Can diabetic educators be fat?

brownbook · Apr 30, 2010

I'm getting tired of the "obesity epidemic." Arnold S. (can't spell his last name, the govenor of California) would be listed as overweight per health charts, BMI. There are healthy active overweight people. Studies show overweight patients survive cardiac surgery better than thin patients. I am probably considered thin. My diet is terrible! I skip breakfast and lunch (not to diet, just don't feel hungry,) and grab some mini snack size candies while working !!! I eat fresh fruits and vegetables about once a week. Of course any obese medical/nursing professional who wheezes and can hardly get out of a chair is not a good role model. Not so much what the scale says they weigh, it is how they carry their weight, how active they are, etc.

happy2learn · Apr 30, 2010

I'm getting tired of the "obesity epidemic." Arnold S. (can't spell his last name, the govenor of California) would be listed as overweight per health charts, BMI. There are healthy active overweight people. Studies show overweight patients survive cardiac surgery better than thin patients.

You are basing "overweight" on the outside appearance when overweight is base on your body fat percentage, something you would never be able to calculate based on looks.

Your whole "overweight patients survive cardiac surgery better" is crazy. I saw that article, and it was a difference of like 2%. We also don't know what type of cardiac surgery was performed and what other risk factors they looked at so I don't find that information very credible. For example, I am not overweight, but I have a bleeding disorder, so I would be more likely to die during heart surgery than an overweight person without a bleeding disorder.

Anyways, health isn't all about weight, there are many factors. People with diabetes can be thin also, and may have been thin there whole life (I know someone like this.)

I also find it ridiculous that someone said that if a person is really thin then that means they haven't struggled with weight. That's an absurd remark. How do you know what that person has struggled with?

BanoraWhite · Apr 30, 2010

Something has been ticking over in my head since I last worked with a diabetic educator. This lady said that a good diabetic educator should not be overweight or fat as they are supposed to role model the appropriate behaviour for their clients.....

Well isn't a nurse or a doctor supposed to be a good role model for a healthy lifestyle too ? Personally, I have had both overweight doctors and nurses, and the only thing I am concerned about is whether they are looking after me and giving me good care ! If THEY are overweight, it does not bother me, it's none of my business and its not my life. For all I know they could have some sort of disorder, or emotional issue which leads to weight gain.

The same goes for an underweight person.

My sister is a naturopath and has various chronic health issues which she has no control over. She is absoutely fantastic at what she does and has multiple degrees and awards. What a shame if people didn't go to her because they thought she is "too lazy" to get healthy.

Heinz beans · Apr 30, 2010

Thanks everyone, its really illustrating both sides I can see. I hope a reach a conclusion in the middle.

tokyoROSE, BSN, RN · Apr 30, 2010

That is very hypocritical to me. I feel very strongly about weight issues and obesity, even more now that I'm a nurse-to-be. How can I preach to my patients that a balanced diet and exercise is the key to good health when I don't do this myself? People love to make excuses about their weight and very few have a legitimate reason IMO. I get that eating well and exercising is hard; fast food tastes better, watching TV is more relaxing than exercise. I get it. But its all about choices. You have only ONE body, so take care of it!! I am thin and when I tell people I work out for two hours each time, they say I don't need it. It doesn't matter the shape you are in now, anyone can benefit from exercise. It is not just weight issues, we all know exercise has rewards too long to list. Would you see a doctor who smokes? A lawyer who gets arrested for multiple DUI's? A pastor who has multiple affairs? When you are in a certain profession, there are expectations, like it or not.

psychonaut · May 1, 2010

Would you want an out of shape personal trainer?

Given the complete wrongness that comes out of the mouths of most personal trainers, and given an assumed high "fitness" level amongst personal trainers, then yes, I could very well want an "out of shape" personal trainer. It would be the knowledge base that matters.

I would want a diabetes educator who is of average weight. I wouldn't want someone who was either extreme.

