Insensitive Drs at Childrens (overweight child)

[Anonymous]

Anonymous wrote:

Anonymous wrote:I don't think being overweight should be considered a "special need".

It most certainly can. "Special Needs" refers to anyone who require assistance for medical, mental, or pyschological disabilities. OP's DD certainly fits that criteria, as does my DH who has diabetes and requires a special diet and certain food at certain times of the day. So does the kid with anxorexia or bulemia or who binges. "Special needs" covers a broad range of disabilities, not all of them visible.

Is my kid special needs then because he sees an allergist?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don't think being overweight should be considered a "special need".

It most certainly can. "Special Needs" refers to anyone who require assistance for medical, mental, or pyschological disabilities. OP's DD certainly fits that criteria, as does my DH who has diabetes and requires a special diet and certain food at certain times of the day. So does the kid with anxorexia or bulemia or who binges. "Special needs" covers a broad range of disabilities, not all of them visible.

Is my kid special needs then because he sees an allergist?

if your child had a life-threatening allergy and needed advice on dealing with a classroom situation, yes, I would suggest you post in the SN section.

I realize you are being snarky but PP is just trying to be inclusive. if your child's allergy presents problems and you need advice, I don't see any problem with posting in the SN section. if you are just going to post that your child has a cold or something, then you are being an asshole. The line between the two is not difficult to see.

[Anonymous]

No...being obese is not special needs, and saying that is an insult to parents who have children with needs that can't be controlled with a little diet and exercise, and a nutrition class.

[Anonymous]

Anonymous wrote:No...being obese is not special needs, and saying that is an insult to parents who have children with needs that can't be controlled with a little diet and exercise, and a nutrition class.

I'm the person who wrote that it is a special need. I have a child with autism and I'm not insulted at all. Special needs come in various packages and even if there is treatment for the condition, it doesn't mean it isn't a special need.

[Anonymous]

Anonymous wrote:


OP -

In the interest of full disclosure, I should say that I am a pediatric sub specialist (doctor), but I do not work at Children's.

I do not think that the doctors had the intent of insulting you or your child. They did not say she was "fat" or "ugly". They offered a nutrition consult because she is actually severely obese (her BMI is 39.5, and morbid obesity is anything over 40). They documented her abdominal exam as being soft and obese because it is - this implies that her belly was soft (which implies no serious internal pathology) but might have been difficult to palpate the internal organs (liver, spleen) due to her size. Another way we write this on a physical exam is "exam limited due to body habitus". This can pertain to many aspects of the physical exam, not just abdominal exam. Also, while it is certainly embarrassing to be measured for the MRI, they obviously had a concern so they did it. I am sure that no one was standing around discussing how someone could make your daughter feel worse about her weight than she already does. Finally, while it is great that she has lost 35 pounds, the doctors had no way of knowing that (unless you told them) and this would still not change any of the above because despite that weight loss, she remains severely obese. If you feel that you were insulted, you should take to a representative from the hospital, but it seems that the doctors were only doing their job - in documenting and recognizing a very serious health concern even though she was admitted with something else.

It is great that you are trying to maintain her self esteem. I am sure she is a beautiful girl. However, the facts are that you and your daughter are severely overweight.While hormone imbalances can certainly contribute, medically speaking, they are generally not the only cause. If she were my patient, I would discuss her weight with you at EVERY visit because it is a SERIOUS HEALTH CONCERN. She is at risk for type II diabetes, cardiovascular disease, joint disease - just to name a few - at a young age. It seems that you are both trying, but you need to keep going. From the point of view of a pediatrician, I do not actually care about YOUR weight - just in the way it impacts HER weight (just like if were a smoker I would not care so much unless you had a child with asthma).

I can tell you that when I see an obese child, it makes me sad for many reasons -and I think most pediatricians feel the same way. First, I am sad because of the social stigma that obesity carries. Being a child (esp adolescent) is difficult enough socially - gaining acceptance and fitting in. Second (and most importantly) I am sad for the medical implications. Thirds, as a woman, I am sad because I know it is a lifelong struggle - something that will always be an issue in the child's life. Fourth, especially when the child has obese parents, I am sad because the family is either in denial or makes it more difficult for that child to lose weight because of their own eating habits and physical activity. 100% of the time it would never occur to me to intentionally embarrass or shame the child (but I would recognize that any discussion of the issue would of course be uncomfortable). Just because it is uncomfortable does not mean that I would not address it.

You need to make this a priority for your daughter (and yourself) - not because she will be more beautiful but because she will be MORE HEALTHY. If you do it together, you will support each other and likely be more successful (the whole basis of weight watchers). Good luck to you both.

Great post, thank you PP for taking the time to say that. You sound like a great doctor.

