Anonymous
Post 11/27/2012 12:48     Subject: Insensitive Drs at Childrens (overweight child)
Anonymous wrote:I wish one of my doctors had told me I was obese instead pf being PC and ignoring it. I'm around 170 and want to get to 145, I'm down from about 185 when I had a morbidly obese BMI. No doctors said anything, but they should have.


Good grief.

Were you under the impression that you weren't overweight? Did you think you weighed 120 lbs?
Anonymous
Post 11/27/2012 12:31     Subject: Insensitive Drs at Childrens (overweight child)
I saw one of my nieces this weekend. The girl is 12 years old and now weighs about 200 lbs. I have not seen her in over 2 years. Before she was heavy but she has easily put on 50 + lbs in those years.

Sadly, I can see how OPs daughter got so heavy and her mom didn't notice.

It doesn't register with my SIL that her child has become so heavy and I think its because she sees her everyday and the weight just slowly crept on. Her comment over the weekend was that her daughter has only gained a few pounds over the past couple of years but really has maintained her weight so she isn't worried about it "because she is going to have growth spurt soon". She really doesn't seem to see that her daughter has gained a huge amount of weight.
Anonymous
Post 11/26/2012 07:00     Subject: Insensitive Drs at Childrens (overweight child)
Anonymous wrote:I know this may not be a "special needs" issue exactly but I need to share.
My DD is 16 and she was admitted to children's hospital in DC. she has no special needs per se. She is overweight, but in the 4 months prior to being admitted she lost 35 lbs. At the hospital it was a constant struggle. she weighs 230, and she is 5'4. The doctors were the most insensitvie people i have ever encountered. she was in the hospital for a head injury but they made no hesistation to send in the nutrtionist and some other doctors to tell her that she was overweight. meanwhile we are waiting 2 days to get seen by the actual neurologist. DD has great eating skills and makes sure to exercise at least 4 times a week, which is how she lost the weight. But i feel like the way she was treated at childrens was obnoxious. they even went as far as to but on the discharge form under how her stomach felt (when they do the physical exam) "soft obese belly". really? WTF. before she had an MRI they came in at 4 am to "measure her to make sure she could fit in the machine". again really? she is a size 14, 38-36-45 so yes while she is plus sized, she is not HUGE. she is in high school and does not get treated even half as rudely by other teenagers. She has a wonderful personality and actually has a nice body "shape" and is beautiful (not just me as her mother, but everyone tells her that even school friends). what makes this whole thing worse is that she is 16 years old and understands that she is "fat" and is working on that. Have any other kids been treated insensitively at children's?

please do not flame me for this, i guess i just felt the need to vent.



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.
Anonymous
Post 11/25/2012 22:44     Subject: Insensitive Drs at Childrens (overweight child)
Anonymous wrote:I wish one of my doctors had told me I was obese instead pf being PC and ignoring it. I'm around 170 and want to get to 145, I'm down from about 185 when I had a morbidly obese BMI. No doctors said anything, but they should have.


Didn't you know?
Anonymous
Post 11/25/2012 20:31     Subject: Insensitive Drs at Childrens (overweight child)
I wish one of my doctors had told me I was obese instead pf being PC and ignoring it. I'm around 170 and want to get to 145, I'm down from about 185 when I had a morbidly obese BMI. No doctors said anything, but they should have.
Anonymous
Post 11/25/2012 11:33     Subject: Insensitive Drs at Childrens (overweight child)
this thread isnt even part of a parenting forum anymore.
Anonymous
Post 11/17/2012 22:25     Subject: Insensitive Drs at Childrens (overweight child)
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.
Anonymous
Post 11/17/2012 22:23     Subject: Insensitive Drs at Childrens (overweight child)
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.
Anonymous
Post 11/17/2012 22:04     Subject: Insensitive Drs at Childrens (overweight child)
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.
Anonymous
Post 11/17/2012 21:31     Subject: Insensitive Drs at Childrens (overweight child)
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!
Anonymous
Post 11/17/2012 21:28     Subject: Insensitive Drs at Childrens (overweight child)
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.
Anonymous
Post 11/17/2012 20:39     Subject: Insensitive Drs at Childrens (overweight child)
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.
Anonymous
Post 11/17/2012 20:39     Subject: Insensitive Drs at Childrens (overweight child)
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:

I am the PP you are responding to and I have fired doctors who think like you do, with glee. I am not my cells under a microscope. And I don't give a rat's ass what I look like in a bathing suit (nice jumping to conclusions about people). But I do care about a lot of other things that I want my doctors to recognize. I have personal habits that are vitally important to me -- running and eating a vegetarian diet -- and I want doctors who will recognize that I need to continue these things when the give me advice. I have feelings, and if a doctor makes me afraid or sad (both have happened) I cannot communicate with that doctor and therefore I can't receive good medical care. I could go on and on but I know that if a doctor can't recognize that I am a different person than the one sitting next to me in the waiting room, thats a shitty doctor.

