Have you ever felt like your doctor was judging you or made you feel ashamed of your weight? Do you avoid seeing your doctor or postpone seeking medical care because you are embarrassed about your weight or want to avoid a potential lecture about weight loss? Unfortunately your fears are not entirely unfounded. Many studies have shown that medical professionals do in fact stereotype obese patients. In September 2003, the journal Obesity Research (now called Obesity) published a study that revealed a weight bias among health professionals who work with obese patients. These professionals “significantly endorsed the implicit stereotypes of lazy, stupid, and worthless” using a self-report questionnaire. Not very comforting is it? Despite studies such as this one, it is important that you do not let your fears interfere with your medical care. Lack of medical care in obese patients is a serious issue and can be harmful to your health. Studies have shown that obese patients are less likely to receive preventative care. Do you think correcting the perception of health professionals will fix the problem? Yes, it will help, but there is another side to this story. Physicians are faced with the difficult task of potentially insulting a patient. Words must be chosen carefully. Doctors fear that patients may feel insulted by the subject of weight loss even if they did their best to bring up the issue of weight with compassion. Because of these issues, the topic of weight loss frequently remains the pink elephant in the examination room and is addressed by no one. The obese patient receives inadequate care and the physician may feel like it is a no-win situation to try to encourage weight loss. Physicians treat obesity-related conditions such as high blood pressure and diabetes on a routine basis. Many of these conditions can be prevented and/or controlled with diet and exercise alone. Often, physicians place their patients on medications to control the disease process without addressing the root cause. Many Americans see their physicians only when they are unwell. They feel that if you walk out of the office without a prescription you have received inadequate care. For example, if a patient presents with an upper respiratory tract infection (a cold) and you tell your patient that there is no indication for antibiotics because they have a virus (which antibiotics don’t treat) they usually leave unhappy and may even find another physician who is willing to prescribe the antibiotic. So instead of a lengthy dissertation about how and why antibiotics are prescribed or the risks associated with their overuse, many physicians give in to their patient’s misconceptions and write the prescription anyway. They avoid an argument or disagreement, and they know this patient will feel more satisfied that the visit was a good one. This fear is only one reason why weight loss and exercise are rarely discussed. To make matters worse, studies show that a significant percentage of physicians actually feel inadequately trained to counsel patients about weight loss--myself included in my days before SparkPeople and my own weight-loss experience. Still the biggest factor in why physicians aren't counseling patients about weight loss? Time. Your doctor literally does not have the time to teach you about how to change your entire lifestyle. Seasoned SparkPeople members know that just defining what the word calorie means is not going to cause you to change your life. This in no way is a five-minute conversation. Honestly, it is an unrealistic expectation for your doctor to be the main source of information regarding a healthy lifestyle. So, on one side, we have the patient who feels (and in many cases is) judged and stereotyped by the physician. On the other side is the overworked physician who fears insulting--and possibly losing--the patient. So, is there anything that you can do to bridge this gap? Yes! You must take the initiative and tell your doctor your plan to lose weight. Remove the pink elephant from the room by bringing up the subject of your weight first so you and your doctor can have a productive conversation. Only then will you receive complete and adequate care. Some tips for speaking with your physician about weight loss:
More than likely your physician will be thrilled that you have taken charge of your health. Having a plan and knowing what you need to do will remove the pink elephant in the room. Hopefully, everything that needs to be discussed regarding your health can be done without the fear of judgment on either side. What if your physician does not seem receptive to your new take-charge attitude? It is vital that you feel your concerns are being heard and met by your doctor. If not, exercise your right to find a new doctor--one who makes you feel comfortable and who puts your health first. Instead of feeling like, “I knew it! I knew my doctor was judging me!” Rest assured that not all physicians feel this way, but most importantly take charge of your health and get the care that you need and deserve! Was your doctor supportive of your decision to lose weight? Does he/she tell other patients about SparkPeople? Have you ever had to "break up" with a health-care provider? Dr. Birdie Varnedore, M.D., is happy to offer her expertise to the SparkPeople community; however, she cannot offer specific medical advice to dailySpark readers. Please do not share confidential medical information here. If you have a personal question or a concern about your health, please contact your health-care provider. |
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