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Section: general-health

Dear Ann Landers,
You recently published a letter from a reader who was angry that four different physicians didn't tell her she could lower her blood pressure if she lost some weight. The woman wanted to know why her doctors failed to mention this to her. I am a physician who has been in practice for several years, and I would like to respond to her question. Long ago, I learned that if a physician wants to drive a patient out of his (or her) office permanently, there are two magic sentences that will do it. One is: "I think you should see a psychiatrist." The other is: "You need to lose some weight." I have a file in my office with notes from fat former patients (and their fat relatives) cussing me out royally because I had the unmitigated gall to broach the subject of dropping some pounds. I no longer tell my patients they need to lose weight. They already know it. I only hope they occasionally look in the mirror. -- Doctor in Bowling Green, Ky.

Dear Doctor,
Sorry you have been a victim of the "kill the messenger" syndrome. I hope it will not discourage you and other physicians from telling your patients what they need to hear. To do otherwise would be abdicating your responsibility. Perhaps instead of lecturing, a better approach might be to give (or mail) the patient a diet and say, "I hope this will help you have a healthier and happier life."

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A Note from Margo:
Hi! It's Margo here. I'd love to know what you think of the letters -- and the answers!

Also, any additional thoughts you might have. Thanks!

Melisa Ortega's Comment

Maryann's Comment
I find it difficult to believe the woman did not know losing weight can help lower blood pressure. We are constantly inundated about the many health problems caused by being overweight. I think she is trying to shift her personal responsibility for her health to her Dr. However, I hope he will start informing his patients that being overweight can definitely cause high blood pressure, regardless of how negatively his patients may respond. Once he has made this clear, he does NOT need to badger his patients by repeating it every time they see him.
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"At every party there are two kinds of people - those who want to go home and those who don't. The trouble is, they are usually married to each other."
-Ann Landers