When Walking the Walk Bites You in the Behind

I have a confession to make. I used to smoke. I don’t know how my patients or attendings in residency didn’t know or if they just pretended they didn’t know, because as a now non-smoker, I can tell a smoker from 10 feet a way.

It does help me to relate to patients who have a hard time quitting, and I can honestly tell them that I do know how hard it is to quit. I can give them practical advice on how to quit from someone who’s been there. They genuinely seem to appreciate that, even though it doesn’t always work. But when it comes to weight, diet, and exercise, that’s a whole other story.

I used to work with a physician who was of, uh, sizable proportions. I would have patients say to me, “How dare he tell me to diet when he’s standing there with his doughnut!?” and “He told me to lose weight. Isn’t that the pot calling the kettle black?”

Now, I, too, have been battling my weight most of my adult life. I gained a good 20 to 30 pounds from stress eating during my internship. I have yo-yo’d like many other people. Right now, with much effort, I am at a healthy weight, I’m exercising regularly and am watching what I eat (for the most part).

And patients resent it. “You don’t understand. You don’t know what it’s like to be fat. You don’t have to lose weight.” And even when I tell them that this was not the luck of the draw, that this is the result of a continuous conscientious effort, they still think I can’t relate to them. OK, I was never obese, but my BMI came pretty close. And, yes, I am healthy enough that vigorous exercise is possible.

Seems that when it comes to diet, exercise, and weight loss, it doesn’t matter if you walk the walk or if you just talk the talk. Eating habits are heavily ingrained and I realize that there are a lot of psychological factors involved in weight loss as well, and I guess being successful at it doesn’t necessarily translate into being able to motivate others to do the same.