Obese Med Students

[MJB]

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.

Or, some don't like sugary soft drinks.

Count me as one of those...but I'm also not a fan of McD's...not even a little bit.

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[MJB]

As for the BMI charts...I was "overweight" when I was starving myself and cutting weight for wrestling in HS at abou 3% body fat...

I weighed anywhere from 170-185 pounds...and for my height, that was "overweight".

My natural weight at that time was about 205...(if I didn't diet or do a bunch of extra workouts).

I'm the first to admit that I need to lose weight today...the football weight from college turned from muscle to fat. Taking prednisone while being treated for Hodgkin's didn't help...and doing nothing but sitting at work and sitting at home studying for the last year hasn't helped much...but I will admit it's a bit hard to take when some people that are NATURALLY slim presume me to be a sloth when it comes to my work ethic, my eating habits, or my lifestyle.

Must be tough in the military where it's part of your job to stay in shape and time is built in for you to do just that during the day.

 

[lilnoelle]

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[Azawakh]

Has anyone seen the Biggest Loser lately. It really drives home what a little exercise and healthy eating can do. They all had loads of excuses before coming on the show too.

 

[Sartre79]

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.

Talk about being way off. Come on.

 

[symphony]

If people weren't overweight before... I think it's really hard to relate. I mean, sure..it's easy to say, "lose weight, exercise.. bla bla bla," but things are not always as simple as it seem.

Think twice, evaluate thrice.

Nevertheless, I do agree that we have to practice what we preach...
..or else how are the patients going to trust us?

I suggest overweight doctors to start an exercise program with their patients (I'll strive for this once I get my M.D.).
That will be good

 

[albaniandoc]

Taciturngosamer, first of all congratulations on losing the weight and keeping it off. Many try but only few succeed. I commend you for that. I give you credit where credit is due.
Second, if you read through my post, I was very careful to articulate specifically, several times, that this has been my experience and my observation. I did not say that all obese people are lazy, just like I didn't say that all Irish are drunk potato loving redheaded catholics. Maybe you have had a different experience with obese people, so your opinion is different and you are entitled to it.
Unfortunately, there is an old saying that says that where there is smoke there is fire. It is a well known fact that Irish are famous for drinking (not all of them), just as Muslim fundamentalists are known for blowing up buildings. I have never heard of a fundamentalist drunk myself or Irish that yell Jihad. So where ever there is some social stigma it must have been started by a handful of events. We can pretty much agree that this is a fact.
Finally, I think that people do not ask to be fat or ask to be lazy, I just think life catches up with them . But I also think that we have a problem in this country called the obesity epidemics and we need to deal with it. Making excuses does not serve anyone. I actually had to write an health care ethics paper and I did about the obesity and how taxing it is on our health care system. As it turned out, my teacher did not find it very amusing and my grade dropped from a solid A to a low B. My only B in like three years.


Again, congrats on your success.

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.



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.




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



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.

 

[MJB]

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.



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.




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



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.

As Frank Slade would say...HOO-AH.....

 

[Bertelman]

Has anyone seen the Biggest Loser lately. It really drives home what a little exercise and healthy eating can do. They all had loads of excuses before coming on the show too.

Little exercise? Ha! Those people are worked to the bone, emotionally manipulated and teased with huge spreads of food while following rigorous diets.

And by the way, most of them are still obese when they leave the show.

I think it's a great show, but let's be honest. it's more than "a little exercise". It is a total lifestyle renovation.

 

[lilnoelle]

I think to a certain extent individuals who aren't obese expect too much in the way of extravagant lifestyle change in the obese. Truth be told, its more difficult for those who are obese to exercise than it is for those who are not obese. We expect an individual to come into the gym and have a "good workout" which would be far more exhausting for an obese individual. Such a difficult experience is not much for motivating an individual to continue exercising. Rather, I think we should encourage smaller lifestyle changes that are not quite as grueling, so as to lose weight slowly and build up physical stamina.
When measuring my own heart rate while returning to exercise after a long absense, I am somewhat amazed at how little effort is required to bring my heart rate up to what is a healthy rate while exercising. Generally, I end up in the aerobic exercise range without even pushing myself (i.e. jogging on the treadmill at a speed of 5.5 mph). For me then, running much harder would actually be bad for me (at least until I build up a stronger heart). I have to think then that those who are obese should be expected to take things at a much slower pace and the extreme measures that are taken (for instance in the show the greatest loser) would also be detrimental to its participants.

