Is it right for a doctor to tell a patient who suffers from bulimia to loose weight?

I took my friend to the doctor today for her follow up visit for torn ligaments on her ankle and the doctor told her she needs to loose weight we both looked surprise because a year ago she weighed less than 100due to her eating disorder she is just now getting her life back together from the disease and the doctor knew this and she told the doc she feels great and thought she looked good, the doctor left and came back with a chart and it says that said that for height she should weigh around 115, she is 5'3 weigh 147 and wears a meduim and size 8 pants. I don't see any weight problem. Is the doctor right? i'm concern that she' fall back into her her disorder.

I do know the difference between concern and ridicule but I had been there were my friend was in a coma due to failing organs because of her disorder and when there's no other comment from the doctor except you need to loose weight, no reason except that your height doesn't match what should be on their chart is a very hurtful especiallywith no offer of solutions.

That doctor has to off his/her rocker, 5'3 at 115 lbs and that's overweight? I'm 5'3 and no way near close to 115 or even 120 and as you can see I'm not over weight, telling a bulimic person she's over weight is the doctor out of his mind? all you can do is be there for your friend like you've been already.

EDIT:
I realize how much of a YA! addict I am when I went to my doctor's appt. Friday and asked about your situation and the answer that my doc gave was under no circumstance that a doctor should say anything about a patient gaining weight if they have an eating disorder because this is a battle that they will continue fight as long as they live even if they seem to getting better.
She also stated the weight is really not a big deal and if the doctor was concern about her weight then it he should have ask how is eating habits now? how often does she exercises? things of that nature and decide if he should bring up that continue to make the progress or say for a healthier heart and body you need to cut down on sweets and carbs and exercise more and also never pull out the weight and height chart for a person that has a disorder because in the patient's like you pulling out a magazine in to them and showing a very skinny model and say this is how you suppose to look, this is what the patient hear remember the patient has a distorted view of her weight image.
I think your friend needs a new doctor, suggest it to her.

no not at all .

the doctor shouldnt of said anything, but tell her that if she is uncomfortable and wants to loose weight, then she should do it in a safe, healthier way, like exercising, or working out a few days in a gym, or running around your block... or eat healthier..good luck!

That sounds like one sicko doctor. I could see if he told her to cut down on junk food, and to eat a lot of healthy food--but he should NEVER, knowing about her problem, told her simply to lose weight. He should be reported to the medical whatever society.

If it is in the best interest of the patients health, by all means "YES". Perhaps he felt it would be best for her recovery if she lost weight or maybe it would reduce the chance of future injury. You have the right to question and discuss any advice a doctor gives you. Perhaps you should be asking the doctor more on this question instead of us.

Good luck to you and your friend. I hope she recovers quickly!

I think you are being a little sensitive and apparently the other people are too. I don't intend to be mean just honest, same as the doctor was. There is a difference between "you need to loose some weight" and "you're fat". I hope you can see the difference. One is concern the other is ridicule.

Sincerely,
Terry

this is a tough one. As a doctor if the patient is overweight he is supposed to inform them i think, but that just doesnt seem right to me. I mean, if your doc thinks your fat thats bound to be a self-esteem killer. And i dont think there is a wieght problem, maybe there is but that aint the point. He should never say that, maybe cut down on junk food or something but never that, it can make the person believe they have to lose weight at any cost. Report him, thats all i can say. He shoudlnt be toying with his patients mental healthy like that

Um, the doctor is telling her crap? Since when is 115 what a 5'3" person should weigh???? Tell her to get a new doctor!!!

Considering the nature of the visit - torn ankle ligament - it sounds as though the doctor's advice does not contain the content that you appear to be reading into it. When you say that "she wears a medium and size 8 pants" you are making it an assessment involving norms of physical appearance and attractiveness. The doctor was not discussing her weight in this way, he was not saying "you better lose weight because guys only like size 6 girls." Rather, the doctor was more likely advising her to lose weight in the context of factors concerning the healing of her ankle ligament. Greater weight means greater strain on the knees and ankles; causing injury or preventing past injuries from healing properly. Alternatively, the doctor may have concluded that her ankle was completely healed and the mention of her weight was out of concern for her overall future health related to heart problems, diabetes, etc. In either case the doctor was required to inform her that he believed she weighed too much and of possible consequences that could come from being over-weight. Doctor's are ethically bound to be completely honest with their patients without regard to how the patient will react. Furthermore, if the doctor lied to her or omitted any information that could have been useful to her, then the doctor would be found liable for any stress, duress, injury , or harm that resulted. That being said, it seems that the doctor should have been sensitive to her previous problem and handled the situation as delicately as possible.

