Why there’s no point telling me to lose weight.

A recent article on BMJ was written by a patient revealing her personal perspective on obesity. She mentions that she is one of over 97% of people for whom dieting does not lead to sustained weight loss. She mentions that she has changed her lifestyle with increased exercise and a whole meal vegetarian diet but her BMI is >30 and has been for her entire life. She avoids visiting her PCP since every visit it’s been inevitable to hear about her weight and that has destroyed rapport with her physicians. She’s constantly told to exercise more, even when she hasn’t been asked about her baseline (She practices weightlifting regularly). Of note, her BP and glucose have always been normal. She concludes with some key messages (suggestions) for providers. 1. Focus on what the patient has come to see you about today. Think twice about unsolicited advice in the guise of education. 2. It is appropriate to give diet or exercise advice when somebody asks you directly but try to focus on other benefits of eating well and getting regular exercise instead of weight. 3. Overweight people know they are. Keep in mind that society’s been telling them that their whole lives.