 
Some tips for speaking with your physician about weight loss:
 
  1. Come prepared to discuss how weight loss and the how losing weight will impact your medical conditions.  Ask your doctor:
  • How will my medications be affected by losing weight? 
  • Will my doses change? 
  • Should I come in for more frequent follow ups while I am losing weight so that we can check if it is time to adjust medications?
If you are like me you, will forget everything that you wanted to say if you feel rushed.  Consider writing your concerns down so you are sure to discuss all of them. 
 
  1. SparkPeople.  How can SparkPeople play a role? Bring your physician this handout and tell your him/her that this is the plan that you will be following.  In the majority of cases, your physician will be supportive and interested in your progress.  If you are successful, you physician will more than likely recommend SparkPeople to more patients.  How’s that for spreading the spark?
  1. Get clearance.  Make sure you have the green light to participate in the diet and exercise plan you have chosen.  Find out if you need to modify your plan due to any restrictions you have been given.  Be sure that you are clear on any restrictions given before you leave. 
 
More than likely your physician will be thrilled that you have taken charge of your health.  Having a plan and knowing what you need to do will remove the pink elephant in the room.  Hopefully, everything that needs to be discussed regarding your health can be done without the fear of judgment on either side.  
 
What if your physician does not seem receptive to your new take-charge attitude?  It is vital that you feel your concerns are being heard and met by your doctor.   If not, exercise your right to find a new doctor--one who makes you feel comfortable and who puts your health first.
 
Instead of feeling like, “I knew it! I knew my doctor was judging me!”  Rest assured that not all physicians feel this way, but most importantly take charge of your health and get the care that you need and deserve!
 
 
Was your doctor supportive of your decision to lose weight? Does he/she tell other patients about SparkPeople? Have you ever had to "break up" with a health-care provider?
 
Dr. Birdie Varnedore, M.D., is happy to offer her expertise to the SparkPeople community; however, she cannot offer specific medical advice to dailySpark readers. Please do not share confidential medical information here. If you have a personal question or a concern about your health, please contact your health-care provider.

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Comments

Honestly never had a doctor who wasn't afraid to tell me to lose weight. Sadly, none of them would help me or guide me, other than to give me some stupid stapled pack of paper and say follow this. None of them considered sending me to a dietician (my current one WON'T send me to a dietician, because she thinks they are idiots and will only teach me to carb count.) None of them will or would even consider doing tests for PCOS and none of them had the background to understand how that could impact weight loss. The only person ever to give me anything for Insulin resistance was my OB, and he did it to help me get pregnant. Once I was pregnant, no more metformin. Now, my current doctor, she's totally into organic, holistic, non processed foods, and this is ok, until I get something like a yeast infection, and her cure is to consume yogurt, oregano oil and lose weight. Funny, her cure for my diabetes is the same... Report
I only saw my doctor when I had a problem. Then I started losing weight and thought I should se him to see what he had to say. Wow! It was really cool to get his opnion and his approval for the way I was doing it. He also told me about plateau's and not to be upset when I get there. That your body just needs time to adjust.
He has also been teaching me to listen to my body about how fast to go,what foods to eat, etc. When I eat, I should write down how I feel afterwards. That'll help me stay away from things I should not be eating.
The bad part to me is that these preventative type appointments are not covered by my insurance. They will pay the fee if I go there for a "problem" but not if I am going to talk about weight loss. That part really bums me out, but I go and pay the fee. The system is messed up. If people are trying t get healthy, they should not have to pay more. We'll be costing the insurance company less in the long run. Sorry for the rant.
I think discussing your weight loss goals with your doctor is one of the best things you can do. When mine tells me that I'm doing a great job, I just beam with pride and excitment! Report
I was one of those people who never went to see a doctor unless I absolutely had to. After being hospitaqlized for 13 days with pnumonia, I decided I had better start taking better care of myself. I quit smoking, joined SP and have now joined a fitness center, I will meet with my trainer tomorrow morning. I need to lose 112 pounds and want my doctor to be a part of this transformation. Not only to moniter my health, but to see that through SP you can learn to live a healthy lifestyle, if only you choose to do so.

