Primary Care Doctor Giving Mixed Messages - Feeling Discouraged

[Jill8008 6]

Hello All,

Sorry this is long

I had my annual visit with my PCP at the end of March. Up 5 lbs from my visit the previous year. I mentioned that I was strongly considering WLS because of numerous health issues and difficulty losing the weight on my own. At the time she said she could agree that it would be a good idea for me, but also (understandably) shared some reservations about the procedure and long-term success.

Fast forward to yesterday, I had my initial consultation with the surgeon, dietician, and psych. Based on my current BMI, co-morbities, etc., it seemed like they agreed I was a good candidate for surgery (although I need to wait for an “official” letter starting I am accepted into their program). The surgeon suggested that my PCP could monitor my 6 month medically supervised weight loss and said that I would need a letter from her basically stating that she agrees I am a good candidate for the surgery and that I have her support medically.

I contacted her office about setting up an appointment to get started on the medically supervised diet and I was a little surprised when my doctor called me back to (I feel) dissuade me from going forward. She said that of course the surgeon considers me a good candidate, basically that they love to cut people open. She encouraged me to try Weight Watchers, Jenny Craig, Seattle Sutton and to see if I can do this on my own. I respect her opinion that surgery is not a decision to take lightly, but at the same time if I felt that I could be successful without the surgery, I would not have it. My BMI is 46 so this is urgent, my health is declining and in the meantime I feel like i’m missing out on life. I’m really looking forward to having this nudge in the right direction to get my health back on track. Up until 2010 I was at a normal BMI so I know what life is like on the other side and I greatly miss it. She didn’t say she wouldn’t “allow” me to have the surgery, and perhaps I’m just overly sensitive, but I felt like she gave me a “if you just tried HARDER” speech. I’ve BEEN trying. Yes maybe I could have tried harder to lose the weight without the help of surgery. Ugh. It’s been bothering me since we spoke.

I will try Weight Watchers (again) for extra support between my visits with her.

Has anyone else had similar experience with their PCP?

[FluffyChix 17,415]

So doesn't your insurance cover the visits to an RD? If so, that's all you need for medically supervised diet. You would get the referral for the RD from your surgeon/bariatric team. Call their office for one.

Bypass your PCP. Make the bariatric team contact the PCP for her letter of rec. She's biased, but work around her.

You will benefit the MOST by going to your RD that works directly with the doc and the bariatric team. I would have been in worlds of hurt if it weren't for my RD helping to streamline the process of getting all the docs to send to insurance.

[DaleCruse 756]

I'm sorry this is happening to you. You don't deserve it. Remember your PCP is just one voice among many. If this person won't give you the support you need, you need to find another route. Talk to your surgical team about what your PCP said. I bet this isn't the first time they've dealt with this. In fact, they may know alternate routes for you. Good luck. You are not alone.

[TakingABreak 2,733]

My PCP wasn't supportive and I realized that I didn't need a referral. Once I came to her and said it was all in motion with a surgery date, her tune changed. Just as an FYI, your OBGYN can also operate as a woman's primary care physician. I don't know if you have a better relationship with him/her but they can also send a referral & do the weight loss monitoring.

[Diana_in_Philly 1,426]

My PCP pretty much did the same thing. I found a new PCP. For more than 20 years I was told I wasn't trying hard enough, needed to just change my diet and exercise more. BTW - I ran into her a few weeks ago in the supermarket. She didn't recognize me. I re-introduced myself and she said something about how she was glad I changed my diet and was exercising - and I looker her square in the eye and said - I'm going to tell you that you have a weight bias. I had VSG, have lost 110 pounds and am keeping it off very easily now. There was no reason for me to suffer for years the way I did because you never even mentioned this was a possibility for me. She stood there stunned.

Find a PCP who will support you. I did and it has made all the difference in the world.

I'm sorry your doc is a jerk.

[FluffyChix 17,415]

2 minutes ago, Diana_in_Philly said:

My PCP pretty much did the same thing. I found a new PCP. For more than 20 years I was told I wasn't trying hard enough, needed to just change my diet and exercise more. BTW - I ran into her a few weeks ago in the supermarket. She didn't recognize me. I re-introduced myself and she said something about how she was glad I changed my diet and was exercising - and I looker her square in the eye and said - I'm going to tell you that you have a weight bias. I had VSG, have lost 110 pounds and am keeping it off very easily now. There was no reason for me to suffer for years the way I did because you never even mentioned this was a possibility for me. She stood there stunned.

Find a PCP who will support you. I did and it has made all the difference in the world.

I'm sorry your doc is a jerk.

That is BLOODY fantastic!!! You win the day Diana!!!!

[jimbo21165 4]

Hello All,
Sorry this is long
I had my annual visit with my PCP at the end of March. Up 5 lbs from my visit the previous year. I mentioned that I was strongly considering WLS because of numerous health issues and difficulty losing the weight on my own. At the time she said she could agree that it would be a good idea for me, but also (understandably) shared some reservations about the procedure and long-term success.
Fast forward to yesterday, I had my initial consultation with the surgeon, dietician, and psych. Based on my current BMI, co-morbities, etc., it seemed like they agreed I was a good candidate for surgery (although I need to wait for an “official” letter starting I am accepted into their program). The surgeon suggested that my PCP could monitor my 6 month medically supervised weight loss and said that I would need a letter from her basically stating that she agrees I am a good candidate for the surgery and that I have her support medically.
I contacted her office about setting up an appointment to get started on the medically supervised diet and I was a little surprised when my doctor called me back to (I feel) dissuade me from going forward. She said that of course the surgeon considers me a good candidate, basically that they love to cut people open. She encouraged me to try Weight Watchers, Jenny Craig, Seattle Sutton and to see if I can do this on my own. I respect her opinion that surgery is not a decision to take lightly, but at the same time if I felt that I could be successful without the surgery, I would not have it. My BMI is 46 so this is urgent, my health is declining and in the meantime I feel like i’m missing out on life. I’m really looking forward to having this nudge in the right direction to get my health back on track. Up until 2010 I was at a normal BMI so I know what life is like on the other side and I greatly miss it. She didn’t say she wouldn’t “allow” me to have the surgery, and perhaps I’m just overly sensitive, but I felt like she gave me a “if you just tried HARDER” speech. I’ve BEEN trying. Yes maybe I could have tried harder to lose the weight without the help of surgery. Ugh. It’s been bothering me since we spoke.
I will try Weight Watchers (again) for extra support between my visits with her.
Has anyone else had similar experience with their PCP?

