Need to lose weight? Neurologist advises stop eating – period.

Angie writes:

I am so happy to have found this! I’m fat…and I have epilepsy. To compound the matter, most anti-seizure medications cause weight gain and drowsiness. My last neurologist, while being a pretty nice guy, was always on me about how badly I needed to lose weight so that the risk of injury when I fall from seizures would be lessened. That I can understand. On my last few visits with him, however, he became much more insistent, as he didn’t see any change on the scales. Tearful, I told him that I had been trying to lose weight, but had been unsuccessful. He asked me what I was doing to try to lose weight, with what I perceived to be an almost condescending tone. I told him I had started to exercise 2-3 days a week, 30 min. a day, cut out red meats, decreased caloric intake, switched to fresh, whole foods only – nothing prepackaged… He smirked at me, and cut me off in mid sentence and said “You are still focused on food! You are not going to lose weight until you get food out of your head! You simply have to stop eating.” He went on to tell me that I could run 5 miles a day and it would only burn x amount of calories, and that would barely be half of one meal, so the only real way to lose weight is to stop eating. He didn’t say stop eating breakfast, or stop eating junk food. He said stop eating. Period. I was humiliated, ashamed, and felt as though this physician was telling me that there was simply no hope for me other than starvation and becoming anorexic.

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34 Comments

  1. That is BEYOND the pale! Wow! I would find a new neurologist and report this one to an oversight committee immediately, as telling a patient to stop eating, full stop, is not only bad medicine it is also UNETHICAL.

    WTF?

    Reply
  2. lilacsigil

     /  July 19, 2010

    That’s appalling. And he’s not even right (in the long term) about losing weight – weight and exercise protect your bone density, especially your hips and femurs. You can recover from bruises and sprains but not a hip fracture or spinal compression in your early 60s.

    Reply
  3. wriggles

     /  July 19, 2010

    It just goes to show how fanatical those who believe in calories in/out can get. All they can see is their hypothesis and actual real people eventually cease to exist.

    What a way to be an absolute tool to a guess, when you don’t have to live (or die) by it.

    Reply
  4. Erin S.

     /  July 19, 2010

    Reporting him might be a good idea just so that when he eventually kills someone there is some kind of record of prior complaints, but I wouldn’t get your hopes up about anything being done. They’ll send an investigator who is likely just as fat hating as the rest of the medical community and what gets put down on paper is that the complaint was the baseless overreaction to a common sense medical suggestion of an obviously (disturbed/non-compliant) patient and that will be the end of it.

    That said, this guy is criminally irresponsible and does not deserve to be practicing medicine.

    Reply
  5. I guess he doesn’t think fat people have families who would sue for malpractice after one of his fat patients dies. More likely, though, he just doesn’t think, period. I would agree with making sure there’s something on file. If he’s pulling this crap with you, I’m sure you’re not the only one. At least you know it’s crap, though; some of his other patients may be considerably more credulous.

    Reply
  6. Kathy

     /  July 19, 2010

    Please don’t listen to this pathetic excuse for a doctor. It’s obvious no one can just Stop Eating. Period. That’s ridiculous. You have the right to a doctor who will NOT make you feel ashamed and hopeless. Please find another doctor.

    Reply
  7. Elizabeth

     /  July 19, 2010

    While I also would be tempted to report him, I doubt that anything would come of it.

    What I would do is find a certified nutritionist. (Personally, I work with Michelle at http://www.fatnutritionist.com , but I don’t know if she is willing to take clients who want to lose weight.) I suspect you will have better luck getting him to butt out by telling him you’re under the care of a professional. When he asks what you’re doing to lose weight, you tell him, “I’m under the care of a professional nutritionist, and I’m following his recommendations to lose weight safely.” Then decline to tell him anything about your eating or exercising.

    I’m sorry that this happened to you, though – that totally sucks.

    Reply
  8. Nikita

     /  July 19, 2010

    Please understand that this “dr.” who in his oath agreed to do no harm is doing some to YOU. Please understand that he is an idiot. Report the fool before he does someone serious harm. Find a specialist – since epilepsy is a mis shooting of the synapses in the brain I am honestly trying to find the connection btw your weight and the mis shots that are occuring w/your nerves. Talk to someone who gives a dang about you and NOT fulfilling their need to feel superior to another. Report the idiot & find another doctor! You deserve better. Oh yes do this too: love, take care of, be kind to, and get a hug from someone who really cares about YOU.

