Obese Med Students

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Show me where fat alone, minus any other normally associated markers (high BP, abnormal blood sugar, high cholesterol) is indicative of future disease. I'd love to see the study.

Overweight and obesity has been correlated with dislipidemia, Diabetes mellitus type two, and hypertension. And this would correlate well with the increased mortality from cardiovascular disease published in a Korean study from a couple of months ago in the NEJM which I have already referenced to.

A high BMI has also been associated with an increased mortality from cancer in the same study.

If all their numbers are fine other than the scale, and their habits are reasonably normal, what's wrong with telling them that they are healthy?

Might be just me, but I believing in preserving health, rather than fixing it when it "goes all wonky". It's better for the health system, and for the patient in the long run.

If they are among the fat people who eventually start getting wonky blood sugars or high BP, sure, nip it in the bud when it starts getting wonky or high and make sure they get it under control

Firstly, you assume, often quite wrongly, that the patient will continue coming in for regular check ups. If you keep telling a person, year after year, that they're healthy, they're going to stop going to the doctor. Chances are, you're going to miss it when their variables start "going wonky".

Secondly, we know that there is a correlation between BP, LDL, HDL and glycemia and the progression of atherosclerotic plaque. We know that atherosclerotic plaque begins to form in young adulthood. So your fat patient would obviously benefit from exercise and shedding weight, because if you lower LDL, increase HDL, lower BP and glycemia, the plaque will progress at a slower pace. If you wait 40 years to encourage them to lose weight and exercise, you're too late. First: because the plaque is there, happily progressing all these years. Secondly: because you can't teach an old dog new tricks, and lifestyle changes are going to be a lot harder from a 40 year old fat person than a 20 year old fat person.

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Not to mention that diet and nutrition education, the cure-all proposed by the nanny-staters, is probably not very cost-effective. Paying for the services of a nutritionist and a motivational trainer, while successful in a few patients, will probably be money poorly spent as most people will continue to over-eat.

Given the time value of money, it is probably more cost-effective to just let people alone, let them get as fat as they want, and if they die of an acute MI before they need thousands of dollars of ICU time we can just put them in the "win" column.

I mean, every poor patient I ever saw was either overweight or morbidly obese. Nutritionists and dieticians don't work for free. That's a lot of clams to spend for a lot of fried clams.

Duke Family Medicine showed us the results of several studies where a receptive group of patients were counseled, instructed in diet and exercise, and even given cooking classes with exceedingly dismal results, the conclusion drawn being that we just need more of that magic educma****ingcation.

Don't they already teach diet and nutrition in our crapulent public schools? I seem to recall this, although it is a dim memory. Surely a school system that can spend a couple of hours teaching kids to put on condoms, recycle, and care for the inevitable baby our two before graduation can sopend some time on the horros of the twinkie.
 
Just because you work at one thing doesn't mean you aren't lazy at something else.........

True. Tell me, are you as perfect as you sound, or are there lazy aspects in your make-up?


It is not complex....You pick out what you are going to eat for a day...and what exercise you are going to do for the day...and DO it....or DON'T do it.....

Fat people choose not to follow a plan....

You choose TO or NOT to.....simple...black and white and dichotomous.

If a plan doesn't work...then you modify it....low the caloric count more...or increase physical activity...and then YOU STICK TO IT...or NOT.

Fat people choose not to follow a plan....


At some point....caloric intake will be zero...and physical activity will be constant....you WILL LOSE weight...

ONLY way you don't is if you choose NOT to follow the plan...

Pretty black and white to me.....

Oh....and don't give me all the excuses that we've heard before........

I hope you meant NET caloric intake will be zero. Otherwise it means not eating anything. Also, to lose weight, net caloric intake must be negative.

As you are apparently perfect in every aspect of your life (wait, not just perfect, but god-like), I will now stop arguing with you. You are right, always will be, and as such, have never had a human weakness and should never have to understand any other point of view, as they are obviously wrong. I mean struggling with willpower is, as you said, as easy and either just eating something, or not.

It is a good thing you are an anesthesiologist, as then you don't have to listen to or consider all of the flawed, merely human opinions of patients (like FM, IM, OB/GYN, etc. are forced to endure). If someone there has an alternative thought to your considered, educated, and perfect point of view, you simply can intubate them. Then, no more torture for your demi-god opinions and knowledge.