 

[vtucci]

Lifestyle modifications are definitely necessary for most people who are obese. Being supportive of your obese patients will go much further in helping them make these changes than being abrasive, dismissive or condescending (which is what a good deal of the medical profession does when dealing with the obese) to them. Get them to take baby steps. Work out a plan that they can actually stick to-- bring in a multi-disciplinary approach (nutritionists for those who would benefit, suggested work-out schedule-- it might be a few laps around the local mall).

As the noelle mentioned, if you have never been obese, then you do not know how painful it can be for some obese people to exercise. Pain in joints esp knees prevents running and a lot of high intensity work-outs where you can burn 700 calories in 30 minutes. It can take twice as long in a low intensity workout and that needs to be scheduled into their day. Obesity also often leads to sleep apnea and their oxygen levels may be considerably lower than most normal people to begin with-- leading to exhaustion. Many patients at the bariatric surgeon's office I went to had pulse ox on normal room air of 90 or lower without any lung diseases.

There is a minority, however, that actually do have genetic predispositions and problems and surgery is an alternative. Yes, genetic predispositions are used as an excuse by many but for some, it is real. Please do not assume that everyone who is obese is overeating and sitting on their butt watching TV all day.

 

[lumanyika]

I'm sorry if my post seems a bit crass, but it's not like these obese/overweight people we are talking about here woke up one day and in utter shock proclaimed, "whoa! where did that flab come from? i must have put on these 200 Lbs during my sleep" in front of their mirrors
I'm sure most overweight pple got that way gradually. when one's favorite clothes start feeling a little snug i think a red flag should go off in the individual's head, and immediately vow to eat 2 krispykreme (i know they suck) doughnuts instead of 4 before 10am.
The weight loss process seen in "The Biggest Looser" is a bit extreme,and as one post said, only a few overweight pple can go through it.Moderation in diet and exercise is key, but unfortunately it's not a fundamental tenet in American culture (insert Texas proverb here), and in my opinion that's why we hear all these excuses surrounding obesity...because most of these unhealthy eating habits were learned through childhood and reinforced by family and society at large.
it takes the individual to initiate and affect change in their lifestyle not the other way around. note that I'm not suggesting a complete overhaul of one's lifestyle, but minor changes to the parts that have a negative effect on one's weight.

 

[MJB]

While I tend to agree with the previous post for the most part...some people do put on weight VERY quickly...

For instance, I gained about 65 pounds in about 5 months...

I was playing football and trying to gain weight, however. When you quit playing...and exercising, the weight doesn't just come off.

Then, I gained 35 pounds on prednisone in the matter of about 3 months during chemo...That doesn't come off easy.

 

[Jiminy Cricket]

I HAVE THE PERFECT SOLUTION!!!!

All of you who are going to be plastic surgeons can operate on all the obese and ugly med students. THis way we will all have classes filled with McDreamies/Steamies and fiesty Pamela Anderson lookalike sororitudes.

I'd be game.....med schl would definitely be more interesting with more C and D students....get my drift!

Who said you have to work out to get skinny!

 

[OncoCaP]

I HAVE THE PERFECT SOLUTION!!!!

All of you who are going to be plastic surgeons can operate on all the obese and ugly med students. THis way we will all have classes filled with McDreamies/Steamies and fiesty Pamela Anderson lookalike sororitudes.

I'd be game.....med schl would definitely be more interesting with more C and D students....get my drift!

Who said you have to work out to get skinny!

I'm a guy, and I find your "solution" to be disturbing to say the least. The women in your class aren't there for your selfish enjoyment or there to serve you. If you want to be surrounded by "C" and "D" women, there are places you can go that provide this as a paid service.

