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Should I change doctors?

AthenorAthenor Battle Hardened OptimistThe Skies of HiigaraRegistered User regular
I've been tossing around the idea of changing my primary care physician for a while now, but I'm not sure if it is fear, annoyance, or something else.

About 2 years ago I finally visited the doctor for the first time in a long time. I was recommended to a general practitioner that was part of one of the bigger regional hospital networks around here, and that I knew my insurance would cover. I did this because at the time I was starting to walk/get more healthy, and I wanted to do that whole "consult a doctor" thing. Plus I wanted to get some things looked at.

The doctor is an extremely nice guy, and has stuck it out with me, even when I haven't been following his recommendations. However, he seems singularly focused on my weight. He keeps wanting to check in on me on a monthly basis, and has put me on a few different drugs to try and help get my weight down, including a water pill that I think has messed with me a bit.

Any time I bring up something that I think is wrong, he kind of does a quick "okay, I'll refer you to X." the net results of that are finally getting to see a counselor (which has led to me going on antidepressants as of about a week and a half ago), getting treatment and therapy for a self-inflicted case of lymphedema in my legs (wearing too tight socks for too long and hurting my lymph nodes), getting through a series of sleep studies and getting a CPAP, and getting my blood pressure down to more reasonable levels.

However, I still kind of dread seeing him, and as a result put off going if I can find any excuse to, which usually amounts to working more. I do like the hospital network as a whole, and the specialists I've seen.. But I'm just not sure about the doctor himself.

The thing is, he always brings up how we're going to beat this, and stick it out, and constantly repeats himself on advice. The last couple of visits he's been pushing a pre-set meal plan that's fairly aggressive, but I'm not ready to invest in yet. I know I need to make changes, eat healthier, and so on, but I'm trying to get my own house in order yet. So having a doctor see me for 15 minutes to go over stuff I already know and check my weight, and then charge me X amount, just.. it gets to me.

It's especially annoying when the doc says that other than my weight and the above-mentioned things, I'm in extremely good shape, health wise. Cholesterol and all those other risk factors are normal. I haven't done some of the normal screenings I figured I'd get as a 30-year old man, but when I first visited him he said he wanted to take care of my weight before doing any of that testing.

So I'm just kind of unsure about where to go. I don't mind visiting the doctor, but I want there to be some kind of worth to it. And it feels like his goals don't line up to mine, at least where I am now. I have a goal to be around 300lbs (I'm currently 425 or so), but that's like 2-3 years off. And monthly checkups just seem to bug me. But then there's the whole thing about finding a new doc and all that...

I know I'm an adult, and I can just pick another doctor. But I feel like that would be insulting him, or giving up, or all that.

Sooo.. does anyone have any advice on finding doctors, or should I stick with my current one?

He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
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  • DevoutlyApatheticDevoutlyApathetic Registered User regular
    What do you want the doctor to tell you?

    From what you've said he's addressed your specific problems promptly and effectively (lymphedema and sleep apnea) and is now working on the remaining problem. That your remaining problem isn't a quick fix and is something that involves a major lifestyle adjustment is pretty much why he has to constantly raise the issue, constantly provide positive support and in general be a pain in the ass about it.

    If you don't want to address it then don't. You can tell your current doctor this and see how things go from there. He is pretty much professionally bound to tell you it's a bad idea.

    If you want a doctor to tell you it's okay to ignore a major risk factor then you're looking for a doctor who will give you bad medical advice which seems like a horrible idea.

    Nod. Get treat. PSN: Quippish
  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    I'm not looking for a doctor to ignore my needs. It's just the constant 1 month checkups over a period of about a year or so that seem excessive. Even 2 month checkups I think I'd be fine with. And as for promptly and effectively, not really.. it took mentioning the lyphedema thing a few times before he sent me to that specialist. The sleep apnea took a while to get rolling too, though I think a large part of that was insurance related.

    i know I'm at high risk. I also know I'm not producing results, because I keep falling back into bad habits easily, especially with my current living condition. And I know that another doctor would say the same thing to me. I just wonder if the visits are excessive.

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • NewblarNewblar Registered User regular
    If your health is poor enough that you need monthly visits then generally a decent doctor will bring up your weight and how to make changes because otherwise they aren't really doing their job. If your goal is to stay alive than your doctor’s goals and yours are pretty well aligned. He keeps on mentioning your weight because it’s a serious health concern likely being a primary factor in your current health issues and something that will likely kill you long before your time and significantly lower the quality of your life.