    Reply
  9. Regina T

     /  July 19, 2010

    Doesn’t starvation dieting CAUSE lightheadedness, dizziness, and weakness? Why on earth would you tell someone with epilepsy–a seizure disorder–to do something that would make them MORE prone to falling down? That’s just irresponsible. His logic doesn’t add up….I get the while “bigger they are, harder they fall” stuff. But a smaller person will less “cushion” will be more prone to bone breakage. He should be helping you pinpoint your seizure triggers and teaching you how to prevent them as opposed to telling you to put your body into a state of starvation and possibly triggering more seizures! What an unethical, irresponsible, and potentially life threatening way to practice medicine! He should be reported.

    Reply
  10. Paul Ernsberger

     /  July 19, 2010

    Low BMI increases risk for fractures, especially hip fractures, which are the most dangerous kind. The article below is just one example of many:

    Clin Orthop Relat Res. 1999 Jul;(364):227-30.

    Body mass and fracture risk. A study of 330 patients.
    Bernstein J, Grisso JA, Kaplan FS.

    Department of Orthopedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, USA.

    Abstract
    Low body mass is a major risk factor for low energy hip fractures among women. The purpose of this study was to ascertain whether normal body mass also protects against low energy wrist fractures. A retrospective analysis of body mass indices of 330 women who sustained hip or wrist fractures from falls was performed. Data were grouped by race and age. The mean body mass index for white patients with wrist fractures was 26.4, compared with a mean body mass index of 22.3 in white patients with hip fractures. For black patients, those with wrist fractures had a mean body mass index of 28.5, compared with a mean body mass index of 22.9 for those with hip fractures. Using data from The National Health and Nutrition Examination Surveys, the mean body mass index of patients with wrist fractures was seen to be equal to or greater than the national mean body mass index, whereas that of patients with hip fractures was substantially below average. Accordingly, normal body mass was protective against hip fractures but not against wrist fractures. Because adipose tissue more typically is distributed about the hip than the wrist, the protective mechanism of normal body mass against osteoporotic fractures may promote better preventative interventions against this disease.

    PMID: 10416413 [PubMed - indexed for MEDLINE]

    Reply
  11. fucking hell. that’s all.

    Reply
  12. inge

     /  July 19, 2010

    As others have said, one of the best things about being fat is that you don’t bang your bones as much when you fall.

    And you burn calories by having a metabolism to keep up — body heat, brain on-line, heart pumping, all that small stuff — not by emulating the proverbial VW beetle. (It runs, and runs, ….)

    I always wonder what the “well, don’t eat anything! at all!” people are using instead of a brain. Pavlovian reflexes, probably. To paraphrase, if you don’t eat, you’ll lose weight, and skin tone, and hair, and finally vital signs. Which is usually not recommended to cure any ill.

    I hope you manage to find a better doctor — though, if he insists on “kicking your food addiction is good for your health!” you might have a hard time finding a *worse* one.

    Reply
  13. This goes beyond just humiliation. It’s medical malpractice. Malnutrition causes disease and death. Food isn’t only adding calories. There are essential nutrients in there.

    Reply
  14. Geekasaurus

     /  July 20, 2010

    I want to know why the hell a neurologist thinks it’s his job to give someone nutrition advice in the first place. The “because you’ll fall” thing sounds like bullshit to me, not only because it’s scientifically crap, but I think it sounds like an excuse for him to police the weight of patients when it’s none of his concern.

    Reply
  15. To the OP: starvation is unhealthy, end of story. It’s unsustainable, it wrecks your metabolism, and it puts an incredible strain on your mind and body.

    Your neurologist is incredibly irresponsible. Ditch him, report him, and find someone better.

    Reply
  16. I always wonder what the “well, don’t eat anything! at all!” people are using instead of a brain. Pavlovian reflexes, probably. To paraphrase, if you don’t eat, you’ll lose weight, and skin tone, and hair, and finally vital signs. Which is usually not recommended to cure any ill.

    Reply
  17. Jackie

     /  July 21, 2010

    My dad doesn’t have Epilepsy, but he used to go on these drastic diets. Like only eating bagles, or only eating vegetables, this was long before the awareness of fat acceptance there is now and he felt that he had to lose weight to be healthy.

    Well he had a stroke, and the doctors believe it was due to him being diabetic, and having too low blood sugar at the time. So, I’m guessing there may be a connection between being prone to seizures, and low blood sugar, which means the last thing you’d tell a patient with Epilepsy is to stop eating. What a quack!

    Reply
  18. Erin

     /  July 22, 2010

    He wants you to stop focussing on food by not eating. Right. It’s a pity that a person whose body is in starvation mode actually becomes fixated on food, and it’s a fixation that doesn’t always go away when the starvation stops.

