What’s Up, Doc? If It’s My Weight, Tell Me!
I heard a story on NPR awhile back that really made me think. It was about how patients say that doctors don’t spend enough time talking with them about losing weight. Some doctors apparently don’t broach the topic at all. One survey showed that a whopping two-thirds of doctors don’t discuss losing weight with their patients, and considering the high numbers of obesity in the country, that’s a lot of overweight people whose doctors avoid the subject altogether.
There are a lot of reasons doctors avoid the weight discussion, the story says. They don’t have the time. They aren’t really taught about weight-loss in med school. Or they’re afraid to bring up a sensitive subject that they themselves may be facing. But isn’t the avoidance of a real medical issue by a primary care physician a wee bit negligent of the patient’s best interests? Seriously: How are doctors not prepared for these types of conversations when they may have to deal with topics like hemorrhoids, irritable bowel syndrome and toe fungus? I mean, those aren’t exactly fun conversations either. As for the time issue, I’m sorry, that’s no excuse. It’s sad to me that a doctor can’t extend an appointment by a few minutes to inform a patient that he or she is at an unhealthy weight.
Yes, everyone knows you should be at a healthy weight. You could say that those who are overweight or obese know the health risks, and they know they should be at a healthy weight, so it shouldn’t take a doctor to state the obvious. But a lot of times people get complacent; they know they should lose weight but have been drifting along unmotivated to change. A medical professional—an authority figure—might be enough to help patients face the reality that they’ve been ignoring. Doctors need to worry less about hurt feelings and more about the real risks their patients might be facing. I don’t think a doctor needs to be a weight-loss coach, but he or she should certainly have the resources to guide patients to qualified nutritionists and experts who can help.
I know if I was at an unhealthy weight, I’d want my doctor to mention it. Would you? —Erin
A few years ago, my doctor suggested that I should try to lose some weight, ideally about 10% of my weight at the time. He fully acknowledged that this was a case of “do as a I say, not as I do” since he himself was overweight. As a result, I totally blew the suggestion off and didn’t begin to seriously consider weight loss until over a year later, when it had become a bigger issue. In hindsight, I wish I had listened to my doctor then and not been so stubborn. I do appreciate his honesty though.
This is interesting. A few years ago when I was at my heaviest weight, I injured my knee through exercise. I put off going to the doctor because I just knew they were gonna say “This is obviously because you need to lose weight” and I wasn’t really ready to hear that. After months, my injury got to the point where it made working out at all pretty hard. I finally gave in and went to my PCP who referred me to an orthopaedic surgeon. He took X-rays, told me it wasn’t too serious and sent me to physical therapy for 10 weeks. My primary care doctor, orthopaedic surgeon or physical therapist never once mentioned my weight, and I felt jipped! I mean, this may not have been the full reason of my injury, but it was not helping! I feel like healthcare providers need to be less timid in this area.
I have heard many stories about women who put off necessary trips to the doctor because they are afraid of being scolded about their weight. I guess I can see both sides here.
My doctor never mentioned my weight – even at my college entrance checkup, where I was 17 years old and weighed in at 307 pounds. Maybe she assumed that I knew it was an issue so why mention a touchy subject? But there’s a difference, I think, between a friend or family member who brusquely makes a comment, and a health care professional who ought to mention potential health issues related to being overweight/obese.
I was nearly 100 lbs over what the BMI index says I should weigh and my doctor never touched on the subject. Eventually I swallowed my pride and asked my doctor about it and she never gave me any specifics about losing weight besides “bumping up my exercise.” Even with a total cholesterol of over 300 and heart disease in my family, her first reaction was to medicate rather than discuss life changes. I switched doctors but my new doctor isn’t much better.
my PC doctor put me on meds for cholesterol when I was 25 and recently married – meds that I found out 3 years later would have caused major birth defects if I had gotten pregnant. it would have been easier and cheaper if the doctor had explained to me that my triglycerides were high because of the extra fat I was carrying around. Instead, 3 years later my OBGYN gave me that bit of information and I made a lifestyle change to lose 15+% of my body weight and I no longer need the medication. The scary thing was that it took 3 years and at least 3 different doctors later to even tell me that the medication would have been disastrous to a pregnancy.