    He keeps on repeating his advice because you’re ignoring it. I’ve been where you’ve been with some other poor health choices and unfortunately I ignored everyone’s advice for pretty much ever until my health kicked me in the ass and let me know if I didn’t change things I was looking at a pretty crappy future. Don’t be me make your needed changes sooner.

    [SIGPIC][/SIGPIC]
  • NightDragonNightDragon 6th Grade Username Registered User regular
    Just to state the obvious...have you asked to see him once every two months, instead? That doesn't seem like an unreasonable request IMO. Every month may be his preference but you could always ask if every other month would be okay for the time being.

    Just don't use that as a means to slow down on your progress! Keep with it, whatever happens.

  • DevoutlyApatheticDevoutlyApathetic Registered User regular
    Athenor wrote: »
    I'm not looking for a doctor to ignore my needs. It's just the constant 1 month checkups over a period of about a year or so that seem excessive. Even 2 month checkups I think I'd be fine with. And as for promptly and effectively, not really.. it took mentioning the lyphedema thing a few times before he sent me to that specialist. The sleep apnea took a while to get rolling too, though I think a large part of that was insurance related.

    i know I'm at high risk. I also know I'm not producing results, because I keep falling back into bad habits easily, especially with my current living condition. And I know that another doctor would say the same thing to me. I just wonder if the visits are excessive.

    I am only guessing but frequent visits as often as that seem to be trying to build up the support, the desire and the strength needed to make the changes he thinks you need to. Do you think you will be more or less likely to break those bad habits if you have a visit each other month instead of each month?

    Right now, to me, it seems like what he is doing all stems from trying to help you make difficult changes. It is completely natural to resist change and look for a way to avoid those who are trying to make us change. It's annoying to be reminded each month that you haven't changed and you're still endangering yourself. You know damn well you didn't do it. You also know that there is a large difference between knowing what you need to do and being able to do it. The first step to breaking those bad habits is to stop ignoring them...like with monthly reminder sessions.

    If you're really serious about this being annoying then talk to him about reducing your visit frequency. Most physicians are realists and know that harping on this stuff drives patients away but they're professionally obliged to try. I strongly suggest before you do this you be absolutely brutally honest with yourself about what this will do to the likelihood of you being healthier.

    I'm sorry to be harsh about this but you're too nice a person for me to tell you otherwise.

    Nod. Get treat. PSN: Quippish
  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    The thing is, I think I am getting better overall. In the last few months I've been getting out more, changed jobs, got a car, started house hunting so I'm no longer living with my parents, treated those long-term health issues, started on anti-depressants, and so on.

    Yeah... I think I'm just scared of bringing up my desire for 2 month checkups. And I may be projecting my frustration. I think I've just been focusing on other things.

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • The EnderThe Ender Registered User regular
    i know I'm at high risk. I also know I'm not producing results, because I keep falling back into bad habits easily, especially with my current living condition. And I know that another doctor would say the same thing to me. I just wonder if the visits are excessive.

    ...It's hard to say.

    How much do you weigh, and how much weight do you intend to lose over what period of time? Are you meeting your weight loss goals, and are you more or less likely to obtain your ultimate weight goal without a monthly check-up schedule?

    With Love and Courage
  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    I'm currently around 420-425, down from a high of around 450-460 last year. However, I'm up from the 410 I was at before the holidays. I still want to be down to 300 or so in about 5 years time. I'm not meeting my goals, but my goals weren't set by me - the doc is wanting me to lose about 5-10 poinds a month. And I don't know if I'm more likely to meet things, as I have this habit of rebelling against authority figures, which I'm working through with my counselor.

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • ceresceres When the last moon is cast over the last star of morning And the future has past without even a last desperate warningRegistered User, Moderator mod
    edited April 2014
    If you can't handle making dietary changes on your own and sticking to them, or don't for some reason think that NOW is the best time to start doing that stuff (it always, always is), then that's likely why he's pushing the preset meals - you need to take away the element of planning you don't have the headspace to do right now (and with it the option of making those poor decisions), because your weight is a problem NOW and the longer you leave it, even if you think "yeah this is something I can tackle in 6 months", even 6 months is basically contributing to a skillion health problems that are building inside you and will continue to do so faster and faster as you age. This is basically the true story of why my knees are shot even though I don't look that heavy right now.

