Gp's And Obesity

The original post was interesting though the finding in the survey were not surprising. Many of the now 'clued up' HCPs have commented about how little they were taught about dietics but most others carry on in blissful ignorance, possibly due to time pressures and also here in the UK due to NICE/NHS guidelines being completely outdated.
It's hard to condem anyone for being obese as 60% of the population now is; as the primary cause are the legacy of wrong dietary guidelines going back at least 30 years and the large amounts of carbs/sugars in convenience foods.

The simple solution is - education, education, education and more education for HCPs and the general population.

BTW - I bought Dr Aseem Malhotra's " Pioppi Diet" for my Kindle to read on holiday. It is absolutely brilliant and goes into very many aspects of diet, exercise, lifestyle and health. I've now bought a hard copy as I want to be able to flick back and forward and have the recipes handy. Just about the best book on diabetic diet etc I've found.

A GP told my Mother she had strained her groin that it would right itself an a few weeks, to keep mobile and to do plenty of walking but on no account to use a walking stick. Not the best advice to someone who consequently ended up walking for 12 weeks on a fractured hip. With a son who deferred to the doctors expert knowledge after all he was a MD, instead of his own good sense. The worst and most stupid words ever that issued from my stupid mouth were "No mum your not to use that stick the doctor says not to"

Having a medical degree does not make you infallible or all knowing I have no guru with or without a degree in medicine.

miahara said:

It's hard to condem anyone for being obese as 60% of the population now is;

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According to the NHS it is 25%

lindisfel said:

I don't think you guys by being extreme encourage health care professional to engage in this forum, which is what I would have hoped.
D.

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I am not encouraged to even visit my GP because of his attitude towards my obesity. It isn't worth the upset. I am prone to depression anyway, I am doing all I can to lose weight. If any HCP is reading this thread and won't engage with us because of what we say..... well it may be a good thing for them to realise that's how some obese patients feel about GP appointments. As I said earlier they are there to serve us, not the other way round. If my comments make even one HCP feel ashamed about the way they treat patients...then good!....now they know how it feels to be obese and have to visit a doctor.

zand said:

I am not encouraged to even visit my GP because of his attitude towards my obesity. It isn't worth the upset. I am prone to depression anyway, I am doing all I can to lose weight. If any HCP is reading this thread and won't engage with us because of what we say..... well it may be a good thing for them to realise that's how some obese patients feel about GP appointments. As I said earlier they are there to serve us, not the other way round. If my comments make even one HCP feel ashamed about the way they treat patients...then good!....now they know how it feels to be obese and have to visit a doctor.

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I am afraid Zand I have misjudged the amount of anger that exists amongst patient that feel failed by the health service and direct their anger at GPs.

In actual fact the politicians who have deprived the health service of funds and its the financial and commercial interest that minulates the food base and science. They need to change and then the base of medicine will change.
D.

lindisfel said:

I am afraid Zand I have misjudged the amount of anger that exists amongst patient that feel failed by the health service and direct their anger at GPs.

In actual fact the politicians who have deprived the health service of funds and its the financial and commercial interest that minulates the food base and science. They need to change and then the base of medicine will change.
D.

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It doesn't cost anything to encourage someone rather than knock them down though does it? My nice doctor managed it and I felt confident enough to go to him about a non malignant lump that was worrying me and also about a Dupuytren's contracture. I wouldn't go to my current GP about those things because he judges me for being obese.

I don't think the majority of doctors would change their attitudes even if money was ploughed into the NHS and even if real science (not manipulated science) was allowed out into the open.

See how easy it is to judge? I'm doing it too aren't I?

Meanwhile an impotent government let's another child go to death's door when they can't import canabis oil into N.I. to save a child's life and they promised a changed policy.
Off course the so called regulation led E.U. can use canabis oil so they can't blame the EU.
D.

zand said:

It doesn't cost anything to encourage someone rather than knock them down though does it? My nice doctor managed it and I felt confident enough to go to him about a non malignant lump that was worrying me and also about a Dupuytren's contracture. I wouldn't go to my current GP about those things because he judges me for being obese.

I don't think the majority of doctors would change their attitudes even if money was ploughed into the NHS and even if real science (not manipulated science) was allowed out into the open.

See how easy it is to judge? I'm doing it too aren't I?

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JohnEGreen said:

A GP told my Mother she had strained her groin that it would right itself an a few weeks, to keep mobile and to do plenty of walking but on no account to use a walking stick. Not the best advice to someone who consequently ended up walking for 12 weeks on a fractured hip. With a son who deferred to the doctors expert knowledge after all he was a MD, instead of his own good sense. The worst and most stupid words ever that issued from my stupid mouth were "No mum your not to use that stick the doctor says not to"

Having a medical degree does not make you infallible or all knowing I have no guru with or without a degree in medicine.

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I know the problem John they can stick together but are just a fallible as we are.
D.

I have never have been obese so I cannot speak from personal experience, but I have had far worse health problems to deal with and fortunately I had developed the inner ability to know how to push on doors and get treated.
I hope we can help others get help without antagonising HCPs.
D.

