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I need to rant (crazy doctor)

Thursday, February 05, 2009

A couple of days ago I went to a new doctor to get my annual prescriptions. I also wanted to ask his advice on other weight loss techniques and his advice on seeing a nutritionist. I never got that far.

I don’t know what this doctor’s problem was, but he went on the defensive right away. Before I could have a normal, doctor-patient conversation, he told me that my only problem is that I am a food addict. He said he had lost over 30 pounds some years ago and he kept it off by just eating sensibly. There is never a need to use a diary or weight & measure your portions if you only eat what your body needs.

I was trying really hard to get what he was saying because I had never seen him before and I thought this might be a “hot button” for him and his style of “bedside manner”.

So I tried to tell him about SparkPeople.com. I tried to tell him that I eat an average of 1320-1600 calories a day, with the average around 1400. I tried to tell him I have been really motivated that last few months and that I have honestly weighed every bite that I eat and I have been doing an average of 45 minutes of exercise 7 days a week. I tried to tell him that with all I have been doing that I have lost about 15 pounds in just over 3 months. I wanted to ask him about my under active thyroid (corrected with medication). I wanted his reassurance that this is normal with all that I am doing, and if not, what I should try.

I say I tried to tell him, because he kept interrupting me and telling me that this wasn’t possible. He told me that he has so many patients that tell him the same story that I must be deceiving both myself and him. (Later he told me that he wasn’t calling me a liar, but that he just didn’t believe me. A subtle difference, I guess.) He went on to say that science shows that my body size needs about 2200 calories a day to maintain itself. He said that if I truly am eating an average of 800 calories a day less than this that I could just sit in a chair, eat my 1400 calories a day and I would automatically loose 10-20 pounds a month. He told me that if he didn’t believe in this science he shouldn't’t be a doctor and it may have been mean of me but I told him I agreed, he shouldn't’t be a doctor.

He also said that if I am not losing it is probably because SparkPeople.com is faulty, or my scale, or my measuring cup and spoons, or I am just leaving out a ton of food everyday. He made it clear that he thinks that the real fault is mine and that I am leaving out LOTS and LOTS of food everyday.

This went on for over a half hour with me trying to get him to believe me and him firmly telling me I was wrong. Needless to say I finally just got my annual prescriptions and left and I have no intention of going back to this quack.

It was only after I got home and calmed down that I started to look into his food addiction theory. What I found confirms my suspicion that this guy is erroneously using the food addiction label on anyone overweight.

Here are just a few of many similar definitions:
1. Although there is no official definition of food addiction, it is much the same way as other substance dependence: "Eating too much despite consequences, even dire consequences to health; being preoccupied with food, food preparation and meals; trying and failing to cut back on food intake; feeling guilty about eating and overeating."
2. “The drive to eat is so intense that it overshadows the motivation to engage in other rewarding activities, and it becomes difficult to exercise self-control.”
3. “An individual suffering from compulsive overeating disorder engages in frequent episodes of uncontrolled eating, or binging, during which they may feel frenzied or out of control, often consuming food past the point of being comfortably full. Binging in this way is generally followed by feelings of guilt and depression. Unlike individuals with bulimia, compulsive over eaters do not attempt to compensate for their binging with purging behaviors such as fasting, laxative use or vomiting.”
4. “Compulsive over eaters will typically eat when they are not hungry. Their obsession is demonstrated in that they spend excessive amounts of time and thought devoted to food, and secretly plan or fantasize about eating alone.”
5. “During binges compulsive over eaters consume as much as 5,000 calories and up to 60,000 calories per day, which results as an addictive "high" not unlike those experienced through drug usage, and a release from psychological stress.”
Signs of compulsive overeating
a) Binge eating, or eating uncontrollably even when not physically hungry
b) Eating much more rapidly than normal
c) Eating alone due to shame and embarrassment
d) Feelings of guilt due to overeating
e) Preoccupation with body weight
f) Depression or mood swings
g) Awareness that eating patterns are abnormal
h) History of weight fluctuations
i) Withdrawal from activities because of embarrassment about weight
j) History of many different unsuccessful diets
k) Eating little in public, but maintaining a high body weight
I am happy to know that I am not a true “food addict”. I may have a few symptoms (g, h & j) and I know that when I quit paying attention my individual meal sizes do get larger, but when I refocus I can control the portion size without feeling deprived. I also don’t eat in secret. I don’t hide food, and even at my heaviest I don’t generally eat when I am not hungry because I am to busy doing other things. So basically a food addict literally lives to eat. I may not be all the way to just “eating to live”, but I have a lot more going on in my life besides food.

And then I started remembering other weight loss programs I have been on with Weight Watchers (WW) being #1. Even though WW uses a points system, each point is the equivalent of 50 calories. When I was on WW I was supposed to eat between 24-32 points per day which works out to 1200-1600 calories per day. SURPRISE, that is almost exactly the same as SparkPeople.com. I even found some old diet literature from another doctor I saw years ago and it was for a 1200-1400 calories diet. All 3 plans tell you to expect a 4-8 pound loss per month if you follow the plan and exercise. So I am still on the low side of the weight loss average, which is frustrating, but not unheard of.

So anyway, I am still angry and frustrated with the doctor, but I am no longer feeling like a total failure and the real lesson I have brought away from this episode is that we have to take control of our own medical health, because doctors can be as big a fools as anyone.

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    Disclaimer: Weight loss results will vary from person to person. No individual result should be seen as a typical result of following the SparkPeople program.