How to Talk to Your MD about Diet, Weight and Exercise

…to Support Realistic and Lasting Change

It happens often in my role as a retail dietitian. A customer approaches me and says, “My doctor says I need to lose weight,” or “My doctor say says I need lower my cholesterol.” And that’s it. Maybe there is a mention of the number of months they have to change before starting medication, but otherwise it seems as if the conversation between my customer and their doctor ends there with these “simple” goals.

Fresh Fruit Kebabs with Lemon Lime Dip
Even figuring out whether you can eat fruit can be overwhelming if you’ve been given vague advice on cutting out sugar.

It is obvious that more needs to happen in this exchange in order for realistic and lasting change to happen. It is clear that my customers need to ask more questions and have an honest conversation with their doctors. Maybe this has happened to you too and possibly you also don’t know how to begin this conversation. Let’s start it together:

Your MD: “According to your chart, you need to lose weight.”

You might be thinking, “according to my chart?!” because you don’t need a chart to tell you that this should be a goal for you. However, rather than leaving it at this obscure goal, ask other things about your chart such as how much weight you need to lose to be in a healthy BMI range or the percentage of weight loss needed to lower your blood pressure if that’s an issue. In both cases, the actual amount you need to lose may be less than you think. After all, you are seeking health, not a magazine cover.

Your MD: “You’re at risk for diabetes. You should watch your blood sugar.”

This one always gets me. I mean, first you are told that you are at risk for a serious chronic disease and then that you should “watch” something that you can’t even see… really!? Here’s the scoop: pre-diabetes is a real and serious condition in its own right and “watching” your blood sugar may involve getting a blood sugar monitor and truly logging your blood sugar values a few times a day, every day. It’s important to ask your doctor specifically about your HbA1C (a blood value that shows your average blood sugar control over 3 months) and what your goal level is. Also, do they expect you to check your blood sugar on your own at home?

Your MD: “You’re at risk for diabetes. Avoid sugar.”

Okay, so this one really frustrates me! SO… you go to the store attempting to “avoid sugar” and are likely quickly defeated (unless of course you shop in a store with a retail dietitian) because you realize that everything pretty much has sugar in it, including our very healthful fruit and skim milk. The bottom line here comes down to two main factors. First, you are seeking foods lower in sugar, but primarily you need to count carbs. Even if a food is sugar-free, it likely isn’t carbohydrate free, so it may still not be a good choice for you. Second, you need to call a dietitian and get the real and true scoop on how to follow a diabetic diet.

Your MD: “You need to start exercising.”

Again, you are likely thinking “as if I didn’t know that?!” But your doctor just needs make sure they say it so they can note it. That’s not to say they don’t mean it, after all, exercise plays such a vital role in your health. That said, you shouldn’t leave it there. You know the type of exercise you like to do. Ask if your plan is adequate because you may be thinking about doing yoga twice a week and walking 30 minutes 1-2 times per week while your MD is thinking 45 minutes of cardio and strength training daily. Make sure that “exercise” is defined.

One more comment about the conversations we have with our doctors. It is critically important that your doctor knows about any supplements, shakes or diet pills you may be using. In some cases these products may be unsafe or contraindicated with medications that your MD is prescribing for you or the condition he/she is helping you manage.