Unfortunately, suggesting that people eat less and exercise more doesn’t seem to actually work that well. We’ve been trying that for decades and the obesity epidemic just keeps getting worse.
Have we though? I seriously doubt doctors are aggressively pushing eating well and exercising. Has anyone ever received a workout plan from their doctor besides some generic PT exercises? Do they develop nutrition plans tailored to you? Do they track your progress? Do they have any incentive for you to actually get better? Do they require regular blood tests and include all the tests that might actually tell them something?
The answer is a resounding no. None of that. Even if you request a blood test, they will include the absolute bare minimum and fight you when you request something like vitamin D or testosterone. General healthcare in the US is farce. You must be your own doctor, do your own research and fight for the care you need and also tolerate doctors telling you that you don't know what you're talking about. Besides being prescribed antibiotics, no doctor has ever fixed any problem I've ever had. I had to do it myself.
I seriously doubt doctors are aggressively pushing eating well and exercising.
Have you ever... been to a doctor when you've been obese? I assure you that they will indeed push eating well and exercising to obese people. Even when you've already been eating well and exercising. This will not be an intervention by the PCP themselves - your primary can really just refer people to substantial interventions - but they will try to refer you to one of three things.
First, they will recommend a book on healthy eating and exercising.
Second, there is behavioral weight loss, which generally is a combination of an appetite-suppression medication like phentermine and a Very Low Calorie Diet through a pre-made controlled calorie diet (such as Medifast or Optifast). A program like this will absolutely require weigh-ins and blood tests.
Third, they will recommend surgical weight loss, most likely gastric bypass, such as Roux-en-Y. There are guaranteed to be medical follow-ups after the surgery.
If you are not clinically obese, and that's great, no, your PCP will not provide that type of advice. They're not there to help you with subclinical concerns with weight. There are plenty of dietitians out there who can.
Anyway, that's not a resounding no - it is extremely common to be referred to these programs if you have any substantial level of obesity. If you're obese, and you haven't been referred to these programs by your PCP, that might be an issue with your primary.
What's exciting about these new peptides is that a simple once-a-week injection might be able to be prescribed by a primary with limited intervention or without outside specialists or surgery and still have good results in terms of weight-loss, as opposed to the truly exhausting requirements of a medically-assisted VLCD or weight loss surgery.
Finally, I have no idea what you're talking about Vitamin D. I've both been diagnosed with a Vitamin D deficiency by my primary (through blood tests!), and Vitamin D supplements are easily available over the counter without a prescription.
If you are not clinically obese, and that's great, no, your PCP will not provide that type of advice. They're not there to help you with subclinical concerns with weight. There are plenty of dietitians out there who can.
yeah. If you are losing weight unintentionally, docs will care a lot and will run tests. Otherwise, being overweight, not so much. Weight loss is a bigger concern than weight gain from the perspective of doctors.
Legally in some states some doctors are mandated to bring up weight loss to sufficiently fat patients. But also, fat loss isn’t covered by insurance generally unless it’s paired with an existing health condition. So fat people who don’t have health problems don’t get help to lose weight but get all the shame. :)
Vacuously false. Do you think "eat well and exercise regularly" is some kind of magic switch? One day you are 120lbs overweight but then you eat well and exercise for a week and star in a film?
Probably because people aren't acting on it, or sticking with it long enough to actually see results.
Especially in today's world when they can just take a pill and loose 10-15 pounds, nobody wants to do something they probably don't like doing (consistent exercise or healthy eating) as part of a short-term or long-term process.
A lot of people, especially those in food deserts or without access to adequate nutrition on a consistent basis (or those who cannot afford quality food, or those unable to prepare it properly) are not going to undergo something where change is gradual versus taking a magic pill, side effects be damned. Sad, but that's the world we live in.
Weight has been increasing for nearly 40 years now in the US among all groups. Trying to point this out as any kind of individual failure just has not, and is not going to work. It's tantamount to telling someone to stop smoking in 1950. Yes, some people did manage to, but the vast majority stopped smoking when their lungs no longer supported them living.
When pretty much everywhere you go is plastered in signs saying "EAT THIS YUMMY UNHEALTHY BULLSHIT" and said bullshit is cheap and highly available don't be surprised when we have society wide problems. Add to that our work practices commonly have us hold down a computer for 8 hours a day, it should be no surprise we are where we are.
A small group that's used a different selection mechanism than the primary population is really a poor metric to judge the majority. It seems likely that we'd find that migrant populations that have to a lot of work to get where they are have a higher motivation level than the general population.
One should look at Asian obesity level growth, then compare the populations you're talking about in particular
Probably because people aren't acting on it, or sticking with it long enough to actually see results.
Like telling penguins they need to flap harder to fly. The literature on diets on abysmal. People lose some weight and regain it, probably as willpower runs out. Look at all these celebrity weight loss shows over the past 2 decades--almost every contestant regains the weight, and these are people who have a lot of money and access to top chefs, trainers, etc.
