Helping you achieve a healthy lifestyle through movement and nutrition

Obesity- Disease or Choice?

 

A recent article on Medscape claims that “experts” are now saying that obesity is a disease, not a choice. The claim is made that obesity is a physiological state and that “overeating does not cause obesity, obesity causes overeating”. The article goes on to state the best things to do for someone who is obese; follow a healthy diet, exercise more, stress reduction, and more sleep.

Having worked with clients who are overweight or obese, I have some thoughts on this.

Number one, sometimes no matter what intervention you may try as a medical professional, Dietitian, personal trainer, or concerned family member or friend, you cannot make a person change. This is a hard pill to swallow, especially to those who are in professions trying to help people. I’ve been training clients for a few years now. I can motivate, educate, and inspire people to the best of my ability but at the end of the day, the client is the one who has to make changes. As the old adage goes, you can lead a horse to water but you can’t make it drink.

Now, I’m not absolving professionals of their role in all this; far from it. I think having a good coach, doctor, or trainer can make a huge positive difference in the lives of clients. Likewise, having a poor coach, doctor, or trainer can absolutely have a large negative effect as well. It is our responsibility as professionals to know our stuff and stay on top of the game. Most importantly, we need to know each client as an individual and know what works and what doesn’t work depending on their personality and circumstances.

Number two, I think that obesity is caused by two main factors: overeating and lack of sufficient exercise. As far as overeating goes, I highly disagree that obesity causes overeating. How did the person get obese in the first place? Are you telling me someone is obese out of the womb and then they start overeating? No, a person becomes obese after years of eating way too much junk food, drinking soda and/or alcohol, and not moving enough. The disease, if you even want to classify it as such, should be addiction to food or binge eating. Personally, I think we get too caught up in these disease vs not disease debates.

At any rate, a person becomes obese- they are not born that way. And it is a choice. It’s like saying someone who is addicted to drugs has a disease. Yes, they are addicted. But, they still have a choice, and they made choices that led them down the path they ultimately took. There have been many people who have overcome their addiction-be it drugs, cigarettes, alcohol, gambling, etc. The difference is these people had the mental resolve and pro-activity to change their lives. Sadly, some people do not.

So is obesity a choice, or a disease? It can be both. But from what I have seen obesity is a more a mental disorder than anything- people just can’t stop eating too much and/or begin exercising. In my opinion, that is either a lack of knowledge of what to do or a lack of discipline to do it consistently. If that classifies as a disease, who really cares. One of the hardest things in life for people to do is change. Habits are so ingrained in our subconscious that it takes a long time to override them. But it can be done. What matters most is that all of us- healthcare professionals, personal trainers, family, and friends- are there for the individual and support them to the best of our abilities.

 

Sources:

https://www.medscape.com/viewarticle/896444#vp_2

Do Doctors Need to be Experts in Nutrition?

 

I recently was reading a few articles regarding the current status of nutrition education in medical schools in America. Apparently, future MD’s receive little training in the area of nutrition, with only 19.6 hours on average spent on the topic in most 4 year programs. Many are arguing that doctors need more training in this area and it got me thinking, do they really need more training to be experts in nutrition?

Hear me out. Doctors fill a specific niche in healthcare. They are the top of the pyramid and have a working knowledge of most everything. However, a doctor’s primary role is to treat disease and manage symptoms. People go to the doctor when they are sick and need to feel better. It is usually an acute thing or for a yearly checkup.  The doctor or primary care practitioner then makes an assessment and either prescribes a treatment plan and/or refers the person to a specialist in a branch of medicine such as a Cardiologist for someone with any problem related to the heart, or say a Physical Therapist for a movement related issue. From there the expert in the given field, say a Physical Therapist, will have a full session with a patient and determine the best course of action for them. I believe it should be the same way with nutrition.

What I mean is, let’s say someone has an eating disorder or is having trouble adhering to a diet plan. What a Physician or any primary care provider should do then is refer the person to a Registered Dietitian who can work with the person to achieve their goals. A doctor not only does not have the training to properly assist the person but also most likely does not have the time. A study done showed that doctors have between 7-22 minutes with a patient before they must move on to the next. There is no way in that time that they can sufficiently educate and help change a person’s eating habits. They have a hard enough time talking to the person about anything, let alone diet.

In conclusion, I do think that doctors should have a good knowledge of nutrition. It is vital, as what a person puts in their mouth contributes largely to their health. That being said, doctors do not have the time to counsel people to make significant changes and should be more willing to refer out to a Registered Dietitian to further help patients achieve lasting health and wellness.

What are your thoughts? Have you ever received dietary advice from a Physician? Have you ever been counseled by a RD? Leave a comment below with your experiences!

 

Sources:

https://www.healio.com/cardiology/chd-prevention/news/online/%7Ba1f5d74a-4c3b-4b92-aac0-5c0be30d4b9b%7D/knowledge-gaps-remain-in-dietary-education-training

https://health.usnews.com/wellness/food/articles/2016-12-07/how-much-do-doctors-learn-about-nutrition

 

Why Doctors Don’t Know Nutrition