Med school que. do they teach you nutrition?

[vash]

That obesity thread got me thinking. Fattyness, I imagine you can be fat in the inside as well. It can't just show up when you climb up on a scale.

Anyways. Eating badly has a hand in everything.

Fat
Heart disease
Diabetes
High blood pressure
Inflammation
Auto immune crap
High body weight is bad for joints

Maybe all of it! As a society we don't think of food as "medicine". It has to be preventative right?

Do they burn nutrition into your brain at med school?

[LEAKYSEALS951]

As a dental student, we got a lot of basic stuff as "hand me downs" from the med classes. For the first two years, many syllabus's (syllabi?) would have M1 crossed out and D1 written in it's place.

I hope med students get more. We had thorough teachings on biochemistry and how various things are processed in the body, but little on nutrition. Whereas premed course would teach the basics- organic chemistry "trans-fats, etc", the medical/dental biochem courses went into thorough details on all the chemical pathways. I remember briefly knowing it inside and out- how things were absorbed, how carbs got burnt, or got converted into fats, and vice versa. It was like Neo figuring out the matrix. For a brief moment, it was all clear.

Ironically, the biochemistry course I took had a catch. If you had an "A" average after the the majority of exams, you were exempt from the last portion of the class.

And the last portion of the class you could opt out of?- a week devoted to nutrition. Guess who was exempt from the last section- yours truly. In the context of all the other work/ exams going on, it was a strategic decision, yet I still remember wishing I had of been there that last week.

Since school, I have been to several continuing education classes that focus on nutrition. Even though they were not dentally related per se, I have always gotten a lot out of them.

Hopefully med schools these days do better. edit- even if the med schools do a thorough job on teaching it, there is the issue of how the doctor should teach it to a largely unreceptive audience in a gluttonous environment/society.

[recycled sixtie]

Interesting observation from the dentist(leaky seal?) about seeing fat bubbles in saliva.
Yick.

As an aside my retired dietician wife imparts knowledge about dietetics on a regular basis. I am not allowed to get fat.

When I watch Dr. Oz on tv I never see him talking about fat people even though half of the folks that ask him questions are overweight. I am guessing he is being politically correct.

Yes I hope the docs get sufficient training about dietetics but telling patients they are fat is common sense if they are fat.

Cliff - watch the documentary "What the Health" on Netflix. It's well worth the time.

Generally, Med schools focus on treatment rather than prevention. That's just how the business model evolved. And I'm not in any way beating on Docs or anyone else in that biz.

[pavulon]

Although patient weight is commonly required to be part of appointment discussions and documentation, the vast majority of people are not in the office to talk about their weight regardless of whether or not it is the root of the issue that brought them in. They simply have no interest in doing the work to get on top of the problem.

The kicker is that given an opportunity, patients will complain on patient satisfaction surveys and/or to representatives (or even worse, social media or BS websites like healthgrades) that their doctor "was rude" or "called me fat" or "made me feel uncomfortable." Such is healthcare today.

[LEAKYSEALS951]

This thread got me thinking about another question for the MD's out there.

What is the standard of care in regards to informing/ treating obesity?

I understand that people get offended easily, and become dismissive or defensive when the subject is brought up. We had two families recently get upset and leave the practice for informing the parents their kids had lice.

In dentistry, we are liable for informing patients of other diseases even if they are in for another chief complaint (for example- a patient comes in for limited oral exams addressing broken fillings here or there, and the dentist does not inform the patient they have periodontitis, the dentist can be held liable for failure to diagnose).

What is the protocol in Medicine? And would creating a more supportive environment help the medical profession drive it home? For example- recent crackdown on narcotic prescribing allows me to tell patients "Sorry, I would love to give you more pain meds, but the laws are really cutting down on what we can prescribe." With that support, I can play the part of empathetic messenger, not the bad guy.

Are there similar opportunities in the area?

[MRM]

For the most part, no. Medical schools don't really teach nutrition as a science. Hospitals have dietitians who are specially trained in nutrition. The thinking is that dietitians should handle that specialty and it would be unnecessary overlap to teach docs the same thing. That's why you get generic advice from MDs to lower your fat intake, increase fiber, exercise more, etc. but not much more than platitudes. Just as a physical therapist is the specialty you need for rehabilitating after an injury (rather than an orthopedic surgeon) a dietician is best suited to give nutritional advice rather than a GP medical doctor. Obviously exceptions exist and specialist MDs know more than dietitians, but the General rule holds true generally.

[recycled sixtie]

When my daughter did her Phd thesis on pediatric obesity one of her projects was a volunteer program where overweight parents supplied inputs about their overweight children. One of the interesting observations was that overweight parents did not recognize their children as being overweight. So the cycle continues.....

[MBAtarga]

I recall a lecture I heard from a "nutritionist" that claimed the average MD received about 4 hours of instruction on nutrition during their medical school training.

[Don Ro]

I've been under the care of three PCP's and a handful of specialists since early '11. Not one has ever uttered a word about fitness and/or weight loss. They just continue to write prescriptions.
Now, when I go in and I weigh 6 lbs. less than the last visit they'll mention that.

But I've recently awakened to realize it's my responsibility to take care of myself by getting back my fitness and weight in the hopes that I can get off the multitude of meds those educated and well-meaning folks seem to be addicted to prescribing.

To my consternation, I've come to realize that I'm being treated by pill pushers.
If I have a negative side effect from one med, another is prescribed to counter that one. Not a good thing.

[LWJ]

Watch "Forks over Knives." Propaganda. Yes. Possible truth? You decide.

[vash]

Originally Posted by Mark Wilson

Cliff - watch the documentary "What the Health" on Netflix. It's well worth the time.

Generally, Med schools focus on treatment rather than prevention. That's just how the business model evolved. And I'm not in any way beating on Docs or anyone else in that biz.

Just watched it. Thanks!

Not sure I believe all of it. Those two sick people really turned it around. Wish they put their doctors on. I'm skeptical

And bummed. We got no shot. We are on our own.

[Tobra]

Originally Posted by pavulon

Although patient weight is commonly required to be part of appointment discussions and documentation, the vast majority of people are not in the office to talk about their weight regardless of whether or not it is the root of the issue that brought them in. They simply have no interest in doing the work to get on top of the problem.

The kicker is that given an opportunity, patients will complain on patient satisfaction surveys and/or to representatives (or even worse, social media or BS websites like healthgrades) that their doctor "was rude" or "called me fat" or "made me feel uncomfortable." Such is healthcare today.

The trick is to ask them how the diet is going. Heavy people are always on some crazy diet.

It comes up a lot for me, like daily. Fat people have foot pain, go figure.