Should Doctors Lecture Patients About Their Weight?

[David Baxter PhD]

Should Doctors Lecture Patients About Their Weight?
New York Times Blog
July 9, 2008

Overweight people already know they are overweight. So should doctors keep nagging them to lose pounds?

That?s the issue tackled recently by one of my favorite medical blogs, called Musings of a Distractible Mind. The author, who goes by ?Dr. Rob,? is Dr. Robert Lambert, an Augusta, Georgia physician who is board certified in internal medicine and pediatrics. On his blog, Dr. Rob muses about a variety of topics like llamas, twinkies and favorite patients. But I was particularly moved by a recent post, which was written after Dr. Rob?s encounter with an overweight patient who was clearly accustomed to being lectured about obesity. As Dr. Rob was about to discuss whether the man needed surgery for sciatica and back pain, the patient interrupted him, hanging his head in shame and blaming his weight for the problem. Dr. Rob writes:

This whole episode really bothered me. He was so used to being lectured about his obesity that he wanted to get to the guilt trip before I brought it to him. He was living in shame. Everything was due to his obesity, and his obesity was due to his lack of self-control and poor character. After all, losing weight is as simple as exercise and dietary restraint, right?
Perhaps I am too easy on people, but I don?t like to lecture people on things they already know. I don?t like to say the obvious: ?You need to lose weight.? Obese people are rarely under the impression that it is perfectly fine that they are overweight. They rarely are surprised to hear a person saying that their weight is at the root of many of their problems. Obese people are the new pariahs in our culture; it used to be smokers, but now it is the overweight.​

Dr. Rob says obese patients don?t need lectures.

Instead of patronizing obese patients with a lecture, I try sympathizing with them. Just because something is simple doesn?t make it easy. How do you quit smoking? You just stop smoking. We should just pull out of Iraq. There should be peace in the middle east. People should stop hurting each other and start being nice. All of these are good ideas, but the devil is in the details. Losing weight is a struggle, and it really helps to have people giving you a hand rather than knocking you down.​

Dr. Rob writes that he still tries to help patients to lose weight, but he is concerned that a ?culture of accusation and shame? is making matters worse for them.

The idea that their personal worth lies on their BMI is extremely damaging. There are a lot of screwed-up skinny people out there; just look at super-models. It is a lot easier to lose weight when you actually like yourself and want to do something about your health. Our culture of accusation and shame simply makes obese people hate themselves. If you hate yourself, why should you want to take care of your body?

Is obesity a problem? Sure it is. But we need to get off of our self-righteous pulpits. Obese people should not be made into a group of outcasts. The ?them? mentality and the finger-wagging are no more than insecure people trying to feel better by putting down others.​

 

[Halo]

I have to admit when I first saw the title to this post I immediately thought...here we go again, some righteous doctor getting on his high horse about telling overweight people they need to lose weight that I almost didn't want to read it

But I am so glad I did and all I can say is WOW!!! This doctor is so absolutely dead on and made so many great points and some that I found really important were:

Just because something is simple doesn’t make it easy.

The idea that their personal worth lies on their BMI is extremely damaging.

It is a lot easier to lose weight when you actually like yourself and want to do something about your health. Our culture of accusation and shame simply makes obese people hate themselves. If you hate yourself, why should you want to take care of your body?

and especially this one:

Obese people should not be made into a group of outcasts.

This doctor has the right attitude for sure. :2thumbs:

 

[Into The Light]

generally speaking i think lectures don't accomplish a whole lot anyway, regardless of the subject. no one enjoys being told off. he is right on the money

 

[Lana]

Amen! I hope that his attitude towards patients that struggle with weight is more addicting to other doctors than lecturing.

This reminds me of a lecture where one professor was speaking about bias, prejudice, and discrimination. He said that those have been greately covered by laws to protect the people. He asked us if we know of any discrimination that constitution did not cover. My reply was obesity and mental illness. I never received a response. Funny how that is.