 

[jdh71]

I wonder if some of the the folks here would insist that one of your patient's just quit having cancer or stop making excuses for their pneumonia . . . where's all that "compasion" you lied about while getting through medical school interviews? The problem here in this thread is not so much with the obese but the attitudes towards the obese - the contempt, the disdain, the mocking. There is quite a bit that is assumed (and you know what they say about assuming, right); that is you either have not been obese and/or struggled with obesity and are placing the issues within your own narrow paradigm. At it's heart obesity is a very complex issue. You have to first deal with the emotional/psychological issues before any of the patholphysiology can be adressed and lasting and meaningful weightloss will occur - it is the rare indiviudal for which this occurs outside of a professional setting. Overeating is simply a type of addiction - a behavioral adaptation to negative feels. In fact, many times people losing weight are actually picking up a separate addiction on the side to deal with the negative - smoking, alcohol, sex, gambling whatever - this type of transference is common throughout all the addiction spectrums. Tell an obese person "exercise more, eat less" is the same as telling an alcoholic to stop drinking - yes! the doctor has spoken and the solution is . . . why didn't the patient think about that? Like other addictions the patient will not change until the patient is ready to change and this change will not occur outside of a freindly, stable, and supportive enviroment - your disdain and disapproval is not motivational (I know that it may sound crazy that your negative opinion is not a motivator! Perhaps the negative opinions of others drives your life? If so, maybe you should stop worrying about the obese and do something about your own codependency . . .) Disapproval only breeds shame, and shame will breed eating in a predictable way. Want there to be fewer obese folks around? Try some love and understanding - you might actually become a better person for it . . .

 

[albaniandoc]

There is quite a bit that is assumed (and you know what they say about assuming, right); that is you either have not been obese and/or struggled with obesity and are placing the issues within your own narrow paradigm. At it's heart obesity is a very complex issue. You have to first deal with the emotional/psychological issues before any of the patholphysiology can be adressed and lasting and meaningful weightloss will occur - it is the rare indiviudal for which this occurs outside of a professional setting. Overeating is simply a type of addiction - a behavioral adaptation to negative feels. In fact, many times people losing weight are actually picking up a separate addiction on the side to deal with the negative - smoking, alcohol, sex, gambling whatever - this type of transference is common throughout all the addiction spectrums. Tell an obese person "exercise more, eat less" is the same as telling an alcoholic to stop drinking - yes! the doctor has spoken and the solution is . . . why didn't the patient think about that? Like other addictions the patient will not change until the patient is ready to change and this change will not occur outside of a freindly, stable, and supportive enviroment - your disdain and disapproval is not motivational (I know that it may sound crazy that your negative opinion is not a motivator! Perhaps the negative opinions of others drives your life? If so, maybe you should stop worrying about the obese and do something about your own codependency . . .) Disapproval only breeds shame, and shame will breed eating in a predictable way. Want there to be fewer obese folks around? Try some love and understanding - you might actually become a better person for it . . .

For someone that seems to point fingers at people assuming, you certainly do quite a bit of it yourself.

Dude, get over it. You are telling me that out of a huge obesity epidemics, all of these people have emotional and psychiatric issues. If that was true than besides an obesity epidemics we have a national psychiatric epidemics as well. Please, that's only making excuses. My real beef is not with people being obese because that who they are, but with making excuses. I would like to meet one patient that says: Look man, I cannot stop eating and I know I am killing myself. I am the only person to blame. Not my problems, not McDonalds, not the doctor, me. Is that too hard to admit. But instead people make excuses and try to pass blame and come up with **** like: Health at any size.

 

[Jiminy Cricket]

I wonder if some of the the folks here would insist that one of your patient's just quit having cancer or stop making excuses for their pneumonia . . . where's all that "compasion" you lied about while getting through medical school interviews? The problem here in this thread is not so much with the obese but the attitudes towards the obese - the contempt, the disdain, the mocking. There is quite a bit that is assumed (and you know what they say about assuming, right); that is you either have not been obese and/or struggled with obesity and are placing the issues within your own narrow paradigm. At it's heart obesity is a very complex issue. You have to first deal with the emotional/psychological issues before any of the patholphysiology can be adressed and lasting and meaningful weightloss will occur - it is the rare indiviudal for which this occurs outside of a professional setting. Overeating is simply a type of addiction - a behavioral adaptation to negative feels. In fact, many times people losing weight are actually picking up a separate addiction on the side to deal with the negative - smoking, alcohol, sex, gambling whatever - this type of transference is common throughout all the addiction spectrums. Tell an obese person "exercise more, eat less" is the same as telling an alcoholic to stop drinking - yes! the doctor has spoken and the solution is . . . why didn't the patient think about that? Like other addictions the patient will not change until the patient is ready to change and this change will not occur outside of a freindly, stable, and supportive enviroment - your disdain and disapproval is not motivational (I know that it may sound crazy that your negative opinion is not a motivator! Perhaps the negative opinions of others drives your life? If so, maybe you should stop worrying about the obese and do something about your own codependency . . .) Disapproval only breeds shame, and shame will breed eating in a predictable way. Want there to be fewer obese folks around? Try some love and understanding - you might actually become a better person for it . . .

