The worst doctor I ever saw was an endocrinologist. I went to her thinking that I might have a thyroid condition as I was tired all the time.
When I finally got into see her, I began to give her the talk about my dieting history, only to have her interrupt to insist I be tested for diabetes. When both my sugar levels and thyroid came back normal, she blamed my fatigue on being fat. (Apparently carrying around weight makes you work harder and tire out faster.)
Another horrible endocrinologist out of Boston is Dr Caroline M Apovian (I will refer to her as "Dr. A" from now on) who has a horrible idea. Take potentially needed prescription drugs away from fat people until they lose weight with lifestyle changes and weight loss drugs.
I am not kidding.
Use of approved weight-loss medications is endorsed for people with a body mass index (BMI) of 30 kg/m and above or at least 27 kg/m with one or more comorbidities. The document "shifts the paradigm" by advising physicians to target the obesity itself first and thereby diminish its related complications — such as hyperglycemia, dyslipidemia, and hypertension — rather than aiming first to treat the comorbidities caused by the excess weight, she said.
Which means to me if you have hypertension, you should just have a stroke if you refuse to take diet pills (which is ironic considering that diet drugs in the past have caused heart disease related deaths.)
Now I'm not against trying actual lifestyle changes first before taking medications. I lowered my cholesterol with dietary changes and an increase in exercise, and if you watch America the Beautiful 2: the Thin Commandments, the director also avoided taking certain medications by becoming an active bike rider. In my case and his, indicators improved with miniscule weight loss.
This is not the case with everyone, and sometimes people have to take medications. Dr. A not just against using medication for high cholesterol, hypertension, or hyperglycemia, she's against mental health drugs that make you fat.
For patients already taking insulin, sulfonylureas, thiazolidinediones, beta-blockers, or certain specific selective serotonin-reuptake inhibitors (SSRIs) like paroxetine — all of which can lead to weight gain — the document provides advice on how to taper patients from those medications and switch them to alternative agents that don't increase weight.
But what Dr. A does have for you is diet pills.
"Medications do not work by themselves, but they can help people maintain a healthy diet by reducing the appetite. Adding a medication to a lifestyle modification program is likely to result in greater weight loss," said Apovian, who is also professor of medicine and pediatrics at Boston University School of Medicine.
And why is Doctor A. peddling dieting and diet drugs?
Dr Apovian serves on advisory boards for Amylin, Merck, Johnson & Johnson, Arena, Nutrisystem, Zafgen, Sanofi, Orexigen, and Enteromedics. She has received research funding from Lilly, Amylin, Aspire Bariatrics, GI Dynamics, Pfizer, Sanofi, Orexigen, MetaProteomics, and the Dr Robert C and Veronica Atkins Foundation. Disclosures for the coauthors are listed in the article.