OP, I second/third/fourth the WW suggestion. I would also suggest that this be something you two do together -- it will be easier for you both to get healthier if you are supporting each other with this life change. My best friend did WW with her mom and they both did a lot better than they'd done on individual diets before because support is so key when losing weight.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm sorry, OP, that people are attacking you and that this thread took such a turn for the worse.

I absolutely, 100% am appalled by the way the doctors have treated your daughter and I think their actions and some of the criticisms here illuminate just how horribly obese/overweight people are treated. Nobody should be made to feel embarrassed or shameful by going to the doctor. Do people really think that shaming a poor 16 yo girl (or her mother) is going to help them out?

Especially when OP's daughter has LOST 35lbs in 4 months? Let's stop admonishing OP for what happened in the past and offer support for a better future.

I am not the nurse that responded directly above this but I am also a nurse and I too feel the same way about the vents as she does. I guess it is hard for me to see standard medical practice (referrals, clinical language on assessment and checking for fit with equipment) as appalling and treating someone horribly. I don't see their intent being to shame.

If a 16 yr old walked in for a head injury and she was 100 pounds underweight, there would also be a medical process. Referrals would be offered, clinical language specific to size would be written and equipment would be adjusted. Even if the mother said, oh there is no need,she has gained 10 pounds in the last 3 months, the fact that she weighed 55 pounds at 5'4 would still be concerning.

I am not sure how the doctor would know about the recent weight loss. Unless it was with a hospital based program then it wouldn't be known. They would be dealing with the patient as they present.

I know people are very very sensitive about obesity and the doctor could have been more careful to be sensitive to that sensitivity but the fat they weren't has nothing to do with fear or hatred of obesity. Doctors are busy and get to the point about most things.

+1

+ 1,000 The child is morbidly obese and is eating Chipotles for dinner. A doctor SHOULD be educating the patient and her mother.

My DD had Chipotle for the first time in 6 weeks for dinner the other day. yes, that really contributed to her not losing another 10 lbs this week.

I can't believe I have to even type these words: WHY are you giving fast food to a morbidly obese child???

We're not talking a child who is 10 or 20 pounds overweight. Your daughter is 100 pounds overweight!

If OP's daughter has to live on 1700 claories a day for the rest of her life, and she calls that starvation, then, yes she has to "starve".
Op please take control of the situation.

Some of you just don't seem to get it. Do you know anything about long term weight loss? It isn't a mystery, its been studied. Putting your body into starvation mode is ultimately going to lead to extra weight. The reason Weight Watchers is the most effective diet out there is because it forces people to make permanent changes in the way they eat. That is the only way to both lose weight and keep it off.

And really stuff it with the lectures for OP. Her DD lost 35 pounds. She is continuing her diet. She had a medical condition that led to weight gain and she is making her way back. I love the holier than though lectures from people who have no idea what it is like to live with such challenges. Glad your life is perfect.

Weight Watchers works for those who take in fewer calories.

Fewer calories doesn't mean you have to eat low calorie for every meal. Over the last two years, I have lost about 45 pounds. SLowly but surely, through permanent lifestyle changes that I can't imagine giving up now. You might watch me eat a piece of cake and think "wow, no wonder she's chubby!" But the thing is, I work that into my day and my week. It's okay to eat chipotle. If this kid is losing 35 pounds in a month she has to be doing *something* right. I have eaten chipotle a few times in the past couple months, too, and have lost ten pounds in that time. WHen people think they can NEVER eat the things they enjoy, the end up failing. FOr me, it's important to make only the changes I can make for the rest of my life. So yeah, I'm still overweight (5'11, just under 200) but I am working out 5 days a week, in excellent shape, and I am still dropping weight.

[Anonymous]

Hello,

Op here. I know, I know, reviving an old thread. Just dropped in to say that DD has lost 40 more lbs. Also, she is still afraid of Doctor's (not terrified, but uneasy). The doctors are still immediatley harping on weight which has caused some emotional breakdowns on DD's case as she feels that she never wants to see another Dr. until she is at a perfect BMI. I tell her that is not good thinking and that some docs are tactful others can be smug and obnoxious.

[Anonymous]

Good for your daughter for losing all that weight.

[Anonymous]

That's wonderful to hear, OP. You should very proud of DD. All the best to you and her.

[Anonymous]

Anonymous wrote:
OP -

In the interest of full disclosure, I should say that I am a pediatric sub specialist (doctor), but I do not work at Children's.

