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In the Year of Our Lord 2023, is that really the case? My sense from the doctors I know as friends is that they are absolutely loath to suggest, "Ya know, diet and exercise could help with..." because they know 1) Patients don't want to hear it, and 2) They aren't going to do it anyway.
I have other close friends who are obese and have proactively asked their doctor for help. Like pleading to have some direction, a support structure, a pathway to success. You know what the most phenomenal response I heard was? "Well, you're getting older... [next topic]."
In forums like this one, people constantly constantly lie about how weight loss/gain works. One bucket is CICO disbelievers generally (the true cranks). Others retreat to some form of, "Well, CICO may be true, but it's not helpful, so we really just need to point out that most people have absolutely no control over their weight." This is a complete lie that is far less helpful than explaining how things actually work and making suggestions for how to properly plan, build a support system, etc. It is not the people who are saying, "This is the way, walk you in it," who are doing the thing that doesn't work. It is the people who are perpetuating this lie, saying that the only choices are shame or doing nothing (or, I guess, like, chemicals or something that magically change CICO), who are doing the thing that doesn't work.
From my experience, that's completely not true. Every doctor suggests it as if it's a novel idea you've just never thought of. They don't have many suggestions beyond that, other than to tell you to go see a specialist, who also doesn't have any ideas to help.
The most frustrating thing I find is that doctors also don't want to tell you to just eat less, which is in my experience the only thing that'll cause you to lose weight. If you adopt a strategy of severely limiting calories or working with some strategy that works for you but is not officially approved (like being really strict but having cheat days), then they think you have an eating disorder, and they warn you about that. They tell you to just lose weight, but don't approve of options that actually work for you.
Perhaps we need some way of gathering data by sending a bunch of obese testers to doctors. Sort of in any event, either response is equally useless, though I can understand why doctors would opt for either path, given their experiences/incentives. What I think we can both probably agree on is that they are not likely to give real, actionable advice that can be directly pursued to success, and that is the real shame.
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