I'm honestly surprised to see *you* fall into this same fallacy. Weight is utterly incidental to the knowledge base or teaching ability of the diabetes educator in question.

I wouldn't go to an overweight personal trainer, I wouldn't see an overweight dietitian. (now my idea of overweight might not be the same as others, I don't go off a BMI and I like a fit yet curvy look) I also know not all skinny people are fit. So in our field I think it's important to "practice what we preach". It's my goal to fully get there before I am working as an actual nurse.

So...no ugly beauticians. No bald barbers. No vets who don't have pets. Personal trainers and dietitians must have a "fit yet curvy" build.

My diet is terrible! I skip breakfast and lunch (not to diet, just don't feel hungry,) and grab some mini snack size candies while working !

As an aside, there is some very interesting research coming out supporting this eating pattern, and putting away the standard "many small meals" myths out there (myths you are likely to hear from your "fit" personal trainer who spends 1/3 of their life planning and preparing their 8 daily meals).

You are basing "overweight" on the outside appearance when overweight is base on your body fat percentage, something you would never be able to calculate based on looks.

The trained eye can approximate body fat level. All methods of body fat measurement (apart from necropsy) suffer from inadequacies and errors. BMI is a useful measure for the vast majority of the population.

That is very hypocritical to me. I feel very strongly about weight issues and obesity, even more now that I'm a nurse-to-be. How can I preach to my patients that a balanced diet and exercise is the key to good health when I don't do this myself? People love to make excuses about their weight and very few have a legitimate reason IMO. I get that eating well and exercising is hard; fast food tastes better, watching TV is more relaxing than exercise. I get it. But its all about choices. You have only ONE body, so take care of it!! I am thin and when I tell people I work out for two hours each time, they say I don't need it. It doesn't matter the shape you are in now, anyone can benefit from exercise. It is not just weight issues, we all know exercise has rewards too long to list. Would you see a doctor who smokes? A lawyer who gets arrested for multiple DUI's? A pastor who has multiple affairs? When you are in a certain profession, there are expectations, like it or not.

I'm leaving this one completely intact, too much good stuff in there. Translated: 1) it is impossible to have knowledge and ability not clearly manifested (i.e. know about DM yet not "fit"), 2) diet and exercise is an issue of morality, and 3) diet and weight control in the health professional is equal to morality (e.g. the drunk driving lawyer and the lascivious minister).

Perhaps I am naive to be surprised at this level of judgment based on physical appearance by educated professionals. By the general populace, certainly, but amongst ourselves? Quite interesting.

rn/writer, RN · May 1, 2010

That is very hypocritical to me. I feel very strongly about weight issues and obesity, even more now that I'm a nurse-to-be. How can I preach to my patients that a balanced diet and exercise is the key to good health when I don't do this myself? People love to make excuses about their weight and very few have a legitimate reason IMO. I get that eating well and exercising is hard; fast food tastes better, watching TV is more relaxing than exercise. I get it. But its all about choices. You have only ONE body, so take care of it!! I am thin and when I tell people I work out for two hours each time, they say I don't need it. It doesn't matter the shape you are in now, anyone can benefit from exercise. It is not just weight issues, we all know exercise has rewards too long to list. Would you see a doctor who smokes? A lawyer who gets arrested for multiple DUI's? A pastor who has multiple affairs? When you are in a certain profession, there are expectations, like it or not.

I have struggled with weight all my adult life. Let me tell you that I glaze over when anyone tries to "preach" to me about diet and exercise. I have tons of knowledge but there are emotional and physical roadblocks that I have to work very hard to overcome. The people who have been the most helpful in this quest are NOT the ones who preach, lecture, or moralize. They are the ones who meet me where I am and help me to figure out the next part of the process, one step at a time.

For many, it isn't a matter of information. A lot of us are exceedingly well informed in a factual sense. What's missing is a way to make it all real in our own lives and a way to take all the theory and find a reasonable way to apply it. If anything, preaching makes success less likely to happen.

