Too Fat To Be A Nurse?

[Newprospnp]

I just got into nursing school (MSN direct entry program) as a career change after 10 years practicing law. To be put it mildly, my general constitution plus years of legal practice have left me absurdly out of shape (as in, 130ish pounds overweight). I'm noticing that healthcare people tend not to be overweight and besides, I'd like to be a "good example" to patients since I'm looking to do primary care ruse practitioner work (at the very least, I'd like to not get the whole "how big a deal is my being overweight really if you, my healthcare provider, are way overweight" question). It probably also has to do with my being a bit older than other students and a guy. I figure I can safely lose about 50 pounds (I.e., 2 pounds a week) before school starts, which still leaves me well and obviously overweight. Also I'm a guy, so already feeling a little self-conscious about what patients think of male nurses/nursing students. Does anyone have any thoughts or experiences they can share?

[beachynurse, ASN, BSN]

KalipsoRed21 said:

...instead of the current unhelpful *** spewed by healthcare and fitness professionals alike, I'm going to tell you the truth. Eating a diet of minimally processed foods with 80% of your diet being veggies is the most beneficial for your health (check out The Blue Zones). Mild/Moderate exercise and resistance training 30 minutes a day is good for your health. Almost all other advice is ***. Losing weight will require you to be hungry/starve yourself. 

I would give anything to be able to have the gastric sleeve surgery. I had the lap band done about 14 years ago, and did fantastic. I lost the weight I wanted to, looked and felt great. I never wanted to go back to the fat me. About 2 1/2-3 years ago I started to develop some GI symptoms like reflux, which after a while developed into aspiration at night. It just got progressively worse, and the abdominal pain was awful. I finally see a GI MD and have an endoscopy, stomach is fine, but band was tight, so he tried to open it up a bit and referred me back to the surgeon that placed it. I go back to him, only to find out after an upper GI that he has to remove the band. After the band was removed, I had to wait 6 months for another upper GI, only to now find out that the damage to my stomach and esophagus was permanent. Because of that damage I will never be a candidate for weight loss surgery again. I have gained most of the weight back, and I can't stand the way I look, and feel. I would give just about anything to be able to have that surgery. I want to feel and look the way I did with the band.

[ZyzzFan]

KalipsoRed21 said:

...instead of the current unhelpful *** spewed by healthcare and fitness professionals alike, I'm going to tell you the truth. Eating a diet of minimally processed foods with 80% of your diet being veggies is the most beneficial for your health (check out The Blue Zones). Mild/Moderate exercise and resistance training 30 minutes a day is good for your health. Almost all other advice is ***. Losing weight will require you to be hungry/starve yourself. 

Losing weight doesn't require a person to "be hungry/starve yourself", it simply requires eating a normal amount of calories per day, and if weight is the only concern it doesn't matter what the calories come from, IIFYM.  I don't abide by IIFYM though and just tend to eat in the outside isles of the grocery store with a diet of mostly meat and some veg.  

Weight loss is psychological, it takes a tremendous amount of effort to consume the calories necessary to be severely overweight.  I like to have my weight loss clients take 2000 calories worth of healthy foods and place them on a platter.  They are shocked when they see how much food it actually takes to eat that many calories.

Living a world where people are undergoing weight loss surgery is very dystopian to me and exemplifies much of what is wrong with the world.

[KalipsoRed21, BSN, RN]

ZyzzFan said:

Losing weight doesn't require a person to "be hungry/starve yourself", it simply requires eating a normal amount of calories per day, and if weight is the only concern it doesn't matter what the calories come from, IIFYM.  I don't abide by IIFYM though and just tend to eat in the outside isles of the grocery store with a diet of mostly meat and some veg.  

Weight loss is psychological, it takes a tremendous amount of effort to consume the calories necessary to be severely overweight.  I like to have my weight loss clients take 2000 calories worth of healthy foods and place them on a platter.  They are shocked when they see how much food it actually takes to eat that many calories.

Living a world where people are undergoing weight loss surgery is very dystopian to me and exemplifies much of what is wrong with the world.

You need to watch the NOVA special I posted. I have been educated in a very similar fashion to you. I believed everything you have said at one time. But practicing what you said is near impossible. I, like every fat person out there, went through most of my life believing my lack of will power and poor choices were the majority of the problem. Turns out those beliefs are merely just that beliefs. Like butter is bad for you and the yellow part of eggs are bad for you and every other piece of poorly backed science, those are not the truth. My will power and my diet are a smaller part of them problem than I and healthcare would like to believe. And the science disproving those lines of thought is pretty damning. 