    You can say "it's just a little longer till I can deal with this" when you're talking about 20-30lbs. You are not. At your weight you are a ticking time bomb of concern and you will be as long as you find reasons to put off dealing with it directly. I know you know that. This isn't something that you can say is a goal to be completed 2-3 years down the road and so you don't have to worry about it until you get other things in order, and just cram it all in at the last minute like a book report or doctoral thesis. That 2-3 years takes into account that you are starting to do something about it NOW.

    Do the preset meals he's talking about, at least until you can "get your house in order," as you say. And keep seeing him. He has already done so much to help you, even making a plan that he's willing to follow up on with you that often; I don't think you understand how rare and wonderful that is. I don't think going to see him every month is meant to give you a bunch of new information; it's to help keep you on track, because seeing where you're at, restating goals, and reassessing frequently, as well as monitoring your body's condition are all important and helpful things. I don't think you should see him less, and I DEFINITELY don't think you should see someone else. Hang onto this one with your life because he sounds AMAZING. He's not repeating himself a bunch for his own health, he is helping you take this huge goal on month-by-month and giving you a clean slate to work from each and every time you see him. Each visit marks a new month and a new leaf you can turn over.

    ceres on
    And it seems like all is dying, and would leave the world to mourn
  • h3nduh3ndu Registered User regular
    edited April 2014
    Athenor wrote: »
    I'm currently around 420-425, down from a high of around 450-460 last year. However, I'm up from the 410 I was at before the holidays. I still want to be down to 300 or so in about 5 years time. I'm not meeting my goals, but my goals weren't set by me - the doc is wanting me to lose about 5-10 poinds a month. And I don't know if I'm more likely to meet things, as I have this habit of rebelling against authority figures, which I'm working through with my counselor.

    At your current weight (especially if you're a male), losing 5-10 pounds a month is very much doable; I only say this as encouragement. He wants to meet monthly so that he can chart out your progress and help motivate you. He can't be there weekly or daily to encourage or track your progress so he has to settle for the next best thing. In a two month period, without encouragement or support you could easily gain back or simply go no where with your weight. The longer you push the meetings apart the more likely it is that no progress or retrograde will occur. Once he sees positive progress in the right direction he'll be willing to extend the time between check ups - because at that point he will trust you to make positive choices in the weight loss department.

    That's (likely) his logic.

    If he has a plan structured that you don't agree with, then tell him. Ask to slow it down. Understand though, that he's trying to help you help yourself. Cutting off your nose to spite your face by finding a new doctor isn't going to help you - especially because the next one is going to tell you exactly the same things and will hope to motivate you to see the exact same progress that he is trying to produce in you. My advice would be to try and follow exactly what he advises - for your current health and for your hopeful future. The vast majority of doctors who care about your health will probably do exactly what he is doing.

    Edit: a healthy lifestyle can change a lot of things for a person - especially their perspective. You can achieve your goals man! It just takes adamant persistence, and a real desire. Don't give up, and don't let fear get in your way.

    h3ndu on
    Lo Que Sea, Cuando Sea, Donde Sea.
  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    Heh. And this is why you reach out to friends and people you trust for an outside perspective.

    I'll look into the meal plan. Maybe I'll get over my fear of not getting to eat what I want.

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • CauldCauld Registered User regular
    One thing that's helped me with doctors overall is to realize that they're people too and I should expect them to act like people. In the end you're the consumer and you should only continue to be a customer there if you're happy with the service you're getting. His job is to provide you with quality medical care/advice, but it's your choice to listen to it. I would imagine there's a good reason he wants monthly appointments, but ultimately you're the one scheduling and going to them.

    If you'd be happier only going every other month, then bring it up to him and see if there's some way you'd both be comfortable with fewer checkups, maybe all he really wants is to check your cholesterol level every month (for example) and you could do that without meeting with him.

  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    Oh no, it's purely weight, temperature, and blood pressure follow-ups. I've only had 2 tests of cholesterol, and they are both normal to low for my size.

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • ceresceres When the last moon is cast over the last star of morning And the future has past without even a last desperate warningRegistered User, Moderator mod
    Athenor wrote: »
    Heh. And this is why you reach out to friends and people you trust for an outside perspective.

    I'll look into the meal plan. Maybe I'll get over my fear of not getting to eat what I want.