    Reply
  19. inge

     /  July 23, 2010

    Oh, a spambot is copying my comment. Without attribution. How not-nice.

    Reply
  20. Piffle

     /  July 26, 2010

    Um, Topomax more often causes weight loss rather than weight gain; any neurologist should know that. It’s half of that weight drug that didn’t pass the FDA recently.

    And, stopping eating, that’ll kill you. I recall reading recently that being anorexic cuts about twenty-five years off your life expectancy. Far, far more than fat.

    Reply
  21. Joppe

     /  August 12, 2010

    I wonder if you are not taking his words a little to literally. Not eating would indeed cause death by starvation, (although with enough water that’ll take quite some weeks, if you are big, even longer.but that’s beside the point)

    I think he or she must’ve been implying that the the amount of intake is too high, although it may be ‘healthy’ food.

    Big people do have strong bones, especially if you eat proper food (good balance) and you are still able to walk. With epilepsia I’d be more worried about skin and fleshwounds, they do tend to heal more slowly in obese people or people who’s heart is under strain.

    As many doctors, your specialist is probably an inconsidered prick, but that doesn’t make him a lousy professional. Maybe he shouldn’t give you any nutritional advice but he probably does know how to treat epilepsia and about safety issues considering falling.

    I feel ambiguous about this story, i don’t think patients should be harrassed, but I also think switching shouldn’t be done easily.
    Joppe

    Reply
  22. vesta44

     /  August 12, 2010

    Joppe – you’re making a couple of assumptions here. 1- that fat people tend to heal more slowly (not necessarily true), and 2- that her doctor thought her food intake was too high. Of course he thought her food intake was too high, she’s fat, and any amount of food she eats is too much according to him which is why he told her to quit eating, to get food out of her head and simply quit eating. Nothing ambiguous about that at all – as far as he was concerned, it didn’t matter how healthily she was eating or how little she was eating, until she quit eating altogether, she was never going to lose enough weight to suit him. And in a case like that, she’s perfectly justified in looking for another doctor.
    If you don’t mind treatment like that from your doctor, that’s fine, that’s between you and your doctor, you’re not asking for our advice. But when someone tells us her story, we are more than willing to listen, commiserate (many of us have been there done that), and give advice. We’re not saying anyone has to take our advice, but it is advice that is freely offered from our own experiences. I’m sure that Angie knows everything involved in looking for a new doctor, she’s an adult, fully capable of making her own health care decisions. Switching doctors is just like switching electricians or plumbers – they all work for us, and if they don’t serve our best interests, then we are fully justified in finding someone who does.

    Reply
  23. Lola

     /  October 3, 2010

    Um, no doubt the doctor was an ass, but he might have a point–not about the weight loss (tiny portions of no more than 5-10 bites up to 6 times a day on unprocessed foods will have you looking like a fitness model in a year if you’re more concerned about weight).

    But about epilepsy- fasting has been proven to help when it’s resistant to all other treatments. It helps so much that some children are put on ketogenic diets (of ALL fat!) to simulate starvation and put their epilepsy into remission.

    That being said, if you’re going to fast your vital signs (and especially your heart) should be monitored, so it’s safest to do in a hospital or fasting center unless you have a medical professional in your family.

    Reply
    • vesta44

       /  October 3, 2010

      Lola – Unless you’ve done the ‘tiny portions’ weight loss method you’re proposing here, and been successful at keeping the lost weight off for at least 5 years, I wouldn’t advise telling anyone it’s a good plan to follow. Too many readers of this site know from experience that diets don’t work, and your little plan is just that, another weight loss diet that will probably fail in the long run.

      Reply
  24. Step one:

    Find a new neurologist immediately.

    Step two:

    Make a complaint about your neurologist to the American Board of Neurology as well as your state’s medical licensing agency.

    Step three:

    Contact an attorney to determine if you can prosecute for malpractice.

    Step four:

    Make an appointment with a certified, licensed nutritionist, preferably one who has experience working with epilepsy who are also over weight.

    This was posted on July 19th – how are you doing?

    Reply
  25. That guy’s an idiot. You hired him to take care of you.