I hate obese people.....they cramp my style!


I think i want a bigger penis too.....

( this thread is ******ed and my comments are all jokes)

 

[Jiminy Cricket]

Hey guys....i know, lets screen the obese people out in med schl interviews.....that way patietns will have good role models and i can get some help for this yeast infection that is growing inbetween my folds.....

 

[SlammaJamma]

There were no fat cavemen.

When concentration camps were liberated, there were no fat prisoners (cruel but true).

Most of the time there's just no excuse. Apart from the things you would die for, what's more important than your health?

 

[jdh71]

For someone that seems to point fingers at people assuming, you certainly do quite a bit of it yourself.

Well, if you are not looking at obesity through the eyes of someone who's been there, then what paradigm would you be using? I'm not making an assumption merely stating a fact of human nature. We all approach life through lenses colored by our own experiences - our own paradigm - we try to wrench all of life into this mold. We are confused by that which does not conform and assume others are wrong while we are right. This is human, and based on your attitude, I was not making an assumption merely pointing out your obvious bias. Further, I said *IF* you are driven by the opinions of others - if being a qualifier, followed by a suggestion - none of which were "assumptions". If the opinions of others are your motivation, then it is qite possible you do need to spend a little more time with your own codependency - look it up - and less time pointing the finger at others. Whats your issue? Just get over it!

Dude, get over it. You are telling me that out of a huge obesity epidemics, all of these people have emotional and psychiatric issues. [sic]

Yes when spekaing of primary obesity and not obesity 2nd to chronic medical condition of side effect of medication.

If that was true than besides an obesity epidemics we have a national psychiatric epidemics as well. [sic]

There is a psychological epidemic here - not everyone needs to services of the medcations provided by the psychiatrist

Please, that's only making excuses.

Describing the disease model is making exuses - how? Is the alcoholic or drug addict "making excuses"?

My real beef is not with people being obese because that who they are, but with making excuses. I would like to meet one patient that says: Look man, I cannot stop eating and I know I am killing myself. I am the only person to blame. Not my problems, not McDonalds, not the doctor, me. Is that too hard to admit. But instead people make excuses and try to pass blame and come up with **** like: Health at any size.

Are you a premed or a first year? Did you spend any time around addicts on your psych rotation? Addicts blame everyone but themselevs - alcoholics will tell you, "you'd drink too if you were married to her!". Ha! You can see the behavior of the addiction clearly. It's classic. Furthermore there are no excuses in any addiction - no one is responsible for you but you and that means the obese are responsible for their own obesity the same way the alcoholic is repsonsible for his disease. treatment comes about when the patient recognizes for himself that he has a problem. this realization is apparent only in the setting of love, care, and support.

the over eating is no more the disease than the drinking of the alcoholic - these are symptoms of what lies beneath.

 

[albaniandoc]

Well, if you are not looking at obesity through the eyes of someone who's been there, then what paradigm would you be using?
Yes when spekaing of primary obesity and not obesity 2nd to chronic medical condition of side effect of medication.



Are you a premed or a first year? Did you spend any time around addicts on your psych rotation?

Again, making assumptions. How do you know that I have never been obese? How do you figure that I am a first year student?
I am actually a 27 year old, who has been an RN for a few years. I start med school in August.
And yes I have had psych experience. I have also had 350+ lbs patients that took a **** in bed because they were too lazy to go to the bathroom (nothing else physically wrong) and asked for the nurse and the exact words were: I just shat myself, clean me.
I have also had patients with blood sugar well into the 300s and still wanted a big dinner. In fact I mentioned that the blood sugar was in the 300s and the response was: So, I still want my dinner.

So, I am not just talking out of my ass. I have had experience with obese people as a personal trainer, fitness instructor and registered nurse.

 

[jdh71]

Are you a premed or a first year? Did you spend any time around addicts on your psych rotation?

