Listening to a CBC radio show , "White Coat, Black Art", about the complications doctors have in treating the obese.
Two anecdotes stand out: 1. An obese mom had a very difficult C-Section, and 2. Doctors have come up with slang to refer to obese patients within earshot (the Iowa Unit, or IU, which is 200lbs/unit - i.e. "that patient is 2.5 IU's" for 500lbs)
I'm curious how resigned medical professionals are to the issue of obesity? Wondering on the inside perspective from the nurses and doctors who frequent this site and are generally in tune with a low carb/paleo style diet.
Is the lack of consensus on how best to treat the obese a contributing factor to the lack of progress?
asked byGabyYYZ (154)
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on September 30, 2013
at 01:43 AM
Prevention is the only cure, IMO, and this is the job of society, not the doctor. Obesity is a de facto incurable, lifelong chronic illness for most victims. Once the system's initial settings are screwed up they don't seem to ever reset properly, and require non-stop monitoring thereon.
on September 29, 2013
at 06:41 PM
I guess the doctors have to keep their original oath in mind "First do no harm" and decide if their action/inaction is leading their patients down the wrong path. I would rather a doctor prescribe explicitly a vegetarian diet to a patient than nothing at all beyond "lose some weight", because at least the patient, coming off of a SAD diet will benefit from the buy-in, regardless of what style of eating. I think a doctor should definitely monitor the patient, and as the results stop improving, then the doctor looks into something else (i.e. add meat, remove soy, etc.)
For the self-directed of us who do their research online, we can do the whole N=1 thing for the most part and find what works, but for those who are very dependent on doctors, any buy-in prescribed by the doctor where people give up sugars and non-foods, and at the very least drastically taper their grain consumption and increase their fat intake, will do wonders for those with a lot of weight to lose. As they get closer to their ideal weight range, they'll realize that what worked before is not as effective without placing additional stress on the body (excess exercise), and that's where a doctor worth his/her weight will step in and do wonders.
on September 29, 2013
at 05:26 PM
Doctors seem to mostly rely on the guidelines of The AMA or whatever medical group or organizations they are affiliated with. Stepping outside those bounds requires a risk taker who isn't afraid of getting sued or being dinged financially for not sticking to procedures. Going to be hard to find those doctors in conventional medical world. No doctor ever had a real discussion with me regarding weight other than an off the cuff "you should lose some weight" type of comment. I don't blame them as it is mostly on me and had I asked for guidance they might have helped. I really didn't need anybody to tell me how to lose weight, I find it rather simple, the trick was keeping it off. Paleo has been the easiest and most natural method for me to lose and maintain the loss.
on September 29, 2013
at 05:25 PM
Not having listened to the episode you mention, it sounds like Peter Attia's TED talk or at least some of the comments/attitudes he initially had when dealing with obese/diabetic patients.
I think the problem doctors have with treating obesity is that the solution is not surgical or pharmaceutical in nature. It's educational, and many doctors often neglect that aspect of their practice. Doctors read the standard line: 'eat less, move more', but don't have advice beyond that. It's all rather nebulous advice that leaves patients not knowing what really to do. It's terribly generic as well, idiotic doctors telling every overweight woman to 'just eat 1200 calories per day', when 1200 calories per day is well under BMR and probably impossible to attain adequate nutrition on when consuming a processed food diet.
Doctors need to collectively grow a pair and take a hardline with their patients. No coddling. If you're over-fat, you're abusing your body as bad as, if not more than, a drug addict does. A nutrient dense diet with moderate activity levels is, as best, simply not abusing your body, that's the bar doctors need to set as a minimum.
on September 28, 2013
at 04:15 PM
dont think doctors are equipped to treat obesity, its not a disease its a lifestyle 'disorder'/issue/problem.i imagine the only way doctors can treat obesity is cutting it out or giving you some kind of 'diet' drug or digestive surgery.
this issue is going to need to be addressed at the cultural level. imo the best thing a doctor can do is try to get the patient back to reality by giving them perspective/information.
i side more with the bias against the morbidly obese, unless you have a serious serious medical condition i cant imagine any reason why someone would let themselves get to that kind of weight. imo we shouldnt be equipping hospitals to deal with people the weight of livestock, i have almost no sympathy for extremely overweight individuals.
tl: DR- treating obesity should be done in the psychiatrists office. anyone whos that obese surely has serious physical or mental issues. (protect the doctors!)