Asking people why they are "non-compliant" (gosh, I hate that word!) makes the assumption that they agreed to answer to you in the first place. The best approach I have ever gotten was from a nurse educator who kindly and gently reminded me of my OWN goals and then asked me, "What stops you from _____?" and she would fill in the current or most urgent desire. Rather than triggering a tripwire of defenses and excuses, she helped me to puzzle out the obstacles and false thinking that kept me from moving forward. I trusted her because she kept the discussion about me, not about her judgments and goading.

So, can a diabetic educator be overweight? Yes, I think there are times when such seemingly contradictory images can be reconciled. Maybe the person has already lost a significant amount of weight and has valuable insights to share. Maybe they do exercise and eat well and this is just the body they were given. Maybe they struggle, too, and know how to get back on the wagon after a fall.

I guess I'd rather have someone like that than a thin person who wants to guilt-trip me or lecture me or give me verbal spankings.

llg, PhD, RN · May 1, 2010

Quoting from psychonaut:

""Originally Posted by llg

I would want a diabetes educator who is of average weight. I wouldn't want someone who was either extreme."

I'm honestly surprised to see *you* fall into this same fallacy. Weight is utterly incidental to the knowledge base or teaching ability of the diabetes educator in question."

Of course I don't believe that beign overweight prevents a person from being able to know and/or convery information. That would be ridiculous. However, I don't need a diabetes educator to give me information. I can read it for myself.

As a patient who has struggled with weight issues since puberty and who now is pre-diabetic with hypertension ... I don't seek the services of a diabetes educator for just basic information. I seek the services of someone who can help with the daily struggle to control my intake and get more exercise. I have found through considerable experience that people who have never personally dealt with such issues are rarely able to relate to the nature of the struggle of it all. While it is possible for a naturally thin person who loves exercise to say the right, therapeutic things to me ... I find that they almost never do. They usually say things like, "Try it: you'll like it" "you'll feel better" etc. when I have never found that to be the case. They rarely have "a real feel" for what it is like to be me and rarely have anything more to offer other than the suggestions printed in the literature -- which I am perfectly capable of reading for myself.

The very overweight person often gives me the same impression -- that they are telling me what they read in a book that I could read for myself. But they can't tell me "how to succeed" to overcome my problems because they haven't found anything that works yet. So, while they can be great at empathizing with me, being emotionally supportive, related to my struggels, etc. ... they really don't have any answers to my problems, either.

So ... for either the very thin or the very overweight diabetes educators ... I realize that they can convey the contents of the literature to me and they can tell me the "textbook" suggestions for changing my lifestyle permanently. But I don't really need to pay someone to do that because I can read for myself. What I would be willing to pay for is for someone who could inspire me ... coach me ... share insights learned from their similar struggles ... have empathy based on a true understanding ... etc. And while I acknowledge that a person of any weight might be able to do that, I have found that such abilities are most likely to be found in people who have actually experienced a similar struggle and found ways to succeed -- not in people who have never experienced such a struggle or in those who have not yet found a way to succeed in their own lives.

And I could fully understand why a person who is very overweight would prefer a teacher/counselor who is also very overweight -- someone who can relate well to their perspective and their lives. Different strokes for different folks. In my previous post -- and this one -- I am trying to articulate MY preferences as a patient, not dictate a standard for everyone.

I am a firm believer that people can deliver good care without having personal experience in that illness. For example, if I were to have a brain tumor, I would not insist that the surgeon who operated on me also have a brain tumor. Nurses do not need to get cancer themselves in order to be a good nurse for a person with cancer, etc. As a former NICU nurse, I know that a person can help new parents without having actually given birth themselves. But I also know that sometimes, patients benefit by talking with people who have gone through similar experiences. New moms want to talk with other mothers to share experiences. Cancer patients often want similar contact with other cancer patients, etc. .... because there is "something extra" gained by sharing and learning from people who have "been there." Perhaps that's why I, as a patient, prefer to receive diabetic teaching/counseling/coaching etc. from someone who has experienced a struggle similar to the one I will face daily for the rest of my life.

