I’ve mentioned before that my doctor is pretty great; she’s never mentioned my size, other than saying ‘some people find it more difficult’ (in response to my talking about how I had trouble losing weight) and ‘keep doing what you’re doing’ (in reponse to my taking up running). I’m very grateful for this.

A friend of mine, who has myriad health problems, including cholesterol issues, high blood pressure, and serious sleep apnea, is morbidly obese. His knees are frequently sore. He is on the verge of developing Type 2 Diabetes. His doctor’s advice? “You have to go on Atkins and lose 100lbs or we’ll have to do something drastic.”

Seriously? This still happens? Well, of course it does. From what I gather, unless they specialise, GPs don’t really get nutrition training. Nor, apparently, training in counselling of any kind. It boggles the mind that even doctors can fall into the trap that a branded diet is a miracle cure; telling someone who has no background in healthy eating (seriously) and likes a beer (or eight) to just go on Atkins and that’ll help fix everything is fucking ridiculous.

We get into a tricky area here, what with the Health At Every Size being the ideal attitude, but in this case, some weight loss would probably be beneficial. But what really needs to happen is actual nutrition education – eating better (in this case, not having seconds of every fried thing), cutting down on the booze (quite a lot), and being more physically active would all be incredibly beneficial, not prescribing (essentially) a diet of deprivation that the patient is not equipped to handle. Small, gradual changes provide the best chance for getting healthier in this case and, apparently, his doctor doesn’t know how to provide that kind of advice.

Obviously, I’m not a doctor, not even on tv, but this makes me sick and sad. I’ll do what I can to advise (in a non-judgy way, of course) to help with small, healthy, SUSTAINABLE steps to get his body working better. I’m still working on the ‘weight doesn’t matter, except when it kinda does’ dichotomy, though, so I’m not sure where to begin. He’s a stubborn guy, too, so this could be frustrating as hell.

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I watched the first two episodes of ‘Weight of the Nation’ on HBO last week. It’s fascinating and infuriating, but I do appreciate one thing about it (even if their obsession with actual weight is kind of cranky-making sometimes): They are very candid about how tricky it is to lose weight/get healthy and that’s nigh on impossible to maintain a weight loss, especially if you fuck around with drastic/dangerous diets. They criticize one of the most populist/popular tv ‘health’ (ish) programs on television (‘The Biggest Loser’) for not emphasizing this, which is commendable and unfortunate; it makes me wish the series was called ‘Health of the Nation’ and was on a channel that more people watch (and was slightly more layperson-friendly).

I also really, really wish that they had explained that the BMI was bullshit instead of setting it up as a valuable tool in the first episode. Argh.