The Questions We Forgot to Ask

Earlier this week I saw a new GP. It was a simple request, and I didn’t feel the need to wait four weeks for my usual GP, who was booked out.

Like many of us, I’m trying to lose some weight for my overall wellbeing. I walk daily and I’m at the gym five days a week. My sticking point is that I eat too much at night, especially when I’m feeling emotional.

So I walked in, he asked the usual “How can I help you today?”, and I told him what I was after: that I wanted to use the GP as a form of accountability for weight loss.

What I got was a lecture that weight loss is about expending more energy than you consume (thank you, Captain Obvious). He told me accountability doesn’t work as a stick for weight loss and that a better stick would be GLP injections (literally a stick). And I needed a care plan, a dietitian and an exercise physiologist. When I mentioned that I know a bit about habits and goal setting, and that I’d been using the Logical Levels of Change to work through this, he told me there’s no evidence for NLP.

He also said there was no evidence for accountability with weight loss, then contradicted himself by saying that accountability would be better coming from the people I live with, because they can guilt me into it. He added that we all have emotional eating issues and that it goes back to when we stopped breastfeeding. Then, once more, there’s no evidence for NLP. He finished by saying the only real way through this was medication, and that he didn’t know what he’d even say to me if he were my accountability. My blood was boiling at this stage as he spoke about all-encompassing themes with literally no supporting evidence.

There was a lot in that appointment that riled me, but I stayed calm. I clarified that all l I wanted was some measurements, as I had never sought help in the form of regular check ins/accountabiliuty before, and this is what I feel like I need.

It riled me because this "communication" method completely went against the grain of coaching ethics, which honours the client as the expert in his/her life and work and believes that every client is creative, resourceful, and whole. 

What it might have sounded like

Being a coach means I often notice the gaps in everyday conversations, the little moments where a different question (or even a question at all) would have changed everything. So here’s how I imagine that conversation going if he’d come in with a coaching mindset.

GP: What brings you in today? 

Me: I’m trying to lose a bit of weight and I’d like to be able to come here for some accountability. 

GP: When you say accountability, what does that mean for you? 

Me: I’d like some circumference measurements and skinfolds. 

GP: And what would that mean to you? 

Me: It would give me something to think about when I’m about to reach for food while I’m full, or feeling emotional. 

GP: Anything else? 

Me: It would feel like having another form of support. 

GP: Is there anything you’ve tried before that you might want to revisit? 

Me: Not really, but I’ve never tried accountability in such a structured way. 

GP: Sounds like you’ve thought a lot about this. Would you mind if I suggested something you may not have tried? 

Me: Sure. 

GP: Would you consider an exercise physiologist? I’m suggesting it because we don’t do skinfold testing here, and they do, so they may be a better fit for what you’re after. How does that sound?

That’s maybe two minutes. I’d have walked out with a plan that fit me.

The assumptions underneath

What struck me afterwards was how many assumptions were packed into that appointment, all because a few questions weren’t asked. He assumed the people around me would know how to support me without piling on guilt. He assumed I live with other people at all. He assumed I wanted medication. He assumed I couldn’t come up with a strategy of my own, and that I’d never seen a dietitian or tried anything else before. He assumed I didn’t know what weight loss is, that I’d come in wanting to be told what to do, and that I wanted to talk about the emotional side of it with him.

I’d also say a word about the NLP comment, because it deserves a fair hearing. There may well be no high-quality evidence that NLP alone successfully treats anxiety, depression or phobias. That doesn’t mean the pieces of it can’t help with changing habits. Logical Levels of Change sits comfortably alongside self-determination theory, evidence-based goal setting and the way we build habits. 

Why I’m telling you this

I don’t think this is really a story about one GP. Most of us do some version of it, and we do it at work all the time. Someone comes to us with a request, we hear the first few words, and we’re already off solving the problem we think they have. A team member asks for feedback, and we give them a pep talk. Someone says they want a promotion, and we assume it’s about money.

Learning to notice your own assumptions is part of self-awareness, which is a foundational leadership skill. It allows us to spot misinformation, stay in line with our values, and work out why something got under our skin in the first place. (This appointment certainly did that for me.)

If you’ve ever walked out of a conversation thinking that’s not what I meant, or realised afterwards that you did the same thing to someone else, that’s a good place to get curious. It’s the kind of thing I explore with the leaders I work with, one conversation at a time, and I’d be glad to chat if it sounds familiar.