In January of 2010 I went to a new doctor in a new area because I was having pain in my gall bladder. He paid attention to my issue, helped me figure out what was wrong and suggested that I could lose weight as one way of fighting the gall bladder problem. The best part wasn’t that he suggested I lose weight, it was that he gave me suggestions about how to go about doing it. Pamphlets with his healthy eating plan all laid out.
Today I’m more than 30 pounds lighter and I’ve kept it off and my gall bladder is doing much better.
I’m grateful he gave me that push to get started, and the example of how to get there, because he himself lived that lifestyle.
I have some friends that are doctors. I spoke with one of them not long ago, he had just returned from a conference, at that conference there was a discussion about law suits, he was told that the number one reason that people sued their doctors was because the doctors told them that they were fat. Until a person is ready to take personal responsibility nothing will make them. The sad fact is that doctors have to be very careful with everything that they say.
I remember back nearly 15 years ago when my doctor mentioned my obesity, and I know now that it was a turning point for me to get healthy. Although I did not immediately act on it, his mentioning my weight did resonate. Since then, I lost the weight and have kept it off for 11 years. my health has improved and I am fit. (which is not something that I thought I would ever be saying about myself back in the day)
Yes, the conversation can be difficult. But it is a worthwhile one. I later went back and thanked that man for bringing it up.
When I was 22 I went to a new doctor for my physical checkup. At the time, I weighed 142 lbs (I’m 5’1″). He did all the tests, then as he examined my vitals he wrote “OVERWEIGHT” in huge capital letters across my entire chart. He told me I had to do something about it. I didn’t like him. He was old, and overweight himself. But even with my defenses up, I listened to him, and joined WW the next day. I lost 22 lbs in 3 months. And to this day I maintain around 125- 130lbs. At my height, 15 to 20 lbs is a huge difference in BMI.
If not for that old doctor taking me to task, I would never have changed my lifestyle, started exercising regularly, and lost weight.
I also have knee issues, and an orthopedist recently told me to “reduce myself” to help my knees out. I told my friends and family, and they were all aghast and defensive FOR me.
My BMI is about 24.9, so “normal”, but I know I could still lose about 10 lbs at no risk of being underweight. It’s gotten to the point where I cannot talk to most people about this, unless they are super health-conscious and fit themselves. This country, America, has made weight a social taboo in many circles. It is absolutely ridiculous, and a symptom of majority rule.
I wish all doctors were straightforward about weight, especially when the perceptions of friends and family are so emotionally overwrought and easily stirred up. Someone has to be the voice of sanity and reason!
When I was bulimic and quite a few pounds overweight years ago I would have just died to have my doc mention it to me. It was on my mind constantly anyway. It would have put me off going to the docs.
I stayed away from the doctor for years for this very reason. When i did finally go, she gently brought it up and gave suggestions as well as opportunities for referrals to a nutritionist etc. It still pains me to think of those conversations… I was already so self aware and ashamed the last thing I wanted was my doctor to make mention of it. Everyone else already did.
Of course I would want to know; you can’t fix, what you don’t know is broken.
Everyone who is overweight knows that they are overweight. They also know that being overweight puts them at risk for various health problems. In a time when customer service and customer retention are at the forefront of the expectations, we aren’t wanting to upset our patients in anyway or leave them with a feeling of negativity. Health isn’t rocket science, do some exercise and eat real food.
I can sort of understand why doctors might be reluctant to broach the subject of weight loss, especially when so many doctors also struggle with their weight. I’ve never had a doctor broach the subject with me that I remember. Actually, one time I specifically asked my doctor whether my weight was a contributing factor to the PCOS she’d diagnosed. Her response was to blow off my question and prescribe two medications, one of which made me nauseous for the next six weeks until I was weaned off it. Neither medication impacted the symptoms of the PCOS. Losing 50+ pounds over the past 10 months has made them completely disappear. So, it may be difficult to bring it up but doctors definitely shouldn’t blow off a patient’s question if they are clearly open to advice about getting fitter and healthier.
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