I also firmly believe that health care professionals should not be expected to be perfect. We are short, tall, skinny, fat, smokers, non-smokers, etc. The same leeway should be given people in health education roles. But I also have to acknowledge that as a patient, I have found that certain types of care are usually best delivered by certain types of people. It bothers me to have to say that ... but that has been my experience and I can't ignore it because it is not politically correct.

~Mi Vida Loca~RN, ASN, RN · May 2, 2010

So...no ugly beauticians. No bald barbers. No vets who don't have pets. Personal trainers and dietitians must have a "fit yet curvy" build.

I didn't say Personal Trainers MUST HAVE a fit yet curvy build. I said my idea of what is overweight might not be the same as someones elses. A lot of curves have to do with genetics. Some people will never have curvy hips and have boobs (well I suppose if they pay for them) some can be super fit and still have them. I said though that my idea of overweight can be different then someone elses, I have seen tons of people call certain celebrities fat or chunky when I didn't think so at all. That is what I meant. I don't see what a Vet not having pets has to do with anything? That isn't the same comparison. Now if I saw their own pets emaciated and not taken care of then no I wouldn't go to them. I don't go to barbers or beauticians, but someone can't help their hair falling out, I don't suppose most people chose to start losing their hair, and some people like their head shaved. That has nothing to do with them being able to give a good hair cut. Dietitians need to have a good knowledge about food and IMO should not be overweight.

I have gone to Sephora to get make up and seen a lady with horrid makeup, when I needed advice on something I did not go to her. Again, if she has no idea how to apply make up and what colors look good on her, I don't want her advice.

Is it judgmental of me, sure it is, I own it and I am ok with it. It may not be right but it is what it is. I'm not perfect and I would love to find one person who doesn't have their own judgments whether they chose to admit them or not.

llg, PhD, RN · May 2, 2010

I have gone to Sephora to get make up and seen a lady with horrid makeup, when I needed advice on something I did not go to her. Again, if she has no idea how to apply make up and what colors look good on her, I don't want her advice.
Is it judgmental of me, sure it is, I own it and I am ok with it. It may not be right but it is what it is. I'm not perfect and I would love to find one person who doesn't have their own judgments whether they chose to admit them or not.

The make-up example is a great one. I'm sure I will use it someday. :yeah:

I also agree with you about the personal judgments/biases.

~Mi Vida Loca~RN, ASN, RN · May 2, 2010

The make-up example is a great one. I'm sure I will use it someday.
I also agree with you about the personal judgments/biases.

It was so bad, I am shocked she got a job there because they are usually pretty picky about make up. It wasn't even bad like she was creative and maybe green eyeshadow isn't my thing. Heck she could have had 80's blue on and if she did a good job with the application and blending and stuff I still would have been fine getting her advice. I know a lot of make up people that like to be creative. But this lady wasn't creative, it was just horrid and he face looked very used and abused. Sort of like a Tammy Fae look but with leathery skin. Very shocked. LOL

Like I stated earlier, I myself need to lose weight to follow my own words, that is why I am trying so hard to get there before I get out in the field, not just for looks either, nursing is a physically demanding job and I have had a lot of back issues, I want to be in my best shape when I am out there on top of being able to "practice what I preach". I will also be able to tell my patients how I understand the struggles, I have been there, and what worked for me ( as long as it was healthy). I am an ex smoker as well, so I get that and I have told friends what helped me.

In the end people have to want to change. I think though being able to display health and well being will only help though in their decision more then it would if you didn't.

I also wouldn't go see a dermatologist with really bad skin.

CrazierThanYou · May 2, 2010

I have a diabetic educator who is rather hefty but she is EXCELLENT! Really knows her stuff!

I wish people wouldn't be so narrow-minded about everything...