Again, making assumptions. How do you know that I have never been obese? How do you figure that I am a first year student?
I am actually a 27 year old, who has been an RN for a few years. I start med school in August.
And yes I have had psych experience. I have also had 350+ lbs patients that took a **** in bed because they were too lazy to go to the bathroom (nothing else physically wrong) and asked for the nurse and the exact words were: I just shat myself, clean me.
I have also had patients with blood sugar well into the 300s and still wanted a big dinner. In fact I mentioned that the blood sugar was in the 300s and the response was: So, I still want my dinner.

So, I am not just talking out of my ass. I have had experience with obese people as a personal trainer, fitness instructor and registered nurse.

No assumptions, merely asking a few questions. You're a first year. That makes sense.

You are talking out of your ass. You no have understanding or experience in any area related to the psychology of this disease - making you rather irrelevent and obsolete to the discussion.

 

[vtucci]

Well, if you are not looking at obesity through the eyes of someone who's been there, then what paradigm would you be using?
Yes when spekaing of primary obesity and not obesity 2nd to chronic medical condition of side effect of medication.



Are you a premed or a first year? Did you spend any time around addicts on your psych rotation?

Again, making assumptions. How do you know that I have never been obese? How do you figure that I am a first year student?
I am actually a 27 year old, who has been an RN for a few years. I start med school in August.
And yes I have had psych experience. I have also had 350+ lbs patients that took a **** in bed because they were too lazy to go to the bathroom (nothing else physically wrong) and asked for the nurse and the exact words were: I just shat myself, clean me.
I have also had patients with blood sugar well into the 300s and still wanted a big dinner. In fact I mentioned that the blood sugar was in the 300s and the response was: So, I still want my dinner.

So, I am not just talking out of my ass. I have had experience with obese people as a personal trainer, fitness instructor and registered nurse.

It is unfortunate that you had a patient who was content to sit in their own filth. The fact that you do not see that they likely have some underlying mental issue which may be compounding their obesity is interesting. Normal people do not respond this way- it is a very primitive instinct to avoid defecating on ourselves.

Also, as a RN and trainer, you should know that for diabetics, their bodies feel as if they are starving because they cells cannot properly take up the glucose due to years of insulin hypersensitivity (if they are Type II) or from a complete inability to synthesize insulin (Type I). Consequently, I am not surprised that a patient with a blood sugar in the 300s was hungry and wanting to devour a huge meal. It happens. They certainly need better blood glucose control--likely in the form of higher doses of insulin (or metformin etc). Until you are a diabetic and know how they feel, it might be wise to be compassionate and understanding and work with them so together you might help them overcome their obstacles to healthy living.

 

[albaniandoc]

No assumptions, merely asking a few questions. You're a first year. That makes sense.

You are talking out of your ass. You no have understanding or experience in any area related to the psychology of this disease - making you rather irrelevent and obsolete to the discussion.

Ok, I am going to stop responding to this post at this point since it has become pointless. Your message reminds me of a typical sleazy defense attorney method of avoiding the real issue by personally attacking, belittling and discrediting the witness. This does not speak highly of your intelligent argument skills.
If I had to make an assumption about you it would be that you are using excerpts from your book and have no life experience. Whatever it is I wish you the best of luck dealing your obese patients.

PS: Next time use the spell check button before posting. It only lowers your credibility when your sentences make no sense.

Peace out

 

[med_heidelberg]

If you want to lose weight, spend 3 months in the Andes, hike all day, do hard labor, and eat potato and barley soup 3 times a day. I lost a ton of weight this way. Not that I was fat before, but it definitely had an effect.

 

[psipsina]

It is unfortunate that you had a patient who was content to sit in their own filth. The fact that you do not see that they likely have some underlying mental issue which may be compounding their obesity is interesting. Normal people do not respond this way- it is a very primitive instinct to avoid defecating on ourselves.

I've never understood when people respond this way. Someone is behaving in a manner that is obviously a sign of deeper psychological issues, and health proffessionals respond with anger or disgust. If we can't understand this how can we expect society to?

I have a family member who has struggled with obesity and has pathological eating habits. She once finished a one of those huge christmas tins of caramel covered popcorn in a sitting, and really didn't even realize she had done it. After much therapy she realized she ate to comfort herself since she had never dealt with being sexually abused as a child. Whenever she felt bad, she ate instead of confronting her experiences because they were so painful for her. If you saw the way she ate you would totally be repulsed, but as a health proffessional a light bulb should go on over your head and cue you into the fact that something more was going on than just overeating. As her physician it would be your responsibility to help guide her to the support she would need to confront the underlying issues rather than just telling her to stop being such a pig.

