First, for those of you keeping score at home, a brief update on the first day of preschool.
It was a very good day. At the end of the day, SuperHeroPrincess, while changing into her nightgown, was trying to negotiate going back to her old school, but just to play on the playground with her friends. She’s missing them, which is so completely understandable, but I can tell that she likes the “inside” stuff better at her new school. I’m so glad she’s expressing her feelings about this, and I’ve let her know I heard her. We were definitely encouraged to come back and visit her old school, so maybe we’ll do that one day this week at playtime, after her new school is over for the day. And, as it turns out, none of the other parents pointed at me and laughed. In fact, one of the teachers, when moving my girl’s emergency kit from the bag I had brought to a plastic zip bag, said she wanted to be with my daughter in an emergency, it was so well stocked. Parenting win!
On to the real reason I’m posting this morning — and I have to hurry off to work and preschool — is the post by the title of “Is Weight-Loss Advice Unethical?” by Dr. Arya Sharma posted on Monday, August 31, 2009. I have been following Dr. Sharma’s blog for a while, and he has about 10 clues or more when it comes to weight and fatness. Occasionally, he will write something that rubs me the wrong way, but it’s usually something I’m able to forgive, especially when his thinking is just so right on, and he is able to use the words “unethical” and “weight loss” in not only the same sentence, but in the title of a post. His main audience is other physicians and clinicians, so he can come off as a bit insensitive at times from the perspective of an everyday fat person. You may recognize his name, as Dr. Sharma was quoted in the Newsweek article on fat hatred as saying “A lot of our weight-loss recommendations are unethical because we shouldn’t be saying lose weight when there is no chance people will keep it off.”
FTW, he starts off in the post writing: “In medical school, I was taught the principle of “primum non nocere” or “first, do no harm.” This principle begs us to always consider the possible outcomes (including the unintended ones) of any actions that we take with our patients, including of course the advise we give them.” Then he goes on to review the ethical considerations he sees:
1) The way this advise is presented.
2) The advise that is given is of little help.
3) Rates of recidivism or weight regain are virtually 100%.
4) Unhealthy weight loss strategies.
5) Lack of hard evidence of benefit.
I recommend reading the whole post. In the end, his recommendation is that physicians work towards stopping weight gain and focusing on weight maintenance. While I think there’s also a lack of evidence of what to do and how best to do it there, it’s a huge step in the right direction (and also may be a relief to someone who is not thrilled about gaining weight, and may lead to exploring things like thyroid levels, vitamin D levels, depression, and insulin resistance, which can be treated with things other than weight loss, as well as encouraging physical activity.)
I’m late, but it was worth it!
Angry Gray Rainbows 
LOL… I saw the title for this post on one of the feeds on the side of the AGR blog page… little did I realize that this awesome title was for a post on our own blog!
Way to go WRT2. I love this idea of weight loss recommendations being unethical… Dr. Sharma makes some good points in terms of “do no harm.” Thank you so much for sharing this with us on the blog… I’m going to be chewing on this idea and hopefully will have more input on this awesome and groundbreaking (IMHO) idea after I’ve chewed on it some…
thanks for pointing us to this! I recently went in to see a new doctor about high blood pressure and in the course of our discussion she said, “now, if you lost 50 pounds would your blood pressure go down? I am sure of it. But would it go down far enough that we wouldn’t need to intervene in other ways anyway? No.” So she didn’t even recommend weight loss. I was floored. Many a doctor has shooed me out the door for health problems saying, “lose weight and then come back” and all the others have said, “we’ll try X and Y but you really should lose some weight too.” Countless times my ED was triggered by these doctors, and I rarely returned for a second visit.
Thank goodness for doctors like Dr. Sharma speaking up about this, even if some of their beliefs are still problematic. At least we know doctors are starting to talk about it.
Well, I guess if your body can carry whatever weight you’re at, then I say keep the weight. I’m 5’9″ and my body can only carry 150 lbs. My knees hurt, my foot hurts, and my surgical scar on my stomach hurts. 150 lbs is not a lot of weight for a woman of my height, that’s just the way it is. To the contrary, if I get under 135lbs, my brain doesn’t work as well. I seem to drift. So I stay at about 145. It isn’t always easy but that’s where my whole body functions at 100%.