Weight Control: Doctors Advising Patients

I read an article in an online medical journal I receive that related a story about a Canadian woman that had a note specific for her doctors in her obituary. She chided them for “fat-shaming” her when she would be seen by physicians. The person felt that at every turn, physicians would “blame” her medical situations on poor weight control and chide/ridicule/exhort her to lose weight. She also stated in her note that she was often “refused treatment” and told to “lose weight first”. Her death was attributable to cancer.

A few years ago, I read a study that demonstrated that almost 50 % of obese people, during yearly check-ups with their primary care physicians, did not have their weight control issue mentioned at all to them by the doctor.

Here are my thoughts concerning doctors and their “responsibilities” concerning their patients that present with poor weight control: First, I strongly believe it is an obligation for any doctor seeing a patient for a medical problem to identify all potential contributing factors and alert the patient. As an example, if an obese person with severe, chronic lower back pain presents to an orthopedic doctor, I believe it is incumbent for the orthopod to tell the patient about the contribution of the weight to the pain. Moreover, rather than simply identifying the obesity as a contributing factor, the physician should offer a solution. This solution could be something as simple as referring the patient to a weight control program.

The situation becomes more tricky for a physician when an obese patient presents with a medical issue not related to the poor weight control. As an example, if a new medical patient presents to me with a sore throat, it is a bit difficult for me to “change the subject” to then talk about weight control. The patient is not coming to me with a problem related to weight, the person already knows that she/he is obese, so how can I, as a physician, bring this topic up without the risk of offending the patient? Now, if the person sees an SP sign in the office and makes one, quick comment such as “you also do weight loss?” that opens the door for me to jump through very quickly to offer our help.

As far as refusing treatment, I do know it is the case that a number of surgeries, such as knee or hip replacements are often delayed until the person can shed some weight. There is a strong medical reason for this: The surgery itself and post-op recovery can be negatively impacted by obesity. I do not see this as “refusal” but rather, a delay to make things safer.

I cannot speak for this woman’s treatment by her physicians. If they were blunt, non-empathetic, cold and not offering help, than perhaps “fat shaming” occurred. On the reverse side, if the doctors never mentioned anything to her about the impact of the obesity on her medical problems, than that, in my opinion, is medical malpractice.

Author
Dr. Robert Posner One of the world’s leading medical weight loss researchers, Robert Posner, MD, operates his state-of-the-art weight loss clinic, Serotonin Plus, in the heart of Burke, Virginia, in the suburban Washington area.

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