Obese Med Students

[Gooch]

I dont want to offend anyone here, but I have been wondering how an obese med-student can sit through lecture after lecture hearing the health risks of obesity and not get motivated to lose weight? How does one expect to be a respected physician if they are significantly overweight? How can you expect patients to take your advice to lose weight seriously? I feel akward for my overweight classmates everytime obesity issues are brought up and I keep hoping to see the weight come off as time goes by, but I'm in my second year and at least 5% of my class could be considered obese without signs of improvement. I know they are driven people because if they weren't they wouldn't be in med school. Maybe Im a jerk for bringing this up...?

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[Rockhouse]

This is obvious, this is the old "do as I say not as I do," some med students smoke, drink in excess, don't get enough sleep, develop stress-related mental health problems for not taking care of themselves - you could go on and on. Its not that surprising that if an obese student doesn't already have a workout routine, that med school would be a hard as hell place to start that habit, knowing the health risks or not. There is also a question of immediacy (as in if i don't study I will fail this test tommorrow as opposed to if I don't workout I will have a heartattack in 25 years) but that is an entirely different subject.

 

[evade]

I dont want to offend anyone here, but I have been wondering how an obese med-student can sit through lecture after lecture hearing the health risks of obesity and not get motivated to lose weight? How does one expect to be a respected physician if they are significantly overweight? How can you expect patients to take your advice to lose weight seriously? I feel akward for my overweight classmates everytime obesity issues are brought up and I keep hoping to see the weight come off as time goes by, but I'm in my second year and at least 5% of my class could be considered obese without signs of improvement. I know they are driven people because if they weren't they wouldn't be in med school. Maybe Im a jerk for bringing this up...?

I'm an overweight med student. I've been overweight almost my whole life, and don't get me wrong, I f!cking hate it. I feel awful every time we have have lectures talking about the health risks of obesity. I am terrified of type II diabetes. Heck, I'm terrified of becoming obese. I'm fatter than I've ever been before because medical school is (a) insanely stressful, and (b) taking up the vast majority of my time. Add to that the fact that I'm living with my SO, and his eating habits are far from ideal. He likes to eat out, he likes to cook fatty meals, and he does not like vegetables (and frequently won't cook them). Add to that, my school is moving locations, and we won't have a gym for a while. I don't live near the gym anymore. Oh, and free lunch in school is pretty irresistable (I'm broke), and it's always fatty. Ditto on the desserts people bring.

All these factors conspire to make it very difficult for me to lose weight. I'm trying, I really am, but it's always been very hard for me to lose weight, even when I wasn't so busy and stressed.

Let's face it though, lots of med students are really unhealthy. Difference is, you can't look at me and know that I only got 4 hours of sleep last night. You can't tell if I drank 'till I passed out this last weekend. If I were thin, you'd have no idea if I hadn't done a minute of exercise for the past 6 months, or if I'd been eating pizza for every meal for the last week and a half. BUT, you CAN look at me and say, "You're fat!" That's the difference, and that's why the overweight get picked on, both in med school and in life.

Yeah, I should change. I'm trying. We all should try to live healthy lifestyles. But no one is perfect, and to think poorly of someone because their imperfection is visible is just plain mean.

 

[SoCuteMD]

Perhaps the fact that obese med students exist, despite the fact that they KNOW what being obese/overweight does to one's body should be a statement to all us future physicians about how HARD it is to lose weight - and how much compassion we need to have for those who are trying. And how hard we need to work to find ways to make it EASIER.

I am petite and a few years ago I was about 25 lbs overweight. Not enough to even look horribly unattractive, but enough that I hated it and wanted to change it. It took me two full years, multiple starts and stops, and a lot of effort to lose those pounds - and this coming from someone who was VERY active her entire life. I would lose 8-10 lbs, hit a new low, flounder for a bit and gain 3-4 (some water weight, some real), then get motivated again and lose another 8-10 (net loss from previous low: 5 or so) and repeat the cycle.

 

[Gooch]

Let's face it though, lots of med students are really unhealthy. Difference is, you can't look at me and know that I only got 4 hours of sleep last night. You can't tell if I drank 'till I passed out this last weekend. If I were thin, you'd have no idea if I hadn't done a minute of exercise for the past 6 months, or if I'd been eating pizza for every meal for the last week and a half. BUT, you CAN look at me and say, "You're fat!" That's the difference, and that's why the overweight get picked on, both in med school and in life.

I completely agree. It's unfair that the smoking binge drinker can hide their weakness much easier than someone who struggles with weight. The obese student/physician isn't less of a person because their imperfections show. I hope you are successful in your efforts to lose weight. Thank you for your reply to help me understand your frustrations and how difficult it is for some to lose weight.

 

[Bertelman]

Don't forget about the role genetics plays in this equation. Being overweight isn't always about overeating and laziness. Sure, there are certainly some folks that could be thin but make unhealthy decision. But I'm sure some of the classmates you are speaking about have tried desperately to lose weight, but have been unsuccessful. I know someone who exercises religiously, follows a very strict diet, yet is still probably 50+ pounds over her IBW.

As mentioned above, what about your fellow students that abuse alcohol, use illicit substances, and make other unhealthy decisions. How are the obese students any different, other than their "vice" being very obvious to anybody. Start by asking respiratory therapists if they smoke. I don't think I've met one that doesn't light up. I've seen cardiothoracic surgeons who perform lung transplants smole cigarettes.