As such, I will now simply impose upon myself an internet intubation when in your presence. Your flawless and complete knowledge and willpower obviously can be a lesson for us all. I look forward to your upcoming book "The Medical God's Guide to How Easy Everything Is". It will effectively cause the end of the entire genre of diet books. I hope you follow up that advice book with the "How Everything in Life is as Simple as Flipping a Switch Off and On" (subtitled - "Nutrition IS Just Black and White") :smuggrin:
 
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Firstly, you assume, often quite wrongly, that the patient will continue coming in for regular check ups. If you keep telling a person, year after year, that they're healthy, they're going to stop going to the doctor.
Fat people, very often, choose not to go to the doctor regularly, often for decades, because their experience is that no matter what they go to the doctor for, no matter what their current lifestyle is, and no matter what health issues they are dealing with, they get the same advice of "it's because you are fat, come back when you have lost weight". So I don't buy the argument that telling them they are healthy will stop them from going to the doctor; I think the opposite is FAR more likely to happen.

Secondly, we know that there is a correlation between BP, LDL, HDL and glycemia and the progression of atherosclerotic plaque. We know that atherosclerotic plaque begins to form in young adulthood. So your fat patient would obviously benefit from exercise and shedding weight, because if you lower LDL, increase HDL, lower BP and glycemia, the plaque will progress at a slower pace.
NOBODY in this thread has suggested that BP, lipids, and other objective health indicators not be monitored and treated. You are making the (false) assumption that fat is synonymous with BP, lipid and blood sugar problems. While many fat people (and thin people) have these problems, not all do.

What a couple posters HAVE suggested, though, is the following:

(1) Given a fat person who has NORMAL BP, lipids, and blood sugars, and given the incredible failure rates and associated risks of dieting, some of us would rather encourage these people to eat well and exercise rather than to diet to lose weight. That is not to say I wouldn't tell a fat patient that, because they are fat, they are at greater risk of developing problems with these things, so we should make sure to monitor them regularly.

(2) Given a fat person who has ABNORMAL BP, lipids, and blood sugars, and given the incredible failure rates and associated risks of dieting, some of us would prefer to address those issues directly through non-diet approaches. Exercise will improve all these things, completely independent of whether the patient also loses weight. Reducing or removing trans fats from the diet will improve some of these things, completely independent of whether the patient also loses weight. Working with a nutritionist to have more balanced meals can improve blood sugars, completely independent of whether the patient loses weight.

That is what a "Health at Every Size" approach is. It is not about ignoring the weight of the patient, or ignoring various objective health indicators. It is about more directly addressing the problems without using BMI as the only or primary indicator of health. And empirically, Health at Every Size results in healthier (though ever-so-slightly fatter) patients than the diet approach.

L. Bacon et al. (2005). "Size acceptance and intuitive eating improve health for obese, female chronic dieters". Journal of the American Dietetic Association 105 (6): 929–936.
 
Speaker: "Welcome to McDonalds, mayy I take your order?"

Obese person: "Yes, I will take a Big Mac, a large order of fries, and a large DIET COKE."

What the obese person thinks: "My diet coke cancels out the burger and fries. I am giving up 250 Cal by ordering diet as opposed to regular."

The problem with obesity is probably half mental. And no, it is not the fault of McDonalds that the person is obese.
 
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?

I've had patients criticize overweight docs who tried giving them advice on losing weight. When you think about it, it's very hypocritical and no one likes a hypocrite.

On the other hand, I think it's ridiculous to see all these skinny actresses going on and on about how much they work out, eat healthy, etc, but then you see a picture of them with a cigarette in their mouth! In fact, I had a doctor friend who died from a heart attack at the age of 42. He had a healthy diet and ran at least 5 miles per day, but smoked at least a pack a day. One day after running, he came home and fired up a cigarette and had a major heart attack. He would probably be alive today if he had never smoked, but had been overweight instead.
 
Speaker: "Welcome to McDonalds, mayy I take your order?"

Obese person: "Yes, I will take a Big Mac, a large order of fries, and a large DIET COKE."

What the obese person thinks: "My diet coke cancels out the burger and fries. I am giving up 250 Cal by ordering diet as opposed to regular."

The problem with obesity is probably half mental. And no, it is not the fault of McDonalds that the person is obese.

I enjoy a burger w/ fries on occasion, but I absolutely can't stand the taste of sugary soda. I have always drank diet soda regardless of what I'm eating.
 
Obese person: "Yes, I will take a Big Mac, a large order of fries, and a large DIET COKE."

What the obese person thinks: "My diet coke cancels out the burger and fries. I am giving up 250 Cal by ordering diet as opposed to regular."

More likely the obese person just likes the flavor of the diet coke better. Most of the really obese people are not driven by calorie concerns or even bother to make defenses. Nutrasweet and other sugar substitutes are chosen universally by lab rats over real sugar as it is more sweet.
 
