Finding a Doc Who Sees beyond the Scale
By Beth Donovan, ~INDYGIRL
It's not easy finding a doctor you like, especially when you're overweight. Some unlucky patients are simply told that their symptoms will go away if they lose weight, without any diagnostic testing to see if there is any other underlying cause for health issues. While it is true that being at a healthy weight is optimum, it is not true that being at an unhealthy weight is the cause of all health problems. Yes, being overweight exacerbates many health issues, but sometimes there is an underlying problem that needs to be addressed--such as chronic pain or depression--before the patient can make any progress. If properly treated, a patient might feel better and thus be able to move more, and therefore lose the weight. So how do you go about finding a doctor who will look further into your situation than just what shows on the scale?
(Note: I'm not a health-care expert, but I am a strong advocate for respect for people of all sizes. These are simply some tips that worked for me and other people I know.) If you want a physician who specializes in dealing with obesity, check for doctors associated with bariatric hospitals, which are the hospitals that perform weight loss surgeries. Doctors affiliated with those hospitals have more experience with larger patients and are often more understanding of the special health issues they have. You don’t want a surgeon; you just want an internist or a primary care physician who is associated with the bariatric hospital.
If there are no bariatric hospitals in your area, opt for an internist, if your insurance and/or budget will allow.
To find the doctor who is right for you, you should first call and ask questions--before making an appointment. Explain your conditions and find out if that provider is qualified or has experience dealing with your conditions. Ask if the care provider has experience dealing with people at your weight and if they are sensitive to the issues that arise with being that weight. If you get satisfactory answers to your questions over the phone, then set up an appointment. At your appointment it is important that you are very clear about your issues and conditions, as well as how you would like to be treated.
This is what I had to do to take my health back. I had grown tired of doctors telling me to “just lose weight,” and “just get out and walk,” with my degenerative spine, herniated discs, and pinched nerves, I couldn’t. Yet, the answer I kept getting from the doctor was either have weight loss surgery or just walk. When the doctor did finally send me to one specialist, he referred to my large abdomen as “that thing” as in “Have you got any hernias in that thing?”
One specialist wouldn’t take my case because of my weight, and another told me to stop making excuses about my pain without offering any solutions to my herniated discs. My pain was debilitating, and I slowly stopped moving and began living in bed.
I also have clinical depression and am bipolar, so that needed to be addressed with medication as well. Many psychiatric medications cause weight gain, so I needed a doctor who really understood the severity of my need to lose weight and my need for sanity. My anxiety kept me awake at night eating, and my depression kept me in bed all day eating.
Why am I telling you this? Simply to show you that weight and non treatment of your other symptoms are solid reasons to go find a good doctor and take the bull by the horns.
After doing what I described in the first part of this blog, I found an internist and nurse practitioner team who helped me greatly. They were able to get me in home physical therapy, provide a walker when I got strong enough to use one, pain medications, anti-depressants and all the other things I required to get myself out of bed and moving again. They helped me with my goal of getting my life back and being able to do the exercise and lose the weight that was so crucial to my good health and well being. I am now 124 pounds thinner, and I simply started by addressing my health issues and setting Fast Break goals.
I’m not saying everyone has a bad doctor or that everyone needs medication. What I am saying is that if you’re out there and you want to take your life back, and your medical team is not giving you the tools or time of day, find a new medical team. Sometimes there are underlying medical reasons we become overweight or stay overweight and we owe it to ourselves to address those issues and have care.
Have you ever had a bad experience with a doctor or health-care provider because of your weight? What did you do about it?
It's not easy finding a doctor you like, especially when you're overweight. Some unlucky patients are simply told that their symptoms will go away if they lose weight, without any diagnostic testing to see if there is any other underlying cause for health issues. While it is true that being at a healthy weight is optimum, it is not true that being at an unhealthy weight is the cause of all health problems. Yes, being overweight exacerbates many health issues, but sometimes there is an underlying problem that needs to be addressed--such as chronic pain or depression--before the patient can make any progress. If properly treated, a patient might feel better and thus be able to move more, and therefore lose the weight. So how do you go about finding a doctor who will look further into your situation than just what shows on the scale?
(Note: I'm not a health-care expert, but I am a strong advocate for respect for people of all sizes. These are simply some tips that worked for me and other people I know.) If you want a physician who specializes in dealing with obesity, check for doctors associated with bariatric hospitals, which are the hospitals that perform weight loss surgeries. Doctors affiliated with those hospitals have more experience with larger patients and are often more understanding of the special health issues they have. You don’t want a surgeon; you just want an internist or a primary care physician who is associated with the bariatric hospital.
