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Frustration with Doctor *rant*


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So my psychiatrist is obsessed with my weight.

And she keeps asking me about it.

I tell her about how I've made small changes that have resulted in me losing 1-2 lbs/week for 2 months, changes that I can maintain for a long time and I'll obviously need to make more changes when the weight loss slows. I explained my philosophy of making lifestyle changes that I can deal with long term so I don't yo-yo. She tries to get me to jump to more severe changes right away to accelerate the whole process. I'm sorry, no. I'm not gonna eat nothing for 2 years, reaching "normal weight" with my muscle burned off and a huge percentage of my BW in drooping flaps of loose skin holding the fat that still remains. NO.

I don't care if it takes me five years if my diet has gone down by 500 calories a day every six months, maintaining a small deficit but enough enrgy to exercise, but it is maintainable emontionally.

ARGH.

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WTF? I'd tell her to cool it or I'd find another psychiatrist. Seriously. She's supposed to help you accept yourself and change what you can - not encourage you to try to be someone you're not. Did her degree come out of a cracker jack box?

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Sounds like she is encouraging you to have an eating disorder. I wonder if there is a patient advocacy, even if you have to get the info from a different shrink. She at least deserves to be yelled at.

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There is a fine line between being underaggressive and overaggressive.

Making only small incremental changes tends toward a bit underaggressive. At the same time going all in without making the small sustainable changes tends toward overaggression. While you have to making the small changes that will make your end point sustainable, at the same time you still have to create a deficit, you have to go beyond what it takes to maintain your end state.

I always used this philosophy:

1) My diet is based around maintaining my end state. Were I to stop exercising completely and stop specifically fueling that exercise (via milk mostly), the habits I developed are such that I will maintain my weight. I learned what it means to eat a 2500 calorie diet and got in the habit of doing so.

2) My deficit was created primarily by excess exercise. At first as I built up this capacity I had to forgo snacks and whatnot to fully create the deficit I wanted, but as I built up exercise capacity, treats and snacks were added back in, however I taught myself that I can live just fine without them and I gained an understanding of proper moderation. For the most part I walked, walked, and walked some more, every single day, on top of the strength training and running that I was slowly beginning to do.

3) As my deficit declined and even became surplus, I did not make those changes to my normal diet. Instead I used milk almost exclusively to make the changes. If I have to take a break from exercise, quit drinking milk and I'll maintain. I didn't want to fall into the injured/former athlete fat guy trap eating to support exercise that is no longer done.

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My thoughts are that perhaps finding a different psychiatrist might not be a bad idea. If you are making steady healthy lifestyle changes and are not in danger of a major medical issue occurring at your currently rate of weight loss, a good psychiatrist should listen, cultivate, and encourage the continuation of the path to a more healthy state. If that person is impeding the your progress, it is always a good idea to find someone that wants to champion your healthiness in positive ways. As much as we would like our doctors to be unbiased, I try to remember that they are human as well.

Also let's not lose sight of how awesome you are doing! Keep up the good work.

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I would maybe look for a new psychiatrist - this one is suggesting things that you have said you don't want to hear, which may be one thing, but they are not helpful.

What you do with your body is your business, and they have no right to push you into things you don't want to do.

There is a list of "fat-friendly" health professionals here. I know that you are working on losing weight and all, but at least this will be a list of professionals who won't badger you about it.

Of course, if you don't want to find a new psychiatrist, and just wanted to vent, my apologies!

If you are just venting, here is my alternate response: "That person is a jerk! Jerky jerky jerky." Dealing with doctors who won't listen is the absolute worst, and you deserve better than that.

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Keep in mind that Shrinks and most Doctors are taught that weight loss is a product of energy in vs energy burned and that can be controlled by your will power. I know a couple shrinks and they love to treat obesity because they get to treat a "eating disorder"

They never get it that it's all about controlling the hormones. Either talk to the Doc ask them to educate themselves. A good doctor will be open minded and look into stuff they don't know. If the Doc refuses, say good bye to the Doc.

Get more sleep,

J.

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Keep in mind that Shrinks and most Doctors are taught that weight loss is a product of energy in vs energy burned and that can be controlled by your will power.

Probably because that's how it works.

They never get it that it's all about controlling the hormones. Either talk to the Doc ask them to educate themselves. A good doctor will be open minded and look into stuff they don't know. If the Doc refuses, say good bye to the Doc.

Get more sleep,

J.

Hormones can play a big factor, as can thyroid. But these only affect how your body processes the things you consume. If you consume less, you will lose weight. If you consume more, you will gain weight. It's the universal law of thermodynamics.

