Comments on: Patients less likely to trust and listen to overweight doctors

By: fluff

fluff — Wed, 01 May 2013 01:39:06 +0000

No I don’t think its evolutionary. It is the Western culture and media who successfully program people to think a certain way. When i was a little girl, innocent, my smiling chubby grandma was the loveliest thing in the world, her weight was not an issue to me, nor anyone else. Our Dr wasn’t thin either by today’s standards. I have weight on due to multiple endocrine problems, unfortunately my son gets picked on for my obesity. People are ignorant and cling to the last ‘ism’ they are allowed.
I read comments under newspaper articles and marvel at people’s harshness and lack of empathy, they usually represent the ‘popular’ attitude programmed into them :(.
Sadly looks seem to be everything now, even respect and ability to do a job has been brought into looks. Very sad.

By: Jon Wade

Jon Wade — Wed, 27 Mar 2013 22:06:33 +0000

It works both ways. When I was studying health sciences with the OU we discussed how doctors sometimes treat overweight patients differently – they feel that they will not make a real effort to follow a prescription etc.

Seems to be some level of mistrust with overweight people – could it be evolutionary? Fat people must be eating more than their fair share and not to be trusted in the group?

By: Tom

Tom — Mon, 25 Mar 2013 12:22:40 +0000

I’m a doctor that used to be overweight (“obese” in fact, according to BMI). After a year and a half eating lower carb/paleo I am now a relatively lean BMI 26 (perfectly healthy for someone who is quite muscular), and have gone from squeezing into size 38 trousers to enjoying shopping for 34 inch waists.
Losing weight has been bittersweet for me: mostly sweet as I feel more confident, healthier etc. but it has outlined the prejudice overweight people are subject to. I feel my patients – in fact, pretty much everyone – gives me more attention, respect and so on.
I fully agree that you don’t want to take advice on weight loss from someone who is obese. But assumptions go way beyond that; getting labelled as fat and lazy, greedy and so on, when in fact I am very much the same guy I was two years ago. We (low carb/primal eaters) of all people should be sympathetic to our overweight friends, colleagues and healthcare providers as we know that they may be trying really hard, but as they have been grievously misinformed about the likely cause of their weight problem and how to manage it effectively, are not seeing results and are becoming disheartened and depressed.
Let’s keep it positive and try to correct people’s misinformation, rather than criticise and mock; they will have had plenty of that already.

By: Chloe

Chloe — Mon, 25 Mar 2013 09:00:30 +0000

Many people are overweight despite ‘knowing’ what they should be eating – I know lots of very overweight dietitians, for example. Other issues come into play, emotional, social, stress-related issues.

I’m a hypnotherapist and am very aware that if I were to be overweight, or bite my nails for example, it would cause people to lose faith in me.

Many people see the isdea of cutting out bread from their diet as too ‘out there’ and unrealistic. Hopefully soon low carb eating will be more mainstream and less far outside of people realms of what is realistic for them.

By: Craig

Craig — Sun, 24 Mar 2013 15:53:58 +0000

The original image you posted of Mark Sisson is typical of the kind of vitriol that is spat between each camp of nutritional advice. Though the image you posted is light-hearted, there really does exist this desire to discredit the other camp through things like body image, or how they died.

It’s why people say that Dr. Atkins died of heart disease – As if to discredit the diet he spent years advocating (http://lowcarbdiets.about.com/od/atkinsdiet/a/dratkinsdeath.htm).

It’s sad… Some people can do fine on grains and carbohydrates. There is more merit in athletes using them. But for the general population, eliminating or limiting carbohydrates is sound advice that will cause no harm.

By: donald

donald — Sat, 23 Mar 2013 22:03:43 +0000

Absolutely Galina , I found the web link you sent very interesting but I would always consult my GP as well in such matters . That is the point I was attempting to make by splitting type 1 into two sub types , obviously all type 1 are people without clinical experience as a health practioner , however , if there are two patients with undiagnosed Hasimoto’s Thyroiditis , they both see a type 3 practioner then , to me it highly likely that a type 1(b) patient will have a better health outcome than a type 1(a).
Today has been very educational !

By: Galina L.

