If only they knew......
 

Busy day today. Attended a few acute emergencies on the wards. In one, the patient's obesity made airway management a real issue. It was surmountable, but made my life more exciting than I like.
In another, the emergency arose entirely from the patient's obesity, and again, the obesity meant the usual management options were not practical.
People know obesity increases the risk of heart disease, stroke, diabetes, cancer.......they don't realize that it makes every aspect of their medical treatment more difficult, and on occasion simply removes therapeutic options .

Rant over.

But it's a disease!!!!:rolleyes:

And they just keep getting bigger. They just don't seem to care.

They don't have to pay for it so why should they give a damn?

It is tough for you docs to do your job when folks are like that. All you can do is your best. It must be frustrating though....

As an EMT it is tough as well. Try getting a 280 pounder through a narrow door while giving CPR and having them hooked to an AED all the while hoping you don't drop them and it's 2:13 AM and you just climbed out of a warm bed and still have to drive 1 hour to the nearest trauma center.

At sixty-six I decided to let my certification expire. I figured if I didn't, I would be on the backboard next. It was fun while it lasted.

"if only they knew" - wouldn't matter. I believe it's mostly a psychological thing whether it's because they are unhappy or compensating or just a habit due to how they were raised. I'm sure that some folks do have biochemical differences that make it easier to be big, but I don't believe that would make you huge. Eating too much is what makes anyone huge.

Because a big mac meal is two bucks and a salad is five-fifty................

And the big mac meal tastes a heck of a lot better than a salad......to many of us.

John Penette Talks About Salad - YouTube



I also blame serving size. I laugh when I see an "All You Can Eat" sign. on a regular menu item I need a to-go box. All I can eat, that would be a 1/2 serving please.

There's a local "all you can eat" place here that advertises a 100 FOOT LONG BUFFET....that means 20 people will fit because they are all 5 feet wide!!!!

Now wait, it's usually three quarter pounders and a large fry and don't forget the extra big freakin GULP!

It wouldn't be bad if it was just one Big Mac.

That will be $10.59, thank you.

Close. A genetic disorder is more accurate. We think of as a self-inflicted problem, which it is, but it is very very difficult for many people to maintain a reasonable wt. in modern society.

Maybe, it's their way of voting themselves off the island. They know the risks, or at least confirm affirm it's an at-risk behavior, and continue with that same behavior....voting themselves "off the island".

I don't get it. Nobody forces the fatties to eat the whole Big Mac. Heck, if they eat just one half and save the other half for next meal they could eat for ONE BUCK and be in better shape :D

Nobody forces the addicts to smoke the whole cigarette.

I saw a newspaper article on sugar-brain effects a few days ago - will see if I can find it.

Even more frightening, obesity is creeping down to my little patients too. And most parents don´t seem to care. Probably because they often are on the large side themselves.

We had to search for a while to find a pediatrician that wouldn't give us grief because our kids are skinny. What they don't realize is that being in the 5th percentile for weight is a GOOD thing these days--all the lardass kids have skewed the data upwards.

I think the brain can evolve and adapt. There is also the concept of self discipline to consider otherwise we would all experience the same reaction as is reflected in the second to the last paragraph in the above article. Our brain was not designed for a specific point in time. If that were true, we wouldn't be where we are today.

"Our brains were designed for a time when food was scarce and starvation was a common cause of death. While too much hunger remains in modern times, most people in the United States face a challenge opposite to what our distant ancestors faced. Natural selection has not wired us for a scenario in which food is abundant, relatively inexpensive and often high in calories."

You can eat to live or live to eat. You don't need to have a perfect diet, but you need to indulge with moderation.

And a little exercise wouldn't hurt once in a while.

I'm a little touchy on this one. My daughter once she reached puberty put on lots of weight, she doesn't eat a whole lot but as she got larger and larger her mobility suffered meaning even less activity. I never really believed in the whole "active thyroid" diagnosis....but don't know what to think. Her doctor has ok'd Lap Band surgery but it scares the crap outta me!!! Anybody ever have somebody go thru this? Docs....what are your opinions on this type of surgery? (she is only 22 years old)

Yes and no.
Calories do not appear out of thin air. To gain weight, one must eat more than one's needs.

Is it easy? hell no. Is it her fault? hard to say. But the calories have been ingested, no matter how one looks at it.

A close friend of mine who is a chef by trade did this surgery a bit over a year ago and has not looked back. He has lost in excess of 125# and looks and feels like a different person.

His commitment to this surgery has been his ticket to success, however. He can eat only about 1/2 to 3/4 cup of solid food at any one time and he feels full. He must take numerous supplements in order to get the nutrients and proteins that his body needs. He also works out regularly with weights and now can even resume playing tennis after many years of being unable.

He has told me repeatedly that he would not only do it again, but recommend it to anyone who simply could not lose weight in the conventional manner. He has been an inspiration for quite a few others as well as to himself.

