Are there "large" med students?

[BlueElmo]

Maybe an NFL quarterback 10 years after retiring.

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[ahowardmd]

To the OP: I am currently considered overweight by my BMI, but if I lose 10 more pounds I will be considered normal weight. Will I lose those 10 pounds? Maybe or maybe not, because I feel good about myself now, and I don't feel like buying new jeans again! To be honest, I am in the best shape of my life right now, as I was always overweight growing up, and for a stretch, obese.

As for having fellow overweight students, I think it depends on what medical school you go to...schools in the mid-west will probably have more fat students, whereas schools in warmer climates will probably have less.

Oh, great. May the coddling begin! Yes, not only will one have fat accomplices around to relieve that urge to engage in healthy behavior, but remaining or becoming fat may actually be beneficial! How far we've come as an accepting society.

I agree. It makes me sick when I see fat people protesting against so called "fatism". If you are in good enough health to go stand in front of city-hall and picket, then you are probably healthy enough to hop on a treadmill!

I think we need to clarify the definition of overweight and obese. The vast majority of the US population is overweight (BMI 25-30) and many med students are overweight. Obese is BMI>30 and I have seen very few students (and doctors) who are obese. I think this clarification is important.

This.

I think calling fat physicians hypocrites is a little much, but I am curious what would make an obese physician get and stay that way. You get how bad obesity is for you pounded into your head throughout your training (and career, I'd assume) yet don't change your ways? That just seems weird to me.

I see doctors eating big-macs, drinking sugary sodas, and smoking cigarettes all the time. It's human nature to do things that make you feel good when you are stressed, even if you know they're bad for you. And patients don't care how fat or how much you smoke when they're in pain and need medical treatment.

 

[MilkmanAl]

I see doctors eating big-macs, drinking sugary sodas, and smoking cigarettes all the time. It's human nature to do things that make you feel good when you are stressed, even if you know they're bad for you.

It is? That sounds more like addiction or some kind of anxiety disorder than human nature. Even if you have to grab lunch on the run, a bad meal per day combined with a stressful schedule does not obesity make.

 

[Kickback]

To the OP: I am currently considered overweight by my BMI, but if I lose 10 more pounds I will be considered normal weight. Will I lose those 10 pounds? Maybe or maybe not, because I feel good about myself now, and I don't feel like buying new jeans again!

I feel ya. I lost 30-ish pounds since doing triathlons, almost nothing fits from before then. I went from around a 36 to a 28-30

 

[298609]

It is? That sounds more like addiction or some kind of anxiety disorder than human nature. Even if you have to grab lunch on the run, a bad meal per day combined with a stressful schedule does not obesity make.

i agree.

i know that when i am most stressed out, a big mac and coke would only make things worse because not only would i probably feel sick after eating all that junk...i would KNOW it's junk and be worrying about how it's ruining my diet. that would make me more stressed...leading to bad skin and that unhealthy feeling (anyone who is a whole food/health food junky knows this feeling after a meal that's bad for you).

 

[richse]

There are a couple of both sexes in my class, but med students seem to be quite fit, as a whole.

Even if someone enters med school overweight I would think anatomy lab alone would make them want to eat healthier and exercise. My cadaver had some serious atherosclerosis and I haven't been able to look at a cheese omelet the same since.

 

[ChimpanzeeMinky]

Even if someone enters med school overweight I would think anatomy lab alone would make them want to eat healthier and exercise. My cadaver had some serious atherosclerosis and I haven't been able to look at a cheese omelet the same since.

Don't worry - given enough time, you'll get over that.

I used to feel the same way about pulled pork. A BBQ sandwich sounds pretty good now!

 

[cliffhuxtableDO]

I think we need to clarify the definition of overweight and obese. The vast majority of the US population is overweight (BMI 25-30) and many med students are overweight. Obese is BMI>30 and I have seen very few students (and doctors) who are obese. I think this clarification is important.

I've actually done some really in-depth research pertaining to this issue, albeit, in a police population. We found the rate of false positives at recruitment was about 60ish% and then after 12.5 years of service the rate is improved, but still questionable at about 50%. (For BMI classification of BMI>30). We compared the BMI numbers to percent fat changes to determine the false positives, etc.

While BMI is good for showing a relationship to mortality/morbidity it is not a good indicator of obesity. BMI and the term obesity need to sever ties.