[ZyzzFan]

KalipsoRed21 said:

You need to watch the NOVA special I posted. I have been educated in a very similar fashion to you. I believed everything you have said at one time. But practicing what you said is near impossible. I, like every fat person out there, went through most of my life believing my lack of will power and poor choices were the majority of the problem. Turns out those beliefs are merely just that beliefs. Like butter is bad for you and the yellow part of eggs are bad for you and every other piece of poorly backed science, those are not the truth. My will power and my diet are a smaller part of them problem than I and healthcare would like to believe. And the science disproving those lines of thought is pretty damning. 

There is a load of horrible advice out there such as your butter example and countless charlatans like Dr. Oz pushing the next nonsensical weight loss "cure" but it still boils down to calories in and calories out.  People's metabolic rates may have slight variations and factors such as use of antipsychotics/corticosteroids etc can make it more difficult to maintain a lead however this doesn't stop someone from not putting themselves into a daily caloric surplus.  The American diet is horronedous and is composed of things I don't consider to be food.

Eat a diet of only meat, vegetables, some fruit, some nuts, and drink only water.  These are foods, not garbage in a box.  The only 3 items I get from the grocery store isles are oats, almond butter, and oil.  Everything else is on the outskirts of the grocery store.  I eat a daily 500 calorie surplus between the months of August-March each year and I struggle to eat that many calories.

Weight loss surgery is not a natural thing, it is a symptom of our times, our diets, and lobbying from groups like the sugar and corn industry.  Sugar is absolutely evil and unnecessary, they hide that garbage in everything even stuff like tomato sauce.  Why the hell is sugar in tomato sauce?  This is why I make my own or spend $8 at whole foods on a jar.

[KalipsoRed21, BSN, RN]

beachynurse said:

I would give anything to be able to have the gastric sleeve surgery. I had the lap band done about 14 years ago, and did fantastic. I lost the weight I wanted to, looked and felt great. I never wanted to go back to the fat me. About 2 1/2-3 years ago I started to develop some GI symptoms like reflux, which after a while developed into aspiration at night. It just got progressively worse, and the abdominal pain was awful. I finally see a GI MD and have an endoscopy, stomach is fine, but band was tight, so he tried to open it up a bit and referred me back to the surgeon that placed it. I go back to him, only to find out after an upper GI that he has to remove the band. After the band was removed, I had to wait 6 months for another upper GI, only to now find out that the damage to my stomach and esophagus was permanent. Because of that damage I will never be a candidate for weight loss surgery again. I have gained most of the weight back, and I can't stand the way I look, and feel. I would give just about anything to be able to have that surgery. I want to feel and look the way I did with the band.

I am so, so sorry to hear that. If you reviewed the video and the article then you can see your path is going to be difficult, but not impossible. The most effective long term weight loss is the gastric sleeve. 
There are two injections that I know of on the market to suppress appetite: 1) Mounjaro 2) Ozempic. Both are for diabetes but have a secondary use as a weight loss medication. Many of my co-workers use this medication, but I’m a little freaked out about the possible complication of thyroid tumors to try it. My co-workers love it. They are losing like 5-9 lbs a week.

But because I’m to freaked out to take the injections and I don’t have the money for surgery. I’m pretty much stuck with the be hungry/fasting plan.

I work 8a-5p. I eat from 12pm-8pm. I eat whatever I want, I’m not looking to change my diet. My husband cooks at home, I eat leftovers and whatever he cooks for dinner. I eat out for lunch with my coworkers occasionally. I find that fasting does make me feel fuller faster at lunch. I just eat during that 8 hour window.
I guess I just don’t want you to go what I have several times. Losing weight feeling good, believing because you have lost weight you now have it under control, then getting tired of what it takes to maintain, the weight coming back on PLUS some, feeling like a looser again on top of just not feeling good because you are heavy again. This time I go into it knowing that FOREVER I will have to reduce my diet. That once I get to my goal weight I can add a few more calories but mostly I will forever have to tell my self no. That forever I will have to be strict about what I eat and limit the things I enjoy eating. Yes, I enjoy “healthy food” but, no, it is not nearly as satisfying as eating the way my family does, the way my friends do. The concept that you can get use to and enjoy a “healthy diet” is a lie unless you give up your family and friends. It is almost like saying you can free yourself of drug addiction but still hang out with those friends and in those places. I find it easier to just limit the time I eat to a small window when my family/friends eat and be distracted/hungry the rest. Because being hungry is going to happen no matter what.