I have printed the handout from above and have printed off my nutritional report as well as my fitness reports for the past month. I see my doctor this Friday and am looking forward to it.

I had bloodwork done a few weeks ago and it came back very good, which suprised my doctor because I am 112 pounds overweight. Being overweight doesn't always mean that your bloodwork will be bad, but it is still unhealthy. It is hard on my joints and I'm sure it's hard on my heart and other organs. Now is the time to get my body in tune with my bloodwork and get everything healthy.

My doctor is learning, through me, that some people do want to take the next step to a healthy lifestyle and not to judge people by thier size. Report
SSCHUETZ1
I left my long-time family doctor because of his attitude towards my weight. This was the doctor who delivered 3 of my children, and was their doctor! Every time he walked into the room, no matter what i was there for, he would tell me "If you would just lose a few pounds everything would be better". So I did lose some weight, over 100 pounds, due to very high stress and not eating... certainly not the healthy way to do it! But he loved it, at first. Then he started saying "If you could just lose 20 more pounds". I realized right then and there that he would NEVER be happy with my weight and I got fed up with it. I haven't been back to see him in almost 10 years. Thankfully I am a very healthy person, in spite of gaining back that 100+ pounds. If I truly need a doctor, I go to the neighborhood clinic, except for my female needs. I am looking for a new family doctor though, because I would like to start getting annual checkups for more than GYN needs. I have no doubt that doctors judge you by your weight.... mine was the worst offender! Report
FIRECOM
My approach at any dr visit is to do a complete "core dump" so that EVERY thing is on the table. I tell him/her that I want to know any and all impacts of the symptoms I have delineated and what are just nonsense. I believe in helping me to get to the absolultely best protocol. I have yet receove nothing but thanks from the doctors in my life, and that appears to be many (darn it) Report
I used to feel very hurt by my doctors remarks. One day I scheduled a longer appointment and explained to him how I felt and told him I need your support and I need to feel comfortable coming into your office with a problem, I also told him he was making things worse instead of better. Report
Hmm, Ive never really met a doctor who cared whether or not I was insulted. I guess that must be something new. Report
I can see the benefit of the weight discussion being patient initiated, but the truth is that sometimes people are deliberately blind to their own problems. And a good doctor should bring up such a major concern that negatively impacts all aspects of health!

On the other hand nothing will work until the person is ready to do it for themselves!

My doctor would mention my weight and I did dread going to him because I hated to hear "the talk". But when I was finally ready to do something -- watch out! Now my doctor likes to use me as a "good example" -- he once told me "Its a pleasure to have you visit...for every person like you there are 9 more out there that just give me excuses." And to be fair I told him "Remember, it wasn't that long ago that I was one of the nine!"

And obesity CAN affect issues like the flu... before I lost weight I would get bronchitis and other such infections at LEAST once or twice in the cold weather.. since I've lost weight... I don't get sick as easily or for nearly as long. Report
Unfortunately, with most doctors I have been to, I have discovered they dismiss concerns, even if I bring them up. Instead of addressing that fact that I have something wrong with the way my body metabolizes food, they simply tell me "you eat too much" or "you need to exercise more." Well, yes, except that I have PCOS and am insulin-resistant. I had to go and do research and tell my doctor what was wrong with me and get it confirmed through tests, etc. I didn't go to medical school; why do I have to diagnose myself before my concerns are treated seriously? Since my doctor was zero help with discovering what is wrong with me, why would I bother to consult him at all about this when I can do the research and figure out a plan of action without him? Report
I think it is way better for this conversation to be patient-initiated. My daughter went to a doctor for the first time with symptoms of flu. Her basic goal was to get a note to legitimize her absence from work. The doctor brought up the weight issue. Did that have anything at all to do with the visit that day? Would reducing her weight have prevented the illness? Would dealing with her obesity issues cure her bout of flu? The answer to all of the above is "Probably not!" Report