Nutrasweet and other sugar substitutes are chosen universally by lab rats over real sugar.


let's see, how to work that into a catch phrase....

"Four out of five lab rats prefer sugar substitutes, shouldn't you?"
 
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...?

NO YOU ARE A JERK ( DEFYING THE RULE OF QUESTION TAGS)
 
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As for the diet thing, my parents whey I was younger only allowed me to have diet soda so I developed a taste for it, and thank God with all the Diet Coke I drink I would gain 30-40 lbs if I switched to regular.
 
*Bangs. Head. On wall. Repeatedly.*

No. I can't believe it. You've got to be kidding me if you're making these kinds of slanderous accusations. At this point, it's downright offensive that people are still saying RUBBISH like this this far.

okay so tell me if you saw me out to eat with my family pre-surgery when i was at my highest weight of 320+ and you saw me eating a salad what would have been the first thought in your mind? would it have been "oh there is an overweight person who is trying to lose weight"? or would have it been "oh there is an overweight person pretending she is trying to lose weight while she is out in public but i bet when she gets home she opens a bag of doritos"? or better yet would the comment that crossed your mind be "who does she think she is fooling?"? i would be willing to bet that it would have been one of the latter two and not the first one.
and if you saw me out now at 160ish eating the same salad it would not cross your mind twice as to why i was eating it.
 
okay so tell me if you saw me out to eat with my family pre-surgery when i was at my highest weight of 320+ and you saw me eating a salad what would have been the first thought in your mind? would it have been "oh there is an overweight person who is trying to lose weight"? or would have it been "oh there is an overweight person pretending she is trying to lose weight while she is out in public but i bet when she gets home she opens a bag of doritos"? or better yet would the comment that crossed your mind be "who does she think she is fooling?"? i would be willing to bet that it would have been one of the latter two and not the first one.

Do not suppose or pretend you will attempt to write you own agenda to pass me off as a prejudiced and intolerant individual, it is almost slanderous.

If I saw you at 320+ eating a salad I wouldn't even have thought anything. I would be minding my own business, and, honestly, I wouldn't really give much of a damn for what you're eating. I have no responsibility towards you, you have to answer to no one for your choices but yourself, I would have no right to give a damn. I don't know you and you're not my patient. Why should I care? You're a free individual, making your own choices in life.
 
okay so tell me if you saw me out to eat with my family pre-surgery when i was at my highest weight of 320+ and you saw me eating a salad what would have been the first thought in your mind? would it have been "oh there is an overweight person who is trying to lose weight"? or would have it been "oh there is an overweight person pretending she is trying to lose weight while she is out in public but i bet when she gets home she opens a bag of doritos"? or better yet would the comment that crossed your mind be "who does she think she is fooling?"? i would be willing to bet that it would have been one of the latter two and not the first one.

Stay away from Vegas if you're so willing to bet.

I'd have thought none of those. In fact, if I had noticed you at all, my most likely thought would have been kind of a vague sadness. Honestly, what pops into my mind when I see a morbidly obese person is how much longer he or she has before the inevitable end of life ICU bill comes due. I'm very glad to hear you're down to a healthier weight.
 
Honestly, what pops into my mind when I see a morbidly obese person is how much longer he or she has before the inevitable end of life ICU bill comes due.
Out of curiosity, is this what you think whenever you see any individual with any apparent illness? If you know someone has, say, high blood pressure, or cystic fibrosis, or any random disease - the first thing that pops into your mind is how much longer they have until their inevitable death? Or, this is something special that you think for fat people?
 
Do not suppose or pretend you will attempt to write you own agenda to pass me off as a prejudiced and intolerant individual, it is almost slanderous.

If I saw you at 320+ eating a salad I wouldn't even have thought anything. I would be minding my own business, and, honestly, I wouldn't really give much of a damn for what you're eating. I have no responsibility towards you, you have to answer to no one for your choices but yourself, I would have no right to give a damn. I don't know you and you're not my patient. Why should I care? You're a free individual, making your own choices in life.

then i apologize for taking your position out of context. i have received many all too pitying stares or the who does she think she is fooling stares while i was out with my family when i was heavier.
i do have an agenda and it is making people realize that there are some people who are obese regardless of what they do or how they eat.....we are not always one in the same. so when you see the person in class or out if you think nothing then bravo to you but if you think something do not let it be "oh they must overeat".
 
Stay away from Vegas if you're so willing to bet.

