Blog | Friday, March 27, 2020

Can doctors help you lose weight?


As a gastroenterologist, a trained specialist in digestive issues, I should have expertise in obesity, nutrition and weight loss strategies. I really don't. While I have knowledge on these issues that likely exceeds that of most of my patients, I received inadequate formal training on these subjects during my gastroenterology training. It is inarguable that digestive doctors—and indeed all physicians—should bring a high level of expertise on these medical issues into their exam rooms. The impact of obesity reaches nearly every medical specialty. Obesity is linked to heart disease, stroke, cancer, arthritis, diabetes, sleep apnea, high blood pressure and many other illnesses.

Most of my overweight patients tend to remain so. Many of them are simply resigned to a shape and size that they feel they cannot alter. Some are not motivated to engage in the hard work and long journey that can lead to a leaner dimension. Some do not recognize that successful weight loss requires a steely and sustained mental commitment to the task. Others have food addiction issues and need an appropriate strategy to break through. Some are convinced that they are plagued with a lethargic metabolism that retains pounds despite minimal food intake. Many eat, not because they are hungry, but because of anxiety and stresses in their lives which have not been adequately addressed.

Of course, medical professionals need more knowledge and skill in addressing nutritional issues. How relevant are these skills to medical practice? According to the CDC, over a third of American adults are obese. And, more of us will be classified as obese if the definition of obesity is broadened. This is analogous to what has happened with diagnosing folks with elevated cholesterol levels. The medical profession, with a huge assist from the pharmaceutical industry, has lowered the ‘normal’ level of blood cholesterol over the years. The result is that previously healthy people now have a cholesterol condition. We saw a similar result last year when ‘normal’ blood pressure levels were made lower which instantly created millions of new hypertensive individuals. Now, many of them may be subjected to the risks, expense and psychological effects of being told that they are diseased. The argument, of course, is that this more aggressive approach saves lives. Let's see over the next decade or two if this hypothesis will be supported or refuted by medical evidence. Keep in mind that many medical ‘breakthroughs' announced with fanfare and optimism have been proven wrong.

So, if you are among the millions who are struggling to shed some pounds, there are pathways available. It can be a challenging road. After all, if it were easy, then we'd all be thin. But, it can be done. The first step on the journey takes place in your mind. Are you all in?

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.