Our Biggest Failure as PCPs: Obesity

Wednesday 8/1/12: 13 out of 37 patients I saw asked me direct questions about starting a weight loss program. Naturally, I got to thinking.

Here I am, giving away pedicures to encourage people to get screened for cervical cancer, filling nylon bags with info about drugs for college kids, practically begging people to have a colonoscopy and yet I am subconsciously sidestepping my patient’s number one health problem: their weight.

If I analyze my success at treating high cholesterol, high blood pressure, and diabetes, I do a pretty darn good job getting most people to goal. However, my tools are usually a pile of prescriptions. It occurred to me on Wednesday that I, like many busy PCP ‘s are missing the forest for the trees.

Here is a standard quote (if you are my patient, I guarantee you have heard some version of it—and I am surprised you haven’t kicked me in the face yet.)

“You know, So and So, your blood pressure/diabetes/cholesterol/back pain/ fatigue/mood/_______ would get so much better if you lost some weight.”

Then, being the excellent doctor that I am, I hand you a script for your ailment.

DUH!!! I just literally pissed myself off!

Why am I dropping that line and walking away?

People KNOW they need to lose weight but they don’t know how. There are so many barriers: which diet? Which supplement? Drug? No carbs? How much exercise? Maybe I should have surgery? But where? And which one?

They also are getting trapped in the “meant to fail” psychology. In other words.”I have always been fat therefore I will always be fat.”

So here I am, a qualified professional. I have been allowed the most implicit of trust and the most intimate information. And what do I do with it? I write a script.

What if I used all that I am trained to understand about how the body works, my personal struggles with weight, the connections I have made over the years with health coaches, nutritionists and personal trainers to help my patients lose weight? I mean really help….as in create an all encompassing individual program for my patients with weight struggles: without surgery or amphetamines or HCG drops or liquid shakes or cardboard tasting protein bars.

Whether your weight has led to a plethora of medical ailments, or it has simply been the biggest bane of your existence, isn’t it past time you got something from your physician besides a band-aid in the shape of a prescription?

So, starting now, my mind is working out a plan that I will share soon. In the meantime, if you are coming in to talk about your cholesterol or blood pressure etc, please be kind and keep your steel toed boots at home– I may still deserve that kick in the face but hopefully not for much longer.


  1. Ok, thisay sound harsh but here it is: — you can’t fix em all Doc. People have to take responsibility for their own health. My theory on obesity and loss of weight is as simple as budgeting money ( for most folks, that is) it’s all about in versus out. Basically : exercise and mind ones calories — on a daily basis, The end.

  2. Cathi Thompson says:

    Hahaha..your office called several weeks ago and left me a message that I am due to come in…I haven’t done that because I have gained weight and just couldn’t face you….it’s not that you EVER made me feel bad, it’s me that is disappointed in myself, thus not wanting to disappoint the best damn doctor I’ve ever had!! But I am intrigued about your plan….do tell…….❤️

    • Oh Cathi we have ALL been there…beating yourself up is not helpful. I think adults trying to lose weight are a lot like young kids trying to learn…life. They/we need constant and sincere positive reinforcements from people we look up to…not shaming. We need support. Anyone can calorie restrict and exercise consistently for a few weeks. It takes camaraderie to make lasting change…I will be your sticker chart!!

      • Cathi Thompson says:

        I LOVE that idea!!! Ok, I will make an appointment, I am well passed due, I truly do need help and inspiration, and the camaraderie would be the bonus!! Btw…the sock thing happens to me, I’m constantly pulling clothes on, taking them off, socks in the boots are nightmarish, I’m with Hadley

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