This post was written by Jessica Lopez of Jefferson Corporate Communications.
There are a couple sources you might turn to when you resolve to lose weight—the first being Google, the next being the colleagues you share a cubicle with who swears that they lost ten pounds from a soup diet they read about. Both sources could give you wholly inaccurate, and possibly dangerous ways to drop the extra pounds.
It’s no coincidence that most weight-loss programs and quick-fix diets are rarely successfully long term. Losing weight safely and keeping it off over time is a lifestyle change that is unique to each individual person. Your primary care doctor (PCP), can be you navigator through this journey and your biggest cheerleader.
I sat down with Janine Kyrillos, MD, FACS, the director of the Jefferson Comprehensive Weight Management Program at Bala, to discuss some ways you can approach the topic with your doctor, what you’ll need to bring to your next appointment, and what to do if you feel judged by your doctor.
Some patients may be shy or hesitant to discuss their weight with their doctor. Can you offer some insight in how to bring up concerns with weight, or the desire to start a weight management program?
Most people feel that being overweight is their own responsibility that they know what to do to lose weight, but that they just don’t do it. That actually isn’t the case. There are so many factors that contribute to someone’s weight that they may not realize or that may not be in their control. Obesity is a disease, not a character flaw. There are ways your physician or provider can help that you may not know about. By just showing you’re interest in talking about it will open up the conversation.
Realize that your doctor may not want to bring it up. A recent study, called The ACTION Study, which looked at patient and physician perceptions regarding treatment of obesity, found that 65% of the physicians they questioned said they didn’t bring up a patient’s weight because they thought the patient would be too embarrassed to discuss it—but only 15% patients in the study actually said they would feel embarrassed.
And remember to allow time. Don’t wait until your doctor’s hand is on the door to say, “Oh, by the way…” Your best bet is to schedule a visit just to discuss weight loss and a weight loss management program that will work for you.
What kind of information will your PCP take into consideration when you express that you would like to lose weight?
You’ll need to tell your doctor where you’ve been. Have you already lost weight and want to lose more? Are you at a plateau? Have you been seeing a diet doctor that sells you medication and gives you shots? Have you lost and gained weight so many times that the thought of a diet makes your blood boil? Unfortunately, many doctors assume people aren’t motivated or interested in losing weight. You may need to tell them otherwise.
Be honest about what you’re eating. Better yet, bring in a food log of everything you’ve had to eat and drink in three typical days. If your doctor doesn’t understand where you struggle, he or she won’t know the best way to help.
Bring in a list of all your medications and supplements. Many medications can affect your weight. Your doctor may be able to adjust medications that could be interfering with your weight.
If you are seeing a new doctor, bring in any lab results that you’ve had done in the past couple years. Reviewing your blood tests will help your doctor identify metabolic changes associated with your weigh which will help to guide treatment.
What are some of the ways to lose weight that your PCP could suggest outside the obvious calorie restriction and exercise?
If your doctor basically tells you to eat less and move more, he/she may not really understand the complexities of weight management. That’s like telling someone with asthma to just breathe less.
Weight management is so much more complicated than counting calories. The type and quality of the food you eat matters much more than the calorie count. We are finally realizing that low calorie, low fat diets actually promote weight gain in the long run. A hundred calories of butter and a hundred calories of sugar affect your hormones and metabolism very differently.
There are many other factors your doctor may address that affect your weight such as sleep, stress, activity level, quality of your food, timing of food, medications you take, family history, etc.
Can you discuss the dangers of losing weight in unhealthy ways? Are the things people should be wary of when selecting a weight loss program?
Many people get dietary advice from friends, trainers, books, miracle, online programs, etc. The best diet is a lifestyle you can live with long term. Quick cleanses, fad diets, and expensive supplements are costly, can make you sick, and usually don’t work. Also, severe calorie restriction or binging and purging can be very dangerous and affect your metabolism.
Any other thoughts you would like to add?
If you feel dismissed or judged by your doctor when discussing your weight, you may consider seeing someone else, or even kindly explaining that their thinking is outdated and unhelpful. Weight management is not about willpower. There are lifestyle changes, interventions, medications, procedures, and surgeries that can have long lasting, life changing effects.
There are now doctors who are specially trained in treating excess weight. I am board certified by the American Board of Obesity Medicine and a member of the Obesity Medicine Association. If your PCP doesn’t know an obesity medicine specialist to recommend, you can search for one through either of their websites.