    Nobody, and I mean nobody, has that fear worse than me. I could write you a book about my emotional attachment to food, and how it's built throughout my life, and the different things I do to try to combat it which work sometimes better than others.

    Seriously.. a doctor willing to design a plan for you to help you take things month-by-month.. and then willing to actually follow up with you? Marry him if you have to.

    And it seems like all is dying, and would leave the world to mourn
  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    I should clarify - he's a GP, he's not the one building the plan. He's recommending going to the hospital's program.

    No part of me wants surgery or anything like that, but they offer structured meal plans and such.

    http://osfweightmanagement.com/

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • CambiataCambiata Commander Shepard The likes of which even GAWD has never seenRegistered User regular
    This is kind of a hot button topic for me, but I'll try to make my remarks minimal and not turn this into a debate. The most important thing to remember is: fat, by itself, is not the pass or fail indicator of health that people like to believe it is.

    One example (and not, by a long shot, the only study of this nature that exists):

    http://junkfoodscience.blogspot.com/2006/11/obesity-paradox-1.html*
    Several studies this week have tried to explain what is being called the “obesity paradox:” the fact that most fat people actually live longer than thin people.
    At this week’s meeting of the American Heart Association, yet another study was reported which found that fatter cardiac patients were more likely to survive hospitalization and invasive treatments than thinner ones, even when adjusting for age and other contributing factors. In this analysis of 130,139 heart disease patients, 5.4% of “normal” weight patients died, as compared to 2.4% of “obese” and 3.1% of “overweight.” Yes, those whose were “obese” were more than two times more likely to survive!
    ...

    While many may be incredulous, the largest body of evidence has found that fatness is not a risk factor for heart disease or premature death, even controlling for the effects of smoking. Ancel Keys and colleagues confirmed this nearly half a century ago upon examining 16 prospective studies in seven countries, as well as actual angiographic and autopsy examinations of 23,000 sets of coronary arteries which found no relationship between body fatness and the degree or progression of atherosclerotic build-up. And the most careful studies ever since have continued to support these findings.

    Dr. Paul Ernsberger, of Case Western Reserve School of Medicine in Cleveland, Ohio, led a review of nearly 400 studies that was published in the Journal of Obesity and Weight Regulation in 1987 which corroborated these results. “The idea that fat strains the heart has no scientific basis,” he said. “As far as I can tell, the idea comes from diet books, not scientific books. Unfortunately, some doctors read diet books.”

    If doctor is bringing up something every month, and repeating himself a lot, he's not being helpful.

    My advice would be either to tell him to tone it down, or to go ahead and find another doctor.

    *
    Since that is a blog link, here is a possibly more acceptable source of scientific information, an excerpt from the Journal of Nutrition.

    "If you divide the whole world into just enemies and friends, you'll end up destroying everything" --Nausicaa of the Valley of Wind
  • WassermeloneWassermelone Registered User regular
    @Cambiata‌
    I don't want to really get into this or at all come off as aggressive or judgmental, because thats really not how I mean it, but health science... especially related to food and weight, is changing constantly. Just this past year there have been a bunch of studies about health and weight that say the opposite of your source.

    Like this one:
    http://annals.org/article.aspx?articleid=1784291
    Conclusion: Compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.

    Since this is a health question I would feel remiss if I didn't mention it since I only saw this the other day.

  • The EnderThe Ender Registered User regular
    Athenor wrote: »
    I'm currently around 420-425, down from a high of around 450-460 last year. However, I'm up from the 410 I was at before the holidays. I still want to be down to 300 or so in about 5 years time. I'm not meeting my goals, but my goals weren't set by me - the doc is wanting me to lose about 5-10 poinds a month. And I don't know if I'm more likely to meet things, as I have this habit of rebelling against authority figures, which I'm working through with my counselor.

    Alright; that's a pretty severe problem, and more than likely why the doctor has been insistent on the schedule - if you don't get a handle on it and start meeting goals to get the weight down, you're at extraordinary risk for problems like type 2 diabetes, joint complications & heart disease.

    I agree with Ceres 100% - that doctor is a keeper. Keep holding to that schedule and keep yourself involved in improving your body.

    With Love and Courage
  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    I'm 6'5" and was 120lbs in 2nd grade. The only people taller than me are my brothers.

