Will Your Doctor Help You Lose Weight? Fat Chance!
I think everybody loves to eat. Eating can be pure, sensual delight. And those that don’t like eating – well, they come see somebody like me because that can be a real problem. It can be a problem for those that REALLY love to eat also – like the 700 lb. woman that not only makes her living in eating contests, but wants to be a record holding “Most Obese Woman” in the world.
I’ve seen some patients who could be in the running for this. Sometimes they have medical treatment to blame. Many medicines can add weight even if you eat nothing but air and water – seriously. I have seen people gain weight regularly, usually 15 to 20 pounds a month or so. Steroids, psychotropics and some other drugs can make you gain weight and keep you losing weight. Even treatments for diabetes – like insulin.
Sometimes they take it upon themselves to just cut pills in half or stop taking them rather than consulting a doctor. I’ve seen some people who managed to get flagrantly psychotic that way. At least one other recently thought she was doing so well on psychotropics that there was no question of changing her meds. She joined a gym and although exhausted, she had lost five pounds of the 150 she had put on.
People sometimes gain weight just sitting back and complaining. They are sedentary and their eating habits are not actually designed for a healthy lifestyle.
Sometimes they decide to change and seek medical help. The ones who approach me ask for alternative treatments.
Sometimes the patients only talk about how wonderful it feels to have a full stomach. One woman told me she starved herself all day because at night, when the panic attacks came, she calmed her panic by eating to her maximum contentment. And she was putting on about five pounds a week.
There is a relatively new term for this – “Comfort Food.”
For her it was a choice of life. She told me if she did not eat the foods she enjoyed at night, she would be suicidal. Food was her drug of preference and her delight. If she could not eat, she would think of suicide right away. Her mother prayed for her a lot. Doctors do not seem to be a great deal of help getting patients to lose weight. Most “official” recommendations (approved by the AMA or government health programs or institutional guidelines in HMOs) recommend everything from Weight Watchers to all sorts of diet pills – both prescription and over-the-counter, which are not without risks. In some cases, serious risks.
In the best of circumstances, patients might consult a nurse or some other doctor-extender who knows more than the doctor, or has read more than the doctor — which is usually not hard. Unless a doctor specializes in what’s called bariatric medicine, general practitioners usually know more than the conventional wisdom (which is proven time and time again not to work).
Yes, Virginia – calorie restriction or reduction and eating salads is never successful. Yet it’s still the first line recommendation of “professionals” (Dietitians, Nutritionists and Medical Doctors). From a psychological standpoint, people who overeat usually feel empty inside, and do not get feelings of plenitude elsewhere. People are not much inclined to follow diets. I certainly do not think it is in any way a normal behavior. It seems new reports on America’s trend toward “Obesity For All” appear every day.
I am one of those who made up my mind to change the status quo. After over 50 years of obesity, I am never the largest person in the room anymore. National obesity is not only a big health problem, it is a mess in most other areas of life. Stores are dominated by sizes I once would have given anything to find. There are lots of obese people around me. They are almost entirely patients, so they have psychotropic weight gain. A lot of what is going on seems to be an over-medicated America. Weight gain is a side effect of a lot of things. I think food additives are a big part of the study — at least, they are for me. The part I hate most is blaming the victim. There are lots of physicians who fire patients for being overweight or put them on waiting lists ( or “Weighting lists”) refusing to perform necessary surgery until they can shed some pounds. I remember when I was in the field of general and orthopedic surgery (very early in my career), we used to joke about how it was more “fun” to operate on thin people. They would say that it took an extra resident — maybe an extra medical student –to retract all the fat, but we would operate. Liability worries have made the world quite different. Now, doctors refuse to operate, and tell people how much weight to lose. And nobody claims that they have ever been told how.
The attitude is, “It’s your fault you are so fat, so it’s your responsibility to lose the weight.”
A fat lot of help that is! So the patients become frustrated and angry and sometimes they come to a psychiatrist for some kind of help and guidance. Literally, the weight loss frustration has made them crazy. People look for hormonal control and the development of new medicines. If some of them actually seem to work, it is because someone has cranked down the criteria. Even a little bit of weight loss helps, so it seems as if putative weight loss drugs offer to achieve smaller losses. I am unaware of any etiological treatment – meaning they discover the cause and base the treatment on that. If it seems that nobody has found a reason, so they can’t treat the reason, you have to look “outside the box” (the standard medical model) at some people who have taken the bold step of making claims that conventional wisdom either refuses to admits, or denies.
I took that course, based on my world travels and my knowledge of foreign people who have come to America (and some who have left America).
Obesity is truly the “American Disease.” It is intrinsic to living in these United States. People who come here end up just like the people who are born here – getting fatter and fatter every day and feeling more and more hopeless about it.
There’s more to discuss than can fit in a single blog post, but I have also started a free online support group for the extremely obese, sharing things that helped me lose over half my body weight.
Anyone wishing to opt-in can sign-up for the free support group and receive regular messages from me – tips and tricks to break the evil spell of American obesity as well as invitations to free phone conferences and tele-seminars.
Quality of life is the ultimate goal of medicine. We cure illness and eradicate disease and alleviate suffering to make people happy and productive.
That’s why I got into medicine – and that’s what medicine today has lost sight of.