Monday, September 08, 2008

28% of Doctors give Nutritional Advice?!

At least in California.

A survey of 46,000 residents revealed that 34% of residents said their doctors discussed exercise with them and 28% said their doctors discussed nutrition.

Not surprisingly, the media is painting this as a shockingly low number. I think it sounds shockingly high.

I think it's high because frankly most doctors simply aren't taught about nutrition and exercise.

I wonder if comments along the lines of,

"you should try to eat healthier"

"you should try to find more time to be active"

"you should try to eat less

They shouldn't you know.

Telling someone who's asking for advice on weight loss or healthy living that they should, "eat less and exercise more" is just about as useful as telling someone who's clinically depressed that they should simply, "buck up".

If we want to have doctors really be able to pull their weight in obesity prevention and healthy living promotion we're going to have to go back to the drawing boards in medical schools and residency programs and really teach doctors concrete useful tips that they can give their patients.

Until then I'm afraid, with rare exceptions, we're going to be stuck with most doctors giving vague to the point of useless nutritional and lifestyle advice.

Has your doctor ever given you any concrete, useful recommendations on diet or exercise?

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  1. I'm in the UK, not US, but I expect things aren't so different here in respect to GPs giving dietary and exercise advice ... or otherwise. However, my own GP has been excellent whatever I've had cause to see him about, including deit and exercise. Actually, he was better on the exercise bit that the dietary advice, but given that I have multiple anaphylactic allergies he probably doesn't know where to begin to give me dietary advice. However, when it came to exercise he was able to refer me to a physio for supervised exercise as I also have extremely severe and brittle asthma. This makes exercise difficult and somewhat dangerous, but I'm battling against the effects of 12 years high dose prednisolone (so far) and need to lose weight, which I know will benefit my asthma too. The exercise supervised by a physio has meant that a programme tailored to my specific needs and situation has been able to be put into place, and I'm in a safe environment with people who know what to do if/when things go horribly wrong. The only big difficulty is that the routine of going is constantly interrupted by frequent and protracted hospital admissions. I'm sure everyone knows how difficult it can be to motivate oneself to restart an exercise programme, and I'm no different. I've wandered off slightly from where I began, but the gist of it is that yes, my GP has discussed these things with me, but I'm sure he's in the minority.


  2. My physician actually gave me the advice of "eat less, move more" and I was motivated enough to define that for myself. Eating less doesn't have to mean "dieting", you can easily eat more food and take in fewer calories. And moving more means any kind of physical activity. Like I said though, I was probably more motivated than most to read everything I could on better nutrition and exercise... I loved these topics so much for a while I even considered becoming a personal trainer to help other people with these topics. I've always kept my motto just what my doctor told me "eat less, move more" I refuse to feel deprived with what I eat or don't eat and the moving more has GOT to be fun for me or else I won't do it. To sum up this strategy I would say get smart and do what works for you.

  3. I forgot to comment....

    It's Doctor Nick!!


    And I found this on wikipedia.... "In a tongue-in-cheek analysis the Canadian Medical Association Journal compared the services of Dr. Hibbert and Dr. Nick.[11] It concludes that Dr. Nick is a better role model for physicians; Dr. Hibbert is a paternalistic and wasteful physician, unlike Dr. Nick, who strives to cut costs and does his best to avoid the coroner, proving Marge's claim wrong that he isn't a doctor at all." I would love to read this article... have you read it? I'm an American student/mother/wife, you're a Canadian physician the odds are more reasonable that you would have read this. lol... I'm going to have Dr. Nicks voice in my head for the rest of the day now... lol

  4. Anonymous10:37 am

    Rather than trying to add more nutrition education to medical school, why don't medical schools teach doctors to REFER to Registered Dietitians? RDs have a minimum of 5 years of education + training in nutrition (including clinical nutrition). Nutrition is their sole focus. They have the time to spend with patients to discuss issues of nutrition at a level appropriate to the patient. I saw an RD for 6 months and it helped me a great deal.

    It frustrates me when my doctor tries to talk about weight loss or nutrition because, frankly, it is evident that he does not have much knowledge of the subject. It is not nutrition from a 'science' perspective that people need help with. It is the actual 'what should I eat' part that is the problem. A physician may know how to explain carbohydrates in science terms, but when it comes to actual food selection, forget it.

    This is the speciality of the RD. Why must physcians pretend they know everything? If someone needs therapy on their broken foot, would a GP try to rehabilitate the foot? No, they would refer to a physiotherapist. So why don't they refer to an RD when someone needs assistance with weight loss?

  5. Anonymous2:31 am

    I recently went to the doctor for some weight loss advice and five minutes later walked out with a prescription for Reductil (sibutramine). I was surprised to say the least, my questions were brushed over, it seemed he just wanted to get me out of there.
    I will be finding a new doctor.

  6. My doctor, a woman about my age, is also a larger framed woman who has some weight issues of her own, so is very helpful. She lost her post-baby weight through Weight Watchers, but I knew that wasn't for me. What she did do probably saved my life, or at least the quality of my life: She recommended I attend the Metabolic Syndrome Clinic in Vancouver at St. Paul's Hospital. A fabulous 12-18 month program that helped me get on track. I will always be forever in her debt for sending me there.