[ZyzzFan]

KalipsoRed21 said:

I am so, so sorry to hear that. If you reviewed the video and the article then you can see your path is going to be difficult, but not impossible. The most effective long term weight loss is the gastric sleeve. 
There are two injections that I know of on the market to suppress appetite: 1) Mounjaro 2) Ozempic. Both are for diabetes but have a secondary use as a weight loss medication. Many of my co-workers use this medication, but I’m a little freaked out about the possible complication of thyroid tumors to try it. My co-workers love it. They are losing like 5-9 lbs a week.

But because I’m to freaked out to take the injections and I don’t have the money for surgery. I’m pretty much stuck with the be hungry/fasting plan.

I work 8a-5p. I eat from 12pm-8pm. I eat whatever I want, I’m not looking to change my diet. My husband cooks at home, I eat leftovers and whatever he cooks for dinner. I eat out for lunch with my coworkers occasionally. I find that fasting does make me feel fuller faster at lunch. I just eat during that 8 hour window.
I guess I just don’t want you to go what I have several times. Losing weight feeling good, believing because you have lost weight you now have it under control, then getting tired of what it takes to maintain, the weight coming back on PLUS some, feeling like a looser again on top of just not feeling good because you are heavy again. This time I go into it knowing that FOREVER I will have to reduce my diet. That once I get to my goal weight I can add a few more calories but mostly I will forever have to tell my self no. That forever I will have to be strict about what I eat and limit the things I enjoy eating. Yes, I enjoy “healthy food” but, no, it is not nearly as satisfying as eating the way my family does, the way my friends do. The concept that you can get use to and enjoy a “healthy diet” is a lie unless you give up your family and friends. It is almost like saying you can free yourself of drug addiction but still hang out with those friends and in those places. I find it easier to just limit the time I eat to a small window when my family/friends eat and be distracted/hungry the rest. Because being hungry is going to happen no matter what.

What types of foods does your family eat that makes it "impossible" to be a healthy lean weight?  Cooking for entertainment is my main hobby and its all composed of healthy delicious foods.  Look at chefs like Jamie Oliver or Gordon Ramsay for inspiration.  Whole healthy ingredients and incredibly delicious as well as enjoyable.  The thought of processed hamburger buns, cakes, cookies, etc is honestly vomit inducing to me.  

Healthy has so many advantages and is also way cheaper than eating processed junk.  

[KalipsoRed21, BSN, RN]

ZyzzFan said:

There is a load of horrible advice out there such as your butter example and countless charlatans like Dr. Oz pushing the next nonsensical weight loss "cure" but it still boils down to calories in and calories out.  People's metabolic rates may have slight variations and factors such as use of antipsychotics/corticosteroids etc can make it more difficult to maintain a lead however this doesn't stop someone from not putting themselves into a daily caloric surplus.  The American diet is horronedous and is composed of things I don't consider to be food.

Eat a diet of only meat, vegetables, some fruit, some nuts, and drink only water.  These are foods, not garbage in a box.  The only 3 items I get from the grocery store isles are oats, almond butter, and oil.  Everything else is on the outskirts of the grocery store.  I eat a daily 500 calorie surplus between the months of August-March each year and I struggle to eat that many calories.

Weight loss surgery is not a natural thing, it is a symptom of our times, our diets, and lobbying from groups like the sugar and corn industry.  Sugar is absolutely evil and unnecessary, they hide that garbage in everything even stuff like tomato sauce.  Why the hell is sugar in tomato sauce?  This is why I make my own or spend $8 at whole foods on a jar.