If there are no bariatric hospitals in your area, opt for an internist, if your insurance and/or budget will allow.
To find the doctor who is right for you, you should first call and ask questions--before making an appointment. Explain your conditions and find out if that provider is qualified or has experience dealing with your conditions. Ask if the care provider has experience dealing with people at your weight and if they are sensitive to the issues that arise with being that weight. If you get satisfactory answers to your questions over the phone, then set up an appointment. At your appointment it is important that you are very clear about your issues and conditions, as well as how you would like to be treated.
This is what I had to do to take my health back. I had grown tired of doctors telling me to “just lose weight,” and “just get out and walk,” with my degenerative spine, herniated discs, and pinched nerves, I couldn’t. Yet, the answer I kept getting from the doctor was either have weight loss surgery or just walk. When the doctor did finally send me to one specialist, he referred to my large abdomen as “that thing” as in “Have you got any hernias in that thing?”
One specialist wouldn’t take my case because of my weight, and another told me to stop making excuses about my pain without offering any solutions to my herniated discs. My pain was debilitating, and I slowly stopped moving and began living in bed.
I also have clinical depression and am bipolar, so that needed to be addressed with medication as well. Many psychiatric medications cause weight gain, so I needed a doctor who really understood the severity of my need to lose weight and my need for sanity. My anxiety kept me awake at night eating, and my depression kept me in bed all day eating.
Why am I telling you this? Simply to show you that weight and non treatment of your other symptoms are solid reasons to go find a good doctor and take the bull by the horns.
After doing what I described in the first part of this blog, I found an internist and nurse practitioner team who helped me greatly. They were able to get me in home physical therapy, provide a walker when I got strong enough to use one, pain medications, anti-depressants and all the other things I required to get myself out of bed and moving again. They helped me with my goal of getting my life back and being able to do the exercise and lose the weight that was so crucial to my good health and well being. I am now 124 pounds thinner, and I simply started by addressing my health issues and setting Fast Break goals.
I’m not saying everyone has a bad doctor or that everyone needs medication. What I am saying is that if you’re out there and you want to take your life back, and your medical team is not giving you the tools or time of day, find a new medical team. Sometimes there are underlying medical reasons we become overweight or stay overweight and we owe it to ourselves to address those issues and have care.
Have you ever had a bad experience with a doctor or health-care provider because of your weight? What did you do about it?
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Comments
Thanks for this blog! It got me thinking. - 10/20/2010 12:20:51 PM
Kudos for teaching others how to be your own advocate for getting the health care you need, and for teaching others courage. Many in the thyroid community experience the same and we have learned to become self-informed, how to discern a good or bad doctor, etc. - 7/31/2010 4:43:49 PM
After 2 weeks, my ankle still hurt (I couldn't stay home for more than a few days). I went to a different orthopedist. This one didn't say a word about my weight, but sent me to physical therapy.
Sure, doctor #2 actually took action to help me heal. But as upset as I was after visiting doctor #1, he was probably right--my weight probably did contribute to my injury. Because doctor #2 didn't say anything about my weight, I was able to dismiss doctor #1 as a quack. It wasn't until a year after seeing doctor #2 that I started taking steps to get my weight under control. Maybe if doctor #2 had said something to me about my weight and the role it played in my injury, i'd be at my goal weight by now. - 7/6/2010 2:43:48 PM
None of my doctors really seemed to have an idea of how I should lose the weight. I suspect that had they given me something to work with, I probably would have tried to lose weight sooner.
I wish doctors could be more helpful when it does come to the actual losing of the weight. - 7/5/2010 12:43:20 PM
Also, use the internet to search out information. Use reputable sites and educate yourself as best as you can.
I have hypothyroidism and for years it has been treated by my internist. Earlier this year, I finally went to an endocrinologist who was willing to aggressively treat me and today I feel immensely better for it.
Always seek out information. You will be happier for it. - 7/4/2010 3:37:41 PM
What bothers me is that I do more right things than wrong with my diet and exercise, and yet the scale does not reward me in kind, which leads me to believe there is a larger big picture issue that no one is helping me with. I'm hoping to find, using the ideas in the blog, a doctor who will take interest in me and help me to achieve my goal of becoming a more healthy person. - 7/4/2010 9:39:58 AM
I honestly don't see why it is ALWAYS necessary for the doctor office weigh-in. I went to on orthopedist for a knee injury--got weighed. Went to a dermatologist for a skin problem--got weighed. Went to the gynocologist for a test. Went back a week later to discuss the results with him--got weighed. Really? Is this even necessary? I mean, I understand when you are getting your yearly physical or have a legit problem that may be weight related, or a possible condition that may be causing weight loss/gain. But, what I would really like to do is to take a big black sharpie pen to that entire column on my patient chart.