 

[ny skindoc]

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.

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? 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 (which does not mean becoming unfat; losing just 10% of body weight will often do it).

Obesity and potential cancer risk:http://www.cancer.gov/cancertopics/factsheet/Risk/obesity

 

[souslepont]

Has anyone seen the Biggest Loser lately. It really drives home what a little exercise and healthy eating can do. They all had loads of excuses before coming on the show too.

Yes, we all have the time (and the energy!) to exercise for four hours a day.

 

[jdh71]

Ok, I am going to stop responding to this post at this point since it has become pointless. Your message reminds me of a typical sleazy defense attorney method of avoiding the real issue by personally attacking, belittling and discrediting the witness. This does not speak highly of your intelligent argument skills.

I wasn't trying to belittle you, in fact my opinion of you and none of your business (think about it). I was trying to make two points, 1) you are a first year medical students which means you have no experience with the material of psychopathology or any time dealing with patients within this paradigm and 2) you have no personal experience being obese. You likened me to a sleazy laywer . . . well, if you are not an expert, why is your "expert" opinion valid. You have not the knowledge or experience to make a relevant point.

If I had to make an assumption about you it would be that you are using excerpts from your book and have no life experience. Whatever it is I wish you the best of luck dealing your obese patients.

You would be assuming wrong then. I am a recovering drug addict and alcohlic - 3 years sober (with clean urines to prove it) who has struggled with weight my entire life - the same reasons I used drugs and alchol are the same reasons I used to overeat. My own recovery and work with those who are starting recovery has given me world of insight. All of this has been substantiated by modern psychological and psychiatric thought as I found through my medical studies.

PS: Next time use the spell check button before posting. It only lowers your credibility when your sentences make no sense.

Peace out

I know when people start attacking my spelling, they have nothing left and . . . I've won

Peace

 

[albaniandoc]

You would be assuming wrong then. I am a recovering drug addict and alcohlic - 3 years sober (with clean urines to prove it) who has struggled with weight my entire life - the same reasons I used drugs and alchol are the same reasons I used to overeat. My own recovery and work with those who are starting recovery has given me world of insight. All of this has been substantiated by modern psychological and psychiatric thought as I found through my medical studies.

Peace

I know I said I would not respond but after reading this all I can say is WOW.
This explains everything. First, I commend you for your work and recovery. I think that everyone that has had to deal with your problems and has turned around like this needs to be congratulated.
After reading your posts I realize that there is still so much that you are still dealing with. The fact that without anyone accusing you, you jump to offense and offer the urine samples brings up your insecurities.
Again, this is the internet and this site is used for entertaining purposes and honestly I am just not interested in a personal vendetta. I expressed my opinion for what is worth. So I honestly wish you the best of luck and hope that you are successful in everything you do.
God bless

 

[jdh71]

I know I said I would not respond but after reading this all I can say is WOW.
This explains everything. First, I commend you for your work and recovery. I think that everyone that has had to deal with your problems and has turned around like this needs to be congratulated.
After reading your posts I realize that there is still so much that you are still dealing with. The fact that without anyone accusing you, you jump to offense and offer the urine samples brings up your insecurities.
Again, this is the internet and this site is used for entertaining purposes and honestly I am just not interested in a personal vendetta. I expressed my opinion for what is worth. So I honestly wish you the best of luck and hope that you are successful in everything you do.
God bless

What you said sounds a lot like truce, and I agree there is no need to escalte any of this further. Good luck this year (in many ways the hardest part is over).

 

[45408]

At it's heart obesity is a very complex issue. You have to first deal with the emotional/psychological issues before any of the patholphysiology can be adressed and lasting and meaningful weightloss will occur - it is the rare indiviudal for which this occurs outside of a professional setting. Overeating is simply a type of addiction - a behavioral adaptation to negative feels. In fact, many times people losing weight are actually picking up a separate addiction on the side to deal with the negative - smoking, alcohol, sex, gambling whatever - this type of transference is common throughout all the addiction spectrums. Tell an obese person "exercise more, eat less" is the same as telling an alcoholic to stop drinking - yes! the doctor has spoken and the solution is . . . why didn't the patient think about that?