Seriously, take it easy on these folks. And thank your higher power that you were born with a proper metabolism and endocrine balance that allows you to maintain your weight.

 

[Law2Doc]

I dont want to offend anyone here, but I have been wondering how an obese med-student can sit through lecture after lecture hearing the health risks of obesity and not get motivated to lose weight? How does one expect to be a respected physician if they are significantly overweight? How can you expect patients to take your advice to lose weight seriously? I feel akward for my overweight classmates everytime obesity issues are brought up and I keep hoping to see the weight come off as time goes by, but I'm in my second year and at least 5% of my class could be considered obese without signs of improvement. I know they are driven people because if they weren't they wouldn't be in med school. Maybe Im a jerk for bringing this up...?

It's a fair point, but there are lots of foibles your comment could be directed to besides/in addition to obesity. A decent percentage of med students smoke, abuse drugs and alcohol, participate in unprotected sex and other inumerable frailties of humanity that someone studying medicine should know better than participating in. Probably more than 5% of your class falls within some of these other categories as well. All these things are major social problems, but sadly, doctors are human, and education about a problem really does not often cure it. As for advising patients, perhaps your obese classmates will do a better job of showing understanding toward their patients' weight issues, and thus actually be better people to tell them to drop a few lbs.

 

[soeagerun2or]

Seriously, take it easy on these folks. And thank your higher power that you were born with a proper metabolism and endocrine balance that allows you to maintain your weight.

The genetic predisposition to obesity is a joke. Sure there are fat kids with fat parents but that doesn't mean it’s heritable. Furthermore, most overweight people are overweight due to motivational issues, skipping exercise out of convenience, and plain gluttony. True medical disorders affecting metabolism exist but are rare when compared to the number of obese and overweight people.

I’ll rephrase the OP’s question more bluntly “Why are you fat if you know it’s bad for you and how do you expect your patients to take you seriously when the rest of society clearly doesn’t?”

 

[Touchdown]

The genetic predisposition to obesity is a joke. Sure there are fat kids with fat parents but that doesn't mean it’s heritable. Furthermore, most overweight people are overweight due to motivational issues, skipping exercise out of convenience, and plain gluttony. True medical disorders affecting metabolism exist but are rare when compared to the number of obese and overweight people.

I’ll rephrase the OP’s question more bluntly “Why are you fat if you know it’s bad for you and how do you expect your patients to take you seriously when the rest of society clearly doesn’t?”

Frankly how can you sit through lectures and believe the BS that obesity does not have a genetic issue. Even when I was in high school in the middle of football season I could never lose much weight. Ive essentially cut out one meal a day (I cut my breakfast and lunch portions in half) and its a slow process. I cant run long distances, I hate it, I have a very weak ankle from football and I cant pace myself; I need motivation (ie a game) however I do enjoy and do walk quite a bit. Right now Im an engma, overweight but normal bp, blood glucose, cholesterol, etc, allthough I fear the day when I cease to be the engma.

Even though I dont like being obese, I can function and Im doing what I can to cut down (I havent really changed weight on a yearly basis since high school, allthough I do fluxuate seasonally) and thats all I can ask. Pretty much my moms side of the family is obese, even though they hardly eat anything. My dad eats a whole lot (much more then the male vs female amounts) more then my mom and doesnt gain weight while my mom does so please dont tell me that there isnt a gentic componet. You also cant tell me you dont know a friend thats as thin as a rail and eats constantly, some of it is due to personal choices, some of it aint, and to put the entire blame on indivduals is pathetic.

 

[Bertelman]

The genetic predisposition to obesity is a joke. Sure there are fat kids with fat parents but that doesn't mean it’s heritable. Furthermore, most overweight people are overweight due to motivational issues, skipping exercise out of convenience, and plain gluttony. True medical disorders affecting metabolism exist but are rare when compared to the number of obese and overweight people.

Tell me exactly what is your experience in this phenomenon. Observation? Let's just say I have a very intimate personal experience related to obesity and genetics. I myself am not obese, and frankly for the duration of high school was very, very skinny. I graduated at 6'3" weighing less than 150#. My mom, in her younger years, was also skinny. My father, on the other hand, has battled obesity his entire life. The only time he was ever skinny was for a few years after a surgical intervention. Bad habits returned, and he is now overweight again. Guess what- I had a sister, too. Just as Mendel might have predicted, she was morbidly obese for most of her life. I promise, if you saw a picture of me and 100 other girls, she would be the absolute last person you would pick to be my sister.

So- the perfect longitudinal study. Two children, one house. One very, very skinny; one very, very fat. To say that obese children coming from obese parents is not SOMEHOW genetically related is like saying the kid with the big nose didn't really get that big nose from his father! Yeah, right.

I would tend to agree that most overweight people are that way because of motivational issues, ignorance and gluttony. But I guarantee there is some genetic component there. I know it doesn't explain the entire weight excess, but suffice to say I don't think I could ever eat enough to become as obese as the largest ones in our society. They have a stacked deck against them.

And back to the original argument, I was not referring to obesity in our society as a whole when I mentioned that many can't prevent their obesity. I was referring to medical students. Through a successive series of hurdles, they have proven that they are motivated. And I would defend that they are not skipping exercise out of sloth, but because there is not enough time in the friggin' day to excel in medical school and exercise regularly (for some).

