Thanks, Barbara.

Just thinking about that doctor some more. She asked me if I kept a food diary. I said that I do sometimes. She said that would make me more accountable.

I don't know. That just rubbed me the wrong way. I've lost an amazing amount of weight (she pointed out that I was still obese), and she's telling me what I need to do to be accountable?

I wonder if she just has a script for various situations. Fat person gets the "eat less, move more, be accountable" talk. The "be accountable" part is tacked on, because most people who follow the "eat less, move more" part of the lecture don't lose any weight. Normally you give the "eat less, move more" part at the first appointment. Then at the second appointment you give the "be accountable" part of the lecture, so you can imply they're not, and they can hang their head and look sheepish and confess to eating mindless - or even while they're asleep.

To me, when you have a new patient in front of you who's lost a lot of weight, you should say, "Holy cow! How did you do that?" Then shut your mouth and listen. Because I'm willing to bet she doesn't have a lot of patients losing weight successfully.