That's my .02.

Very true, people use to take pride in their appearance, nobody wanted to be the sloppy fat guy, but now, in the PC world, there is an excuse for not exercising, girls don't care if they are fat & sloppy or that their bellies hang out http://forums.pelicanparts.com/suppo...leys/pukey.gifhttp://forums.pelicanparts.com/suppo...leys/pukey.gifhttp://forums.pelicanparts.com/suppo...leys/pukey.gif

It's a problem of self discipline, lifestyle, peers, and education. It is not insurmountable, and I think the word is getting out. Sugary soft drinks and fast food are killing us via heart disease and diabetes. I think Mayor Bloomberg's soda ban was a stunt to get people talking about the problem. HBO has a special about it. Word is getting out. I'm cautiously optimistic that the trend of obesity it will change.

I know it is not one kind of PC to sound PC, but I would like to see the word "fault" replaced with "choice" in discussions like these. It is all about what we choose to eat and how we choose to exercise. "Fault" has a moral implication, "choice" is something we control every minute of every day. To turn obesity around, we have stop thinking about morals and start making healthy choices.

How has she tried to lose the weight so far? An acquaintance got the lap band thing and lost weight for about a year, but five years later she is bigger than ever. On the other hand, my best friend was told he had to lose weight or start taking insulin. He entered a hospital-directed lifestyle modification program and lost 110 lbs. in a couple of years. He eats like a horse, but changed WHAT he eats and is trim and non-diabetic 3 years after he started.

the problem with that idea is that two people can make the same choices and only one will become obese

agree with last sentence, but the env. will have to be changed for many people - maybe 1/3, maybe most

I do not think half of obese people in the US became obese through some illness. Certainly there are physiological causes in some cases, but one out of two?? What is this illness that has suddenly come upon us?

You can have all and any ilnesses, but the math is the same.
To be fat one has to eat too much for his needs.
The saying goes, one does not get fat from suckling stones.
It would be more efficient to operate changes on mentalities than digestive tracts.

disorder not illness

human physiology & behavior is adjusted for times of resource scarcity; today we have the opposite

and, in most of the world, humans are surrounded by easy easy access to sugars and high fat foods - so-called "fast foods" are loaded with them

Honestly, I think it is a combination of the fatty food and less activity at schools. I went and had lunch with my son for lunch. They have fattening food in the cafeteria and then they have a very short recess (whatever time is left after they finish their lunch). And they only get one. All day. I remember when I was a kid, I ran around like a maniac at least three times a day at school. Some schools don't have PE programs (my son only has it once a week) and in the afternoons after school, a lot of kids stay indoors playing video games. But a lot of it is a direct relationship with the parents. Most likely, heavy kids have heavy parents. Not all but most. I try to have my boys active all the time. Through organized sports and just having fun hanging around, so they see it as a part of life. We also indulge in our fatty foods but balance it with our healthy food too. .

Healthy meals take time too. For most working parents, easier to pull through the drive thru. I make a conscious effort to cook over the weekends and freeze stuff. Although a new salad place has opened up where you can go through a drive thru and order. It has about 10 different salads in their menu. I love it already! Expensive though. A salad with a drink runs about $13-$15. An extra value meal is cheaper...

A lot of truth to this. Eating healthy can be expensive.

Lap band surgery horrifies me.

To be succcessful, the patient must follow a strict diet post-op, yet the only people who have such surgery are those that have demonstrated that (for whatever reason) they are unable to follow a strict diet.

I've seen dreadful complications. Not just gut perforations etc, but stuff like blindness (Vit A deficency), cardiomyopathy. I do not refer any of my patients for lap band surgery or gastric bypass because these procedures have such appalling complications that I cannot reconcile it from an ethical point of view. Especially as these arte often marketed as a "quick fix" when they're anything but.

This is my biggest fear.....from bad to worse in the search for help. She does a food diary and shares it with me almost daily....and she seems to have stopped gaining weight. So I should have said she doesn't SEEM to be eating much...(or showing what/how much she eats). She is on depression meds as well.(she has issues)... I think the weight and self esteem issues are a large part of it, I also think it leads her to eat for comfort possibly.
A friend has suggested a diet plan called "Ideal Protein" Very carb and fat restricted from what I understand. Has anybody ever heard of this plan? Do you think its safe? Is it realistic to think she just won't bounce right back to where she is now?
I appreciate your input on this subject.

Choices, and quantity....
It always amazes me when I see someone shoveling food into their face like no tomorrow.

http://forums.pelicanparts.com/uploa...1367189579.jpg

I've heard of doctors who won't do the surgery until after the patient does the required lifestyle changes. I think this is the responsible approach. If she can't change the way she makes food choices the surgery is an expensive and dangerous waste.
I know people who are on low carb lifestyles who seem healthy and who have lost a Loy of weight.