True medical disorders affecting metabolism are rare? Then why is there an entire specialty dedicated to this field? Are endocrinologists rare? Are thyroid disorders rare? Weight gain is a somewhat common side effect of medicines which are very commonly prescribed, like OCPs and antidepressants. Throw a stick into your classroom and you'll surely hit a woman taking one of those.

So, please tell me why you think genetics have absolutely no role in weight. While you are at it, try talking to some of the overweight people in your medical school class. Ask them why they are unmotivated, gluttonous sloths.

 

[sga814]

Being someone who used to be obese, but lost 50 lbs- lemme tell you- being skinny and maintaining that weight is not all too easy. Some of the best physicians I know.. are well overweight- so if you want to criticize someone, do it because of how they act towards they patients, not on how they act towards themselves (perhaps being obese is a sign of altruism? ).

If you're going to bash obese medical students, then why not bash those who drink, smoke MJ , smoke in general, drink 5 cups of coffee a day, take amphetamines and other stimulants, and those who have unprotected sex???!?

 

[lipstikisntfood]

What I want to know is: when overweight students (and doctors) counsel patients to lose weight, do the patients give them a hard time? Does it make you feel uncomfortable counseling someone to lose weight, or do you feel like you're better at it if you've had personal experience with how hard it is to do so?

 

[bjackrian]

As (future) physicians, we have an obligation to counsel our patients using the best medical knowledge we have--to tell them the risks of their behavior, whether it's obesity, substance abuse, wearing a bike helmet, whatever. IMO, it is not in any way hypocritical to also participate in/suffer from/imbibe in those behaviors yourself. Your job as a physician is to give the patient information so that he/she can make their own (hopefully) informed decisions using the best knowledge we have.

 

[soeagerun2or]

Tell me exactly what is your experience in this phenomenon. Observation? Let's just say I have a very intimate personal experience related to obesity and genetics. I myself am not obese, and frankly for the duration of high school was very, very skinny.. I had a sister.. she was morbidly obese for most of her life..

There are stupid families with smart children and smart families with a dunce, equally not an attributable to genetics.

So- the perfect longitudinal study. Two children, one house. One very, very skinny; one very, very fat. To say that obese children coming from obese parents is not SOMEHOW genetically related is like saying the kid with the big nose didn't really get that big nose from his father! Yeah, right.

One household for one generation does not adequately substantiate a genetic study. What other traits does your sister share with your father? What molecular studies have been conducted linking the two?

They have a stacked deck against them.

The only deck they have stacked against them is a misalignment of priorities. There are countless stories of fat medical students losing weight or previously lean medical students succumbing to stress and gaining weight. It is a priority and lifestyle issue first and foremost and clearly the overweight students do not make proper diet and adequate exercise a priority.

 

[Bertelman]

There are stupid families with smart children and smart families with a dunce, equally not an attributable to genetics.

I agree. There are stupid parents that have smart kids. We're not talking about intelligence, which is a quality that we don't even know how to quantitate, let alone properly attribute to genetics. Let's get back to physical attributes. I understand that penetrance is not 100%. I am sure that in your travels among the world's largest people, that in all your research experience, you have seen skinny people emerge from obese parents. I have, too. But their existence does not preclude the possibility that there are also fat kids that are fat simply because their inborn metabolism is somehow different from yours. Are you telling me that your appearance is similar to your parent's out of pure circumstance? How can you believe in genetics for certain traits, and not somehow believe that a trait for obesity exists? It's a physical trait, yes? If a mom has large breasts (glorified bags of fat), what do you think the chances are that her daughter will likewise have large breasts? Negligible?

One household for one generation does not adequately substantiate a genetic study. What other traits does your sister share with your father? What molecular studies have been conducted linking the two?

You're right. So, please, share with me your experiences. Please, tell me about the time YOU were 200 pounds overweight, realized it was all because you ate too much, and changed your life bo losing it all. Again, I grew up in the same house as my sister. She ate the same meal, the same portion size, played alongside me, yet was always larger than me. She was not gluttunous, she was no unmotivated. Please, you still have not explained why she was so large.

The only deck they have stacked against them is a misalignment of priorities. There are countless stories of fat medical students losing weight or previously lean medical students succumbing to stress and gaining weight. It is a priority and lifestyle issue first and foremost and clearly the overweight students do not make proper diet and adequate exercise a priority.

I'm sure there are countless stories of such. That doesn't discount the other stories of those who have done everything within their power, with little or no success.

Oh, by the way, you never got back to me on why so many doctors exist (endocrinologists) to treat such a rare disease- disorders of metabolism. Ohh, that's right, you had to look up the word "endocrinologist" to see what I was talking about.

Please, leave this forum before you get banned for trolling...again. Leave the educational discussions to those with an education.

 

[Touchdown]

To all of you people calling out obese students I must ask:

Do you continue to drink/smoke/have too much caffine/use illegal drugs?

If so, why after seeing all of these lectures about how bad it is for you. soeagerun2or, do you do any of these things? I sure do hope not, because there is even less of an excuse a fine person of moral fiber and physical prowless should, those of us overweight dont have the choice to give up food or can be blamed for eating food from the begining. Drinking, smoking, and using other drugs is something your body doesnt ever need and is completly an invention of man to get away from reality. Ill take a chance for type II diabetes and high blood pressure over liver failure, alzheimers (alcohol,) lung/throat cancer (tobacco,) and major loss of brain cells (all of the above.)

