To add to this, the hormone thing is not just a little side benefit. They’re currently studying these same drugs for use in treating addictive disorders.
I realize this is just anecdotal, but as someone with a very addictive personality, there are certain things that just aren’t appealing to me anymore, like online shopping.
It’s really fascinating stuff.
It kinda makes sense as these drugs affect the pleasure/reward part of the brain. That’s probably why the food noise is minimal, cravings have gone and social food enjoyment has gone.
Yes, some of my friends taking it no longer crave nicotine and have lost interest in alcohol. These drugs change how the body reacts to food/drink/substances pretty amazing.
I wouldn’t want to take something to say stop smoking then not want to eat. I’ve read that many people who stop taking these weight loss drugs do so because they like to eat.
Seems like when a patient has obesity with undesirable health effects, there is no good way for a physician to talk to the patient about it (and not talking to the patient about it also is not good).
I just read an article yesterday about how Oprah is now backtracking on her initial criticism of people taking Ozempic as “the easy way out” for weight loss. Coincidentally, Weight Watchers, on whose board Oprah is still a member (although she sold her ownership interest), recently acquired an online pharmaceutical distribution company with the intent of being able to offer Ozempic to WW members (for a fee).
This is what I am wondering - how people on here would suggest a doctor speak to patients about their in such a way as to not be considered, “fat-shaming.” I am curious as to what specific words /phrases people would find acceptable. Because it certainly seems like a Catch-22 for doctors.
IMO there is a big difference between a physician sharing factual, science based, helpful information and yelling and fat shaming. If seen both first hand. It’s all in the delivery.
I had a doctor flat out not believe me when I told them I followed a Mediterranean diet and exercised (despite lab work being excellent), and that I needed to get real with myself and eat better. That was the extent of the advice.
That’s a far cry from the doc who ran metabolic panels and referred me to a nutritionist who helped me craft a diet that got my fasting glucose level down which was the only thing off in all my blood work. (FWIW following a diabetic diet in terms of making sure I balance whole carbs, proteins and healthy fats (even though I’m not diabetic), along with foods from the Mediterranean diet is what works for me.)
My husband had a heart attack at 47. He has an autoimmune disease, is on biologic medication for it. The medication has changed his quality of life by leaps and bounds.
There are complications from his condition. One was a heart attack.
After his heart cath, the physician told his parents and myself that he needed to quit smoking. My husband has never ever smoked. We denied that he smoked but the physician repeatedly stated that he needed to quit smoking until my husband’s father was emphatic that he doesn’t smoke.
I don’t blame the doctor, I’m sure many of his patients lie about their smoking.
My husband condition was one of the causes of the heart attack. His weight and high stress job were also part. Husband lost weight and changed jobs. He has not had any more episodes.
My husband’s first group of cardiologists were not a good fit. He needed a different approach, one that encouraged high intensity exercise. So he switched and found someone that was a better fit. For him.
I think that’s the key. Find someone who is good for your life. Don’t dwell on those who aren’t.
For me personally I knew I was obese, I didn’t need any doctor to tell me. But it’s perfectly fine to talk about it and diet during my annual wellness visit.
It should not be discussed when I saw him for anything else. ( I had a knee injury, poison Ivy, nerve damage from a dog bite and a broken ankle from a fall on the ice) my Doc derailed all these visits to talk about my weight, the real reason for my visit was rushed and secondary. I really dreaded going and put off other possible visits because of his fat shaming.
For doctors I think it is a difficult situation to navigate when confronting a patient about weight. First of all, if the dr himself/herself is overweight they might not feel comfortable discussing with patients. However, the bigger issue is if a patient sees a dr once a year for a well check; and is getting “you have gained a few pounds try exercising a bit more,” that said patient will probably continue to gain weight. Having a hard conversation about what a future could look like 30-60 pounds or more overweight is the right thing to do. Who wants to finally be able to retire at 65 but cannot do anything meaningful because complications of weight.
That is why, despite the naysayers, these weight-loss medications are life-changing.
Re doctors talking about weight: everything depends on the delivery. If there is genuine caring and empathy that’s what will make the conversation go well. This is a life lesson and applies in all difficult situations. Coming from a place of empathy and caring is what matters.
The doctor aspect of this and how they communicate with you and the respect or faith they have in you is so important.
I was struck early on in my research before deciding to take Mounjaro by this interview with Dr. Fatimah Cody Stanford - she’s an obesity expert who’s a recent addition to the govt’s dietary guidelines advisory committee.