I'd have thought none of those. In fact, if I had noticed you at all, my most likely thought would have been kind of a vague sadness. Honestly, what pops into my mind when I see a morbidly obese person is how much longer he or she has before the inevitable end of life ICU bill comes due. I'm very glad to hear you're down to a healthier weight.

good thing i am not a betting person then huh? ;)
 
For all you know if they are women, they might have just had a baby...There are people that are overweight and are much healthier than the rest of us. I have a friend that works out 4-5 times per week, eats very healthy, doesn't drink or smoke, no caffeine or soda (she only drinks water and the occasional juice) and is still 30 punds overweight! SO there is more to it than the eye sees. When talking to patients take into consideration their lifestyles. While some people eat too much and don't work out, there are others who eat healthy and just aren't ever going to be a size 6! As a doctor, you're supposed to be compassionate, right?
 
? I thought at least a few posters here mentioned that they are fat and healthy? Wasn't there someone training for a black belt at over 200 lbs? Then there's me and Panda, statistically obese but healthy. Others?

It's also a mistake to assume that someone is healthy just because they aren't fat. They might have disordered eating that is just as harmful as the pizza-rolling thing, they might have a terrible diet and live a totally sedentary lifestyle and have high cholesterol, diabetes, etc...

I am one of these- I was over 200 since I was 10 and managed to get a blackbelt in karate and work on my feet over 18 hours a day as waitress running circles around my skinner colleagues (even when I was my heaviest at 374). My cholesterol level has also long been 145 (total) and all the other indicators have also been excellent- my BP is low to normal ranging from 90/60 to 120/80.

Also, Law2Doc, before my surgery when I could drink soda, I chose Diet Coke but I felt it was less sweet than regular. I found regular sodas (except for ginger ale) and any fruit drinks/sweetened teas etc. to be revoltingly sweet. I don't know if humans should be compared to lab rats until we know whether the taste buds are the same in number and composition.

Maybe we are the exception, but it is better to keep an open mind when going in to see a patient than to approach them with preconceived notions of who they are, what they eat and what their activity levels are. As the obesity epidemic threatens to spiral out of control, we need doctors to act as advocates and work with their patients to address these health problems.

Condemnation, revulsion or disbelief will only cause your patients to seek advice elsewhere.
 
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?”

I hope you never make it out of medical school..You obviously have no compassion if you can't even feel compassionate towards your classmates..
 
I hope you never make it out of medical school..You obviously have no compassion if you can't even feel compassionate towards your classmates..

It's not that I don't feel compassion it's just that logic over-rides my compassion. I look at smokers and alcoholics the same way when they make excuses about their lifestyle choices. Life can be tough but does not excuse for personal failures.
 
I opted for the gastric bypass surgery instead of lap ban because of the hormonal component (not just the malabsorption that you get with the lap band).

Why would a person have issues with malabsorption with a lap band but not gastric bypass? It is GP that causes malabsorption, lap band just takes longer to move food.

I realize GP has a place in treatment of morbid obesity but a lap band is much safer, it can be reversed by removing the band, and it is a safer procedure not to mention cheaper. GP spooks me a little, it is a little too invasive especially in comparison to LBs and it can't be reversed.

I am doing very well with it and have lost over 77 pounds in a little over 3 months.

That is absolutely fantastic! I'll bet you are thrilled! You really deserve a pat on the back for this, you have every right in the world to feel proud of yourself. Congrats to you!

Not all fat people are hoarding cookies and cake and other crap in their pantries like alcoholics stashing bottles.

Very true. Let's face it, being fat is simply not socially acceptable when comparing it to many other issues. There are many misconceptions out there. However, I do agree with other posters about diet and exercise. I'd venture a guess that most morbidly obese folks do not eat the best of diets and they don't exercise. But that doesn't mean it holds true for everyone.

Congratulations again for the 77 pound weight loss!
 
MilitaryMD...

It's not your fault....Let's find a better way...blah, blah, blah.....and not the direct way.....YOU"RE FAT...YOU're LAZY...STOP EATING SO MUCH...TAKE RESPONSBILITY.....CHANGE YOUR SLOVENLY LIFESTYLE...

IF you don't want to change your slovely lifestyile.....then accept being FAT and all that goes with it.


I can see why you are a military doc and in the specialty that you are. If you were in private practice you would never cut it. You would lose patients left and right. As it stands now your patients have no choice in docs.

While I understand your point and agree with it to a certain degree, your delivery system is horrific, your attitude is nasty, and you still aren't getting certain points that are bloody obvious. I'll bet you stand there and degrade a schizophrenic patient while demanding he just quits hearing voices too, eh?
 
Hodad....