People in glass houses...

 

[getunconcsious]

I completely agree. It's unfair that the smoking binge drinker can hide their weakness much easier than someone who struggles with weight. The obese student/physician isn't less of a person because their imperfections show. I hope you are successful in your efforts to lose weight. Thank you for your reply to help me understand your frustrations and how difficult it is for some to lose weight.

Very true. I'll sheepishly admit here to being the smoking binge drinker. I would never judge an obese person (med student or not) on their lifestyle because I know from experience with alcohol and cigs how hard it is to change. I've gotten better, but it's always an uphill battle. And the people who know me feel awkwarded out whenever they lecture about the health risks of drinking and smoking. But I think people that have never struggled with food/alcohol/drugs/tobacco/whatever don't really realize how hard it can be to change.

 

[YouDontKnowJack]

just starve.

remember your basic biochemistry- they taught something like... fat is metabolized during starvation.....

if you're fat and lazy, you can always go to your neighborhood plastic surgeon and get lipo <--- maybe this is why people don't care about being fat.

 

[Law2Doc]

just starve.

remember your basic biochemistry- they taught something like... fat is metabolized during starvation.....

Actually I think they teach that the body works hard to preserve its fat reserves during starvation situations and burns your muscles away first. This is pretty much the reason that most viable diets avoid long periods of fasting.

 

[Bertelman]

I guess he don't know the facts.

 

[racerx]

To all of you people calling out obese students I must ask:

Do you continue to drink/smoke/have too much caffine/use illegal drugs?

If so, why after seeing all of these lectures about how bad it is for you.
People in glass houses...

I agree.

It seems that there is an abundance of doctors-to-be that already have the "I am a demi-god, am infallible, and am perfect in my lifestyle. . .you should be as perfect as I or you are worthless" attitude. Jeez, wait until you are in residency before you all express your superiority complex.

I am overweight and will make one hell of a doctor. One reason is that I will try my best to not prejudge my patients. You might try it too. Losers.

One of my favorite lyrics:
"I don't want you and I don't need you
Don't bother to resist, I'll beat you
It's not your fault that you're always wrong
The weak ones are there to justify the strong

The beautiful people, the beautiful people
It's all relative to the size of your steeple
You can't see the forest for the trees
You can't smell your own **** on your knees

There's no time to discriminate,
Hate every m0therf***er
That's in your way. . ."


BTW, we'll see how trim and in shape y'all are by the time you're all 40. Time changes things. I hope you remember your views then.

 

[YouDontKnowJack]

Actually I think they teach that the body works hard to preserve its fat reserves during starvation situations and burns your muscles away first. This is pretty much the reason that most viable diets avoid long periods of fasting.

well i guess i don't know jack about biochemistry.


no actually, my trusty brs biochem review book says that "the body uses fat stores as its primary source of energy during starvation, conserving functional protein. the length of time that a person can survive without food depends mainly on the amount of fat sotred in adipose tissue"

 

[liverotcod]

well i guess i don't know jack about biochemistry.


no actually, my trusty brs biochem review book says that "the body uses fat stores as its primary source of energy during starvation, conserving functional protein. the length of time that a person can survive without food depends mainly on the amount of fat sotred in adipose tissue"

But you can't make glucose from fat, and ya know the CNS and RBCs gotta have glucose. My understanding was that death by starvation was usually due to protein wasting for gluconeogenesis.

 

[Zoom-Zoom]

I excercise a lot. I run around 40 miles a week. I only eat when I'm hungry. Despite this, I am and have always been about 25 pounds over what my weight should be for my height. I'm not obese, but I can imagine that as hard as it is for me to lose weight, it is potentially even more diffcult for some individuals.

 

[YouDontKnowJack]

back to the original topic....


fat people are complacent. they don't care what you think.

They'll take up 2 seats if they feel like it. whatre you gonna do?

 

[Law2Doc]

They'll take up 2 seats if they feel like it.

They may take up 2 seats even if they don't feel like... But they often have bigger laps, so the total number of potential seats does not decrease.

 

[chocomorsel]

To all of you people calling out obese students I must ask:

Do you continue to drink/smoke/have too much caffine/use illegal drugs?

If so, why after seeing all of these lectures about how bad it is for you. soeagerun2or, do you do any of these things? I sure do hope not, because there is even less of an excuse a fine person of moral fiber and physical prowless should, those of us overweight dont have the choice to give up food or can be blamed for eating food from the begining. Drinking, smoking, and using other drugs is something your body doesnt ever need and is completly an invention of man to get away from reality. Ill take a chance for type II diabetes and high blood pressure over liver failure, alzheimers (alcohol,) lung/throat cancer (tobacco,) and major loss of brain cells (all of the above.)

People in glass houses...