I'm not a medical genius, but I know that being thinner doesn't automatically equate to being healthy. There are plenty of UNhealthy skinny people. Ever seen a meth-addict, Doc? I really feel for those of you that have had doctors brush you off with the "just lose some weight" mentality. I hope you have the time and/or opportunity to look into new doctors. Good luck with all your goals.
- 7/3/2010 5:36:00 PM
I am dealing with the issues of getting the correct medical care for one of my nieces at FT Gordon who fell and has had a severe back injury more than nine months ago. It has been difficult to get them to even send her to a neuralogist for her injury and not just a GP or Internist. I am sure she has L4-L5 injuries, as is her mother, but getting the proper medical care, no matter where you are at is what is needed first. If you can't get to an appropriate health care practitioner, you can not begin to address the problems. Once you find the true cause or issue, you can begin to properly treat those issues, which will help the individual progress in their healing and recovery. Then that individual can progress on their own quest for weight loss, better physical fitness and balance in their life. - 7/3/2010 5:15:03 PM
- 7/3/2010 11:25:34 AM
I did have a bad experience with a doctor who was a former military doctor~that showed through immediately! I dismissed him in the middle of labor with "GET THAT MAN OUT OF MY ROOM NOW!!!" Had a new doctor on the spot, and all went well after that. It was just for delivery of course, and then I didnt see him again, as I was back in my hometown with my warm hearted doctor.
Just recently my absolute favorite doctor's contract wasn't renewed here without warning to him or the community. He had great faith in my potential for weight loss, and knew I was seeking it, as well as having already vested years in eating healthy, exercising, and living right, without success. After blood work showing I was the ultimate bill of health where lab work was concerned he put his neck on the line funding me with the program I now represent at the same clinic as the only weight loss coach in our small town. God bless him for having the faith in me he did. He too saw I needed a couple scrips to help me with anxiety, possibly bipolar symptoms, and got me straightened out there too. His only downfall was taking a look at my 100 pound plus weight loss, and then seeing my 13 year old daughter and questioning how I could help so many others with weight loss, but not her.
Her body is still growing, bones forming, and she has severe food allergies that are literally life threatening. There isnt any way I will force her to lose weight. She is beautiful inside and out, with a great self esteem naturally. If and when she is ready I will help her, but not until she lets me know its time. Personally I call this good parenting, rather than forceful parenting. I'd feel horrible if I set her up for binge eating, anorexia, or any of the other obsessions that can come with young girls and boys who are suddenly told they arent acceptable because of their current size. Sooo this doctor who is a five star doc in my eyes, and forever shall be have agreed to disagree, and thus carry on with our relationship from there. :o) - 7/3/2010 11:01:08 AM
they don't look at symptoms...they only look at LAB VALUES...
Sometimes I think we were better off as a Nation when the Doctors were in 'it' for the HELP factor, and not the almighty dollar. - 7/2/2010 11:07:54 PM
You are spot on when saying you need a doctor, or a team of doctors to help you when you have multiple problems associated with weight gain.
I have Major & Chronic Depression, disintegrated discs in my back, Diabetes and Ischemic Heart disease. Luckily for me, my three specialists, a nurse and my GP provide me with support and advice on how to handle my different issues.
It's difficult, but if you don't accept anything but the best, things are going to look nearly insurmountable, which triggers the Depression which triggers harder blood glucose control which triggers the heart to have to work harder which . . . .
Without a good team who really has your best interests in mind - it will be a long hard road.
PS: If any doctors had made comments such as you experienced to me or my wife, they would have been reported to the state medical board (hopefully my temper would have been held in control and I just didn't smack them!). - 7/2/2010 10:50:13 PM
The office kept shuffling me around to different doctors, and when one of them ordered an MRI and it confirmed a meniscus tear, I went to see yet another doctor for a surgery consult and he didn't even have the MRI report because it was at another of their offices. Then he told me some people with torn menisci didn't need surgery, so it was optional... I guess he, too, ignored the part where I said I could barely walk. This office is, by the way, an area where most people are very thin and very wealthy, and I genuinely believe part of my sub-standard care was based on them viewing the fat lady as somewhat less than human.
I am new to the area and didn't know what to do. I finally did a google search, read some doctor ratings, and picked a new ortho surgeon that way. I lucked out, because this one knew his stuff. I had my consult, during which he told me this type of tear definitely needed surgery, and had surgery within a few weeks of the consult. And now I can walk!
