Weight Loss
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Doctors and nutrition - do you know how much training an m.d. has in nutrition?


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Answer:  2 credit hours.


There's so much talk on here sometimes about talking to your doctor about a healthy weight loss program.  My family is lousy with doctors, and this always struck me as too much faith placed in the omniscience of doctors in all things to do with the body.  Had a long talk with my physician sister-in-law tonight during which she asked ME how I was losing so much weight, because she needs to lose a few pounds and thought she might follow whatever method I'm doing for awhile to see how it works for her.

Sure, there are doctors who specialize in nutrition, but your average physician (from surgeon to general practitioner) specializes in illness, disease, injuries and medication.  That's it.  Another doctor in the family likes to say "People are basically billygoats.  We can survive on anything."

just saying...

 

 

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Over the years, every time I've asked various doctors for advice about weight loss, I've been handed a copy of a 900 to 1000 calorie diet.  It's always been the same thing and it's terrible advice.  Not one of them had a clue, and until a couple of years ago neither did I.  I just tried my best, would lose about 20 pounds then stall, try to eat even less, and fear the weigh ins.  Then, after no weight loss after starving, I'd give up and gain it all back.

January 22, 2006, I joined CC and my life changed.  Thank you CC friends, for all the support.  And thank you CC for providing me with all the tools and information I needed to transform my way of living.

Wow.

when I was in nursing school, OUR nutrition class was worth THREE credit hours!

ha, well that makes 2 things on my list never to trust to doctors.  never ask them about nutrition, and never NEVER let them try to draw blood.

After a lifetime of doctors telling me to lose weight, I finally found a doctor who has lost weight himself.  He knows how hard it is to lose weight and add exercise into a busy schedule.  Seeing a dr that's been through it himself really helped me. 

Its terrible isnt it...altho my endocrinologist was super impressed with this site and when I got down to approx a size 12 (dont ask me about now!) he was impressed and said that if I could manage to maintain that loss and never lost another pound, I would be golden. He said my body was the product of thousands of years of evolution and designed to hold weight -- thin people were the anomaly.   Yeah, apparently he was right.

Maybe this is something that we should work on educating our doctors... I wonder if CC has materials geared toward the health profession that we could start taking with us to appointments.

My understanding is here in Canada, that unless they specialize in it, MD's get virtually no training in nutrition and prevention.  They are trained to diagnose, then treat either by slicing you open or give you a pill.  If you are looking for advice on nutrition, consult someone who is actually trained in that, not your doctor.   You probably won't like what they have to say, because for the most part, they go against the grain regarding what you are taught by mass media, but they sure know what they are talking about!!..lol.

Original Post by johnnypenso:

My understanding is here in Canada, that unless they specialize in it, MD's get virtually no training in nutrition and prevention.  They are trained to diagnose, then treat either by slicing you open or give you a pill.  If you are looking for advice on nutrition, consult someone who is actually trained in that, not your doctor.   You probably won't like what they have to say, because for the most part, they go against the grain regarding what you are taught by mass media, but they sure know what they are talking about!!..lol.

At my med school we got about 6 hours of lectures on nutrition. Maybe 10 if you count breastfeeding and geriatric nutrition.

I have done a lot, I mean a LOT of independent research on it through my own journey, though. I hope to be able to help my patients with it, too.

BTW the best resource I have found is the Harvard nutrition source. I actually like it even better than Canada's food guide these days. The food guide used to be my first tool to refer to people, but the harvard one is more up-to-date on research and medically accurate. the only thing that cheeses me off is that they don't actually tell people how many portions of things to eat. The food guides always tell you to eat way too much starch and possibly not enough protein, especially in the context of a reduced-calorie diet.

Frankly, I think there should be Public Service Announcements about healthy weight loss, especially the concept of a "healthy calorie deficit." We all hear the same stuff about a healthy loss of 1-2 lbs a week, but no one knows what that means or why, if 1-2 is ok, 3-4 isn't better! Well, no one who hasn't been on CC or isn't a nurtritionist, I guess!

I've been one of those who has lost the same 10 lbs over and over, never getting beyond that, simply b/c I didn't know about the deficit issue! What a difference it makes.

I LOVE CC!!!!

my doctor has told me for years to change my lifestyle.  i just laughed...  yeah, right...  just change your lifestyle...  and what for?  i need my favorite foods or there's no sense in living!

LOL  little did i know, i CAN still have ALL my favorite foods!!!

and we, as a nation have been told since, like forever, to eat our fruits & veges.  who wants to do that, though?  ME, now!  :D

and we've all been told to exercise at least 1/2 hour a day.  who needs that crap?  ME, now!  :D

i don't know how many credits these doctors would need to tell us these 3 simple things to do.

eat better, eat less & stay active!  ;)

It depends on the med school.  In mine we actually had a course in it like any other course.

