Talking with your doctor about weight loss can be difficult. Especially if your doctor has already dispensed a negative opinion about weight loss and weight loss programs. But, if you are organized with the right tools and information, even the most backward of doctors will be forced to deal with your request.

If, however, you feel, for whatever reason, you cannot discuss losing weight with your doctor, I suggest you seek a second opinion. You need not abandon your long-term doctor. But it might be in your best interest to seek out a specialist in weight loss methods. You may have been referred by your family doctor for specialty care for other problems in the past; treatment for the specialized and demanding effort of losing weight should be no different. Some physicians are not trained or willing to embark on difficult and lifelong treatment for obesity. That's fine. There are many physicians who stand by, ready to take on the problems of losing weight and maintaining the loss. we, at the ABC, are part of this growing group of doctors,

Meeting your new weight loss specialist should not be stressful. Don't make it that way. After all, if you have high blood pressure, are you embarrassed about the level of your blood pressure? If you are diabetic, are you ashamed about your high blood sugar? If you have high cholesterol, do you worry that your doctor will disapprove of your cholesterol level? I didn't think so. At the ABC and with bariatric physicians everywhere, this is what we do. We deal with overweight patients everyday. We deal with them frankly, honestly, and with deep feeling for their struggles. We know how the overweight patient feels: what they fear, the frustration and hopelessness they have, and the battles they fight.We do not judge, we are here to help. We want to help. It's what we have dedicated our lives to fight against. We find the disease of obesity fascinating, worrisome, frustrating, and rewarding. We feel sincere, heartfelt joy when one of our patients smiles the smile of success. We warm in the glow of the faces of patients who have achieved a healthier, more energetic self.

You will need to work with your doctor to decide which type of diet, physical activity and other lifestyle modifications will help you achieve your goals. You and your doctor will decide, together, whether a prescription medicine can give your plan a boost.

By discussing with your doctor what you have tried before - successfully and unsuccessfully - in past weight loss efforts is essential. Knowing what worked and what didn't work in the past will help guide future efforts. If you have tried remedies that you bought from television infomercials - no matter how weird or ridiculous they may seem to you know - let your doctor know. We will not think any less of you for trying something not prescribed by a doctor. Most all of our patients have. We just need to know about all your past efforts. It is of particular importance if you have taken the infamous drug combination "fen-phen" in the past. Millions of people did, so you shouldn't feel alone. Anything you have taken or tried for weight loss is important, so make some notes before your scheduled doctor visit.

Also, take the time to write down all the medications - prescribed or "over-the-counter" (like Dexatrim™, Metabolite™ or Accutrim™, for example) - you take now or have taken in the past. Better still, bag up all your medication bottles and bring them to your first visit with your doctor. Make notes on your past health and problems for which your regular doctor has treated you. Try and recall all dates your were hospitalized and what problems required treatment. Your doctor will appreciate both your prompt, ready responses to questions and the fact that you're taking the time to seriously consider your weight and its effect on your health. If you want to really make a good impression, keep a diet and activity diary for 1 week before your first appointment. After the doctor (including me!) picks his jaw up off the floor and wipes the grin off his face, it will be a huge help for your doctor to get a snapshot of your diet and lifestyle.

In conclusion, for you to be fully prepared, follow these important steps:

1. First, gather all the prescription, nonprescription and herbal medicines you take, including vitamins. Bring the medicine bottles with you so there will be no question as to what you are taking.
2. When evaluating your weight-loss options, your doctor will have questions about your eating habits and activity levels. If you aren't regularly exercising, don't hesitate to admit that. You are not the exception; you are the rule. Be honest and admit your weak points (lack of organization, lack of activity, snacking and binge eating, etc.) and your strong points (determination, enthusiasm, willingness to change, etc.). A good candidate for medical treatment to achieve weight loss will be one who is willing and able to accept diet changes and have realistic weight-loss goals. If you have some thoughts about what kind of exercising you can do realistically, write them down. Be honest with yourself. If you are not able to walk safely in your neighborhood, tell your doctor. These sort of logistical problems are the seeds of new ideas.
3. To help your doctor determine your health risks and whether you may have a genetic tendency to gain weight, write down your family's health history. What medical conditions do your family members suffer from? Diabetes? Heart disease? High blood pressure or high cholesterol? Are any other family members overweight? Genetics is very important in determining just how significant obesity is to your health and how urgent your weight loss is for your future health. If you have a close relative who died of a heart attack at age 40 and was overweight, it is significant. If your mother weighs 250 pounds, has a 22 dress size and is still active and healthy at age 70, that is also important. Take some time to think about those close relatives you can recall.

Rest assured, there is nothing that you can tell your doctor that he hasn't heard before. If you spent a year taking coffee enemas avery week to try and lose weight, it's not new. If you spent 6 months getting acupuncture to stop overeating, old news. If you have tried the cabbage diet, the rice diet, or alternate day fasting to lose weight, I have already heard it. Nothing is new under the wide sun of weight loss fads. Be honest, be unashamed, be frank. All will lead to a healthy, productive, fulfilling relationship with your bariatric doctor.