jeneralist

I prefer to think of "coming into balance", "acheiving health and fitness", and "growing into myself".

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Or, "my body finding the place where it's happy".

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Cool!

I'd like to also find something of the "(verbing) some weight" or "(blanking) some pounds" form.

Doctor-speak is full of phrases that put the emphasis in the wrong place. For example, if I give someone some medication for a particular condition, and it doesn't help them, the standard phrase is "patient failed a trial of drug X." Me, I think that drug X failed the patient....

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How about "shape shifting"?

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My favorites are "noncompliance" and "drug seeking behavior." They're are usually understood as: "patient doesn't really want to get well," and "patient is an addict." More often, I think they mean: "I didn't manage to come up with a treatment that worked for the patient," or "the patient is in chronic pain and wants to be treated."

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A-yup.

Back when I was in med school, I had to give a 15 minute talk on how to improve "patient adherence." I think the preceptor expected me to talk about the precontemplation-contemplation-etc model for behavior change. Instead, I suggested that patients might be more likely to accept the advice of a doctor who hadn't just kept him waiting until 5:30 for a 4:00 appointment.

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I'm a big fan of "conditioning" and "fitness." After all, weight isn't the problem- bodybuilders are real, if rare. The problem's fat. And since just "loosing" things from your diet often doesn't work- you've got to add exercise- I think an overall focus on fitness rather than weight would be a lot healthier.

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But there are many times when decreasing weight, rather than increasing cardiovascular capacity, is needed. If someone comes into my office weighing 300 pounds, and they've got knee pain, reducing the load on their knees is going to be a big part of helping them. I'm not specifying which part of the calories in/calories out, diet & exercise, to focus on (at least, not in the 1st sentence).

If I just say something like, "I think your knees would begin to feel better if they didn't have so much strain on them," some patients would think that I'm recommending that they stay in the reclining chair watching TV. I need to be more specific: "I think your knees would begin to feel better if they didn't have so much strain on them. If you could lose twenty pounds, that would make a big difference in how you feel." And then I'd talk about steps to take.

But I don't like saying "lose." It's a very negative word -- and unless I give them a different one, it's the one my patients will be saying to themselves in their internal dialog.

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"I think your knee is under too much strain. The best thing you can do right now is to tell me about how active your lifestyle is and about your diet so we can find how best to get you to a place where your body is supporting itself rather than causing itself stress."?

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I can see that end of the problem, and I guess it wasn't what I was thinking about. But, in some ways, my brain breaks this example down into two seaparate but connected issues. There are thin patients with knee pain who *do* have to be more sedentary to reduce the load- elderly individuals with severe arthritis, for instance. And being 300 lbs is a big problem even if a person's knees are ok.

I think your idea of "shed a few pounds" is a good one. Even something like referring to "loosing fat" rather than "loosing weight" would be good. I'm thinking of elderly patients again, now- I've seen some who are *delighted* to loose weight, but don't seem to connect it with the fact that they're getting weaker because of muscle atrophy.

I'd probably want to go with something like: "I think your knees would improve if they didn't have so much strain on them. If you could get in a bit better shape, that would make a big difference." Which, yes, in some sense avoids the core issue of loosing weight. I'm not sure there's a great solution.

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I'm not sure if it's what you meant, but what you wrote has me thinking about the difference between "losing" weight and "loosing" weight. I've got a mental image of walking to the gate of my fenced-in yard with a wild Fat Beast, 20 pounds growling wild animal, in a cage. (In my imagination, it sort of looks like an injured and recovered sloth, with elements of a small, overfed orangutan.) I open the cage door and shout to the critter, "Go away! Be free!" to get it to return to the wild.

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Heh. Actually, it's just that I can't spell!

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onyxtwilight.livejournal.com

Discard, drop, jettison, slough, eliminate, purge?

I don't know that there's a way to say "lose weight" without using a negative word, if you're committed to referring to the extra weight itself -- which, in fact, has to be let go, cast aside, melted away.

Re-gain a healthy weight, perhaps.

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I like re-gaining health.

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Exactly. It needs to be actively cast aside, instead of passively lost. I mean, when else in life do you *try* to lose something? "Hmm, I'll leave my car keys here, under the comforter in the spare bedroom, and then I'll distract myself, and in the morning I'll have forgotten where I put them." There are times someone actively gets rid of something they don't want -- "lose" isn't the right word for something someone tries to do.

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onyxtwilight.livejournal.com

Well, for the record, "shed" and "drop" seem the most natural to me, conversation-wise. "You need to shed some weight."

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tracyandrook.livejournal.com

It is a very good point, trying to lose something is like not thinking of an elephant.
If one actively does something that uses calories, one passively loses fat almost as a side effect. Besides surgical removal, (which I don't think you are recommending) one can't actively lose fat.
"Drop" was good, because one could either actively or passively drop something.
To me, excess weight oten feels like a thick sweater that I cannot take off. "Shed" is good.
If it were me, and I had all the time in the world, I would want to be maybe encouraging activity (=empowerment) as opposed to passivity (=letting it creep up)to get at the cause of the problem. What _can_ the client _do_, etc. "What do you currently do for exercise? What do you like to do? What do you wish you could do if you were in better shape?" But, it takes longer to draw the client out into a discussion.

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