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CRMagic t1_iyj57jp wrote

There are a few categories of people where the BMI doesn't correlate well with the actual body fat content. Really roughly, it's young adults, women, and bodybuilders.

Any doctor worth their salt should already know about those and be explaining to you why they are concerned in spite of that, if they even are. Otherwise, you're complaining about docs using a pretty robust indicator for health problems that works for the vast majority of the population.

I seriously doubt you will find a competent family practitioner who completely disregards BMI.

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Dbol504 t1_iyj6ivj wrote

I have a feeling someone doesn't want to be told they need to go on a diet.

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CRMagic t1_iyj7su8 wrote

Hey, I understand. It can be hard to hear that. I tried to cling to the "BMI is inaccurate" excuse, too. But as I looked into it, I realized I was trying to fool myself.

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neonlumberjack t1_iyj8y6x wrote

I’m not actually though. My doctor didn’t tell me to lose weight or go on a diet at all. The BMI doesn’t take into consideration several aspects that contribute to weight and shouldn’t be used as the only way to determine what a healthy weight should be. I’m looking for a doctor who is aware of that.

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the_noblesteed t1_iyj9z5a wrote

Why does how the doctor perceive BMI matter then if you aren't going to him with weight issues? I'm confused by this whole thing

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neonlumberjack t1_iyjbhep wrote

At check-ups, you’re weighed and then given your BMI. It matters because I’d like a doctor who doesn’t only look at the BMI as an indicator of a healthy weight

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CRMagic t1_iyj9nnw wrote

What's the problem, then? Bring up your concerns with it with him. Again, it's going to work in most cases, and if he's already ignoring it for you, seems like problem solved.

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neonlumberjack t1_iyjb4us wrote

The thing is that he told me I was at a healthy weight and didn’t need to exercise more than I already was, but then wrote in my notes that I was overweight and that we discussed lifestyle changes when we didn’t. And I have brought up my concerns about the BMI, and he wrote me off.

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neonlumberjack t1_iyj8fzj wrote

I fall into the category where the BMI doesn’t correlate well, but my doctor is using the BMI as an indicator, which is the problem, so I’m looking for a doctor who doesn’t use the BMI in such a way. I’d like to find a doctor who has a better understanding of how to determine a healthy weight.

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CRMagic t1_iyj9708 wrote

So why does your doc refuse to acknowledge your special case?

If you honestly fall into a category that BMI is that inaccurate for, you might need a specialist nutritionalist. BMI works for 95% of what an FP or GP is going to see.

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neonlumberjack t1_iyjadu3 wrote

Not sure. When I asked to change a prescription of mine, he agreed and wrote a script for the exact same thing I’d been taking. He also wrote in my notes that I “denied being depressed”, which is just…yeah. So there’s a few other reasons why I’m looking for a new doctor, but the BMI being completely applied when it shouldn’t be is an issue.

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xcityfolk t1_iyjb9bn wrote

> “denied being depressed”

This is medical speak for, "when I asked the patient if they had depression they said they didn't." For instance, if a doctor said to a patient, "do you have any pain that I should be aware of," and the patient said they did not, the doctor would note on the chart, "patient denies pain." It doesn't mean, that you argued about it or that there was some kind of disagreement, just that his findings for depression were negative.

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neonlumberjack t1_iyjbp0e wrote

Nothing else was worded that way. Everything else was worded as “doesn’t have x, y, or z”.

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xcityfolk t1_iyjfjww wrote

I write charts every day and that context is way more common that "doesn't have.." We use deny to describe pertinent negatives and complains to describe pertinent positives.

So a person walks into the ER trouble breathing and chest pain, you might write, "patient complains of epigastric pain, palpation in negative for rebound. Patient also complains of pain during inspiration. Patient denies any injury or illness prior to onset."

It just means that the patient said they weren't sick or got hurt before the pain, it's a pertinent negative. I don't know your doctor of course but this is the standard. It's been like this for a long time and people often confuse the context the way you are.

read this:

https://forums.studentdoctor.net/threads/the-patient-denies.373980/

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CRMagic t1_iyjaybo wrote

You're kinda changing your story here. No one can really help you if you're kust mad at the doc, so my advice would be to simply go get some other opinions and stick with the doctor who gives you the one you want.

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neonlumberjack t1_iyjb9hi wrote

I’m not changing my story?

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CRMagic t1_iyjc3i9 wrote

Now the actual issue is "my doc agreed to rewrite my prescription but didn't and thinks I'm denying being depressed". Those are different issues than BMI, and the first one is a priori to me: I don't want a doctor who doesn't listen if I say something didn't work. BMI doesn't even factor in there.

If it's just one of your new criteria is also "and doesn't use BMI", well, circle back to my top level comment. Good luck!

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neonlumberjack t1_iyjcir1 wrote

No, the main issue is the BMI. I was just trying to add context because you asked why my doctor wasn’t taking it into consideration. I’m not sure why, but there’s also other things he’s done that are off. Sorry if that wasn’t clear

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Dbol504 t1_iyj50rl wrote

What's your beef with it? It's a decent enough proxy for being overweight unless you're an athlete or workout regularly. In which case you probably don't need diet advice from your doctor.

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neonlumberjack t1_iyj7lmo wrote

It doesn’t take into consideration several things that affect weight, such as bone density, muscle mass, sex, age, race. It’s not a good indication of what a healthy weight should be. I don’t necessarily have “beef” with it, but I’d like a doctor who doesn’t solely look at the BMI for an accurate reflection of a healthy weight. I’m also not “looking for diet advice” from my doctor, but you are weighed at check-ups, and that weight is then applied to the BMI.

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Dbol504 t1_iyj8qv6 wrote

Unless you're Wolverine you don't have enough extra bone density to throw off BMI. And your age, race and sex won't matter when you look at a BMI that says you're this tall and weigh this much so you are either over, under or at a healthy weight. As for muscle mass if you're that built to be throwing off BMI your doctor can look at you and tell. My BMI always comes back high but I also compete in bodybuilding. The doctor just shrugs and notes extra muscle and we move on with the physical.

Lastly - you know you're allowed to ignore your doctor when they tell you that you're overweight and need to diet? Most of the US does already.

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neonlumberjack t1_iyj9kf5 wrote

Age, race, and sex definitely play a role in weight. Men, for example, have less fat than women do. One reason for this is because women have breasts. So your doctor doesn’t solely base your weight on the BMI…that’s what I’m looking for lol

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CRMagic t1_iyjadi0 wrote

No one argued otherwise. The BMI is a tool, one that works in most cases, and has some known outliers, like just about any other tool used to determine things in medicine. Wholesale rejection of it because it doesn't work in your case is illogical. And your doc doesn't seem to be basing advice to you on it based on other comments in this thread, which sounds to me like you already have what you want.

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