Do not suppose or pretend you will attempt to write you own agenda to pass me off as a prejudiced and intolerant individual, it is almost slanderous

I believe the word you are looking for is libel, not slander.
 
there is a little genetic influence of obesity but it is far too often used as an excuse. Think of what obesity is. severely overweight. This excess weight is fat. What is fat? Efficient energy storage. So genetics may come into play but this energy has to come from somewhere which is the over-eating/eating lots of high calorie foods. I believe 95% of the time someone blames genetics for obesity it's really poor lifestyle planning.
 
Good luck Noelle.:luck: What diet do you plan to use? Do you plan to add exercise as well?

1)give up Mountain Dew (something I've tried many times and had some difficulty)
2)drink as much water as I possibly can, should help me give up the mountain dew in addition to other things
3)watch what I eat, but more importantly, take control of my portions
4)avoid sweets (I eat too much candy and deserts
5)take a dietary supplement to help me curve cravings (although if I start having headaches or anything from the caffeine this will go out the window)
6)do an exercise video, probably Tae-Bo, hopefully 4 days a week. Exercise is both going to be the hard part of this, but definitely is going to be necessary, because if I don't exercise, I will probably lose motivation to continue eating right. I have a hard time finding time to exercise, and as it is, won't be able to work out until Wednesday at the earliest (traveling out of town for a funeral tonight till late Tuesday night) The most convenient time would be early morning, but I have a very difficult time getting up to exercise in the morning.

I figure I'll probably wipe out a good 600 calories a day by avoiding soda and candy. That may even be on the low end.
I would like to lose 20-30 pounds, need to lose 15 to be on the upper end of what will be considered healthy for my height.
 
You could say the same of students who smoke in med school

The same of students who binge drink

The same of students who ride motorcycles (me)


Just becase we are informed doesn't make us examples of perfection. Besides, I am sure most overweight people, smokers, and motorcycle enthusiasts know that what they do is a danger to their health. It doesn't take a med school course.
 
1)give up Mountain Dew (something I've tried many times and had some difficulty)...
Cutting out soda was one of the best decisions I've made. They're nothing but garbage calories. Also consider changing your food choices at the grocery store - that way you only need to exercise restraint once. I try to buy fruits instead of snack foods for times between meals. Good luck.
 
Cutting out soda was one of the best decisions I've made. They're nothing but garbage calories. Also consider changing your food choices at the grocery store - that way you only need to exercise restraint once. I try to buy fruits instead of snack foods for times between meals. Good luck.

Ha, yeah, now I need to decide what to do with the 24 pack of Mountain Dew and box of Cordial Cherries I bought the other day. Part of me thinks that I should allow myself an indulgence like once a week so I don't overdo it, in which case, I can keep what I've already bought, instead of throwing it away, but then again, that may run me into trouble.
I guess I can bring them to my parents house tomorrow and let the family indulge so I don't.
 
1)give up Mountain Dew (something I've tried many times and had some difficulty)
2)drink as much water as I possibly can, should help me give up the mountain dew in addition to other things
3)watch what I eat, but more importantly, take control of my portions
4)avoid sweets (I eat too much candy and deserts
5)take a dietary supplement to help me curve cravings (although if I start having headaches or anything from the caffeine this will go out the window)
6)do an exercise video, probably Tae-Bo, hopefully 4 days a week. Exercise is both going to be the hard part of this, but definitely is going to be necessary, because if I don't exercise, I will probably lose motivation to continue eating right. I have a hard time finding time to exercise, and as it is, won't be able to work out until Wednesday at the earliest (traveling out of town for a funeral tonight till late Tuesday night) The most convenient time would be early morning, but I have a very difficult time getting up to exercise in the morning.

I figure I'll probably wipe out a good 600 calories a day by avoiding soda and candy. That may even be on the low end.
I would like to lose 20-30 pounds, need to lose 15 to be on the upper end of what will be considered healthy for my height.

You may want to check out WeightWatchers online (not the in-person stuff which most med students probably don't have time for). I'm not an obese person but tall and can easily change clothes sizes if I don't watch what I eat. I found that I would lose about 30 pounds or so, keep it off for maybe 6 months or a year and then gain it back during a stressful time. Losing weight is the easy part. Keeping it off is almost impossible for most people (chance of failure as defined by gaining the weight back without about a year (~95%, similar to giving up smoking). This last time (started 7/1/06), I went with weightwatchers online lost 30 lbs fairly quickly (quicker than they recommend) and have kept the weight off so far. I like the way you enter your weight periodically and can see a graph so I can see the long term trend. When I would gain in the past it was just a fraction of a pound here and there that added up. With the graph I can see the long-term gain before it gets out of control.
 
