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Dr. Vash describes the best way for an obese patient to approach a weight loss plan with her physician.
Dr. Vash:
One of the things that’s upset me as a treating physician is when people, patients come in to me and they have given me a history of how they have been treated by other physicians, and I am really, really upset, seriously, about that interaction with other physicians.
I want to give women some tips when they are meeting their physician or healthcare provider about weight loss, and one of the first important things is please take ownership of this issue. It’s a problem that you can solve with good medical advice. Do not shy away from asking the physician, “I have a problem. I know I have a problem. I want to change this. Will you help me change it?”
That opens the whole discussion up where the physician is taken off guard and says, “Wow, I have a patient that recognizes the problem, is not defensive. They want to have help and they will listen to what I am saying.” That’s a whole different dynamic than, “I gained the weight. It’s not my problem. I don’t know what it is. It must be my metabolism.” Well it’s not your metabolism. Less than five percent of obese patients have a metabolic problem.
So take ownership of that; ask the physician to help you. Now, he or she has to be a caring physician who will work with you. Don’t settle for a patronizing response. “Oh, a little weight won’t hurt you. Suzy, your daughter will grow out of it. A little weight is not that bad. Don’t worry about it. It’s probably your age. Most women gain weight after menopause. Don’t accept that. You don’t need to.
There’s no reason why you shouldn’t be healthy and have the weight that you want. We want a realistic weight. If you are 250 pounds getting down to high school weight of 112 is not realistic. Should you have to stay 250 or it’s very difficult, no, even if you got down to 195, not a go weight, but it’s less than 250. That weight reduction, by reducing your fat will reduce your risk for chronic diseases. You will feel better. You will look better and you will have a better quality of life.
One of the things that I have told patients and that kind of knocks them back in their seats is that I lean forward and I tell them, “Look, your weight, your obesity is not going to kill you outright but it will certainly maim you. It will cause you to lose your eyesight. You’ll have kidney disease. You’ll have heart disease. You’ll have your knees go out and your back go out. Who wants to live another 25 years in chronic, unmitigated pain?”
Take the challenge. Give yourself that benefit of weight loss. Work with me. I’ll work with you. You ask your questions, I’ll answer them. Work with me. I promise we can get some of that weight off you.
About Dr. Peter Vash, M.D., M.P.H.:
Dr. Vash is an Assistant Clinical Professor of Medicine at the Center for Health Sciences at the University of California, Los Angeles (UCLA). He is a Board Certified Internist specializing in Endocrinology and Metabolism, with an emphasis in obesity and eating disorders.
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