Friend, we do not disagree that the American diet should include a more nutrient dense, preservative free foods. I know you are in shock. I get it. Watch the NOVA PBS special I posted. It turns out the adage “Calories in and calories out” is not as true as we have convinced ourselves. In the study on the movie they measured the activity of a primitive village. These people were massively active, walking 5 - 10 miles a day and still only burning 1800-2500 calories. The same average you and I burn in our more sedentary life style. The reason gastric sleeve surgery works is not because it is shrinking your stomach as we thought. It is because cutting out part of your stomach reduces the amount of signals your stomach sends to release hormones that make you want to eat. I don’t advocate surgery because I think extreme measures should be first. I advocate gastric sleeve surgery because it has proven to be the most effective and life saving surgery to reduce massive obesity. More effective than the concept of “eat healthy and exercise”. 

[ZyzzFan]

KalipsoRed21 said:

Friend, we do not disagree that the American diet should include a more nutrient dense, preservative free foods. I know you are in shock. I get it. Watch the NOVA PBS special I posted. It turns out the adage “Calories in and calories out” is not as true as we have convinced ourselves. In the study on the movie they measured the activity of a primitive village. These people were massively active, walking 5 - 10 miles a day and still only burning 1800-2500 calories. The same average you and I burn in our more sedentary life style. The reason gastric sleeve surgery works is not because it is shrinking your stomach as we thought. It is because cutting out part of your stomach reduces the amount of signals your stomach sends to release hormones that make you want to eat. I don’t advocate surgery because I think extreme measures should be first. I advocate gastric sleeve surgery because it has proven to be the most effective and life saving surgery to reduce massive obesity. More effective than the concept of “eat healthy and exercise”. 

I watched parts of the special you posted, it's not good science.  Overweight "scientists" will go to the ends of the Earth to justify their lifestyle choice of being overweight.  First of all walking 5-10 miles is not being "massively active".  Most ER nurses will walk that amount in a 12 hour shift if they track their steps yet most of them are still average overweight Americans.  Go to most places in Europe besides the UK and tell me how many overweight people you see.  Its a cultural thing and a lifestyle choice.

1800-2500 calories is a massive amount of food, to get over that takes a poor diet.  Like I said anyone can roughly estimate their metabolic rate and easily eat within its range to not gain a surplus of body fat.  The hormones regarding hunger are irrelevant here, just because a person has a signal that tells them they are hungry doesn't mean they have to grab a plate of cookies and shove it in their mouth.  Ignore the urge to eat and distract yourself, its the power of mind.  When I drop to 8% or so bodyfat prior to the Summer months I just simply choose to eat a certain amount of calories and ignore my urges of hunger.  

[foxypaws, BSN, MSN, RN]

I eat one large meal a day when working, and one or two 100-150 calorie snacks. On off days I eat two large meals. I don't drink anything but water, black coffee, and drinks that use stevia or sugar alcohols as sweeteners.

How can I do it? As others have said I eat whole foods; specifically a strict ketogenic diet that controls my seizures. You almost never get hungry when you eat high fiber vegetables and satiating quantities of fat. My blood work has never been better.

I lost the weight and kept 70% of it off permanently. Four years and running. 

[JKL33]

Newprospnp said:

Hi folks,

I just got into nursing school (MSN direct entry program) as a career change after 10 years practicing law.  To be put it mildly, my general constitution plus years of legal practice have left me absurdly out of shape (as in, 130ish pounds overweight).  I'm noticing that healthcare people tend not to be overweight and besides, I'd like to be a "good example" to patients since I'm looking to do primary care ruse practitioner work (at the very least, I'd like to not get the whole "how big a deal is my being overweight really if you, my healthcare provider, are way overweight" question).  It probably also has to do with my being a bit older than other students and a guy.  I figure I can safely lose about 50 pounds (I.e., 2 pounds a week)before school starts, which still leaves me well and obviously overweight.  Also I'm a guy, so already feeling a little self-conscious about what patients think of male nurses/nursing students.  Does anyone have any thoughts or experiences they can share?

Best wishes!

You sound like a conscientious person--if you can listen and relate to patients you will generally gain their trust.

Quote

(at the very least, I'd like to not get the whole "how big a deal is my being overweight really if you, my healthcare provider, are way overweight" question)

I get you, but remember that we don't advise people on health practices for our own good, but hopefully theirs. It is up to them if they want to work towards health or make excuses such as the above.

You're getting lots of different perspectives in this thread so I will share mine. I was flirting with overweight during NP school, sitting and studying (while snacking) for hours daily. I did choose to make significant effort to optimize my weight and overall fitness; I began those efforts in earnest the same day I passed my boards. I am glad I did. I had various reasons, unhappy with how I looked, wanting to be more fit, and yes--wanted to take the advice I knew I would be giving out daily. I didn't want to sit there discussing "30 minutes vigorous activity 5 days a week" when I was doing none of that.