Ha, yeah, now I need to decide what to do with the 24 pack of Mountain Dew and box of Cordial Cherries I bought the other day. Part of me thinks that I should allow myself an indulgence like once a week so I don't overdo it, in which case, I can keep what I've already bought, instead of throwing it away, but then again, that may run me into trouble.
I guess I can bring them to my parents house tomorrow and let the family indulge so I don't.

Pitch them immediately (in the outside trash can to avoid the temptation of fishing them out :laugh: )! Get used to eating fruits and veggies if you're serious.
 
Ha, yeah, now I need to decide what to do with the 24 pack of Mountain Dew and box of Cordial Cherries I bought the other day. Part of me thinks that I should allow myself an indulgence like once a week so I don't overdo it, in which case, I can keep what I've already bought, instead of throwing it away, but then again, that may run me into trouble.
I guess I can bring them to my parents house tomorrow and let the family indulge so I don't.
TOSS. THEM. NOW.

Making one choice (throwing them away) is much easier than making them continually (resisting the urge to indulge).
 
This is a touchy subject and I will probably get flamed for saying what I am about to say but I will do it anyway.

I used to work as a personal trainer and fitness instructor for a few years. I even considered doing some bodybuilding shows. My main clients were obese trying to lose weight. I think if I didn't have compassion I would have found another job at that point and not pursued medicine now. So if anyone wants to start with the lack of compassion, please spare it.
It has been my observation (just my opinion) that usually obese people have other problems associated with it. I am not saying it is laziness or anything, but I am saying that they lack desirable qualities. For example a couple of my clients were very educated with graduate degrees and good jobs, but had no friends because no one wanted to socialize with them at work and once I went to one of their houses it reminded me of that Friend's episode where Ross couldn't sit anywhere in his gf's apartment.
Second, they bitched and moaned about everything and anyone but it was never their fault and never took responsibility for their actions. They would be late continually for their sessions and didn't want to do the warm up or the cardio or abs. It was always a fight to keep them in the gym or even to have them eat less food. They would cancel for **** like: Oh it's raining outside.
I also work with a nurse in open heart surgery that is obese. She is in her late 30s and is not involved with anyone. I can tell you that people are willing to look past the looks but her personality is about the same as of that of a used tissue. She is the epitome of laziness. Always trying to pass on her duties or having other people do it for her. She is habitually late, leaves early and has the ****test attitude. When we go out she orders a full side of fries ( a whole plate) and complains that she has bad genes.
Sometimes, I just want to scream.
Now this has been my experience, so anything is possible.


As far as health at any size that is complete bull****. I got up to 220lbs when I wanted to compete in bodybuilding and wasn't fat by any standards but I could rarely run more than 2-3 miles, my joints were hurting all the time, I started snoring and having apnea, it was hard to breathe going down the stairs or tying my shoes and even though I was in good shape just the extra weight was hard to carry. We have devised standards and charts for a reason. Saying that you can have health at any size it's making more excuses.
Peace on earth
 
I'm starting med school next year and I know that I'll be facing a tough and demanding challege my first year, physically and mentally. I also know that when I eat right and keep in shape (especially cardio 3 X week for 30 min (been shown to be as effective as an SSRI)) I will feel better and therefore will be able to deal with whatever med school throws at me.

In regards to how patients will react to your advice against being overweight when you are in fact overwieight, I can't imagine all of your patients taking you seriously. You might be a great doctor but your patients may still not take you seriously.

I've got a lot of respect for all of you in med school and those trying to get into med school but at the end of the day there are always those students and doctors who find time to exercise and eat right so I imagine it's not impossible, through probably very difficult. I really hope I can do that next year.
 
1)give up Mountain Dew (something I've tried many times and had some difficulty)
2)drink as much water as I possibly can, should help me give up the mountain dew in addition to other things
3)watch what I eat, but more importantly, take control of my portions
4)avoid sweets (I eat too much candy and deserts
5)take a dietary supplement to help me curve cravings (although if I start having headaches or anything from the caffeine this will go out the window)
6)do an exercise video, probably Tae-Bo, hopefully 4 days a week. Exercise is both going to be the hard part of this, but definitely is going to be necessary, because if I don't exercise, I will probably lose motivation to continue eating right. I have a hard time finding time to exercise, and as it is, won't be able to work out until Wednesday at the earliest (traveling out of town for a funeral tonight till late Tuesday night) The most convenient time would be early morning, but I have a very difficult time getting up to exercise in the morning.