    Not making excuses, as I know I'm fat, and I understand the language, but it'll be unlikely that I drop dead tomorrow.

    I won't change docs though.

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • GizzyGizzy i am a cat PhoenixRegistered User regular
    Athenor wrote: »
    I'm 6'5" and was 120lbs in 2nd grade. The only people taller than me are my brothers.

    Not making excuses, as I know I'm fat, and I understand the language, but it'll be unlikely that I drop dead tomorrow.

    Your body can handle a lot of things while you're young that it will handle less and less as you age.

    Switch Animal Crossing Friend Code: SW-5107-9276-1030
    Island Name: Felinefine
  • schussschuss Registered User regular
    Athenor wrote: »
    I'm 6'5" and was 120lbs in 2nd grade. The only people taller than me are my brothers.

    Not making excuses, as I know I'm fat, and I understand the language, but it'll be unlikely that I drop dead tomorrow.

    I won't change docs though.

    Yeah, just keep working on it and you'll get to a healthy weight sooner than you think. It will alleviate a number of your other problems too (as you've complained about your back and your mattress not being up to the task, both of which can be directly improved via weight loss).
    The good news is that you're gigantic (I mean height-wise), so compared to others, you actually have less to lose.

  • schussschuss Registered User regular
    Also - in regards to the heart thing - Obesity may not be risk factor for survival of heart disease operations, but that's a very esoteric stat. When you look at general population (based on items such as http://circ.ahajournals.org/content/67/5/968.short ), it's likely because obese individuals are more likely to develop heart disease in the first place, so you get people that would otherwise be healthy into the "heart disease" bucket, which means it makes sense their survival rates would be higher, as many probably remove their risk factors throughout treatment by eating better/exercising. The correlating population in non-obese individuals didn't have heart disease in the first place.

  • PsykomaPsykoma Registered User regular
    Athenor wrote: »
    However, I still kind of dread seeing him, and as a result put off going if I can find any excuse to, which usually amounts to working more. I do like the hospital network as a whole, and the specialists I've seen.. But I'm just not sure about the doctor himself.


    Forget the weight and how serious it may or may not be, because that's a debate which won't be solved here.

    The quoted part is the most important section from your post.
    Talk to the doctor. Tell him how his attitude is making you not want to go see him.
    If he says that's irrelevant, find a new doctor.

  • CelestialBadgerCelestialBadger Registered User regular
    Athenor wrote: »
    It's especially annoying when the doc says that other than my weight and the above-mentioned things, I'm in extremely good shape, health wise. Cholesterol and all those other risk factors are normal. I haven't done some of the normal screenings I figured I'd get as a 30-year old man, but when I first visited him he said he wanted to take care of my weight before doing any of that testing.

    That just means that you are lucky and tough and have not hurt your health *yet* with your weight. My ex was healthy as a horse (despite being overweight) until he hit 35 and got diabetes. So being healthy *now* doesn't mean you will be healthy at 40. When you are young, your body can deal with pretty much anything. It's as you get older that bad things start to happen.

    The doctor keeps repeating himself because he is not superhuman and sees a lot of patients a week. It's OK to say "You told me this last month, and I'm working on it." If he's as nice as you say, he won't mind.

    Mention all the drug side effects. He needs to know this so he can try new options. If you just suffer them, he'll think they are working fine.

    Honestly you probably just dread him because he is telling you stuff you already know and feel bad about. No-one likes that stuff. That's why people call it "nagging." But if you don't go, you could just end up putting these issues off and off until you have serious health problems. Better to tackle them now when you are young and resilient.

  • ThundyrkatzThundyrkatz Registered User regular
    Most people have already said everything you need to hear, but I had to comment as this hits close to home for me as well.

    when I was 30 I was 365lbs. Felt good, had great cholesterol and BP and everything. Was able to move around and be nimble and all the other excuses I would tell myself to avoid the truth that I was really unhealthy and fat.

    So fast forward to today, I am 38 and have actually lost 90 lbs over the last 8 years through diets, exercise and meal plans and stuff. Mostly in chunks, 40 here, 40 there with long pauses in the middle. because eating like that sucks.

    So here is the truth for you. if you are 400+ lbs when you get to be 35 or 40, you will not be health any more. At 30 you are at the end of the stage of life where your weight and your general health are not a big deal.

    what else have I done in the last 8 years? Cholesterol is up, BP is up, Reflux is worse, had to have my Gall bladder removed, most recently I slipped a disk in my back. Why? cause I am not 30 anymore. If I was still 365, I shudder to think what else would have gone wrong.

