Breakfast AND lunch required!

Today I had a very interesting pt encounter.

Full disclosure: I'm overweight. Actually I'm clinically obese. I'm a big girl [and I like big girls ;-) ]
Anywho....I also work out. I love the gym. I max out at about 450 lbs for the leg press. I run and do all manner of crazy physical activities. Though I still haven't heard from the team, I'm trying to intern with a pro women's sports team and thus I work out because I have to be able to move my athletes. Currently they're mostly smaller than me because I work in pediatric sports medicine.

But today.....I had an overweight kid. They weren't there for a weight loss appt but none the less we digressed to that when they said "I don't eat breakfast or lunch."

Excuse me what?

You heard right. A child that doesn't eat breakfast or lunch.

They miss breakfast because they don't get up early enough to eat it and they spend lunch with their math teacher (their mom was like "they're a nerd!" in an accusatory tone as if something's wrong with being a nerd. Hello....you're at the doctors which is one of the official spaces for adult nerds to meet and work!).

We went over appropriate eating and what goes in a lunch box. Talked about going to the deli and getting samples to decide what kind of deli meat to get and that you can only get meat that has wings. No bologna and no pork!

Anyway....I went to my attending later and said "you know I felt slightly uncomfortable counseling this pt about appropriate eating and dieting because I'm not exactly at my ideal weight." My BMI is over 40. I'm soooo not ideal but I'm also sooo not your average person at my weight. Her response was that they've done studies that show that overweight providers have a tendency to gloss over weight issues because they have them themselves and they feel hypocritical AND that the pt isn't going to do it anyway because they're going to think "well if my MD is fat, who are they to tell me?"

The answer is....I'm your medical provider. I spent years in school...decades really to have this knowledge. She told me always rely on that. Their visit isn't an indictment about you. This is you using your expertise to help them live their best life and if that includes losing weight you need to say so.

In that she made me feel really comfortable about confronting the weight elephant that often shows up in pt visits because being obese as a child is very different from being obese as an adult. Obese children don't even develop the way average sized children do! Obese kids can't do a basic push up and often have trouble standing on one foot...its crazy for real. Also I may be big but I'm highly functional. I did a whole exam on one knee today. Oh and I have to squat all the time because kid pts don't seem to know what "squat like a frog" means.

She's great. My attending's so so great.
She's a great mentor and I honestly really like her as a person.

Anyway....clinic days are the best days.