I think my changes do help me relate to patients struggling with weight and fitness. I know how hard it is to work all day and have family and community  responsibilities and try to force myself to find time to do some kind of exercise several times a week, for example. I love carbs as much as the next person, for another example, but I have found ways to maintain normal weight without feeling like I am suffering or missing out. Without focusing on myself, I try to use my experiences to relate to patients and so far have quite a number who come in excited with the small changes they are sustaining toward better health.

So I support your desire to lose weight, mostly because of what it will mean for you and your health, but also because I do believe that in secondary ways your efforts and experience will also help your future patients.

Again, good luck ~

[KalipsoRed21, BSN, RN]

ZyzzFan said:

What types of foods does your family eat that makes it "impossible" to be a healthy lean weight?  Cooking for entertainment is my main hobby and its all composed of healthy delicious foods.  Look at chefs like Jamie Oliver or Gordon Ramsay for inspiration.  Whole healthy ingredients and incredibly delicious as well as enjoyable.  The thought of processed hamburger buns, cakes, cookies, etc is honestly vomit inducing to me.  

Healthy has so many advantages and is also way cheaper than eating processed junk.  

You just keep spouting out you way of life. Good for you. Honestly I cannot believe that you are in healthcare with this kind of prejudice? My family eats mashed potatos, rice, pork chops, ground beef, tortillas, squash, broccoli, and salad, roasted chicken. We have a garden we pull from in the Spring and fall.  We do not entertain much. I am a nurse and my husband is a brick mason. We eat what people who make 65-85k a year can afford. We do eat out but we do not go to chains. I get my lunch from the grocery store, a local store, or taco truck, or left overs. 
I don't really give a hoot that processed foods make you want to vomit. Processed foods are some of the most affordable at the supermarket. And many people make far less than my husband and I do.

Yeah, how hungry you feel matters. Good for you. You keep your prejudice and I will tell the truth as science now knows it. I'm glad you made it 4 years in your weight loss journey. I hope you can keep it up. I kept it off for 4 years the first time too. Actually I kept it off 6 the first time and 2 the second. I am just saying that it is time to stop lying to people who are obese. No more telling them that they can lose weight without feeling hungry; that is a lie. No more telling them they can keep it off without feeling hungry; that is a lie. I should know because 1) I have lived it. 2) That is what the science says.

[ZyzzFan]

KalipsoRed21 said:

You just keep spouting out you way of life. Good for you. Honestly I cannot believe that you are in healthcare with this kind of prejudice? My family eats mashed potatos, rice, pork chops, ground beef, tortillas, squash, broccoli, and salad, roasted chicken. We have a garden we pull from in the Spring and fall.  We do not entertain much. I am a nurse and my husband is a brick mason. We eat what people who make 65-85k a year can afford. We do eat out but we do not go to chains. I get my lunch from the grocery store, a local store, or taco truck, or left overs. 
I don't really give a hoot that processed foods make you want to vomit. Processed foods are some of the most affordable at the supermarket. And many people make far less than my husband and I do.

Yeah, how hungry you feel matters. Good for you. You keep your prejudice and I will tell the truth as science now knows it. I'm glad you made it 4 years in your weight loss journey. I hope you can keep it up. I kept it off for 4 years the first time too. Actually I kept it off 6 the first time and 2 the second. I am just saying that it is time to stop lying to people who are obese. No more telling them that they can lose weight without feeling hungry; that is a lie. No more telling them they can keep it off without feeling hungry; that is a lie. I should know because 1) I have lived it. 2) That is what the science says.

Processed foods are not the "cheapest foods" at the supermarket.  Healthy whole foods are significantly cheaper than processed high calorie junk.  The rhetoric you are posting is dangerous and ends up hurting people.  Spouting nonsense like it's impossible to lose weight and live a healthy lifestyle.  Is this what you tell your patients?  Hey its impossible to be healthy so just enjoy being sick all the time?

These are just excuses; it literally takes zero effort to be lean and eat in a normal caloric maintenance.  Overweight people place a tremendous weight on the healthcare system and their lifestyle choice ends up hurting others and raising the costs of everyone else's healthcare.