[Jill8008 6]

Thank you everyone for your responses. I truly feel better and I now know that I have a few more options for working around my PCP. I will also be finding a new PCP.

[Ylime 453]

I'll echo what others have said about finding a different doctor. Every doctor has their own opinions about weight loss and it doesn't mean one is right and one is wrong. My appt with my PCP is next week and I don't know how she will react. I'm hopeful only because my surgeon knows her, but I failed to ask him if that was a good thing or not. But I have already identified a few other practices I could go to if she isn't supportive.

Since I am self-pay I don't have to meet any insurance requirements, but I still want a medical team that is on my side and will support me when I need it. I read someone else say that you can also call your surgeon's office and ask them what PCPs most often refer their patients for the surgery so you can get an idea of who could be in your corner.

I have a lot of medical issues and have dealt with my fair share of a** hole doctors. But in a large metro area doctors are in abundance and I have no patience for Jerky ones.

[Jill8008 6]

2 hours ago, Diana_in_Philly said:

My PCP pretty much did the same thing. I found a new PCP. For more than 20 years I was told I wasn't trying hard enough, needed to just change my diet and exercise more. BTW - I ran into her a few weeks ago in the supermarket. She didn't recognize me. I re-introduced myself and she said something about how she was glad I changed my diet and was exercising - and I looker her square in the eye and said - I'm going to tell you that you have a weight bias. I had VSG, have lost 110 pounds and am keeping it off very easily now. There was no reason for me to suffer for years the way I did because you never even mentioned this was a possibility for me. She stood there stunned.

Find a PCP who will support you. I did and it has made all the difference in the world.

I'm sorry your doc is a jerk.

Your story of facing your doctor in the supermarket made my morning. I’m sorry that you were made to feel that way too. It’s awful. My doctor is also biased and sadly misinformed about bariatric surgery. Thank you for sharing your story ❤️

[JazmaniaRNY 80]

My doctor has always been positive. The outlook he has is “look I am trying to help you stay on this earth for as long as you can..... so if you want to help then that would be very appreciated” so I did and I got RNY on 2/7/18 and now I’m 33lbs down and I see him in a week I’m hoping to be close to 40lbs down and hopefully ready to eliminate all diabetes meds....

All I can say to you is no one can make this decision for you, everyone will have mixed feelings, so you have to follow your heart. What do you want? I understand where she is coming from, but WLS is a tool. You have to use it wisely if not it can easily be the most regretful decision you have made. I have been overweight 10years and it took me a good 8 years to determine WLS was a fit for me. I did weight watchers, I joined exercise programs, I tried eating healthy, I eliminated foods, and just was not losing how I believe I should have so I opted for surgery. Now that I have had it, I still exercise, I still eat healthy, I still have eliminated a lot of things and the difference between then and now is the weight is coming off faster. As long as you are willing to try and never give up there is no reason why this won’t benefit you. Good luck!

[Bryn910 519]

I am sorry your doc is being a jerk about this. Your PCP should have your best interest in mind.

my PCP was the same until I broke down and told her she needs to give me the referral. I told her all my worries about my future and my abilities to get pregnant and she did have me the referral.

Try to work with your surgeon and see if there is anyway to have another healthcare professional oversee your diet/weight loss program. During my first one for my sleeve surger, I had an athletic trainer follow me. They took my vitals, gave me exercise programs and I had to see them 2 times a week for 6 months. And yes it was covered by my insurance.

Best of luck to you and your journey! Keep us updated

[TakingABreak 2,733]

On ‎04‎/‎18‎/‎2018 at 8:43 AM, Diana_in_Philly said:

My PCP pretty much did the same thing. I found a new PCP. For more than 20 years I was told I wasn't trying hard enough, needed to just change my diet and exercise more. BTW - I ran into her a few weeks ago in the supermarket. She didn't recognize me. I re-introduced myself and she said something about how she was glad I changed my diet and was exercising - and I looker her square in the eye and said - I'm going to tell you that you have a weight bias. I had VSG, have lost 110 pounds and am keeping it off very easily now. There was no reason for me to suffer for years the way I did because you never even mentioned this was a possibility for me. She stood there stunned.

Find a PCP who will support you. I did and it has made all the difference in the world.

I'm sorry your doc is a jerk.

I freaking LOVE this story. I hate how you had to wait so long because of your PCP, but I loved the courage you showed to confront her & how ultimately you took control of your life and chose differently!

[newmebithebypass 713]

i cannot fathom a doctor not supporting me getting healthy. especially when it is grounded in medically sound advice from any doctor i have gotten to get this surgery since i was 20. but that is mostly because i live in a very liberal state where all the doctors all know each other all have gone to the same medical schools and have all refered each other patients to one another gotta love Maryland expensive af to live here but man do you get good medical care. oh and the private schools are amazing lol.