    Now is your window. Take 1 year of your life, heck take 3 months and hit it. just suck it up and do the meal plan and don't cheat. If you fall off the wagon, get back on don't give up. your 40 year old self will thank you.

  • PacificstarPacificstar Registered User regular
    Newblar wrote: »
    He keeps on repeating his advice because you’re ignoring it. I’ve been where you’ve been with some other poor health choices and unfortunately I ignored everyone’s advice for pretty much ever until my health kicked me in the ass and let me know if I didn’t change things I was looking at a pretty crappy future. Don’t be me make your needed changes sooner.

    My father is a physician, and is pretty old school. If you kept ignoring HIS advice, my father would dump YOU as a patient. I for one, would be really happy that you have a primary care physician that is so committed to developing a real relationship with you and is committed to your long-term health. The vast majority of primary care/GP's don't give a shit.

    With regard to the "get my house in order", sometimes it's better to let EVERYTHING change at once, rather than going about it gradually. A clean break from the lifestyle you're trying to move away from is often easier to maintain than a gradual change. Also, with eating, remember that everyone has good and bad days. Don't beat yourself up about the bad days, it's the "well I already ruined it" mentality that causes people to relapse. Accept your mistakes and move on.

  • Fuzzy Cumulonimbus CloudFuzzy Cumulonimbus Cloud Registered User regular
    You dread going to the doctor and being bothered about your weight because its embarrassing and acknowledges what you don't want to acknowledge because its painful. I know that feeling. It happens every time I go to the doctor. The thing is, >350 is a huge risk factor for complications down the road. You had mild lymphedema at the age of 30. That is a big deal. It means that you are obese enough that your circulatory system is struggling. It also means that you are at a really big risk for diabetes and complications from diabetes. He is persistent because he knows statistically what will happen to you.

    The biggest part of this is being active. Fret about the food and stuff (I know it suuuuucks), but make sure you are being ACTIVE. Its the easiest way to diminish complications from obesity. No one actually judges the fat dude going for walks in the neighborhood. In fact, most people root him/her on (if they aren't, I never ever want to know!). Obesity is somewhat reversible and the best risk-reducer is ACTIVITY. Be active and you are far less likely to develop the complications. FYI, you won't drop dead tomorrow. You're totally right about that. However, you're going to have a significantly lower quality of life in your 40's and 50's and have a significantly shorter lifespan if you don't change something.

    That being said, don't be ashamed. The medical system is really good at telling you what to do but no one truly understands the mechanisms of obesity yet. There are psychological and physiological components. You aren't a bad person and you aren't weak or less than anyone else.

  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    The lymphedema, for the record, is due to the fact I spent 2 years wearing socks that would leave a 1/4" indentation around my calf, and I was stupid.. Yeah.

    Of course the doc didn't worry about it for a year of that time...

    But yeah. As I said, I'm gonna go on the meal plan, and now that the weather's nicer I'm going to look into walks again.

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • MegaMan001MegaMan001 CRNA Rochester, MNRegistered User regular
    I graduated with a Bachelor's in Nursing in 2009, graduated with a degree in nurse anesthesia with 2012. Been a certified registered nurse anesthetist for the last two years.

    After reviewing your posts I didn't see where you said how tall you were, only how much you weigh. I thought this was an oversight at first, but after reading the entire thread, it definitely wasn't an oversight.

    You didn't want anyone to calculate your BMI.

    To be honest, I had a lot of responses planned here. You were fat, you were unmotivated, you just didn't "get it". Instead, I think you're incredibly smart and you're looking for something to tell you otherwise.

    Well, I think you are wrong. From what i can tell, your primary physician has dictated an aggressive, probably effective, method to lose weight and keep it off.

    Normally this is where we all say "No, man, you can do this on your own" - but clearly you can't. Do what your doctor tells you and hate him or her every step of the way.

    I am in the business of saving lives.
  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    I wouldn't call it aggressive... though that's my own fault, really. My counselor's also been pushing me on it as well. I fully admit I can't do it myself, though, and that's why I'm looking to outside sources. I can usually go for about 3-4 months of exercise semi-regularly, depending on if my fears flare up. I think my last visit to the gym was the first time in decades I saw another guy naked, and I've got some trauma swirling around that which made me just let my membership lapse when I switched jobs.