I do not think that the doctors had the intent of insulting you or your child. They did not say she was "fat" or "ugly". They offered a nutrition consult because she is actually severely obese (her BMI is 39.5, and morbid obesity is anything over 40). They documented her abdominal exam as being soft and obese because it is - this implies that her belly was soft (which implies no serious internal pathology) but might have been difficult to palpate the internal organs (liver, spleen) due to her size. Another way we write this on a physical exam is "exam limited due to body habitus". This can pertain to many aspects of the physical exam, not just abdominal exam. Also, while it is certainly embarrassing to be measured for the MRI, they obviously had a concern so they did it. I am sure that no one was standing around discussing how someone could make your daughter feel worse about her weight than she already does. Finally, while it is great that she has lost 35 pounds, the doctors had no way of knowing that (unless you told them) and this would still not change any of the above because despite that weight loss, she remains severely obese. If you feel that you were insulted, you should take to a representative from the hospital, but it seems that the doctors were only doing their job - in documenting and recognizing a very serious health concern even though she was admitted with something else.

It is great that you are trying to maintain her self esteem. I am sure she is a beautiful girl. However, the facts are that you and your daughter are severely overweight.While hormone imbalances can certainly contribute, medically speaking, they are generally not the only cause. If she were my patient, I would discuss her weight with you at EVERY visit because it is a SERIOUS HEALTH CONCERN. She is at risk for type II diabetes, cardiovascular disease, joint disease - just to name a few - at a young age. It seems that you are both trying, but you need to keep going. From the point of view of a pediatrician, I do not actually care about YOUR weight - just in the way it impacts HER weight (just like if were a smoker I would not care so much unless you had a child with asthma).

I can tell you that when I see an obese child, it makes me sad for many reasons -and I think most pediatricians feel the same way. First, I am sad because of the social stigma that obesity carries. Being a child (esp adolescent) is difficult enough socially - gaining acceptance and fitting in. Second (and most importantly) I am sad for the medical implications. Thirds, as a woman, I am sad because I know it is a lifelong struggle - something that will always be an issue in the child's life. Fourth, especially when the child has obese parents, I am sad because the family is either in denial or makes it more difficult for that child to lose weight because of their own eating habits and physical activity. 100% of the time it would never occur to me to intentionally embarrass or shame the child (but I would recognize that any discussion of the issue would of course be uncomfortable). Just because it is uncomfortable does not mean that I would not address it.

You need to make this a priority for your daughter (and yourself) - not because she will be more beautiful but because she will be MORE HEALTHY. If you do it together, you will support each other and likely be more successful (the whole basis of weight watchers). Good luck to you both.

OP, what a lot of people are trying to tell you, in more or less sensitive language (the best I quoted above), is that your DD's weight loss should be your number one priority. You will have to accept that her ego and yours will be bruised in the process. I do not say self-esteem, because I am convinced that it is better for your daughter's long-term self-esteem and self-image to be shocked now by others' reactions, including the professional reactions of the hospital staff, in order to motivate a change, than to be obese life-long.

In other words, you are missing the forest for the trees. The mortification you thought you both underwent is nothing compared to the stigma of being morbidly obese in our society and the grave ill-health that will affect your daughter very soon. The situation has gone too far for you and your DD to do this alone. Get professional help, enlist the ped, who will recommend an experienced nutritionist, a psychologist, etc.

Good luck.

[Anonymous]

Anonymous wrote:Hello,

Op here. I know, I know, reviving an old thread. Just dropped in to say that DD has lost 40 more lbs. Also, she is still afraid of Doctor's (not terrified, but uneasy). The doctors are still immediatley harping on weight which has caused some emotional breakdowns on DD's case as she feels that she never wants to see another Dr. until she is at a perfect BMI. I tell her that is not good thinking and that some docs are tactful others can be smug and obnoxious.

That is great news!

Just curious, but what caused your daughter to become so overweight? Was it eating habits since she was young? Did overeat in secret? I did know a girl who was adopted from Serbia who was in an orphanage at 4yrs old and not fed well, and when she came to her new family here, she hoarded food under her bed and would binge eat. By the time she was 18, she was very large. I'm just curious when I see large children how they end up at that point.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Hello,

Op here. I know, I know, reviving an old thread. Just dropped in to say that DD has lost 40 more lbs. Also, she is still afraid of Doctor's (not terrified, but uneasy). The doctors are still immediatley harping on weight which has caused some emotional breakdowns on DD's case as she feels that she never wants to see another Dr. until she is at a perfect BMI. I tell her that is not good thinking and that some docs are tactful others can be smug and obnoxious.

That is great news!

Just curious, but what caused your daughter to become so overweight? Was it eating habits since she was young? Did overeat in secret? I did know a girl who was adopted from Serbia who was in an orphanage at 4yrs old and not fed well, and when she came to her new family here, she hoarded food under her bed and would binge eat. By the time she was 18, she was very large. I'm just curious when I see large children how they end up at that point.

I can assure you that most overseas adoptees grow out of such issues at a much, much younger age, with specialized treatment or without. I'd be more worried about my American-born and raised child assuming that what most people eat here is actual food.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
OP -

In the interest of full disclosure, I should say that I am a pediatric sub specialist (doctor), but I do not work at Children's.