Tannith said:

There was a BBC news article bout 4 years ago about why GPs did not address weight with their overweight/obese patients who came with other problems. On the "Have your Say" at the bottom one GP commented "They cry"

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Indeed. I am a trainer and do not like to upset my clients either. I think I saw GPs on HFW s programme on obesity being trained in how to raise the topic and get pracice staff to regularly weight patients prior to a consultation. There were no crying patients and some came out saying stuff like ' I did not know I was obese,,,' and ' I did not realise that being overweight could effect my knees...' So maybe it would be wise to draw attention to the elephant in the room, if its relevant, if not particularly comfortable at first.

NicoleC1971 said:

Indeed. I am a trainer and do not like to upset my clients either. I think I saw GPs on HFW s programme on obesity being trained in how to raise the topic and get pracice staff to regularly weight patients prior to a consultation. There were no crying patients and some came out saying stuff like ' I did not know I was obese,,,' and ' I did not realise that being overweight could effect my knees...' So maybe it would be wise to draw attention to the elephant in the room, if its relevant, if not particularly comfortable at first.

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So you raise the question of weight with a client/patient then what? The OP clearly states that HCPs themselves know they need retraining in obesity and further that the majority feel the that the reason for obesity is overeating. No use having info in front of you without the necessary skills to address the underlying problem.

lindisfel said:

amongst patient that feel failed by the health service and direct their anger at GPs.

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nope. i dont feel failed. I AM failed. And i do not think we are directing our anger at GP's etc, judging from what I am rading on this thread. The anger if for the Power That Be, but there is avoidance to engage with the lower ranks, as they have to toe the NHS mantra, and so their advice is useless and positively harmful to us, so why see them?

lindisfel said:

but I have had far worse health problems to deal with and fortunately I had developed the inner ability to know how to push on doors and get treated.

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I dont really know how to answer that one except to say that, having not been obese, perhaps you dont realise the way it affects everything in life, including mental health and bullying and total strangers commenting and ridiculing you.

Knowing how to push doors and get treated: well, thats Ok if you can get someone to listen, get someone to give you the treatment.

I get the impression that you haven't grasped what some of us are up against here.

Guzzler said:

So you raise the question of weight with a client/patient then what? The OP clearly states that HCPs themselves know they need retraining in obesity and further that the majority feel the that the reason for obesity is overeating. No use having info in front of you without the necessary skills to address the underlying problem.

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What treatment would you suggest they need to offer?

Mr_Pot said:

What treatment would you suggest they need to offer?

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Far be it for me as an iddy biddy patient to suggest anything and I'm not the one being consulted and I'm not the one who, apparently, should never be questioned.

This discussion reminds me of an appointment I had a few years back with a clearly overweight (if not obese) locum diabetes consultant.
He glanced at my records and looked at me, rather concerned: "You need to take care; your weight has gone up in the last year." I was surprised as I have always been slim so I just shrugged. When I later looked at the results, my BMI had increased from 21.5 to 22.
This guy was not a GP but it showed me not to expect health care professionals to understand weight management.

Guzzler said:

Far be it for me as an iddy biddy patient to suggest anything and I'm not the one being consulted and I'm not the one who, apparently, should never be questioned.

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Maybe in a lot of cases the doctors don't have a solution, apart from diet, either.

Mr_Pot said:

What treatment would you suggest they need to offer?

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Individualised diet plans would be great now that technology enables this approach but I suspect the main problem here is getting a consensus other than the Eatwell plate model which seems to fail for so many diabetics and others too.
Since GPs do already send people to commercial weight loss organisations they could refer to the Low Carb programme on this site too if it gets the relevant clinical approval.
The x-pert health programme is aimed at pre diabetics and diabetics and is available more widely across the country. Again they take a low carb approach although do discuss the alternatives.
For some people it does seem that bariatric surgery is a highly cost effective and successful way to treat obesity but does seem to be rationed and that rationing has a moral element to it unfortunately.
At present it seems that getting a consensus on what works which is backed by evidence seems to be the hardest thing and I do think the market would respond to the demand for effective diaobesity management programmes.

Mr_Pot said:

Maybe in a lot of cases the doctors don't have a solution, apart from diet, either.

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They admitted as much in the OP poll.

Mr_Pot said:

Maybe in a lot of cases the doctors don't have a solution, apart from diet, either.

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I think it would be helpful for the HCP's to be more open to different types of diet, listen and record patient experience and enter it on a national database for future dietary advice to be based on. I think it would help to be listen to respectfully by HCP's and have our efforts and results acknowledged. I think it would also be helpful to have the Eatwell plate removed from its demi-god status and be simply a range of dietary ideas to try.

I am speaking in general, not for T2 dietary advice specifically, although a seperate data base of what has worked for T2s wouldnt come amiss either.

Its the refusal to listen to the patient, and the dismissal of any results which waver from the Eatwell plate which I find so dogmatic, rude, ignorant and harmful (yes, I am a tad frustrated by this)

I have on my medical notes that, after being part of a drug trial 25 years ago, I put on 7 stones in 6 months and the weight has refused to come off. I am not the only one this happened too, it harmed my liver (which has since recovered). I have 6+ years of HbA1c results showing my low carbing has significantly lowered my bs without a significant weight loss (2 stones over 6 years, which were additional weight i put on after the drug trial ended) yet i still get the Your Fault, Eatwell Plate mantra.