We also got trained on LISTENING to people, and lots of other things that, it seems, many doctors don't get taught to do....

V.

 

Nurse here, married to a physician, mother of a physician and I know that physicians and nurses receive very little education in nutrition.  There is so much to cover with "the body" they can't know everything and most don't claim to do so. 

 On the other hand I have a granddaughter who is a senior in college her major is nutrition and she will go on to get at least her masters degree.  I think a doctor can legitimately diagnose weight problems and then be competent and refer you to a nutritionist.  This is not a negative for them but an acknowledgement that nutrition is a whole field in itself.  Not too many pediatricians do neuro surgery, nor do automobile mechanics work on refrigerators............same thing.  You just can't know it all, although some folks seem to think they do.

My Doc readily admitted he knew nothing about nutrition and weight loss- he had suggested that I join weightwatchers- er, been there, done that. I explained what I'd been doing, and why, and he was stunned- he actually said I sounded like I knew what I was talking about and had no hesitation referring me to a nutritionist for further help ans he was no use to me (in his words!).

The Doc before that told me to eat 1000cals and exercise for 1hr a day....

I'm a first year medical student and we don't have a formal nutrition course.  We do learn about the complexities of the biochemistry of weight loss, ie why it is so hard to lose weight.  One reason why is that why you cut your calories (going from 2,000 to 1,500) after awhie your metabolism will slow, so that you only need 1,500 a day to maintain your weight.  Everyone who is a dieter knows this already. Also, 90% of people regain the weight they lose within 1 year and 60% gain more back with it.  If you want someone to meticulously go through your diet with you, go to a dietician, its their job.

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About to graduate med school. We received probably the same 6 lectures on nutrition as the other student, however these were not about calories or how to lose weight but more vitamins and how to recognize a vitamin deficiency (VERY rare in civilized societies). On the first national exam one section is devoted to nutrition (not sure how many questions) but again this was all about vitamin deficiencies. I am not going into primary care so will never receive a question from a patient about weight loss. My family, friends and CC have taught me what I needed to know about weight loss.

As an MD - Gastroenterology to be specific (we are susposed to be the most aligned with nutrition) I can vouch that our nutrition training is quite poor.  As obesity becomes more prevalent this may change but there is a general culture in American medicine that it is useless to develop methods for helping patients loose weight because (1) they never succeed and (2) they always gain it back.  Its a nihilistic approach that doctors equate weight loss with those other "impenetrable" risk factors like smoking and drinking.  Most of my training has been thru independent research and learning from other docs who have specialized in weight loss.

The real problem is that weight loss takes time intensive education.  Something that most busy physicians cannot do without angering a waiting room full of patients who already might be waiting 1 hour to be seen.  Fortunately, the Registered Dietician is a great physician extender and all docs should really know several good ones that they can refer too.  My most recent approach for patients is the following...I tell them:

You have to understand that as crazy as this may sound, hunger is not an emergency, and that if you want to loose weight, for the most part, you are going to get comfortable with the  feeling hunger, particularly if there are emotional eating patterns in their life.  I explain to them about metabolic homeostasis and caloric deficits and generally refer them to a nutrtionist if available.  I have also recently been refferring patients directly to this web site.  Although I do think excercise is important, I don't reinforce their false hope that you can excercise your way to health by eating cheetos and big macs.  I sort of emphasize a tough love approach that is based on changing the way one things about eating - switching from mindless eating to mindful eating....I explain how calorie and nutrient counting made that change in my life.

The problem with MDs and nutrition - is that nutrition is to some degree more than "chronic disease" a personal problem, dealt with at 11:48PM when you are hungry and think you can't fall asleep without making some toast with butter and jam.

 

I did not mean to give the impression that I think of myself as "knowing it all", but I do know for a fact that my medical school did more nutrition training than most in the u.s. That's not to say that I'm a nutitionist, and I certainly always refer to a nutritionist when working with patients. But we did not just get "the same 6 lectures"... :)

V.

 

I am a dietitian, with 6 years of nutritional training, including a 2 year internship rotation in acute care, nursing home care, food service, public school, hospice and trauma, a MS degree in nutrition and a requirment for 75 continuing education credits every five years. The medical board suggests medical schools provide 25 hours of nutritional traning for M.D.s (I'm serious) and few schools meet this requirement. Most doctors will refer you to a dietitian because they have to do other important things like save your life. They would much rather that we handled it so they can focus on that.

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