 

[Bobblehead]

It's impossible to walk past a box of stale donuts left over from morning report/day shift at 3am without at least thinking about it.

Having little time to eat and needing to eat enough to tide you over until the next time you may be able to eat grooms bad eating habits quickly, usually starting during 3rd year of med school. Weight tends to increase with PGY level during residency.

 

[tinery]

Even if someone enters med school overweight I would think anatomy lab alone would make them want to eat healthier and exercise. My cadaver had some serious atherosclerosis and I haven't been able to look at a cheese omelet the same since.

egg whites

 

[URHere]

Having a sports injury, working long shifts, etc. are things that are out of your control. Being overweight is not....

I am curious what would make an obese physician get and stay that way. You get how bad obesity is for you pounded into your head throughout your training (and career, I'd assume) yet don't change your ways? That just seems weird to me.

I just wanted to point out that in the case of chronically obese/overweight patients, losing pounds and maintaining a healthy weight can be quite different than it is for the college student struggling to shed that extra 5 pounds. Many of these patients go on very restrictive diets and stringent exercise plans only to find that they will gain the weight back unless they continue with a very low calorie (1200 calorie/day) diet. It's not a case of "don't eat sticks of butter" and "stay under 2000 calories" for many of these patients. They need to eat far less and burn far more than someone who has always had a BMI of 22. Yes, it is possible to follow those rigid plans, but keep in mind that they may drastically interfere with work and life in some cases.

If you are a surgeon and the caloric restriction gives you fits of light-headedness and shaking hands, how likely are you to stick with it?

Note: No, I'm not one of the obese medical students. I just think that the challenges that the chronically overweight/obese face deserve a little bit more respect.

 

[cliffhuxtableDO]

It's impossible to walk past a box of stale donuts left over from morning report/day shift at 3am without at least thinking about it.

Having little time to eat and needing to eat enough to tide you over until the next time you may be able to eat grooms bad eating habits quickly, usually starting during 3rd year of med school. Weight tends to increase with PGY level during residency.

Thanks for the idea for a related study. "Longitudinal comparison of body composition classification systems of medical students through residency" haha. As if I'll have time for that.

 

[cliffhuxtableDO]

I just wanted to point out that in the case of chronically obese/overweight patients, losing pounds and maintaining a healthy weight can be quite different than it is for the college student struggling to shed that extra 5 pounds. Many of these patients go on very restrictive diets and stringent exercise plans only to find that they will gain the weight back unless they continue with a very low calorie (1200 calorie/day) diet. It's not a case of "don't eat sticks of butter" and "stay under 2000 calories" for many of these patients. They need to eat far less and burn far more than someone who has always had a BMI of 22. Yes, it is possible to follow those rigid plans, but keep in mind that they may drastically interfere with work and life in some cases.

If you are a surgeon and the caloric restriction gives you fits of light-headedness and shaking hands, how likely are you to stick with it?

Note: No, I'm not one of the obese medical students. I just think that the challenges that the chronically overweight/obese face deserve a little bit more respect.

Aerobic exercise 60-90 minutes/day is necessary to maintain any significant weight loss, especially for the population you're referring to.

 

[JJMrK]

I've actually done some really in-depth research pertaining to this issue, albeit, in a police population. We found the rate of false positives at recruitment was about 60ish% and then after 12.5 years of service the rate is improved, but still questionable at about 50%. (For BMI classification of BMI>30). We compared the BMI numbers to percent fat changes to determine the false positives, etc.

While BMI is good for showing a relationship to mortality/morbidity it is not a good indicator of obesity. BMI and the term obesity need to sever ties.

Interesting. Did you publish anything on that? I wouldn't mind reading it.

 

[cliffhuxtableDO]

Interesting. Did you publish anything on that? I wouldn't mind reading it.

I've got an abstract I can direct you to. It doesn't have the specificity, sensitivity,false positive, false negative data though. The full paper has those data and I'm submitting it within the next few weeks. PM if you want to see the abstract.

 

[ahowardmd]

Aerobic exercise 60-90 minutes/day is necessary to maintain any significant weight loss, especially for the population you're referring to.

I just read through this paper that somebody posted the other day, I thought it was really interesting. Apparently aerobic exercise is a big waste of your time, if it isn't coupled with strength training. The idea that you should do only aerobics is apparently from the "dark ages" of fitness advice. I've actually noticed that once I started strength training along with running and biking, I started to lose more weight.

