Communication with your doctor is a two-way street. You cannot expect him to ignore your weight issues because they directly relate to your health and he's supposed to take care of your health. If he doesn't bring up the weight discussion, then more than likely it's because he is reading your body language and your reticence. And then you have a situation that I described in my previous blog - a poor doctor and a poor doctor relationship. Obviously you may not want to discuss your weight situation because you feel defeated, or because your assumption is that your doctor is judging your failure to do something about it. In fact, doctors can be quite empathic and helpful if given the chance. But at the end of the day, no matter how much he is willing to advocate, the true weight battle is yours and yours alone. So how do you create a comfortable relationship with your doctor, so that you can talk about your weight and strategize solutions (which may or may not work) without feeling a sense of embarrassment or even failure?
(1) Be brave enough to start the dialogue. Let your doctor know that you care, that you truly want to find a practical diet or lifestyle plan that will work.
(2) Let your doctor know that this is a sensitive discussion and that you feel like your inability to lose weight is being judged by him and others
(3) Share your challenges with him - maybe you need more education or support or some diet book suggestions
(4) Share your emotions and feelings with him - you need to be brave enough to share in this very private setting or you won't be able to strategize with your doctor
(5) Let him know you are willing to get on the scale, have your waist measured, hear your BMI number, though you may not yet be ready to actually do something about poor results. If not, let him know you need time, but work through this resistance
(6) Ask for help - he needs to know that you are willing to listen to his suggestions and recommendations
(7) Let him know when something doesn't feel comfortable - it may be the language he uses or his body language or his interpretation of your efforts - just do it respectfully
(8) Be willing to try different treatment options - be open minded
(9) Ask if the doctor has other patients who have kept off weight for significant periods of time and then see if you can contact them as a possible resource or support team
(10)Try to separate from your emotional and reactive responses - we sometimes hear things that are not being said because of our own biases and preconceptions
One area of particular challenge is parents who have overweight or obese children. Pediatricians feel very daunted as they try to communicate serious concerns to parents who, in turn, feel they are being judged on their parenting skills. The truth is that statistically speaking, overweight parents have overweight kids because many of the unhealthy habits and foods in the home are being shared by all family members. Pediatricians often find it really hard to bring up the discussion for fear that their concerns will be misinterpreted as serious criticisms. For the sake of our children, we need to get past our own self esteem issues and allow doctors to treat our kids before the weight issues contribute to life-long chronic diseases. There's a phrase - Do I have your listening permission? That's really what your doctor is asking you when he tries to talk about the health and welfare of your overweight or obese child.