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Keep in mind that Shrinks and most Doctors are taught that weight loss is a product of energy in vs energy burned and that can be controlled by your will power.

It is and it can be.

Will power is only needed though to turn changes into habits. Weight loss isn't a constant battle of will power (at least it shouldn't be). Maintaining habits doesn't require near the willpower that creating habits takes.

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Umm, I'm fat because I eat a lot and I have until recently been completely sedentary.

I eat a lot because I have no discipline to defer immediate gratification, aka low willpower.

Weight loss is very complicated, saying "It's the hormones" is just as narrow as "eat less move more"

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Umm, I'm fat because I eat a lot and I have until recently been completely sedentary.

I eat a lot because I have no discipline to defer immediate gratification, aka low willpower.

Weight loss is very complicated, saying "It's the hormones" is just as narrow as "eat less move more"

This.

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Umm, I'm fat because I eat a lot and I have until recently been completely sedentary.

I eat a lot because I have no discipline to defer immediate gratification, aka low willpower.

Weight loss is very complicated, saying "It's the hormones" is just as narrow as "eat less move more"

Agreed.

A good doctor (especially a mental health specialist) should be helping you to create and sustain those habits that lead to weight loss, without the expectation of "willpower" - obviously someone who has low willpower can't use it as a reliable and sustainable force for weight loss. They should also be getting into the 'why' of your current lifestyle habits so you can start to change them.

That said, a psychiatrist and a psychologist are for very different things. When it comes to diagnosed mental illness for which drug therapy is required, a psychiatrist is the one you want. For behavioural changes on a cognitive leval (for example, habit and lifestyle changes for weight loss) a psychologist is going to be more helpful.

But sounds like you're on the right track anyway :)

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Hey GrimmThing and others,

I'm not blind to people's opinions or beliefs. Food is like some special area people get really upset about super fast, yet they don't want to try anything really different.

I'm didn't come here to derail this thread, I assumed most people around here are up on questioning the science they have been spoon feed. All I'm asking you to do is apply the "idiot principle".

"Doing the same thing over and over again expecting a different result"

Eating less, being hungry all the time, working out, and expecting to loss weight over the long haul. Over the short term this approach works I'm not questioning or debating that, but I wanted long term results. So for me and my little n+1 study I got going on, I decided that a typical standard diatribe approach wasn't basic common sense. I was one of those must eat 6 times a day, or I'll bite our head off people. But when I went with the LCHF approach and I have to remind myself to eat, zero cravings, my willpower (I was a 300 pounder so my track record of willpower is crap) doesn't even come into play any more. The hardest thing I had to over come was "boredom does not equal hunger."

If you want to travel down the road you've chosen, I'll shut up and encourage you.

If your open minded to challenge the common of weight lose paradigm and are willing try new things, I'm here for you and we can dive in.

Either way, good luck, find a doctor that encourages you and your comfortable with.

Peace, J.

P.S. get good sleep, it does the body good.

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I went to the doctors and asked what my healthy weight should be and she told me I should weigh 120 and be a vegetarian. Nothing else. Just 120. And don't I want to start losing weight so I can finally be beautiful?

Doctors disgust me.

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I went to the doctors and asked what my healthy weight should be and she told me I should weigh 120 and be a vegetarian. Nothing else. Just 120. And don't I want to start losing weight so I can finally be beautiful?

Doctors disgust me.

Definitely time for a new doctor.

I'm 5' tall and my doc wants to see me at 140 and I'm 5' tall. If I ever get there, we'll see what *I* want LOL.

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I've never had a doc tell me to be a vegetarian. That doesnt sound quite legit. Not that it's a bad idea necessarily, but it ain't for everyone, especially young women. We chicks need our iron!

Sadly having a MD (or any other health degree...) does not equate to decent "bedside manner." One of the smartest guys I know is a doctor who doesnt get along with anyone, isn't a great listener, and is morbidly obese (with all the attendant health problems). People are like that.

If you don't like your doc, fire her or him. Your health is too important to trust to someone who gives you bad vibes. I've learned the hard way that if a health care provider doesn't listen to you, that's a really bad sign. NEVER trust an expert who doesnt listen and doesnt deal with your questions. That's a sign they are more interested in their opinions than in you. And you do not want to be treated by someone who doesnt care about you.

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I went to the doctors and asked what my healthy weight should be and she told me I should weigh 120 and be a vegetarian. Nothing else. Just 120. And don't I want to start losing weight so I can finally be beautiful?

Doctors disgust me.

