excuse me, but i'm certified

[tamiki]

I recently started an employment services program for the disabled. During the early morning break, a few of us congregated in the cafeteria. I started eating my 2nd meal, and this woman said, "You're pretty organized," referring to the multiple tiny tupperware containers I had my food in. One had avocado, another nuts, another fish, etc...

So I give her the low down (spent 2 years in psychiatric hospital, trying to lose weight, already lost 20 pounds) and she picks up her giant black and white cookie as says, "Yeah, try to eat small meals, too." Then she takes another bite of her cookie, wraps up the other half and goes, "See, that's enough for this morning."

A few days later, we are all sitting together again, and the topic of diet/weight loss comes up again. At that point she says, "You know, I'm a nutritionist. I used to work as a dietician for 20 years," in various levels/positions of organization.

She says her daughter, who is 11, eats everything in sight, yet is still skinny. And her son, who is a bit older barely eats, but is chubby. So she says that both of their eating habits "worry her."

After all that, she talks about herself, "well, since I'm on these psychiatric medications, it's hard to lose weight." I have already been on the shit she's on (and lost 20 pounds while taking one of her two current meds).

I, rather tactlessly, say, "I don't use psych meds as an excuse."

So she responds, "Yeah, I don't either, they just effect your metabolism," and she pretty much gives up on the conversation like she did her weight.

So she is an experienced "nutritionist/dietitian," supposedly formerly at a high level.

[Dastardly]

Feeling you here bro.

My mother has diabetes and a massive weight gain problem as a result of it. The dieticians she has seen at the hospital and most doctors tell her to fill up on carbs.

[cervicornis]

Your mother is overweight and diabetic, and her doctors are telling her to fill up on carbs? I find that hard to believe.

[Christian S]

This is the sad truth... Many doctors are completely clueless about diabetes. I heard one MD tell my dad (who is also a type 2 diabetic) that he shouldn't worry too much about eating sugar, and that fat was actually worse than sugar for diabetics. Luckily he listens to me since I've been working with t2 diabetes research for over a year, and he's now at a normal bodyweight and has his blood glucose under control.

[PVC]

This is the sad truth... Many doctors are completely clueless about diabetes. I heard one MD tell my dad (who is also a type 2 diabetic) that he shouldn't worry too much about eating sugar, and that fat was actually worse than sugar for diabetics. Luckily he listens to me since I've been working with t2 diabetes research for over a year, and he's now at a normal bodyweight and has his blood glucose under control.

Your dad's lucky to have someone like you to steer him in the right direction.

[Patrick]

Well, let's be fair... there are times when a person with diabetes has not only that disease but also a very poor track record at managing the disease with a combination of drugs, diet, and exercise. This means some diabetics, from time to time, have to ingest highly sugary foods to re-establish a good blood sugar level. This is not the fault of the physician; diabetes treatment is fairly well understood. It's the patient's behavior that's the question mark in most (but not all) cases. I'm not talking about this specific case, but I do mean to point out that diabetes is well understood and there are plenty of doctors both smarter and better educated than us, and the rest of them seem good at following lock-step with what the textbooks say, right -- that's what the basis of this complaint is, isn't it; adhering to the 'fat is bad' mantra, even if it's the wrong mantra? The point is, lots of them are smart and most of them can follow rules, so let's keep perspective. Doctors aren't out there killing diabetics left and right.

Shitting on doctors is fine, and I've got plenty of feces to spare for those guys and gals, but they ain't completely ignorant.

[Greg C]

Your mother is overweight and diabetic, and her doctors are telling her to fill up on carbs? I find that hard to believe.

The ADA for a long time has told diabetics to eat carbs. That has changed somewhat, although you can see here, they are still at the top of the recommendation list of "healthy food choices" - at least the grain has moved down...

http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices.html

[Sami]

Well, let's be fair... there are times when a person with diabetes has not only that disease but also a very poor track record at managing the disease with a combination of drugs, diet, and exercise. This means some diabetics, from time to time, have to ingest highly sugary foods to re-establish a good blood sugar level. This is not the fault of the physician; diabetes treatment is fairly well understood. It's the patient's behavior that's the question mark in most (but not all) cases. I'm not talking about this specific case, but I do mean to point out that diabetes is well understood and there are plenty of doctors both smarter and better educated than us, and the rest of them seem good at following lock-step with what the textbooks say, right -- that's what the basis of this complaint is, isn't it; adhering to the 'fat is bad' mantra, even if it's the wrong mantra? The point is, lots of them are smart and most of them can follow rules, so let's keep perspective. Doctors aren't out there killing diabetics left and right.

Shitting on doctors is fine, and I've got plenty of feces to spare for those guys and gals, but they ain't completely ignorant.

No one's talking about that. They only recommend that for acute hypoglycaemic events. We're talking about gaining the bulk of one's energy from carbohydrates.

[tamiki]

At least doctors know more than nutritionists and dietitians.

[Christian S]

Well, let's be fair... there are times when a person with diabetes has not only that disease but also a very poor track record at managing the disease with a combination of drugs, diet, and exercise. This means some diabetics, from time to time, have to ingest highly sugary foods to re-establish a good blood sugar level. This is not the fault of the physician; diabetes treatment is fairly well understood. It's the patient's behavior that's the question mark in most (but not all) cases. I'm not talking about this specific case, but I do mean to point out that diabetes is well understood and there are plenty of doctors both smarter and better educated than us, and the rest of them seem good at following lock-step with what the textbooks say, right -- that's what the basis of this complaint is, isn't it; adhering to the 'fat is bad' mantra, even if it's the wrong mantra? The point is, lots of them are smart and most of them can follow rules, so let's keep perspective. Doctors aren't out there killing diabetics left and right.

Shitting on doctors is fine, and I've got plenty of feces to spare for those guys and gals, but they ain't completely ignorant.

I think you're right Patrick, most doctors are of course following a textbook. The problem is that many of them are still following the advice given in textbooks 30 years ago and haven't bothered keeping up with the research. Of course, practicing doctors cannot be specialists in every topic. But in an area that moves as fast as diabetes, this will unfortunately lead to misinformation being given to the patients.

PVC > I'm afraid I can't take that much credit, the massive life change you have to make is a big personal battle. It takes some balls to stop smoking, start exercising and completely change your diet all at once, I'm not sure if I could do it myself.

[Guido]

I think you're right Patrick, most doctors are of course following a textbook. The problem is that many of them are still following the advice given in textbooks 30 years ago and haven't bothered keeping up with the research. Of course, practicing doctors cannot be specialists in every topic. But in an area that moves as fast as diabetes, this will unfortunately lead to misinformation being given to the patients.
Word. The ADA is about the last place to change as far as making recommendations that are in lock-step with any actual unbiased scientific research. It took them 30+ years to finally change the damn food pyramid (which is still flawed just to appease the various food lobbying groups) for God's sake. Unfortunately, such places are where most doc's get their information and upon which they base recommendations, at least the less knowledgable ones.

I've stated my frustrations on here before about how woefully inadequate and out of date the education is on diet and nutrition, which only serves to make much of the dogma self-perpetuating. It's possibly as bad or worse than the misinformation out there as far as exercise advice.