SMOKINCHOICES (and other musings)

November 16, 2013

Docs 2 up Obesity care

Your health

Docs told to get serious with obese patients


ATLANTA — Next time you go for a checkup, don’t be surprised if your doctor gets on your case about your weight.

The medical profession has issued new guidelines for fighting the nation’s obesity epidemic, and they urge physicians to be a lot more aggressive about helping patients drop those extra pounds.

Doctors should calculate your body mass index, a weight-to-height ratio. And if you need to lose weight, they should come up with a plan and send you for counseling.

“We recognize that telling patients to lose weight is not enough,” said Dr. Donna Ryan, co-chairwoman of the guidelines committee.

The good news? By next year, most insurance companies are expected to cover counseling and other obesity treatments, following in the steps of the Medicare program, which began paying for one-on-one help last year.

More than a third of U.S. adults are obese, and that’s been the case since the middle of the past decade. Officials define someone with a BMI of 30 or higher as obese. A 5-foot-9 person would be obese at 203 pounds.

Doctors are well aware that excess weight can trigger diabetes and lead to heart disease and other health problems. Yet surveys have shown that only about a third of obese patients recall their doctor talking to them about their BMI or counseling them about weight loss.

  • The guidelines were released this week by a group of medical organizations that include the American Heart Association, the American College of Cardiology and the Obesity Society.  (Too bad they didn’t include certified Nutritionists on this panel — apparently, they’re the only ones trained in such things)

They come amid a spate of important developments in the fight against obesity.

Last year, the Food and Drug Administration approved two more obesity-fighting drugs. And this year, the AMA labeled obesity a disease, a measure intended to get doctors to pay more attention to the problem and prod more insurers to pay for treatments.

Yet many people have been on their own when it comes to slimming down, left to sift through the myriad diets and exercise schemes that are promoted for weight loss. And most doctors have little training in how to help their obese patients, other than telling them it’s a problem and they need to do something about it.

“I feel for these guys,” said Dr. Tim Church, a researcher at Louisiana State University’s Pennington Biomedical Research Center. “They have patients who come in and ask them about the latest fad diet. They’re not trained in this stuff, and they’re not comfortable” recommending particular diets or weight-loss plans.

The guidelines advise doctors to:

• At least once year, calculate patients’ BMI, measure their waists and tell them if they are overweight or obese.  (probably going to charge a decent fee for their services, when in fact, a 2 minute calculation and a scale’ll do it!)

• Develop a weight-loss plan that includes exercise and moderate calorie-cutting.  (Kidding, right? – based on what?)

• Consider recommending weight-loss surgery for patients with a BMI of 40 or for those with a BMI of 35 who also have two other risk factors for heart disease such as diabetes or high blood pressure.  (Lifetime of health problems – side effects because the doctors are inadequate)

• Refer overweight and obese patients who are headed for heart problems to weight-loss programs. Specifically, discuss enrolling them in at least 14 face-to-face counseling sessions over six months with a registered dietitian, psychologist or other professional with training in weight management. (Dietitian’s training comes from the same medical profession as the doctors, whereas the Certified Nutritionist fully understands the body function and what it needs to achieve maximal, integrated function.

Web or phone-based counseling sessions are considered a less-effective option.  (I dunno, some of the most well-known and successful nutrition-based physicians and prominent Nutritionists maintain marvelous websites for additional help, whatever it takes to help people get the job done)

Diane LeBlanc said the new guidelines are overdue.  More than year ago, the Baton Rouge, La., woman sat down with her longtime family doctor to talk about her weight and get a referral for help. She had tried dieting without success for more than a decade, had high blood pressure and was about to hit a dress size of  20.

  • She said the doctor smiled and told her: “There’s a lot of programs out there. But really, you just have to eat less.”

“It just devastated me,” Le-Blanc recalled. “He was saying, ‘It’s all in your mind.’ I was thinking, ‘If I could do that, don’t you think I would have done it by now?’ ”

She changed doctors and has lost 40 pounds from her 5-foot-4 frame since May after getting into an intensive Pennington weight-loss program that includes counseling sessions.

Doctors “need to get the message,” LeBlanc said. “Just telling someone you need to push the plate away is not going to work for everyone.”