Don't forget Heart disease, cancer, arthritis, OSA, lung disease and I'm sure there's a host more attributed to obesity.
I do agree with you though, about other bad habits medical students have. I know lots of people who drink tons of caffeine, smoke, have issues with alcohol, take amphetamines, and I'm sure there's more. Plenty of med student fit into any of the above categories, so yes, the obese people shouln'd be called out simply because their problem can be seen easily to the world.
I, personally don't fit in any of the above categories, (although I did drink quite a bit in my first year and some of my second year of medical school), but that phase is over. I'd rather not deal with the hangovers anymore, because the few that I did have sucked ass.
So anyhow, while I do believe that there's a genetic component to obesity, in most cases, obesity/overweight is just plain due to bad eating habits and laziness. I mean look at countries in Europe where people walk everywhere and you can count how many obese people there are around you as opposed to the US, where people get in a car to drive two blocks. Seriously, the bottom line is the majority of Americans are lazy, and life in America is way too convenient. Instead of parents coming home from a long day's work and cooking for their kids, they go and buy fast food, because they are "too tired" and kids think that eating junk food is ok, because their parents feed them junk. So if you grow up your whole life eating unhealthy food, I'm sure it would be hard as an adult to break 20+ years of bad eating habits and now start eating healthy nutritious food. A lot of these people don't know how to cook these healthy meals.
People at my school always tell me how healthy I eat because I pack my lunch 3-4 times a week, cook 2-3 times a week and eat plenty of veggies and fruits. But that's how I grew up eating, so it's easy for me to stay away from candy, pastries and junk. But I'm sure if I started eating like some of my classmates, I might put on a few pounds. Maybe not much because my family consists of thin people, but I'm sure I could, because I weighed 5 pounds more in first year due to my partying and alcohol intake.
Anyway, I guess we could go on and on about why people are fat, but bottom line is, a vast majority of them are fat because they consume way more calories than they burn. That's all there is to it.

 

[Analyzethis]

I totally got the perspective of how a patient must feel talking to a fata## doctor. I was sitting through a grand rounds in surgery-and one of the chiefs was giving a talk on bariatric surgery and obesity in pregnancy and going on and on and on about the downsides of obesity, its risk factors blah blah-I just mean totally talking down about obesity-well the catch was this girl was a fatty! I mean obese-and I admit the whole time I had trouble focusing on her lecture because I was too overtaken to the fact that here is a fat girl telling me and others not to be fat-so I can see if patient was talking to a fat doctor, they might not take them so seriously-it was a unique experience. I agree-why cant people just stop eating. Seriously I am in great shape but if I find myself putting on a couple extra for whatever reason and my jeans get a bit tight, than I just stop eating for a week-eaitng really minimal food and lose it. Poeple have no self control is the problem

 

[racerx]

I agree-why cant people just stop eating. Seriously I am in great shape but if I find myself putting on a couple extra for whatever reason and my jeans get a bit tight, than I just stop eating for a week-eaitng really minimal food and lose it. Poeple have no self control is the problem

I understand that it is difficult for you to understand. I mean, as perfect and full of total self-control as you are and all. . .

There is a psycho-social aspect that all of you beautiful people fail to acknowledge. Why can't a person that has OCD just stop washing their hands? Why can't a depressed person just "perk up"? Also, there are components of learned behavior in selecting healthy foods as well as stressors for those that eat when under stress. Unlearning the behavior isn't as easy for some as others, depending on a multitude of factors (culture, upbringing, etc.). Of course, understanding that would require understanding that people are fallible beings. Like I said in a previous post, not everyone is the demigod-doctors-to-be that all of you Biffs and Buffies are.

I am not making an excuse for fat people, just letting you know how self-superior and shallow you all sound, while wrapping yourselves in a smug little blanket of clueless. This thread should be titled, "No Diving this End of Pool."

 

[getunconcsious]

I understand that it is difficult for you to understand. I mean, as perfect and full of total self-control as you are and all. . .

There is a psycho-social aspect that all of you beautiful people fail to acknowledge. Why can't a person that has OCD just stop washing their hands? Why can't a depressed person just "perk up"? Also, there are components of learned behavior in selecting healthy foods as well as stressors for those that eat when under stress. Unlearning the behavior isn't as easy for some as others, depending on a multitude of factors (culture, upbringing, etc.). Of course, understanding that would require understanding that people are fallible beings. Like I said in a previous post, not everyone is the demigod-doctors-to-be that all of you Biffs and Buffies are.

I am not making an excuse for fat people, just letting you know how self-superior and shallow you all sound, while wrapping yourselves in a smug little blanket of clueless. This thread should be titled, "No Diving this End of Pool."

I agree. Why can't I stop smoking? And maybe more disturbingly, why is it so much more ok that I can't stop smoking than it is that someone's obese?

Sometimes people have rough lives. Sometimes people have brain chemistry issues. Some people have metabolic issues. Whatever it is, I think you have to try not to judge people.

 

[Acabee]

Today, I have eaten an immense amount of food, and all of it cr-p. I am about to go buy potato chips, and that will probably be probably the most excercise I will get all week. I am 5'4 and 100 lbs, and I guarantee you that next week I will be the same, because I have eaten this way my entire semi-adult life.
Weightloss, quitting smoking, etc. entail a choice between comfort and discomfort. For some genetically less fortunate people, losing five pounds entails more discomfort than it does for others, who could lose the weight with an extra monkey-spank. And the discomfort isn't just a matter of a rumbling stomach, it interferes with one's life. Starving interferes with concentration, nicotine withdrawal interferes with emotional restraint. So you have to choose, and people with fast metabolisms or unaddictive personalities have less to lose.
I don't think it's a doctor's job to tell someone, "Quit smoking! Go on a diet!" because only the patient can do the cost-benefit math. I think a doctor should make the tools to do so available to his/her patients and do his best to impress upon them the drawbacks of failing to take advantage of them. A fat, smoky, boozy doctor is no less qualified to do this than any other.