    Reply
  26. Chris

     /  October 20, 2011

    While I’m a bit late to the game here, I wanted to throw in my two cents about this issue as I’m both on anti-epileptics and research biochemistry related to these drugs. One of the main reasons these drugs cause weight gain is that they increase your blood sugar and how your body processes blood sugars. This means that in a way you become diabetic (which is a common cause of becoming overweight/obese) Most people think that being overweight causes these disorders, but it is the other way around. The best way I have seen for folks to lose weight when they have insulin resistance (either normally or medicine-induced) is to go on a ketogenic (low-carb) diet or go for a diet based on Glycemic Index. I won’t go into the extreme details of how this works, but essentially if you stop creating opportunities for insulin production to go high by having high blood sugar from eating carbohydrates, you will not have the opportunity to store fat as readily and will lose weight.

    A doctor that tells you to stop eating is an idiot. While fasting can be beneficial for some people, it should never be undertaken by people on medication without being in a controlled environment. Replacing one meal a day with a vegetable juicing regimen can be extremely helpful though. Some even find that vegetable juice fasting tolerable for every meal to help them lose weight quickly and restore lost vitamins and trace minerals to improve overall health. Personally, I can’t stomach vegetable juicing for every meal and like having solid food, but it works for many who can. Hopefully, this can give you some information that you didn’t have before and a way to figure out how to manage your lifestyle and your body a little more efficiently.

    Best,

    Chris

    Reply
  27. julie

     /  April 11, 2012

    I live in Paris and suffer a alot from ‘fattist’ remarks . The most hurtful was this week. I was off work with flu synptoms, fever, aches – feeling rough. During the examination I told the docotr I’d”eaten very little in past 24 hours. To this he replied with a sarcasric smile – well thats not necessarily a bad thing for your figure is it? Reading this youd think I’m obese – I’m actually about 10 kilos overweight ( 66 kilos for 160cm). The psychological effect of these comments is serious. It even crossed my mind that I should just stop food to lose these extra kilos.

    Reply
  28. Laurie

     /  May 21, 2012

    I became border-line anorexic (whatever that means) in my twenties. My gynocologist told me it looked like I had lost weight and asked how I did it. I told him I had quit eating; I think I was reaching out for some help. He said (and I’ll never forget it) “well, whatever works.” I never went back.

    Reply
  29. Brendan

     /  July 10, 2012

    If you simply stop eating your body will store fat and what you do lose is muscle and water…

    Reply
  30. Nikki

     /  August 13, 2012

    He could just be saying that you will never out exercise what you eat. if you swim for 2 hours every day, then eat 6000 calories a day, you’re not going to lose weight, because you’re consuming more than you’re burning. if the same person spends 2 hours in a pool a day and eats 2000 calories or less, then you would be losing weight. simply because your caloric intake has to be less than your caloric burn in order to lose weight. if your caloric burn is the lesser number, you won’t lose weight. is his bedside manner complete crap? yes. there are better ways to say what was said.

    Reply
    • vesta44

       /  August 13, 2012

      Nikki – There are people who eat an average amount of calories every day and exercise more than adequately to burn all the calories they eat and then some, and they still don’t manage to lose weight. How each person’s body burns calories is a very individual matter based on whether they’ve ever dieted, how many times they’ve dieted, their genetics (do they have fat people in their family), what medications they’re taking, what illnesses they have, and the list can go on forever. To say it’s as simple as calories in/calories out reduces people to machines who are identical in every way, and that’s just not so (and even supposedly identical cars will get different gas mileage depending on the type of gas put in them and who is doing the driving). Your approach is as simplistic and wrong-headed as that doctor’s, and the only reason I approved your comment is to educate you on the facts of weight loss – check out the Big Fat Facts at Big Fat Blog or all the links on Fierce Freethinking Fatties for studies showing that calories in/calories out is the biggest fallacy perpetrated by the medical community (and they know it, and have known it for over 50 years).

      Reply
  31. Hannah

     /  October 6, 2012

    I’m sorry you’ve had to put up with this crap… Your doctor obviously has a very meagre understanding of nutrition. – and even LESS of an understanding about how you’re feeling right now. Complete cessation of eating – apart from being ineffective for weight loss, which isn’t really the point – is not at anyone’s best interests. I would totally recommend finding a different doctor, or else ask to be referred to a (qualified!) dietician, who can help you maintain a healthy lifestyle. Incidentally, it may also be worth filing a complaint against your doctor, because his “advice” is not only irresponsible, but dangerous. Please do get angry at him, and not at yourself. (I’d like to say more, but I’m restraining from using four-letter words!!)

    Reply
  32. Dusky Flower

     /  January 30, 2013

    A doctor told you to be anorexic.

    A DOCTOR told you to be anorexic.

    A DOCTOR TOLD YOU TO BE ANOREXIC.

    I’m pretty sure that lawyers should be involved and that that guy shouldn’t be a doctor anymore.

    Reply

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