Do some doctors just get a kick out of telling you to lose weight?

[Crawdle]

Saw my gp for the first time in years. He commented that I looked very well (told him I have lost 30 pounds with about a stone until I am in the normal bmi range).

Anyway, as we were talking about how to treat the issue I went in for he was looking at his computer when he said “okay and then we really do need to get your weight under control to bring you into the healthy BMi range, it will be extremely beneficial”

Like okay?? I told the gp I’m on track to be in the healthy range by my birthday (end of summer). We even discussed my plans to go on a special trip to watch a sporting event for a few mins!

He said all this whilst his gut (MUCH larger than mine) was pressed against the desk.

AIBU to find this very annoying?!

He just took on a very serious tone when he said it. No “you’re getting there blah blah”

What kind of help would you like to offer?

Part of the appointment where he asked me what menopause symptoms I was struggling with - mostly weight gain despite healthy eating, exercise, PT, etc - he referred me to a dietician/nutritionist.

He then asked if the frozen shoulder I’d had previously was any better as he said he thought there were some indirect links to menopause. I said the previous times had resolved, but I had it again. He referred me again.

I don’t understand how you can say that you talked about your trip and details of your weight loss but still think the whole thing was impersonal just because he told you that the condition you were there to talk about will be affected by your weight. He was just doing g his job and telling the truth.

You haven’t said that your problem was ignored completely or that you didn’t get treatment so presumably you were happy with everything else about the appointment. You also make a nasty dig about the doctors weight, so this seems like it’s more of a problem with you than the doctor.

She didn’t. It was just by sight. I wouldn’t mind but my BMI was about 26!

@Sesma the only difference between a clinician and a non-clinician is that one has been educated and trained in medicine, and the other hasn’t. Clinicians don’t have magical powers to resist all the temptations that non-clinicians are subject to. Yes our increased awareness probably makes us more likely to be healthy, but ultimately we’re human, and we have failings, just like everyone else.

It may have prevented some of Covid though, in those times it was quite apparent many were overweight.

But surely that is subjective? We are talking about a stranger and how they viewed that conversation. Being fat causes A LOT of serious health conditions. In type 2 diabetes you can actually reverse it with weight and blood sugar level management.

How could doctors losing weight prevent their patients getting Covid?

Do you think that we don't notice that GPs seem to see us as a nuisance, and that they would prefer to commune with their computers than with their patients?

A lot of these comments show how uneducated people are and have no idea what doctors and other HCP have to do when seeing patients. How do you know what their job entails? It would be like going to a bank for debt advice, then asking you questions, which they need to do for their job, then getting in a huff because they’re asking you questions and advising you on how to reduce your debt. Then making a comment about the worker having some debt. If you’re fat you know you are fat. Lose weight don’t lose weight. No one really cares.

Overweight and obese people know they need to lose weight. Unless your condition would directly benefit from weight loss, I don’t think it should be brought up and I think it can make people avoid going to see their GP.

@IMadeSomeReal Well we can’t often refer to dieticians as they won’t see straightforward overweight people for weight management any more, but our HCAs are trained to offer advice. We can prescribe orlistat, which is not as effective as mounjaro but works for a lot of people. We can signpost people to reputable mounjaro prescribers. People with a high enough BMI can be referred to secondary care to go down the bariatric pathway. And of course we have leaflets, but in this age of internet such things aren’t really needed. We can refer to exercise classes and gyms.

But the hardest part is suggesting that someone’s weight is having a negative impact in the first place. This is often met with a barrage of excuses and denials, and also aggression. Recently I had a man get right in my face and scream at me that I couldn’t possibly understand what his life was like because I was a rich privileged doctor who had no idea about real life. And of course it’s evident from MN that any mention of weight is considered offensive. So lately I keep my mouth shut. I’m not prepared to take abuse just for doing my job.

My Doctor told me I’m too fat last week. Sadly he’s right .

I wasn't fat though, my BMI was under 20 and I was told I could probably lose some weight, this was many years ago but I haven't forgotten it.

I mean it’s their job to treat patients so no I don’t think that and seems you’re projecting your own experiences to rather than facts. GPs have to document every single patients visit. There are serious consequences if they do not do this. This is not something that GPs are HCP want to do, as it takes up time that could be used with a patient. Documentation was set up by a higher authority, not nurses or GPS or HCP. Surely you can understand they have to record the patient visit?

But being fat is not healthy. Even if you don’t have any other conditions, you have more visceral fat that literally squashes your organs and a highly percentage of developing long term health conditions over a slim person. These are facts. Same goes to an underweight person, they also have a greater risk of bone disease or heart failure because of their lack of weight. If someone had a drug problem would you not bring it up because they might get upset? Even if that drug problem is causing major health problems?

Alcoholics know they need to give up boozing.

Smokers know they need to give up smoking.

Vapers know they need to give up vaping.

Drug users know they need to give up using drugs.

None of that means doctors should be forced into silence about those things.

Who told you this? A doctor? A nurse a HCA? If your bmi was less than 20 why didn’t you say you weren’t overweight? Or where was the evidence to support their claim you were overweight?

I am slim now, but all I am saying is I didn’t need a doctor to tell me I was fat unless I came with a health condition directly caused by being fat. Most fat people know what a healthy diet looks like and how to lose weight in theory.

I asked for help with my weight a year ago at my GP surgery and was told there was nothing they could do (I had a BMI of 40!). I went for a Mounjaro private prescription, but the GP couldn't advise as they apparently didn't know anything about it. Seems the help available is very variable!

@LottieLamaz I believe there is evidence that advice from a HCP increases the chances of people successfully modifying their lifestyle - dieting, quitting smoking, reducing alcohol etc. That is why the GP contract requires these brief interventions.

Everyone knows that smoking is bad for you, but I think a smoker is more likely to try and quit if a clinician mentions it in passing when discussing something unrelated.

We all know how easy it is to drift along and ignore that habits we have that aren’t good, and sometimes having someone draw attention to it is the push we need to make changes.

Ugh, so annoying when they do that. In my country we pay quite a bit for healthcare, and there have been a few times I've paid to see a doctor only to be diagnosed as fat! Yes doctor, I am aware that I'm a bit overweight, but can we also look at my health issue please?

I disagree with you. I would want to go to my GP if I was sick without being told I am fat. Respectfully.

I understand that if I came with backache or diabetes then it would be something which would be discussed. If I come with an ear infection, I don’t need to be told I need to lose weight .

Ruddy HCPs trying to help people. Just because we don’t want to hear that losing a bit of weight might help our health, doesn’t stop it being true. Friends and family are the ones to praise us for our previous efforts, not doctors on a 10 min appt.

@LottieLamaz studies have demonstrated that brief interventions have a beneficial impact on behaviour. It may not work for you, but the overall evdience suggests it does for most people. This is what has lead to GPs being required to document eg smoking status, and add a code for advice given.