Then why has the level of addiction increased by such magnitude? I think you're looking too deeply here. You're looking at emotional/psychological reasons, but I think it's clear that the problems are socioeconomic.

 

[Tired]

Then why has the level of addiction increased by such magnitude? I think you're looking too deeply here. You're looking at emotional/psychological reasons, but I think it's clear that the problems are socioeconomic.

Wait, so getting back to the original theme of the thread:

If the overall consensus is that obese people have underlying emotional/psychological issues that they haven't dealt with, does that mean we should be keeping them out of medical school until they "deal with their issues"?

And if TheProwler is right, and it's more an issues of socioeconomics, should obese medical students get more financial aid (so they can buy healthier food)?

(Not that I'm intentionally trying to start s*it here, but this thread has cracked me up so much, I can't bear to see it die . . .

 

[BeatrixKiddo]

Wait, so getting back to the original theme of the thread:

If the overall consensus is that obese people have underlying emotional/psychological issues that they haven't dealt with, does that mean we should be keeping them out of medical school until they "deal with their issues"?

And if TheProwler is right, and it's more an issues of socioeconomics, should obese medical students get more financial aid (so they can buy healthier food)?

(Not that I'm intentionally trying to start s*it here, but this thread has cracked me up so much, I can't bear to see it die . . .

har har harh ahrhahrhahhrharhahrhahrahhaaaarhhharharhh har har har har har

 

[EMT2RN2MD]

If you want to lose weight, spend 3 months in the Andes, hike all day, do hard labor, and eat potato and barley soup 3 times a day. I lost a ton of weight this way.

Amazing! But, that doesn't come in a bottle, or require psychotherapy. Good luck getting research dollars from the deep pockets "big pharma" or NIH to prove your point.

 

[jdh71]

Then why has the level of addiction increased by such magnitude? I think you're looking too deeply here. You're looking at emotional/psychological reasons, but I think it's clear that the problems are socioeconomic.

Modern life with all it's stresses compounded by emotional psychological trauma from our youth from increasing broken families is the generally accepted reasons for the increase. Man as a species either evolved or was created to live best within a certain paradigm - that of the functioning family unit. Todays modern world has created a selection pressure for which the species is doing its best to adapt. Addictions are nothing more than a immature emotional survival mechanism. The psychological literature on this is very interesting.

Socioeconomic reasons merely contribute more stress. You find more addictions across the board in this demographic.

 

[jdh71]

Wait, so getting back to the original theme of the thread:

If the overall consensus is that obese people have underlying emotional/psychological issues that they haven't dealt with, does that mean we should be keeping them out of medical school until they "deal with their issues"?

And if TheProwler is right, and it's more an issues of socioeconomics, should obese medical students get more financial aid (so they can buy healthier food)?

(Not that I'm intentionally trying to start s*it here, but this thread has cracked me up so much, I can't bear to see it die . . .

Everyone's got underlying emotional and psychological issues. I'd love to see many medical students deal with their workaholism and perfectionism - to keep folks out of medical school for these reasons . . . well . . . you'd have no more medical students. FYI, the literature shows all addicts score high on perfectionism . . .

 

[45408]

And if TheProwler is right, and it's more an issues of socioeconomics, should obese medical students get more financial aid (so they can buy healthier food)?

(Not that I'm intentionally trying to start s*it here, but this thread has cracked me up so much, I can't bear to see it die . . .

I was implying nothing of the kind.....

But the US has got a significantly growing obesity epidemic (pun intended), and it's due to a lot of things - like the fact that almost no one can walk to work, or that the US puts a premium on being busy and having "lots to do," which precludes going to the gym for 4-8 hours a week.

 

[45408]

Modern life with all it's stresses compounded by emotional psychological trauma from our youth from increasing broken families is the generally accepted reasons for the increase. Man as a species either evolved or was created to live best within a certain paradigm - that of the functioning family unit. Todays modern world has created a selection pressure for which the species is doing its best to adapt. Addictions are nothing more than a immature emotional survival mechanism. The psychological literature on this is very interesting.

Socioeconomic reasons merely contribute more stress. You find more addictions across the board in this demographic.

then why haven't we seen a similar drug explosion?

 

[jdh71]

then why haven't we seen a similar drug explosion?

we have

 

[Good Mountain]

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...?

What about the fact that 50% of the physicians smoke?