And you are wrong about other "in healthcare." I've had cancer, I have several chronic medical conditions, and I have a lot of doctors. None of them have this ridiculous attitude. or at least the ones who did, i fired.


Actually, you are wrong. They all feel like the PP stated because THAT is their job. Some of them just pretend otherwise to make you feel better about yourself. If you need someone to take care of how you feel about yourself then you need a therapist. If you need someone with the technical skill and know-how to keep your body healthy then you need a medical doctor.


I have an oncologist and a surgeon and both doctors are HIGHLY skilled but will also actually talk to me. If I am anxious (as you would be if you had cancer) they will reassure me with actual medical facts. If it is important to me to spend a certain vacation with my family, they will schedule chemotherapy sessions around that date. If it is important for me to go running while going through cancer treatment, they will make sure that my side effects are treated in such a way as to allow for that. This is not therapy, this is good medical care. If either of them treated me as only the vessel for cancer cells, as you seem to treat your patients, no one would go to them unless their insurance forced them to. the fact that you are attacking OP about not having her DD diet when ehr DD is, in fact, dieting tells me you jump to (negative) conclusions about people.

So I repeat -- you are a bad doctor and an asshole.

Hey, folks on this thread, would any of you go to this poster for medical treatment?


I am sorry that you are sick.
However, most doctors say the right things. What they are thinking is another.
Most doctors that I know who still get twisted up in all patient care issues do not survive for long. They end up in research or getting shunted to some other place where they take their burnout pills.
Detachment is normal, it is the best way to cope. Even the smiling agreeable doctors detach, and some are really good at making you feel super special while still detached.
Anonymous
Post 11/17/2012 19:42     Subject: Insensitive Drs at Childrens (overweight child)
Anonymous wrote:
Anonymous wrote:

I am the PP you are responding to and I have fired doctors who think like you do, with glee. I am not my cells under a microscope. And I don't give a rat's ass what I look like in a bathing suit (nice jumping to conclusions about people). But I do care about a lot of other things that I want my doctors to recognize. I have personal habits that are vitally important to me -- running and eating a vegetarian diet -- and I want doctors who will recognize that I need to continue these things when the give me advice. I have feelings, and if a doctor makes me afraid or sad (both have happened) I cannot communicate with that doctor and therefore I can't receive good medical care. I could go on and on but I know that if a doctor can't recognize that I am a different person than the one sitting next to me in the waiting room, thats a shitty doctor.

And you are wrong about other "in healthcare." I've had cancer, I have several chronic medical conditions, and I have a lot of doctors. None of them have this ridiculous attitude. or at least the ones who did, i fired.


Actually, you are wrong. They all feel like the PP stated because THAT is their job. Some of them just pretend otherwise to make you feel better about yourself. If you need someone to take care of how you feel about yourself then you need a therapist. If you need someone with the technical skill and know-how to keep your body healthy then you need a medical doctor.


I have an oncologist and a surgeon and both doctors are HIGHLY skilled but will also actually talk to me. If I am anxious (as you would be if you had cancer) they will reassure me with actual medical facts. If it is important to me to spend a certain vacation with my family, they will schedule chemotherapy sessions around that date. If it is important for me to go running while going through cancer treatment, they will make sure that my side effects are treated in such a way as to allow for that. This is not therapy, this is good medical care. If either of them treated me as only the vessel for cancer cells, as you seem to treat your patients, no one would go to them unless their insurance forced them to. the fact that you are attacking OP about not having her DD diet when ehr DD is, in fact, dieting tells me you jump to (negative) conclusions about people.

So I repeat -- you are a bad doctor and an asshole.

Hey, folks on this thread, would any of you go to this poster for medical treatment?
Anonymous
Post 11/17/2012 19:35     Subject: Re:Insensitive Drs at Childrens (overweight child)
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:

Wow, you may have an MD, but you are a serious asshole. This child has lost 35 pounds. Clearly the family HAS talked about it, believes it matters, and the child is dieting. (I disagree that dieting is all about eating less food. More important is eating the right foods. No one will keep weight off by starving themselves. Another sign that you are really a terrible doctor). If you are so bad at listening to your patients, if you regard them with such distain, if you don't care about their feelings (I will not pay a doctor to make me feel bad. It is not a necessary part of medical care and it shuts down necessary communication between the doctor and the patient -- something you clearly don't understand) you really are a crappy doctor, whatever your skills.



???


When your body feels like it is in starvation mode your metabolism will slow down and hang on to calories. That is why you often see people gaining a lot of weight after dieting and ending up more overweight than when they began. Portion control is important to dieting but the key to keeping weight off is learning to substitute healthy foods for unhealthy foods and eating when you are hungry (which is to say not when you are full and that you shouldn't ignore actual hunger and starve yourself_.