Whether this doctor's advice carries any lasting impact on your friend's emotional state will remain to be seen. In my opinion it seems more alarming that your friend is 30 lbs overweight. Bulimia is cyclical in nature; the cycles are sometimes short - binging in the morning and purging in the evening - or they are long - months of purging followed by months of binging. Most treatment and post-treatment programs insist that the girls stay within a narrow range of their expected body weight. Going to far above that can indicate that the person is engaging in binging behaviors which will be followed by another purge. Even in women who have gained greater control over their behavioral problem being overweight can cause them to begin obsessing over their body image and cause recidivism.

In short: the doctor was right and had to say what he\she said. While you should be concerned over your friend's emotional state as a result of that, you shouldn't view her greater body weight as a true sign that she has overcome her problem. Bulimia is tricky, not very well understood, and lethal. If you are truly concerned then you should probably rent some books out of the library to better understand what you can look for and how to be there for her as a friend.

Addendum to original post:

How the ligament was damaged does not necessarily have any impact on what effects its healing. Additionally, while you might "know" the difference betwen concern and ridicule you might not feel that difference. Your experiences with your friend are filled with sincere emotion and it can be difficult to suppress strong emotions.

You can report the doctor to the relevant state agencies or medical boards, but this will do absolutely nothing. The matter would probably not be pursued and even if it was the doctor is right and had to tell her the truth. The median weight for someone of her height is 115lbs. The range of weight considered healthy is between 107lbs and 140lbs for a 5'3 female. Being 135lbs would classify one as overweight, 147lbs would be approaching, and possibly meeting, the clinical requirements for obesity. Their are many different factors that can contribute to one's body weight (muscle mass, breast size, frame, etc) but the Body Mass Index (BMI) is the accepted method for determining healthy weight relative to height. A BMI of 30 is necessary for clinical obesity; the lowest BMI possible for your friend is 26, but it could be higher depending on other factors. This is only to say that the doctor was required to inform your friend of his\her concerns and liable for not doing so. There does not appear to be anything for which the doctor can be held accountable. To be maximally effective doctors need to be able to be honest with their patients, not to concern themselves with how to tell their patients important information in a way that, while it may seem more pleasing to the patient, degrades the seriousness of what they are talking about. To avoid potentially aggravating your friend's illness would require the doctor to convey the imformation in a manner that could make it easier to dismiss and less likely to be acted upon - this would be medically unethical.

If there is any possible criticism that could be made it would be of the BMI as a useful, valid, and reliable tool, but it doesn't seem relevant to this post. Whatever its flaws it IS the current convention for assessment and doctors cannot simply create their own methods without putting themselves in legal jeopardy. If, for instance, the doctor ignored the BMI and, using different criteria, decided your friend to be healthy and your friend developed diabetes; she could sue the doctor for clinical malpractice and would probably win as a lawyer would simply portray the doctor's method as some sort of wierd mysticism.

It seems unlikely that the doctor was acting out malice, but was probably genuinely concerned about your friend's health. His diagnosis appears accurate and the manner of delivery necessary. You might consider raising these concerns to the doctor personally, so that you can better understand why he\she said what he\she said in the way that he\she did. It might make you more comfortable with the doctor's reasoning or make the doctor aware of the insensitivity. Eating disorders are not very well understood by the public at large and are disdained, to some degree, by both males and females in the medical establishment- even psychiatrists. It can be difficult for sufferers to have their condition fully appreciated and it is obviously problematic. Discussing it with the doctor could make him\her aware of this, but on the face of it there does not appear to be any reason to assume the doctor was being insensitive.

at 147 she is only slightly overweight for her height as are the majority of americans. I would say that is alot less dangerous to her health than bulemia. What an idiot doctor!

Hmmm...If it was causing her a health problem she might need to lose weight. But it sound like she feels fine. I think it would be unnecessary in her case. Especially because that could trigger the Bulimia again. She should find herself a different Doc.