A recent article on Health.com, The Surprising Reason Why Being Overweight Isn’t Healthy by Ginny Graves, has spurred a lot of reaction. The focus of the article is pointing out how the medical profession can tend to be biased against overweight women to the point of misdiagnosing or not diagnosing them at all.
The article was also posted on CNN. Just reading through the endless comments will give anyone an accurate picture of how biased the general population is against overweight people. Doctors are people too. Just because they have obtained a level of education only a minute portion of the population is smart enough and determined enough to achieve, doesn’t remove their personal opinions and biases.
Doctors are human. Receiving the degree, certification, licensure, or reciting an oath, does not automatically remove the person’s opinions, values, paradigms, or biases. Most people can intellectually agree to a doctrine and accept it on an intellectual level. Unless the person can honestly accept the doctrine on a core spiritual level and change their paradigms, their personal biases will not change. This is true for any medical practitioners, including doctors, nurse practitioners, physician assistants, nurses, chiropractors, etc.
Doctors are human and have personal biases just like the rest of the population. To effectively address the problem of Overweight Patients being discriminated against, we must recognize this aspect of our doctor’s personal perceptions. Health care practitioners need to recognize their own biases and paradigms as well. They also need to be aware of the frustrations they feel when treating overweight patients for complaints that are typically a result of weight.
Doctors and other practitioners are held to a higher standard because of their profession. Because the main part of their job is working with people, they have to understand overweight people’s paradigms and feelings.
First thing, we already know we are fat! Most overweight people also are aware of the long list of health problems and diseases associated with being overweight. We usually are already well educated on the topics before a doctor ever brings them up to us. Any overweight person who has searched the internet, read a magazine, or been on an organized diet, will already have at least a basic education in the health risks of poor diet, inadequate exercise and obesity.
When a health practitioner needs to talk to his overweight patient about health risks or weight loss, he will only be effective if he approaches the patient with dignity.
o Don’t make any assumptions! Just because a person is fat does not mean they eat a lot of fast food or candy or are couch potatoes.
o Do directly ask your patient specific questions about her lifestyle and habits in a non-judgmental manor.
o Don’t assume an overweight person is lazy, weak-willed, or doesn’t care. There are many different factors at play in an individual’s life, health, genetics and past that contribute to their weight problem.
o Do act with compassion and open-mindedness. Objectively evaluate all of the factors at play in each individual patient’s case. Understand that people who are overweight can be extraordinarily sensitive about their weight. This is especially true if the person has failed at dieting or has past emotional traumas.
o Don’t dismiss your patient’s needs because of their weight. Even when some patients are so overweight that diagnostic tests and evaluations are difficult, it is the practitioner’s responsibility to insure that the patient gets the care necessary even if it means referring the patient to a different provider.
o Do be objective when treating your overweight patients. If there is a problem with appropriately sized exam tables or diagnostic machines, be sensitive and actively find an alternative place to have your patient examined.
o Don’t use guilt, shame or cajoling to talk to your patient about her weight problems. It is disrespectful, insulting, and hurtful. Many overweight patients who are highly sensitive about their weight problem will withdraw and cope by binge eating.
o Do set in place an effective, sensitive, and comprehensive method to treat your patient’s obesity. Create objective, non-judgmental questionnaires to learn what issues are behind your patient’s weight. Do not simply pass off your patient to someone else. Follow-up with them and be an active participant in the team who is treating your patient’s weight (dietician, therapist, support group, diet plan, etc).
When health practitioners can be sensitive and respectful of their overweight patients, they can actually make progress in their care. Check your attitudes. If you are a physician, make a commitment to treat your overweight patients with the same care and concern you treat your patients who smoke, drink alcohol in excess, abuse drugs, or do anything else that is destructive to their health.