 

[Law2Doc]

Today, I have eaten an immense amount of food, and all of it cr-p. I am about to go buy potato chips, and that will probably be probably the most excercise I will get all week. I am 5'4 and 100 lbs, and I guarantee you that next week I will be the same, because I have eaten this way my entire semi-adult life.

I totally agree with your point, and certainly know my share of slim people who eat absurdly large and unhealthy meals, snack frequently, never exercise and often even lose weight while doing this. If you go to health food stores there are a variety of calorically dense formulas for the hard gainers. But I must warn you that many people do hit an age where what once was quickly metabolized away no longer is. What worked at 20 may no longer work at 30, 40 etc.

 

[Belfagor]

It's a fair point, but there are lots of foibles your comment could be directed to besides/in addition to obesity. A decent percentage of med students smoke, abuse drugs and alcohol, participate in unprotected sex and other inumerable frailties of humanity that someone studying medicine should know better than participating in.

That has been renumerated a few times in the course of this thread. There is a very big difference between a visible foible and one that is concealed.

If an obese physician is lecturing a patient on weight related health issues, no matter how idealistically many people here will try and frame it: it's hypocritical. It's blatantly hypocritical.

The same for the oncologist puffing on a Marlboro in front of his lung CA patient.

But what about these supposed throngs of med students who invariably do something else unbecoming of a physician? Binge drinking on weekends, banging hookers with reckless abandon, or 8-balling themselves to happiness? The patient doesn't know. As long as the physician presents themselves during office hours, does their job correctly and their extracurricular habits don't directly affect the well-being of their patient, it's not a visible issue.

I won't go to an obese doctor. I don't care how brilliant, skilled, or highly recommended they are. Maybe that's rude and inconsiderate of a possible hypothyroidism or other condition, but I want my doctor to have control over themselves before they exercise control over my health.

Now, I won't go to a doctor who I know is doing coke, but I'd have to find out about it first. Obesity is a visible and overt criterion by which to judge someone's regard for health and well-being, whether that is politically correct or not.

 

[YouDontKnowJack]

it's good to have obese people in america

this just means drs will have more fat patients to treat.

more pts, more $$$$.

 

[Rendar5]

I actually remember learning in med school about studies that said most of obesity in our society was not due to "low metabolism" and it actually was due to poor lifestyle habits. Now it doesn't mean that some people aren't more naturally inclined to gain weight than other people, or that some people really don't have disorders that totally obliterate their metabolism (say PCOS, which has the potential to do just that in a certain percentage of sufferers). But it does mean that on average, an obese person you randomly see on the street is fat because of their lifestyle.

Unless you think the genetics of 20% of the American population has changed drastically over the last 20 years?

Anyway, without true lifestyle change, losing weight really wont' be possible to a great extent. Sure, you could diet, but you will yo-yo right back up there. Hell, it's what I do. It's basically all about portion control and hunger control (as in, don't skip breakfast, split ur calories into several meals instead of 2-3) and regular exercise in some form, whether it's a 30-minute walk to work or whatnot (only time I was ever optimal wieght was in Costa Rica when I had to walk back and forth 2 miles to school each day). BTW, snacking = evil and so is biggie-sizing. I am guilty of only one of those 2 sins on occasion, though, hehe.

 

[Law2Doc]

Now, I won't go to a doctor who I know is doing coke, but I'd have to find out about it first. Obesity is a visible and overt criterion by which to judge someone's regard for health and well-being, whether that is politically correct or not.

Most drug using and smoking individuals do have tell-tale signs if you know them. Most nonsmokers can identify a smoker pretty readilly by the smell they carry on their clothes and hair. The smoker him/herself won't ever smell it. People who sniff too much on multiple occurrences and not during allergy season may be showing the classic tell of a coke user -- we've all known the types who claim they have "allergies" 365 days a year.. Pupil dilation and bloodshot eyes often tell a story. Personalities and mood swings definitely do. So yes, a lot of these things are overt, if you are looking.

But it's not really about being overt or not -- that's not the issue. It's folks who criticize others for one frailty, but have ten of their own. "Let him who is without sin cast the first stone" is not an original concept --It has nothing to do with political correctness. It would be nice if every doctor was healthy and not a hypocrite when giving advice. But that isn't always the case. All I and many others in this thread is saying is don't bash someone for one foible unless you are prepared to bash everyone else whose foibles are similarly reprehensible. And I suspect few of the critics on this thread are without foibles. They probably have many. In fact, those that flail out against others tend to be among the furthest from perfect, because those with their act together usually aren't as focused on others.

 

[YouDontKnowJack]

Unless you think the genetics of 20% of the American population has changed drastically over the last 20 years?

it's totally genetic.

there's a gene that causes people to reach for the potato chips and soda. i forget what chromosome it's on...

 

[Law2Doc]

Unless you think the genetics of 20% of the American population has changed drastically over the last 20 years?
.