I do not think that the doctors had the intent of insulting you or your child. They did not say she was "fat" or "ugly". They offered a nutrition consult because she is actually severely obese (her BMI is 39.5, and morbid obesity is anything over 40). They documented her abdominal exam as being soft and obese because it is - this implies that her belly was soft (which implies no serious internal pathology) but might have been difficult to palpate the internal organs (liver, spleen) due to her size. Another way we write this on a physical exam is "exam limited due to body habitus". This can pertain to many aspects of the physical exam, not just abdominal exam. Also, while it is certainly embarrassing to be measured for the MRI, they obviously had a concern so they did it. I am sure that no one was standing around discussing how someone could make your daughter feel worse about her weight than she already does. Finally, while it is great that she has lost 35 pounds, the doctors had no way of knowing that (unless you told them) and this would still not change any of the above because despite that weight loss, she remains severely obese. If you feel that you were insulted, you should take to a representative from the hospital, but it seems that the doctors were only doing their job - in documenting and recognizing a very serious health concern even though she was admitted with something else.

It is great that you are trying to maintain her self esteem. I am sure she is a beautiful girl. However, the facts are that you and your daughter are severely overweight.While hormone imbalances can certainly contribute, medically speaking, they are generally not the only cause. If she were my patient, I would discuss her weight with you at EVERY visit because it is a SERIOUS HEALTH CONCERN. She is at risk for type II diabetes, cardiovascular disease, joint disease - just to name a few - at a young age. It seems that you are both trying, but you need to keep going. From the point of view of a pediatrician, I do not actually care about YOUR weight - just in the way it impacts HER weight (just like if were a smoker I would not care so much unless you had a child with asthma).

I can tell you that when I see an obese child, it makes me sad for many reasons -and I think most pediatricians feel the same way. First, I am sad because of the social stigma that obesity carries. Being a child (esp adolescent) is difficult enough socially - gaining acceptance and fitting in. Second (and most importantly) I am sad for the medical implications. Thirds, as a woman, I am sad because I know it is a lifelong struggle - something that will always be an issue in the child's life. Fourth, especially when the child has obese parents, I am sad because the family is either in denial or makes it more difficult for that child to lose weight because of their own eating habits and physical activity. 100% of the time it would never occur to me to intentionally embarrass or shame the child (but I would recognize that any discussion of the issue would of course be uncomfortable). Just because it is uncomfortable does not mean that I would not address it.

You need to make this a priority for your daughter (and yourself) - not because she will be more beautiful but because she will be MORE HEALTHY. If you do it together, you will support each other and likely be more successful (the whole basis of weight watchers). Good luck to you both.

OP, what a lot of people are trying to tell you, in more or less sensitive language (the best I quoted above), is that your DD's weight loss should be your number one priority. You will have to accept that her ego and yours will be bruised in the process. I do not say self-esteem, because I am convinced that it is better for your daughter's long-term self-esteem and self-image to be shocked now by others' reactions, including the professional reactions of the hospital staff, in order to motivate a change, than to be obese life-long.

In other words, you are missing the forest for the trees. The mortification you thought you both underwent is nothing compared to the stigma of being morbidly obese in our society and the grave ill-health that will affect your daughter very soon. The situation has gone too far for you and your DD to do this alone. Get professional help, enlist the ped, who will recommend an experienced nutritionist, a psychologist, etc.

Good luck.

Really dip shit. You act like the situation has gotten worse.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Hello,

Op here. I know, I know, reviving an old thread. Just dropped in to say that DD has lost 40 more lbs. Also, she is still afraid of Doctor's (not terrified, but uneasy). The doctors are still immediatley harping on weight which has caused some emotional breakdowns on DD's case as she feels that she never wants to see another Dr. until she is at a perfect BMI. I tell her that is not good thinking and that some docs are tactful others can be smug and obnoxious.

That is great news!

Just curious, but what caused your daughter to become so overweight? Was it eating habits since she was young? Did overeat in secret? I did know a girl who was adopted from Serbia who was in an orphanage at 4yrs old and not fed well, and when she came to her new family here, she hoarded food under her bed and would binge eat. By the time she was 18, she was very large. I'm just curious when I see large children how they end up at that point.

I can assure you that most overseas adoptees grow out of such issues at a much, much younger age, with specialized treatment or without. I'd be more worried about my American-born and raised child assuming that what most people eat here is actual food.

I know an adoptee from Korea who did this as well. She too was adopted as a 5yr old child. She struggles to this day as an adult.

[Anonymous]

http://www.forbes.com/sites/trevorbutterworth/2013/05/27/top-science-journal-rebukes-harvards-top-nutritionist/