Well, my colonoscopy has been postponed. Yeesh. And it wasn’t me; I didn’t chicken out. The nurse called and the doctor is taking a day off on Friday. I got all wound up, and now I’ll wind down until April 18th – prep day, followed by the no-big-deal procedure on the 19th. Thank you for all your well wishes. When it FINALLY happens, I’ll let you know how it goes with more subtlety and decorum (but less humor) than Dave Barry. Thank you, alert reader, Mulberry for the link.
I am especially pleased to learn that many maintainer friends did not experience a weight shake-up from their colonoscopies. Had I not heard from you, I wouldn’t have taken it for granted. I don’t trust the words of doctors and other “experts.” With regard to weight management and weight rebound, simply, they’re out of their depth. What’s more aggravating, they don’t acknowledge how out-of-their-depth they are.
Regular reader, Ali, just recently ran into an “expert” (chiropractor) who dismissed her dietary choices (which were working pretty well for her) in a conversation that lasted less than ten minutes. With the pseudo-scientific authority granted by the likes of journalist and weight-loss opportunist Gary Taubes, she stated simply, “you must go low carb.” Well, Gee, lady.: thanks but no thanks. Low carb works for some people, and I’m happy for them, but if it worked for everyone we’d all be trim. Anyone over the age of 20 in this country saw the rise and crash of the New Atkins Revolution (which nearly killed our grain markets and bankrupted our grain farmers at the beginning of this century). Had the Revolution worked for everyone, I’d have jumped on board too. Instead, most of us witnessed sad stories of radical weight loss and rebound among earnest, disciplined people. The few who succeeded then must now work at least as hard as I do to maintain their losses in a carbolific society (who pushes them to portion control, while pushing Ali and me to drop our bananas).
One sure sign that you’ve found a person who knows something is that they are secure enough to acknowledge that they don’t know everything. That’s why Arya and Yoni have charmed me. And I especially love this post from Barbara Berkeley, The Perfect Diet: Does it Exist? The one word answer is “nope.” People who have earned their bona fides do not pretend to have the one and only answer.
I have been trying recently to find a doctor locally who might help me, be my partner, in figuring out this whole weight game. Maybe, as a bonus, we’d improve my health too.
I’m not having any luck. I’ve Googled my city’s name and the words “weight-loss maintenance” and other related search terms, and all I get are a bunch of weight-loss product sales reps, who happen to have MDs. At their websites they brag about helping people lose weight rapidly, and make vague claims about their patients’ success, sans year markers or other tangible signs of maintenance. None has a maintenance support group or other system in place for after the big loss. Pretty clearly, you lose weight and then you’re on your own (and they claim you’re a success, regardless of what happens to you, since they don’t care to know). Sure, the door is always open. If you regain after their program and have the courage to return and tell them about it, then you can try again, or they’ll refer you to a bariatric surgeon.
Gee. That’s the state of this field? (I gotta wonder how Arya, Yoni and Barbara feel about all these yahoos. They probably feel they can’t say anything negative, but I can: it’s a sorry field and I’m sad they’re lumped in there.)
Since what I want doesn’t exist in Kansas City, I will again enter into Fantasyland. What would I want? Let me dream it into being. This is the 2012 precursor to my 2050 fantasy. The people exist right now who could make this happen, if they just were willing. Woof.
I’d like a staff that uses words like “weight management,” as Arya does, or “maintenance,” as Barbara does. I know my size acceptance friends find that unsettling, since they feel medicine really should be about health, not weight, but that vocabulary would be far superior to the flim flam we now hear. And I’ll accept that my maintenance is probably a cosmetic concern. We don’t have trouble with doctors dealing with both health and cosmetic issues in other fields – plastic surgery, dermatology and the like – so let’s allow some doctors to help us with weight management, even if it’s not solely about health. Ideally, I’d want to find a practice with several doctors in related specialties, and a Registered Dietician.
It would be nice if it had an endocrinologist who would run tests that would far exceed the simple blood tests I get at my annual physical. Perhaps we may find additional thyroid issues that may be treated with more precise medication than what I now take. We could look at my insulin and test for insulin resistance, of course (which I don’t suspect are my issues), but also plasma ghrehlin, leptin, peptide YY3-36, aghouti-related protein, cortisol, among others. Perhaps we could look at my numbers both after fasting and after meals. I’d spring for that. Many people spend much more on their hobbies than what I’d spend with a good endocrinologist to help me with my unpaid job. Maybe he or she would find something that would benefit from medication or could pass my results along to the dietician and others.
Respecting the endocrinologist’s findings, I’d like the dietician to talk to me about more than portion control, and maybe also look at issues like eczema, in addition to weight management. I’d also like to have access to a sports medicine practitioner and an orthopedist, who both understand the importance of maintaining a structure that can withstand the kind of exercise regimen that maintenance requires. I’d appreciate some supervision as I adjust that regimen, to make it less onerous while preventing a weight slide.
Instead of medical practices like this, we have know-it-alls conveying little knowledge at all, and inflating the easy, breezy weight-loss mythology that’s making us all crazy.
Next post, I think I want to look at some more science. The state of culture and medicine is depressing me. Friends, could you send me some good links to look at, please?