Wow, imposing vegetarianism and random weight goals, and thin=beautiful mentality. What is it, a bingo for stupid, incompetent doctors? Where did this person go to med school? Because it seems to me he/she graduated from the school of douchebaggery of Cosmopolitan magazine.

Definitely a doctor to never EVER see again.

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Think of it this way: Doctors work for you. They are your employees. You are free to fire them at any time and find someone more competent/compatible with your health and wellness goals. You do not have to give them your money if they are making you feel like shit about yourself. Find someone you are in sync with.

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You're already on the right track. Congrats for being not distracted. I agree with the other people that changing your psych might not be a bad idea. I even think that you should do it. If you can and if you have the time, maybe you can do some investigation on your current doctor. If you know her other patients, try talking with them and ask for feedbacks. :)

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About the calories in, calories out theory people are talking about:

Probably because that's how it works.

Hormones can play a big factor, as can thyroid. But these only affect how your body processes the things you consume. If you consume less, you will lose weight. If you consume more, you will gain weight. It's the universal law of thermodynamics.

It is and it can be.
Umm, I'm fat because I eat a lot and I have until recently been completely sedentary.

I eat a lot because I have no discipline to defer immediate gratification, aka low willpower.

Weight loss is very complicated, saying "It's the hormones" is just as narrow as "eat less move more"

Please read "Why We Get Fat" by Gary Taubes. There are many many many examples of how this is NOT true including references to a multitude of studies on both the calories in and calories out side of things. I'm only at chapter 4 too.

It actually is what we eat that makes us fat or not, not so much the amount of food or exercise we get. So really, it is more about hormones, particularly insulin, than anything else. Just try eating food that does NOT raise insulin levels and you will more than likely find that you will either lose weight or at least stop gaining it.

So my psychiatrist is obsessed with my weight.

And she keeps asking me about it.

I tell her about how I've made small changes that have resulted in me losing 1-2 lbs/week for 2 months, changes that I can maintain for a long time and I'll obviously need to make more changes when the weight loss slows. I explained my philosophy of making lifestyle changes that I can deal with long term so I don't yo-yo. She tries to get me to jump to more severe changes right away to accelerate the whole process. I'm sorry, no. I'm not gonna eat nothing for 2 years, reaching "normal weight" with my muscle burned off and a huge percentage of my BW in drooping flaps of loose skin holding the fat that still remains. NO.

I don't care if it takes me five years if my diet has gone down by 500 calories a day every six months, maintaining a small deficit but enough enrgy to exercise, but it is maintainable emontionally.

ARGH.

At then end of the day, if you feel good, keep doing what you're doing. If you're getting the results you want, then you are succeeding. The only thing I would caution you is that be careful that you won't rebound if this is a diet that you will not keep when you've lost the weight you want to lose.

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Gary Taubes isn't a biologist. He isn't qualified to disregard the actual science of fat.

People get fat by eating a caloric excess.

If you can eat a caloric deficit, you will lose weight.

Please prove me wrong. Show me someone who ate a caloric excess of low-insulinogenic properties and lost weight.

"low insulin" only works as it helps maintain blood sugar which prevents cravings for some, leading to low caloric intake.

"low Carb/Paleo" works because it is hard to eat a low carb diet to caloric excess.

"Low-fat" was a giant mistake because overeating on low-fat is trivial.

If utilizing mental tricks works for you great, but it's calories that determine weight loss.

GrimmThing - Warrior

Maybe I'm just too dumb to collapse - - too ugly to die !! I'll let you figure out the reasons...

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Gary Taubes isn't a biologist. He isn't qualified to disregard the actual science of fat.

People get fat by eating a caloric excess.

If you can eat a caloric deficit, you will lose weight.

Please prove me wrong. Show me someone who ate a caloric excess of low-insulinogenic properties and lost weight.

"low insulin" only works as it helps maintain blood sugar which prevents cravings for some, leading to low caloric intake.

"low Carb/Paleo" works because it is hard to eat a low carb diet to caloric excess.

"Low-fat" was a giant mistake because overeating on low-fat is trivial.

If utilizing mental tricks works for you great, but it's calories that determine weight loss.

You're right, he's not a biologist, but I said he referenced many studies and examples of people who ARE and are supposed to be experts on this subject. He is more of a reporter, absolutely. I never claimed he was anything but this. This also doesn't mean he's wrong.

Also, regulating insulin is the necessary step in regulating weight. This IS biology. Research insulin, how it works and what it does for and to the body.

I agree that low fat was a giant mistake, but for different reasons.

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