I figure I'll probably wipe out a good 600 calories a day by avoiding soda and candy. That may even be on the low end.
I would like to lose 20-30 pounds, need to lose 15 to be on the upper end of what will be considered healthy for my height.

Morning exercise is very helpful. I find that when I exercise in the morning, I am more likely to watch what I eat throughout the day. Also, exercise is a good way to start the day. Its almost like an anti-depressant/motivator, as mentioned earlier in the thread. Good luck!!
 
I'm starting med school next year and I know that I'll be facing a tough and demanding challege my first year, physically and mentally. I also know that when I eat right and keep in shape (especially cardio 3 X week for 30 min (been shown to be as effective as an SSRI)) I will feel better and therefore will be able to deal with whatever med school throws at me.

In regards to how patients will react to your advice against being overweight when you are in fact overwieight, I can't imagine all of your patients taking you seriously. You might be a great doctor but your patients may still not take you seriously.

I've got a lot of respect for all of you in med school and those trying to get into med school but at the end of the day there are always those students and doctors who find time to exercise and eat right so I imagine it's not impossible, through probably very difficult. I really hope I can do that next year.

Some patients may not take the advice of a doctor who is obese and others might listen to them more because they know that the doctor has been there and is not being condescending to them.
 
This is a touchy subject and I will probably get flamed for saying what I am about to say but I will do it anyway.

I used to work as a personal trainer and fitness instructor for a few years. I even considered doing some bodybuilding shows. My main clients were obese trying to lose weight. I think if I didn't have compassion I would have found another job at that point and not pursued medicine now. So if anyone wants to start with the lack of compassion, please spare it.
It has been my observation (just my opinion) that usually obese people have other problems associated with it. I am not saying it is laziness or anything, but I am saying that they lack desirable qualities. For example a couple of my clients were very educated with graduate degrees and good jobs, but had no friends because no one wanted to socialize with them at work and once I went to one of their houses it reminded me of that Friend's episode where Ross couldn't sit anywhere in his gf's apartment.
Second, they bitched and moaned about everything and anyone but it was never their fault and never took responsibility for their actions. They would be late continually for their sessions and didn't want to do the warm up or the cardio or abs. It was always a fight to keep them in the gym or even to have them eat less food. They would cancel for **** like: Oh it's raining outside.
I also work with a nurse in open heart surgery that is obese. She is in her late 30s and is not involved with anyone. I can tell you that people are willing to look past the looks but her personality is about the same as of that of a used tissue. She is the epitome of laziness. Always trying to pass on her duties or having other people do it for her. She is habitually late, leaves early and has the ****test attitude. When we go out she orders a full side of fries ( a whole plate) and complains that she has bad genes.
Sometimes, I just want to scream.
Now this has been my experience, so anything is possible.


As far as health at any size that is complete bull****. I got up to 220lbs when I wanted to compete in bodybuilding and wasn't fat by any standards but I could rarely run more than 2-3 miles, my joints were hurting all the time, I started snoring and having apnea, it was hard to breathe going down the stairs or tying my shoes and even though I was in good shape just the extra weight was hard to carry. We have devised standards and charts for a reason. Saying that you can have health at any size it's making more excuses.
Peace on earth

Okay- no doubt there are whiners who are obese and you seem to have run into a few of them. There are also whiners who are thin. Not all obese individuals have a jolly sense of humor or a strong work ethic. Likewise, not all beautiful people can carry on a conversation.

For those of you who were never fat as a child or teenager, there are typically two ways a child can develop: 1. internalize every criticism and develop a horrible self-image and very low self-esteem or 2. develop a chariasmatic personality with very strong confidence and care about the opinions of a very select group of people whose judgment they trust.

In my experience, most people go the first route. If it is the first way, this often sets up a horrible, self-perpetuating cycle where they are being self-destructive in their diet and exercise because they don't think they are worthy to succeed or as good as everyone else. This is likely to set up a very bad relationship with food as well.

As far as the personal side goes, I understand that the obese nurse may have lacked a personality and this is the major reason you believe she is single. However, there are many vivacious, intelligent women who are obese and still single because most people, unfortunately, do not look behind the physical. There is some variation in this though depending on the race and ethnicity of the gentleman and what is considered culturally acceptable or desireable by them.
 
It has been my observation (just my opinion) that usually obese people have other problems associated with it. I am not saying it is laziness or anything, but I am saying that they lack desirable qualities.