Not that I necessarilly buy it all, but the endocrinologists' response to this question is that the genes have always been there and relatively latent, but that the environment has changed and enabled them. The whole "super-size me" fast food and sugared soda calorically dense world of the last few decades has enabled those genes to kick into higher gear; they are normally presumably meant to sock food away, slow metabolism, and help those genetically blessed folks weather times of fast and famine. Unfortunately we have the opposite of famine here in the US, and we were probably never expected (by evolution or intelligent design) to have access to such high calorically dense absurdly large portioned foods as we do. Again, not that I necessarilly buy it, but that is what has changed.

 

[xSTALLiONx]

There is a psycho-social aspect that all of you beautiful people fail to acknowledge. Why can't a person that has OCD just stop washing their hands? Why can't a depressed depending on a multitude of factors (culture, upbringing, etc.). Of course, understanding that would require understanding that people are fallible beings. Like I said in a previous post, not everyone is the demigod-doctors-to-be that all of you Biffs and Buffies are.

There are torture victims that have post-traumatic stress disorder.. but if you read the studies.. they show that ~75% of them do.. that means 25% of people get over it and realize theres more to life than worrying about lashings or electrocution to the balls in the past... Its all about being strong.. if you're mentally strong, you can overcome everything.. if your mentally weak, you will be fat or not control your smoking, etc..

I think its foolish to say that we should give therapy and be understanding of these weak people.. If I can't push myself to do something, I expect to be hit with a stick like a warrior until I am strong enough to accomplish anything! (ie. see the Last Samurai with Tom Cruise.. where the child is weak but built to be strong)

Why should I be understanding to a fat patient or a smoker? You are wasting my time that I could be spending helping someone who ISN'T killing themselves and needs real help.

Even more stupid is those who go to psychiatrists with their problems.. has anyone heard of one person who was actually cured? They all are as f-ed up as ever..

 

[xSTALLiONx]

I actually remember learning in med school about studies that said most of obesity in our society was not due to "low metabolism" and it actually was due to poor lifestyle habits.

I believe that is BS too but even IF one's metabolism was 1/2 which caused them to gain weight.. start eating 1/2 portions!.. That fat surrounding your body is all the food you ate that you didn't NEED to eat.. Remember.. Calories In - Calories Burned = Excess calories..

In addition, I'm sure all of us have been at some meeting where you are really hungry but only a small portion of food is given out.. and afterwords, you could go for seconds... However, this pain is NOT excruciating.. If a fat person eats one Caesar salad for lunch and is hungry still.. YOU DON'T NEED TO EAT MORE.. (and don't be a cranky biotch either) and you don't need to make up for it during dinner.. or later in the week with a sweet snack..

 

[YouDontKnowJack]

fat girls have more cushion for the pushin.
fat girls need loving too.

 

[racerx]

Now, I won't go to a doctor who I know is doing coke, but I'd have to find out about it first. Obesity is a visible and overt criterion by which to judge someone's regard for health and well-being, whether that is politically correct or not.

Too bad that with the cokehead physician you may find out after you have become the victim of drug-induced malpractice. I challenge you to find a single case of malpractice where the weight of the doctor figured into it.

Also, as Law2Doc stated, as you advance in years, the ability to burn off fat seems to decrease. I can't wait until you are 45. . .we'll see how trim you are. Of course then you may be dead from a cokehead physician screwing you up.

Glad to see you judge a book by its cover. BTW, not all fat people have bad hearts, cholesterol issues, or get diabetes. Prejudice isn't only about race.

 

[racerx]

Its all about being strong.. if you're mentally strong, you can overcome everything.. if your mentally weak, you will be fat or not control your smoking, etc..

I think its foolish to say that we should give therapy and be understanding of these weak people.. If I can't push myself to do something, I expect to be hit with a stick like a warrior until I am strong enough to accomplish anything! (ie. see the Last Samurai with Tom Cruise.. where the child is weak but built to be strong)

As you have found the perfect answer to shedding the frailties of being human, may I call you Siddartha? We are not all as perfect and "strong" as you. Thanks for projecting your values and views on those of us that couldcare.

I bet all of you folks that prejudge fat people are the same that expect no prejudging of cultural practices or "choice of what a woman does with her body." I don't prejudge those things either, but neither do I prejudge what people want to do with "their" bodies when it comes to weight either.

Who are the hypocrits?

 

[1Path]

I can't wait until you are 45. . .we'll see how trim you are. .

FYI, being in your 40's doesn't equal being obese or even overweight for that matter.

Maintaing a healthy weight, although more difficult as you get older, is not impossible (excluding serious illness/injury of course) for a person who 1) Commits themselves to eating healthy food most of the time 2) Excercises on a regular basis 3) Has and/or maintains the will power to know when to put the Health Bar Crunch ice cream DOWN!!!

 

[baylormed]

I think, largely, there is a social/living-style component to the obesity problem (although genes do play a role, I do not think it is the largest role).

I remember a few years back about a study where the Pima indians in New Mexico and Arizona (who have a high obesity rate) were compared with the Tarahumara indians (they are the same tribe, they are just called diffrently in these two countries). Despite their shared genetic background--take into consideration that these tribes never/rarely mated outside of their own kind because of their value system), the indians on the American side had high obesity rates while the ones on the Mexico side had low/none. The cause: American life-style and eating habits, which included not exercising enough and eating processed/fast-food in great quantities.

