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Doctors and Obesity: What Can You Do?

Doctors are as puzzled about obesity as the rest of society. I know this because I am a physician and I am also obese.

For the doctors, you give patients all of the wisdom you gained from years of studying, the best coaching you can muster, and they fail to improve. After awhile, simple human nature takes over. Obese patients seem unable to follow directions, fail to lose and maintain weight loss, keep getting sicker, and they ruin your day. For the doctor that means frustration that turns into anger, then resentment, then resignation and apathy.

The real problem for doctors is that they don’t have the proper tools for treating obesity. Current treatment for obesity addresses lifestyle – portion size, food selection, exercise – all necessary for weight loss. But actual obesity is a brain disease – disordered neurotransmitters trying desperately to manage a very stressed supersized body with toxic and inadequate nutritional substrate for fuel. Pushing the gas pedal harder doesn’t get a broken car to run faster or better. The good news is that brains are plastic, they can heal.

So what can the obese patient do? Your doctor hates fat. If that’s true, you are partners, and can forge ahead trying different options together. Some will work for you, some will not, some will work for awhile. Address the addiction and depression/anxiety and emotional eating that invariably accompany obesity. Watch out for medications that increase your appetite. Move a little, change something everyday, reawaken your curiosity, eat the highest quality food you are craving – you will eat less of it.

Hopefully your doctor is mature enough not to hate fat people. If that is the case, change doctors. You do not need to endure additional suffering.

Go forth in good mental health!

Sara L. Stein, M.D.
Author, Obese From The Heart: A Fat Psychiatrist Discloses

reprinted comment in response to LA Times article October 22, 2009 | 11:23 am

Extra pounds, and attitudes about them, can affect doctor-patient relationships

Posted by: Sara L Stein, MD | November 05, 2009 at 08:28 AM

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