Ok, that generalization is like saying that all Irish are drunk potato loving redheaded Catholics. And all Latinos in the U.S. are wet backs with 16 children who can't read and work as migrant laborers. Or saying that people of African decent are all somehow less intelligent based on some phoey anthropomorphic measurements of the skull. The ignorant and downright ridiculous comparisons I think can be continued until doomsday given how often one societal group maligns another.

Second, they bitched and moaned about everything and anyone but it was never their fault and never took responsibility for their actions.

Obviously, all thin and healthy people who do stupid things that hurt themselves and others take full responsibility for their actions. That's why all dead beat dads are obese right? I bet all serial killers are fat too.

Seriously, I think that nearly all obese people who have any insight at all know why they're fat (and I'm not saying that everyone does. In fact I'm cynical enough to think that most people don't have the insight it takes to get out of a bucket). And I'm pretty damn sure that most obese people, with an atom of insight, realize that it IS their actions that caused the rapid expanse of their waistline. But its a heck of alot easier to bitch and moan about others when you're working out with some patronizing personal fitness trainer and are sweaty, hot, uncomfortable, and not in your element.


I also work with a nurse in open heart surgery that is obese. She is in her late 30s and is not involved with anyone. I can tell you that people are willing to look past the looks but her personality is about the same as of that of a used tissue. She is the epitome of laziness. Always trying to pass on her duties or having other people do it for her. She is habitually late, leaves early and has the ****test attitude. When we go out she orders a full side of fries ( a whole plate) and complains that she has bad genes.

Oh goodness, there is just so much wrong here....

Sometimes, I just want to scream.

I think we finally found a point we can both completely agree on.

Sorry to jump down your throat, but a lot of things in your post drove me a little batty. And I admit it: I was an obese person. I used to have a BMI of 36. Yes, I was unhealthy. Yes, I ate like crap. Yes, I didn't exercise like I should have. Contrary to your opinion though: I had and continue to have a great number of wonderful friends, an active social life, a clean apartment, and a good work ethic. I also knew I was unhealthy and I knew exactly why. Having people shove it in my face on a day to day basis didn't help me come to some sort of 'ephiphany' about my weight. Neither did sitting in my biochem or nutrition classes make me feel guilty enough to loose weight.
I lost weight when I took the time to decide that I was worth it. Today my BMI is 22. I did it the old fashioned way which doesn't work for everyone.

Obesity, boild down to basic information IS a simple issue of mathmatics. But its at heart a multidimensional problem that requires that people change eating habits learned in childhood, find new coping mechanisms, learn new skills, and have a basic understanding of nutrition. It is about will power to some extent. But obesity is caused by the only addiction in which the addict is required to continue taking the 'juice' to live.

Having the God given sense to recognize that you're lucky not to have to deal with obesity is the first step in being able to not sound like an ass when talking about it. Yes, diet and exercise work. But some people can't do it, so don't poo-poo other weight loss options. And don't poo-poo people who don't have either enough insight to change or enough mental and physical energy to put into weightloss because they're dealing with too many other life issues.

And next time you rant on like you did think about this: Insert some minority group name for the word obese and see if you like how you sound. I'm not saying the two issues are equivalent. Just think about how it sounds and if thats the sort of individual you'd like to come across as.
 
I've also known quite a few individuals who are overweight that make up for it with a fantastic personality.

I understand that you may have good intentions. However, seriously, what is there to make up for? A person is fat, a person is thin, or a person is somewhere in between. The notion that this should be considered in our assessment of a person's quality is just preposterous.

Your statement is so dangerously close to something like, "he's very accomplished for a black man" or, "she's smart for a woman."

You people are so backward.
 
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...?

No, you're not a jerk. I think that you bring up a good point. They should be concerned, if not for their own well-being, then perhaps for the examples that they are setting for their patients. HOWEVER,, one could also argue about the people with the less-than-obvious risky behaviors, such as those who smoke, take drugs, or binge drink (this third onee, especially, is a very serious problem @ many med. schools), are doing just as much to damage their health as those who are obese.

It's easy to pick out obese medical students because you see them every day in class...Their "problem," so to speak, is obvious, exposed for all to view in plain sight...However, that doesn't make pointing them out any more right...

It's so interesting...I have a friend at a medical school in the north, and she and I have talked about this. Her class has about 2-5 obese people. Although no one says anything to these people, her classmates certainly talk badly them and make disrespectful comments (especially during clinical correlation lectures). Yet, she tells me that whenever the issue of alcohol, and it's effects, are brought up in lecture, everyone laughs and brushes it off as nothing serious, including the handful of well-known drinkers in the class...
 
I am thin as a rail but my meth habit is a tad out of control :D
 
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.

Good response.
 
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