In my family's case, my all of my dad's brothers are overweight, while my dad is not. If you saw my dad eat what he eats you would be surprised. And medical exams show no evidence of high colesterol or sugar problems. However, my dad has a job that requires walking all day long, while most of my uncles have office jobs. Also, my dad does not drink, while my uncles are guaranteed to have at least a couple of beers every day.
My mom has never been overweight, and she never diets or "schedules" exerciese. But again, my mom is very active. By active I mean she can't sit down for longer than 1 hour even when she's at home, and her job is also one that requires constant walking.
At my house, you'll always find plenty of "fattening" foods such as pastries and tortillas (yes, we are hispanic), but you'll also find that my mom COOKS for us from scratch (she absolutely hates frozen or processed food in any form or shape), with fresh vegetables and fruits (she actually goes to the supermarket EVERYDAY), and for the most part we don't eat much red meat, mostly fish, and a little chicken. None of us is or has ever been overweight (even though tortillas are part of our daily diet )

Again, LIFESTYLE.

 

[racerx]

FYI, being in your 40's doesn't equal being obese or even overweight for that matter.

Maintaing a healthy weight, although more difficult as you get older, is not impossible (excluding serious illness/injury of course) for a person who 1) Commits themselves to eating healthy food most of the time 2) Excercises on a regular basis 3) Has and/or maintains the will power to know when to put the Health Bar Crunch ice cream DOWN!!!

No kidding. I thought at your 40th birthday party, they presented the birthday boy/girl with their fat suit. I wasn't suggesting that everyone that turns 40 becomes obese. I was pointing out that many of the people throwing stones may very well find that extra 50 lbs in middle age. As shallow as they are, I hope they do.

As impossible ass it might seem to you future nobel prize winning nutritional experts, not everyone that is overweight sits around on their behind with a "Heath Bar Crunch ice cream" in their hand planning meals of pork rinds covered with alfredo sauce.

However, I can see that you all will always believe that all obese people are sloths that pack food into their faces constantly. That's how you feel and it will never change. Too bad you are all a bunch of narrow-minded, predjudicial, know it alls who feel superior and better than many of your fellow human beings.

How nice and compassionate you all are. I hope that when a patient with a weight problem comes to you, you don't say, 'you're weak, just get of your @$$. With the tone on here, you can tell many of you feel obese people are beneath contempt, I hope it doesn't show through when you deal with your obese patients.

 

[1Path]

not everyone that is overweight sits around on their behind with a "Heath Bar Crunch ice cream" in their hand planning meals of pork rinds covered with alfredo sauce.:

I already qualified my statement about health conditions, but I guess you were too quick to ASSume that I meant otherwise.

But wake yourself if you think most obese people are that way due to some underlying health condition. Wait, let me rephrase that, eating poorly and not exercising WILL lead to health conditions that make it difficult to maintain a healthy weight, and FYI, I'm not talking about a size 2 here. So what came first, the alfredo sauce or the lack of a decent diet/exercise regime? I'm betting on alfredo sauce which I LOVE (along with the heath bar ice cream) but KNOW I have to eat that crap in MODERATION so I can be reasonable assured of wiping my own a$$ into old age!

I also think there are some definitive cultural differences as to what "obese" is. In a lot of latino and black communities, a size 12 for women is "all good" and I personally think women this size look great!!!! To others it's "obese".

 

[racerx]

Again, LIFESTYLE.

I agree. As I pointed out earlier, but was told it is whining and that obese simply need to be strong. Oh yeah the same scientology fan that said this also said psychiatrists are worthless. Mmkay...

Lifestyle = learned behavior. If a person has been exposed to a certain way of preparing meals and eating their whole lives, it is a major change that the person must undertake. While it is not impossible, it is difficult. This can cause many failures and false starts before the behavior is un-learned.

 

[1Path]

With the tone on here, you can tell many of you feel obese people are beneath contempt, I hope it doesn't show through when you deal with your obese patients.

I'm headed toward pathology, so any obese patients I'll deal with will likely be on that table 5-10 years sooner than they would have been had the led a different LIFESTYLE.

The issue isn't (or shouldn't be) in being obese as a medical professional. It's in knowing and/or having access to life saving information and choosing not to do anything about it. Obesity is an illness and should be treated as one and unlike some diseases like pancreatic cancer, there ARE some viable treatment options available for those who are committed to changing thier lifestyle choices. That same commitment and drive that got folks into and out of med school can certainly be applied here with the same successful results.

 

[racerx]

I'm headed toward pathology, so any obese patients I'll deal with will likely be on that table 5-10 years sooner than they would have been had the led a different LIFESTYLE.

The issue isn't (or shouldn't be) in being obese as a medical professional. It's in knowing and/or having access to life saving information and choosing not to do anything about it. Obesity is an illness and should be treated as one and unlike some diseases like pancreatic cancer, there ARE some viable treatment options available for those who are committed to changing thier lifestyle choices. That same commitment and drive that got folks into and out of med school can certainly be applied here with the same successful results.

Absolutely agree with you. However, some folks (not you) on this thread, have suggested that it is a problem that can be solved as simply as snapping your fingers. They also suggest it is a character flaw that is solved as simply as a snap of the fingers. They lack the compassion to understand that, as humans, obese people have human frailties that make lifestyle changes a bit more difficult. . .but doable.