Guest guest Posted January 5, 2008 Report Share Posted January 5, 2008 Are Obese Physicians Effective at Providing Healthy Lifestyle Counseling?Patients come to physicians expecting professional advice and a role model to emulate. Studies show that it is more difficult for physicians to give credible medical advice when they do not follow this advice themselves.5 Confidence scores from patients receiving health counseling from physicians who are obese are consistently lower than those from patients seeing physicians who are not obese.6Family physicians provide preventive services and may be held to a higher standard of healthy behavior than physicians in more technical specialties. Not surprisingly, physicians with poor personal lifestyle habits are less likely to counsel patients about a healthy lifestyle.7 Physicians who are obese are less likely to diagnose obesity in patients and are less comfortable with providing obesity counseling.1 A study demonstrated that overweight physicians do not necessarily classify themselves as such.8 Furthermore, physicians who are not overweight are more likely than physicians who are overweight to proactively address obesity with patients before related comorbidities develop, and to do so more aggressively.7 These findings may be caused by the physician's personal denial of his or her own obesity, lack of personal experience with effective weight loss and related resources, or fear of lacking credibility.http://www.aafp.org/afp/20070301/curbside.htmlWhen Doctors Take Their Own AdviceFor years, when Minnesota physician Dr. Balgobin saw patients with diabetes and high blood pressure, he found it difficult to counsel them about losing weight and exerciseThat’s because Dr. Balgobin was overweight himself — at his heaviest, he carried 304 pounds on his 5-foot-6-inch frame.“It was hard for me to tell them about losing weight and exercise because I’ve been big all of my life,'’ said Dr. Balgobin. “I would say, ‘Yes, it’s a struggle.’ But then I would say ‘they’ say to reduce calories and exercise. I could never put it on me as the authority figure.”But in January, Dr. Balgobin, a family practice doctor for Fairview Health Services in Apple Valley, Minn., says he was inspired by one of his own patients who had lost 60 pounds through diet and exercise. He talked to his wife and together they decided to change their eating habits, exercise more and try to lose weight together.Dr. Balgobin said he used tools on DiscoveryHealth.com to calculate his metabolic rate and calorie needs. He cut out fast food and began counting calories, and he and his wife began working out at a health club together. He also began eating breakfast regularly.Dr. Balgobin has since lost 120 pounds. He says weight loss has not only changed his life, but it has changed his relationship with his patients.http://well.blogs.nytimes.com/2007/11/07/when-doctors-take-their-own-advice/---- (and others),I think the best way to get yourself to exercise is to follow your own advice. What do you tell patients who have the same problem getting motivated to exercise? If you don't like using the treadmill, then no wonder you don't use it. Choose a form of exercise that you enjoy, then you will want to do it. For me it's 2 hrs of basketball twice a week. If the problem is finding the time to exercise, then don't "find" the time because nobody ever has extra time. Instead schedule the treadmill so that it is part of your routine. Every evening from 7-7:30PM or whatever. After a while it will become automatic. This is what I tell my patients. Or maybe you could see your (gulp!) doctor (who hopefully isn't overweight)?Personally, my vice is fast food, but I'm trying. No french fries this month! SetoSouth Pasadena, CAAhh, sometimes you have to lead by example :)I can't expect my patients to diet and exercise to help manage theirdylipidemias ec if I don't do this myself.On Jan 6, 2008 10:59 AM, T. , MD <DonSpinelakemed> wrote:>> I actually do have a treadmill in our guest bedroom, which is right next to> the exam room, but my patients generally don't have to wait for the> appointments, and the fact that I only have three parking spaces means I> have to run on time, so it would never be used.>>>> The real issue, is how I can motivate myself to get on that treadmill?>>>> don-- Graham Chiuhttp://www.synapsedirect.comSynapse-EMR - innovative electronic medical records system Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 5, 2008 Report Share Posted January 5, 2008 I wear a pedometer and ask to see the patient's pedometer. We do a comparison. I also ask them to bring in their last month's record of daily steps. Why is a rheumatologist interested in exercise? Because patients with inflammatory arthritis have greatly increased cardiovascular risks ...so I consider management of their diabetes, hypertension etc part of the management of their rheumatoid disease. My current BMI is 21.8 ( yes, Synapse calculates this for me ) ... and it didn't get there by eating fast foods, and lying on a couch! > Are Obese Physicians Effective at Providing Healthy Lifestyle Counseling? > -- Graham Chiu http://www.synapsedirect.com Synapse-EMR - innovative electronic medical records system Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2008 Report Share Posted January 6, 2008 My current BMI is 21.0 (as it has been for the past 20 years). For me, however, my neuroses and irritable bowel play a major role. Both are usually controlled by running, so I am forced to try and stay in shape. I also have to eat a relatively high fiber diet and no caffeine. I kind of wonder sometimes if my patients could use a dose of IBS periodically. Part of the reason we get overweight is that it is just so darn easy. If we could feel our bodies sliding into dysfunction, we would be more likely to do something about it. So why, with the shear brilliance of the human body, didn’t we evolve so that sitting on the couch too long hurts and exercise feels good; so that eating fast food makes you sick and eating fruits/vegetables and legumes makes us feel great; so that sweat smells like perfume and perfume smells like, well, sweat? Then again, maybe we did. Maybe, it’s just that evolution is being out marketed. Our brains have simply been programmed to overrule our bodies. Hmmm, I think I’ll go grab a Coke (caffeine free) and watch TV so I don’t have to worry about it. J Re: Doctor, Heal Thyself I wear a pedometer and ask to see the patient's pedometer. We do a comparison. I also ask them to bring in their last month's record of daily steps. Why is a rheumatologist interested in exercise? Because patients with inflammatory arthritis have greatly increased cardiovascular risks ...so I consider management of their diabetes, hypertension etc part of the management of their rheumatoid disease. My current BMI is 21.8 ( yes, Synapse calculates this for me ) ... and it didn't get there by eating fast foods, and lying on a couch! On Jan 6, 2008 12:07 PM, Seto wrote: > Are Obese Physicians Effective at Providing Healthy Lifestyle Counseling? > -- Graham Chiu http://www.synapsedirect.com Synapse-EMR - innovative electronic medical records system Quote Link to comment Share on other sites More sharing options...
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