 

[BeatrixKiddo]

What about the fact that 50% of the physicians smoke?

Smoking is fun and cool. It's never cool to be fat.

 

[45408]

we have

 

[BeatrixKiddo]

I was implying nothing of the kind.....

But the US has got a significantly growing obesity epidemic (pun intended), and it's due to a lot of things - like the fact that almost no one can walk to work, or that the US puts a premium on being busy and having "lots to do," which precludes going to the gym for 4-8 hours a week.

I laugh at fats logon ahahahahahh ahhaha see hahahahahahha hmwahahahahha mwamahahahahha

And pretty peoples laughs at me hahahah hahhwhahwahhah ahhammasahah

Oval of life knawmean

 

[jdh71]

yeah, all those meth addicts are funny. the addiction to heroin is on the rise. cocaine and marjiuana are being used increasingly too.

yet you laugh like an idiot? ignorance is bliss - at least that's how the saying goes. please let me know where you are going to train or are training so that I may avoid that institution like the plague . . .

 

[Tired]

Smoking is fun and cool. It's never cool to be fat.

Also, when you can't taste anything, you can drink spoiled milk and not really mind. At least until the diarrhea starts . . .

 

[45408]

yeah, all those meth addicts are funny. the addiction to heroin is on the rise. cocaine and marjiuana are being used increasingly too.

yet you laugh like an idiot? ignorance is bliss - at least that's how the saying goes. please let me know where you are going to train or are training so that I may avoid that institution like the plague . . .

Ah, the inevitable ad bad doctor argument. You're as reliable as a Timex, my good man.

 

[jdh71]

Ah, the inevitable ad bad doctor argument. You're as reliable as a Timex, my good man.

It wasn't an argument

 

[45408]

yeah, all those meth addicts are funny. the addiction to heroin is on the rise. cocaine and marjiuana are being used increasingly too.

yet you laugh like an idiot? ignorance is bliss - at least that's how the saying goes. please let me know where you are going to train or are training so that I may avoid that institution like the plague . . .

Anyways, before you ride that high horse for too long, here are some statistics to mull over. You stated that "we have" seen an explosion in drug usage akin to the obesity epidemic.

http://www.whitehousedrugpolicy.gov/publications/factsht/druguse/index.html#general

These are the people who admit using illicit drugs in the past year, by age group, comparing 1979 to 2001.

12-17 Decreased
24.3% in 1979
20.8% in 2001

18-20 Decreased
45.5% in 1979
31.9% in 2001

26-34 Decreased
23.0% in 1979
16.1% in 2001

35+ Increased
3.9% in 1979
6.3% in 2001

Overall (12+) Decreased
17.5% in 1979
12.6% in 2001

"In 2001, an estimated 0.7% of the population age 12 and older reported using cocaine, including crack, at least once in the past month. Such use peaked in 1979 for 18- to 25-year-olds at 9.9%; in 1982 for 12- to 17-year-olds at 1.9%; and in 1985 for 26- to 34-year-olds at 6.3% (table 2)."

"2005 Monitoring the Future Survey Shows Continued Decline in Drug Use by Students"
http://www.drugabuse.gov/newsroom/05/NR12-19a.html

"The survey also found that the rise in use of MDMA (ecstasy) in teenagers seen over the past 2-3 years slowed from 2000 to 2001 among students in grades 8, 10, and 12. In addition, rates of heroin use decreased notably among 10th and 12th graders, and a gradual decline in use of inhalants continued in 2001 with a significant decrease occurring among 12th graders."
http://www.drugabuse.gov/MedAdv/01/NR12-19.html

"The 2005 NSDUH results also indicate that there were 192,000 persons aged 12 or older who had used methamphetamine for the first time within the past 12 months. This is a statistically significant reduction from 2004 when there were 318,000 past year methamphetamine initiates."
http://www.whitehousedrugpolicy.gov/drugfact/methamphetamine/index.html




And on the other hand, you have the obesity stampede of McDonalds-goers in the morning:
(direct link to the CDC's powerpoint presentation: http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/obesity_trends_2005.ppt )

Here's the summary. You go from 10-14% obesity rates in every state (less than 10% in some), to a situation where only three states have less than 20% obesity. I showed you a rising, nationwide increasing trend in obesity, and a nationwide decreasing trend in drug usage. Fire away.