It burns me up to think about those sub-standard doctors I saw who no doubt make a ton of money and live in huge houses... and kept me in pain for two months as I navigated through their incompetence, all the while paying co-pays to go see them and get the wrong information. As someone else on this board said, I really wish there were more doctors who remember they are supposed to be healers, they took an oath, and less that are in it for the money and prestige. - 7/2/2010 9:13:06 PM
Thanks for a very thoughtful - and thought-inspiring - blog, Beth :) - Sandi - 7/2/2010 8:27:27 PM
I've learned to research my own condition, find out about the medications or treatment I need, and to be as specific as possible with my doctor. Otherwise, I won't get what I need. Fortunately, my HMO allows me to select a specialist without my primary care doc getting involved. Of course, I'm doing all the work while my docs are being paid the big bucks. What's wrong with that picture??
- 7/2/2010 4:48:35 PM
I too have switched doctors a number of times over the years. Many seem to loose sight of the fact that they are healers and the employee of the patient. We patients also MUST remember that WE are the ones who have the control and power. If the care we are receiving is substandard, then WE MUST act to do something about it.
I found a wonderful physician who ultimately became MY advocate with insurance companies so that I could be approved for weight loss surgery. At a "get acquainted" visit we chatted and I told him I was not interested in losing weight at THAT time (I wasn't) and could we do business on that basis. He answered, "Yes." I knew he was a keeper! He helped me manage high blood pressure, depression and repeated bouts of bronchitis until I asked him.
- 7/2/2010 11:30:14 AM
Hugs,
WW - 7/2/2010 10:38:50 AM
This same doctor decided I was far too overweight and needed exercise. Rather than realize that if you can't walk without pain, you can't enjoy a walk, he gave me Tylenol #4, told me to take a couple and get out and walk. Needless to say, I never filled the prescription.
I have deformed bones in my feet, and my right leg is a quarter inch shorter than the left, a condition that should have been addressed when I was a child. At 45 years of age, I finally couldn't walk one morning and went to an emergency clinic. The physician who saw me there was appalled at what I had been told by the pill-pusher and did several things, three of the most important were in recognizing that in order to lose weight, I have to be able to move without pain. What he did was: a) confirm that I have a legitimate problem CAUSING my weight gain, b) ensured that I saw a reputable podiatrist to alleviate the pain in my feet, and c) gave me a form to have access to handicapped parking until my foot situation was resolved, which was about a year.
I have not even spoken to the other physician in five years. I see him in the street and cross over. I will not have anything to do with him and I will not acknowledge him when and if I do see him. His treatment of me was dismissive, irresponsible, and dangerous as I believe most overweight people are treated. We are not seen as feeling people but rather as problems that need to be shoved under a very large rug.
Finding the right physician is imperative, but there are so few of them out there. There has to be something done, but what? Far too many overweight people are living in isolation and solitude out of shame and fear of persecution. There are far too few people out there that recognize that we are the symptoms of what is wrong with a society of overeaters. We are victims of over-processed foods produced by indifferent corporations and their media hype that are only interested in the bottom line, their dollar profit. We are seen as the jokes of society and not worth being taken seriously, and that includes the medical profession. - 7/2/2010 10:10:03 AM
I have struggled with this because I feel the doctor should have taken her pain more seriously. Just because someone is overweight does not mean that all ailments are caused by that weight. Especially in my moms case. She was rather active prior to the tumor, despite her high weight. However, had my mom made healthier choices during her life she would have been at a healthier weight and may have had a better chance against cancer.
In the end it is so very important to have trusted medical advisers who treat people as individuals and respect them. Our bodies are just one part of who we are. We are mind, body and spirit. - 7/2/2010 9:43:37 AM
A chiropractor was more help - he actually did did x-rays before he made recommendations - with care, the muscles became stronger and for several years DH was able to keep himself aligned - the bulged disk and calcified bone growth several years later did require surgery but that is another story.
The moral is you do have to shop around for proper medical attention to your particular needs.
Great blog! - 7/2/2010 9:36:16 AM
But more important, thank you so much for sharing and encouraging all of us to be our advocates in our quest for health. And if the medical staff we have chosen chooses not to be in our best interest then we have the God given right to seek that medical attention elsewhere without feeling bad about it.
We wouldn't want that for our own children, so why should we be any different?
God bless you Beth for your contribution and most worthy article for sparkpeople sparkies! - 7/2/2010 9:10:37 AM
But it IS possible to find a good doctor and I urge everyone to do so, it really makes a huge difference!! - 7/2/2010 8:43:17 AM
Finding a great dr. is hard. I usually prefer females, but our family dr. is pretty good, although he is in his mid 30's, so maybe it helps that he is younger, too. - 7/2/2010 7:17:59 AM
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