Galina L. — Sat, 23 Mar 2013 18:07:39 +0000

Just some clarification, I don’t want to tell that every other person who can’t tolerate cold has a Hashimodo decease, my message is that all that is not a very clear issue. Many people may have low-thyroid symptoms after a successful weight-loss. I noticed a tendency on a blogosphere to blame LC and paleo diets for low-thyroid symptoms, while it is just a part of our body normal reaction to resist the weight loss.
We can’t relay on doctors alone to sort out all health issues. We have to learn how to manage our health and properly listen to our bodies.

By: Dr John Briffa

Dr John Briffa — Sat, 23 Mar 2013 17:28:12 +0000

Donald

By ‘clinical experience’ I mean clinical experience as a health practitioner.

Thyroid autoantibodies are not routinely checked for in my experience, which is part of the problem, I think.

By: donald

donald — Sat, 23 Mar 2013 17:24:13 +0000

Thanks Galina & John
I do think (1) should be split in to 2 subgroups ,(a) people who take little interest in their health and are unable or unwilling to learn , you only need to look at junk food sales to see how big this group is, & (b) people who try & live healthily & are actively interested in health & desire to learn more , I hope I & most (if not all) your blog readers are type 1b !
Fair comment re test , I was just curious as to whether thyroid antobodies are routinely tested for by British GP’s .

By: Dr John Briffa

Dr John Briffa — Sat, 23 Mar 2013 17:14:07 +0000

Donald

If you have no medical experience then you have no clinical experience, probably, so it sounds likes 1. applies.

I don’t know what your GP tested for so I can’t comment on whether or not the test would normally pick up Hashimoto’s. The condition is normally diagnosed when what’s called ‘thyroid autoantibodies’ are present.

By: Galina L.

Galina L. — Sat, 23 Mar 2013 17:08:28 +0000

Donald, it is great that you are looking for the second opinion. As I understand, there is a disagreement even between medical professionals about what it normal when it comes to the thyroid test results. In my case symptoms were present even with normal lab results after I started to take synthroid until I changed my medication for natural pig-derived thyroid (it contains T3).
May be you would find that blog interesting – http://www.stopthethyroidmadness.com/

By: Donald

Donald — Sat, 23 Mar 2013 16:47:18 +0000

Hi John
Hopefully none of them ! I claim no medical experience , I tend to be sceptical of both “sides” of an argument initially & try & do my own research on reputable websites both independent & government/official body backed . In this instance I commented based on the writings of a GP who , with hindsight appears to fit category 3. On Further research it seems the incidence is somewhat higher than my initial research led me to believe , my error.Apologies. I found this online which gives a higher incidence than the first article & I am happy to accept your word that you believe it to be underdiagnosed. http://emedicine.medscape.com/article/120937-overview#a0156
Can you clarify one thing for me please , when my GP took a blood sample & told me (2 days later) that it was normal would such a test normally pick up Hasimoto’s , or should I be requesting a further test ? (50 yr old male , primary symptom marked decrease in cold tolerance in last two years)

By: Paul

Paul — Sat, 23 Mar 2013 14:48:16 +0000

One definition of insanity is, “undertaking the same task over and over again, but expecting a different result”.

So, with a 95% failure rate of dieting, one would question whether the ‘eat less, move more’ mantra has any place in weight loss advice.

It follows that an obese health care professional who suggests such advice yet for whom it has clearly not worked on a personal level (and probably on several occasions), and who would have seen many patients who have failed, is clearly insane.

‘Insane’ is an entirely rational conclusion for a patient to arrive at if being ‘advised’ by an overweight GP, or nurse.

By: Dr John Briffa

Dr John Briffa — Sat, 23 Mar 2013 14:16:59 +0000

Asclepius

Thanks for that – very funny and very relevant!

I’ve put the strip at the bottom of the post.

By: Dr John Briffa

Dr John Briffa — Sat, 23 Mar 2013 14:08:03 +0000

Galina L and Donald

I see Hashimoto’s thyroiditis (and other forms of hypothyroidism) regularly in my practice, and hypothyroidism is a quite common cause of excess weight in my experience.

In my view, those who say these issues are rare are:

1. people with no clinical experience

2. people with clinical experience who see patients vastly different to the ones I see (unlikely)

3. people with clinical experience who don’t often consider and test for Hashimoto’s or perhaps thyroid disease generally (see Galina’s comment above)

4. people who believe that all overweight people must be lazy and/or greedy and that hormonal issues (including thyroid disease) are largely an ‘excuse’

Donald – do any of these apply to you, do you think?