Now, I admit, it's not peer-reviewed, but it's still interesting!

http://nymag.com/news/sports/38001/

 

[cliffhuxtableDO]

I just read through this paper that somebody posted the other day, I thought it was really interesting. Apparently aerobic exercise is a big waste of your time, if it isn't coupled with strength training. The idea that you should do only aerobics is apparently from the "dark ages" of fitness advice. I've actually noticed that once I started strength training along with running and biking, I started to lose more weight.

Now, I admit, it's not peer-reviewed, but it's still interesting!

http://nymag.com/news/sports/38001/

Great another idiotic journalist talking about how exercise makes you hungry therefore defeating the purpose of exercise... It's really not that interesting. To make this all very simple if you want to lose weight you have to expend more calories than you take in, plain and simple.

Not to mention body composition is mostly determined by what an individual consumes, some studies claim as much as 90% of your body comp comes from what you eat. I've seen more of a consensus around 75-80%, but the point is you are what you eat.

Reduce the intake, increase the expenditure, you're golden.

 

[MilkmanAl]

Many of these patients go on very restrictive diets and stringent exercise plans only to find that they will gain the weight back unless they continue with a very low calorie (1200 calorie/day) diet.

Fair enough. Mine was an honest question, not a "What are they DOING?" kind of thing. I still don't really understand how intake<output --> weight gain, though, regardless of how much your metabolism sucks. That excludes when you're just starting out on the exercise kick when you're going to be building muscle mass like mad, of course.

 

[ahowardmd]

Great another idiotic journalist talking about how exercise makes you hungry therefore defeating the purpose of exercise... It's really not that interesting. To make this all very simple if you want to lose weight you have to expend more calories than you take in, plain and simple.

Not to mention body composition is mostly determined by what an individual consumes, some studies claim as much as 90% of your body comp comes from what you eat. I've seen more of a consensus around 75-80%, but the point is you are what you eat.

Reduce the intake, increase the expenditure, you're golden.

I was referencing it more for the "aerobic exercise by itself is the dark-ages of exercise" than for that other stuff. At some point in the article the guy talks about how a good weight loss routine should be coupled with strength training. I'm no dietitian, but it sounds like he has a point. Get these fatties off the treadmill once in a while and onto a weight bench!

 

[spyderracing32]

Great another idiotic journalist talking about how exercise makes you hungry therefore defeating the purpose of exercise... It's really not that interesting. To make this all very simple if you want to lose weight you have to expend more calories than you take in, plain and simple.

Not to mention body composition is mostly determined by what an individual consumes, some studies claim as much as 90% of your body comp comes from what you eat. I've seen more of a consensus around 75-80%, but the point is you are what you eat.

Reduce the intake, increase the expenditure, you're golden.

I agree that this article isn't really all THAT interesting, but only for people who are really in the know about this stuff, and it's not uninteresting for the reason you pointed out (that wasn't even the point of the article). The whole discussion about LPL and insulin is something that a lot of people really never consider when planning a diet. Also it's pretty clear that the endocrine system plays a greater role in your ultimate physique than most are willing to concede (think steroids).

The studies about LPL really explain the post-workout glycemic window utilized by people who are serious about weight training. That is, if you undergo a strenuous weight training workout, you should consume a protein shake with 60-70g of some simple carb within 30 minutes of finishing (preferably immediately after). Why? Due to the fact that this LPL transition from muscle to the fat cells is going to occur after roughly 30 minutes post-workout. So, what you're doing is providing all of the proper nutrients in a highly bioavailable form, and you're providing an insulin spike at the right time so that these nutrients are directed to the right place.

I can remember my dad telling me I was going to get fat having such a sugar loaded shake daily after my workouts, but I've always researched anything I was going to try and I was pretty confident I would not. Now, 5 years after starting to weight train seriously (consuming one of these shakes roughly 5 days a week over that period) I'm 6' tall at 210, less than 10% BF, and my lifts would probably all rank very highly compared to anyone on my school's football team (I'm at a Big 10 school, and I'm very angry at my football program... guess which school I'm at?). If my own father, who has ready access to this info from me, was skeptical, I think that speaks to the nutritional knowledge of the general US public.

So, in hindsight, I'm gonna go ahead and say this is a pretty cool article.