(My Comment:

Guess I’ve kinda had my say already!  But  I’m not done yet.  I firmly believe that full care of the body is the rightful domain of the healers of the world.  It always has been that way.  But not so much here in our own country. It couldn’t be more graphically depicted than right here in this story.  But since almost all diseases which are causing the most chronic damage can be attributed to lifestyle and dietary habits  — “food’s” rank tops the list in importance.   Yet the medical complex doesn’t even feel a sense of inadequacy or ineptitude about the inability to be knowledgeable and conversant on the subject.  It falls squarely in their area of responsibility!  And they have let us down – hugely, yet tried to maintain their superior authority in all areas concerning “HEALTH”.  

They know little about health;  they know medicine (pharmaceuticals) which are chemical based,  do zilch  to heal, but in fact have a great many perils involved in the ingesting and usage of them.  Just read the documentation or listen to all those possible side effects in the commercials we hear 24 – 7.

Bad Advice

The Medical Mind has been making pronouncements forever and generally, we are finding that the “truth” as it is given to us to live by turns out to be wrong.  Of course, we are all in this learning process together — but the pomposity and weight of their pronouncements has the ability to affect the way people live and think.  Mid 20th century:  don’t use butter, bad for us — use margarine.  Because ‘saturated fats’ were labeled bad.  Stuff changes  (in our thinking), as we learn more.  Now Butter is good (provided the bovine from which it comes was grass fed or free-range.)  I never used margarine as I couldn’t stand it. People don’t give up their ideas or what they believe, easily.  

Many still use bad oils (which are really bad for us), yet won’t eat a trace of fat on their meat.  (which is actually just fine to eat and even helpful,. . providing the animal is being fed right)    To this day doctors are advising patients to eat a lo-fat or no-fat diet, along with plenty of wholesome grains and plenty of dairy to get all the calcium we need.  Follow this advice and one is assured of developing arthritis,  hormonal problems, heart disease, diabetes together with obesity, and yes — Alzheimer’s.  And this is just what we have here in America, following all this  advice. 

We  need fats

We need plenty of healthy fats in our overall regime:  (real) virgin olive oil,  coconut oil,  avocados, nuts and seeds, free-range eggs,  If people would stop with worry over cholesterol and bring fats back into their lives, body is happy and numbers go down.  Do your homework, buy a book or two. Be smart on choices.

We are Over-calcified 

Most of us are familiar with David Wolfe and his helpful discussions on aging and mineralizationAmong other things he has spoken of is the over-calcification of our bodies.  All very insightful.  (has XLNT books) Of course, an earlier source of information which taught me much was Dr McDougall  He doesn’t advocate the taking of vitamins so much other than the B vitamins (vegetarian, ya know).  He pointed out the huge bony structures that large animals maintain by ingesting the grasses of the field.  – – the plant kingdom.  And further, that no animal other than “some humans” ingest milk beyond the weening stage.  Most humans do not drink milk.  One gets all the calcium needed from the plant kingdom.  period.  I haven’t taken calcium for at least 30 years.  Never broken a bone. 

So why does our “Medical Mind” keep telling us to to take so many pills to protect our bones.  And a lot of them are quite costly.  Ah well, that’s the name of the game isn’t it?   But it’s not helping the bones, these beautiful, trusting ladies do what their doctors tell them and wind up with some pretty bizarre breaks in strange places (upper thigh  bones and jaw bones — imagine).   Anybody wants the real low-down on how bones function, whats happening with them and how, check out Dr Loren Cordain of the Paleo Diet books fame.  This brilliant man is a personal hero the way he can reduce complicated function to easy to get words — Bam! . . .you get it. It’s the balance — not just the calcium incoming, but outgoing and how and why that happens.   

Then there is the Grain thing

Grains in any form are doing us in.  Its a shame really because most all of us grew up smellin’ something lovin’ comin’ from the oven. (Don’t tell anyone, but there is some Sour-Dough hiding in my freezer for those times I just gotta have it.)  Until wheats were messed up with genetic modification, decades ago, it may not have been so injurious, I dunno. GMO’s have ruined about everything else, so I guess it should be no surprise.  (again, if you want a better understanding check out info in Paleo regarding what grains do to our gut, how and why it harms us biologically).  

These days however,  everyone with a brain and a computer is writing a treatise on what grains are doing to us and ruining our health. One of the latest was a man Dr Mercola interviewed – especially good.  Wrote a book called “Grain Brain”.  Explained how the insulin levels are messed up with  simple carbs in general , but grains in particular and leading to intolerance, diabetes and also Alzheimer’s.   These are intrinsically linked.  Said Alzheimer’s was a diabetes of the brain.  . so to speak.    

Folks, I’ve run on too long, gotta go to bed, it’s 4:30 now, so I’ll be screwing up my Saturday.   G’nite  Jan)


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