    Funny thing is that since getting on Prozac, I've been feeling like I've got a lot more energy during the day. My current plan is to not even wait until my next checkup, but to just email the doc and see if we can get things set up.

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • MegaMan001MegaMan001 CRNA Rochester, MNRegistered User regular
    I think that's a good idea, Athenor, and I think your head is in the right place to really make some changes. Really stick with the plan and you'll see results and look out for your support systems. There are more than one exercise / weight loss threads on the forums and those guys are really good about supporting everyone. They helped me when I started on my weight loss plan.

    I am in the business of saving lives.
  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    Okay.. switching gears just a bit.

    Yesterday all I had to eat was some pieces of chocolate in the morning and a few slices of deli meat during the day.

    I think that my appetite suppressant and the fact that I just bumped up my anti-depressants is making me go a little overboard on the not caring about eating thing -- today, my body is trembling a bit, I'm light headed, and a few other things, which I think are signs of starvation, but my stomach isn't exactly doing anything.

    Right after I make this post I'm going to go force myself to eat, which is something I've had to do before on occasion with this appetite suppressant. Is this normal when taking that combination of drugs? The pharmacist said there weren't any known interactions, but I've seen this happen before with this appetite suppressant, and that's kind of why I didn't want to take it anymore, as well as a main reason I want to get on the pre-set mealplan.

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • StericaSterica Yes Registered User, Moderator mod
    edited April 2014
    Don't think of it as "I can't have X again." unless X is crack or carbon monoxide or something. That's a bad mindset that makes you less inclined to stick with it and feel like shit when you do cheat.

    There is nothing with having a cupcake once in a while: you just can't be like me and devour twelve in one sitting.

    Sterica on
    YL9WnCY.png
  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    Yeah, that self control is the biggest problem. Like I can go on just water for months at a time, with only a couple sugary drinks during that time. But if you give me a bag of chips and they are easy access, I'll go through the whole thing pretty much in one go. But if there's a mental or physical block on doing it, I'll not even bother. Like using the kitchen, which I feel is outside of my domain. There's nothing more fun than my brother hovering around me when I'm trying to cook dinner, waiting to cook his Keto-oriented chicken breasts and meat and such.

    I promise I'm working on getting over those blocks (as my counselor puts it, "being selfish"), but it's just not that easy to tell people I interact with on a daily basis to wait to accommodate me, so instead I do the opposite, and my health suffers as a result.

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • schussschuss Registered User regular
    If you're worried about portion control etc. - get a bunch of containers, then use that for portion control. Even if you're eating chips, you have to put them in a bowl/container first. If you make eating the whole bag harder, it's a lot easier to resist.

  • PacificstarPacificstar Registered User regular
    Decide what you're going to eat at the beginning of the week, and just eat it. Regardless of whether you're hungry or not. As long as the plan you make is nutritionally sound, you should be fine.

  • useless4useless4 Registered User regular
    Buddy of mine had gastric bypass and had zero appetite, what he did was portion out his daily required food (as to not die, pass out etc) and set an alarm for each time it was time to consume a portion of it. keeps him going since he isn't hungry at all.

  • cabsycabsy the fattest rainbow unicorn Registered User regular
    You can also use recovery record, which is a decent app, to remind you to eat meals and then log them. I tend to forget to eat for long periods of time so I had to use it for a while to get myself to eat more than a single meal a day

  • AthenorAthenor Battle Hardened Optimist The Skies of HiigaraRegistered User regular
    Okay, so, follow up.

    Today I had my appointment with my doctor. Down 10 pounds, blood pressure is 136/80.

    We're continuing with the appetite supressant.

    Also, I am scheduled to interview with the weight loss guys of the hospital. The doctor mentioned that it's very aggressive - 900-1000 calories or so a day, and they recently had a case of someone losing 60 lbs in 6 weeks. It's all doctor supervised, with lots of blood tests and things like that.

    I'm nervous/scared, but as the doctor put it, the idea is to get the weight off, then work on keeping it off.

    So.. yeah.

    He/Him | "A boat is always safest in the harbor, but that’s not why we build boats." | "If you run, you gain one. If you move forward, you gain two." - Suletta Mercury, G-Witch
  • PacificstarPacificstar Registered User regular
    Good luck!

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