This is a really good interview (I just read the transcript; didn’t watch it):
In it, the thing that most spoke to me was this part:
“My own biases as a physician, as someone who has not struggled with my weight, has been an athlete, these types of things. I had a patient that was in her mid-40s who had severe obesity, and had struggled with severe obesity her entire life. I was in internal medicine and pediatric resident in South Carolina. And what I would do is every single visit, she would come in and see me every two to three months. I would give her this diet recommendation, or this exercise recommendation. All of these things. And over the course of three years, you know, I didn’t see her weight shift. She would shift maybe down two pounds, up one pound, really maintaining her weight set point. Well, one day, Hari, I was leaving my workout, I ran into the grocery store and who did I see but this patient. As she was about to check out at the grocery store line. So, I’m talking to her, she’s like, hey, Dr. Stanford. I’m like, hey. And we’re talking, but I’m trying to glance at her cart, and I’m trying to glance without looking, right. I’m trying to be inconspicuous. Not doing a good job at it, because she says the following to me. She says, see Dr. Stanford, I’ve done everything you told me to do. And when you looked at her cart, and this generates some emotion from me. It was pristine, perfect, everything we had ever talked about for three years in her grocery cart as she’s about to check out at the grocery store. And it was at that point that I realized that this is not just about diet and exercise.”
For me, its a bit of pot calling the kettle black. As a woman, I don’t need a chubby old man telling me that I should try to lose a few pounds so I can be healthier. Or when a doctor starts lecturing me on how I need to be less stressed because that isn’t “good for me” yet has not sat down long enough to even barely know a tenth of what it is I all have going on outside of that little room. Or when they tell you that you need to eat healthier without asking you what your current diet is like.
Acceptable to me imo: “Are you concerned about your weight?” “Has your weight or physical fitness ever interfered with your daily activities?” “What do you feel are your greatest barriers to eating more vegetables and fruits and less processed or fried foods?” Or “What hinders you from exercising multiple days a week?”
And better yet, asking those types of questions, listening to the answers, and then starting with reasonable baby steps that work with the patients reality and showing support.
As someone with IBD and IBS, I’d be pretty scared to try them. Not to mention I already take enough medicine. I am able to lose weight with strict diet and exercise, I just also seem prone to injury which prevents me from exercising. lol
Haven’t read through the whole thread, but even a “small” amount of weight like 25 pounds can make a big difference in how someone feels. I gained 22 pounds over COVID (I was already overweight to start with). I honestly do not care about how it looks on me… I am naturally a small sized person, and I actually kind of like the feeling of being a physically bigger person(!!). But on the other hand I have really noticed the physical effect it has on me to haul around the extra weight. The weight has an effect on my feet and joints and I really feel how much work it is to haul around. Like carrying a weighted backpack all day. Losing 25 pounds would definitely make me feel better physically. It might not seem like a whole lot, but since menopause, I really really struggle to lose ANY.
I have not pursued any of these weight loss drugs… but I am certainly interested in the discussion of them.
I just learned a friend has elected to take the drug for weight loss and has lost 15 pounds. Doesn’t sound like a lot but she’s only 4’10" so really quite a bit for her. I’d be surprised if she weighed 140, so at least 10% of her body weight.
Since you quoted me I do want to say that my comment was made early in the thread…and I’ve learned a lot (and a lot of different circumstances!) in the subsequent posts.
People have mentioned the hypocrisy of, “chubby,” doctors telling them to lose weight. “Pot calling the kettle black.” That really is not a valid reason to dismiss what they advise. The condition of the messenger doesn’t negate the truth of the message.
Change it to smoking. If a person with a lit cigarette hanging out of their mouth tells you smoking is bad for you and you should not smoke, their failure to abide by their own advice doesn’t make it any less true.
I don’t think that’s the point.
Somebody telling you to just lose weight and acting like you’re shiftless and lazy and weak for not doing so … when they themselves are overweight … it’s not that the directive is false.
But it does show that carrying out the directive is extremely difficult or even impossible for many, maybe most of us.
It’s true: If all there was to it was eat less and exercise more, everyone who wanted to lose weight and keep it off would have done so already. Including doctors, I presume.
So as a patient, you kind of sit there, thinking, “Oh, of course, why didn’t I think of that?” And with that kind of attitude from a doctor, you start to hate yourself and wonder what’s wrong with you. While at the same time noticing that your doctor is fat. And the psychology of all this is just terrible.
