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    In The News: Speak Up, Doc!

    Stethoscope_around_doctor_s_neck_uid(3)Earlier this week, The Los Angeles Times published a most interesting article by board-certified specialist in preventive medicine Valerie Ulene, who offered a unique perspective on the overweight and obesity problem in the United States — specifically the lack of awareness on behalf of overweight and obese individuals coupled with the minimal help offered by some general practitioners.

    “A National Consumers League survey conducted by Harris Interactive in 2007 found that… eighty-two percent of obese people surveyed considered themselves to be simply overweight; among those who were in fact only overweight, close to 1 in 3 believed that they were normal weight,” the article reports.

    Even worse, “a 2005 study released by the Centers for Disease Control and Prevention found that only about 40% of obese people are actually advised by their healthcare professional to lose weight.”  Yikes!

    I was particularly enraged — and rather disgusted — by this tidbit:

    “Physicians are reluctant to bring up weight because it’s such a loaded issue,” says Dr. William Dietz, director of the Division of Nutrition, Physical Activity and Obesity at the CDC. It’s a difficult and often emotional conversation to have with patients, so some doctors just avoid it.”

    Absolutely ridiculous!  How much longer are these physicians planning on hiding their heads in the sand like ostriches?

    I am flabbergasted that a medical professional would be so fearful of a “loaded” and possibly emotional conversation as to ignore a blatant health problem in a patient.  With that logic, then patients would also not be told of cancer or HIV diagnoses.

    If so many doctors are apparently so paralyzed by “difficult conversations” that they render themselves useless, maybe medical schools should seriously consider adding a few courses on counseling skills to the curriculum.

    Besides, I am not sure why general practitions are so weary of expressing concern for an overweight or obese patient’s health.  All they really should be doing is voicing their concern and then referring them to a professional (such as a Registered Dietitian) who can take it from there.  I know many doctors have deity complexes, but no one — including myself — is expecting them to tackle nutrition in their practice.

    My blood pressure rose a little more upon reading this:

    “Sometimes doctors feel they have little to offer in the way of a solution. Weight-loss counseling frequently proves ineffective, weight-loss medications produce only modest results and obesity surgery isn’t appropriate for most people.”

    Considering that the vast majority of doctors in this country are completely unfamiliar with nutrition concepts, it is no wonder they think weight-loss counseling proves ineffective.  Additionally, the mere fact that they push weight-loss medications shows a basic lack of understanding.  How can we expect the general population to stop seeking out a magic pill when many doctors apparently think one exists?

    Doctors: remember that Registered Dietitians are out there.  Refer to them!  And, if you don’t think you can handle telling a patient their health is at risk because of their weight, consider another profession.



    1. Holly said on October 15th, 2009

      I think many doctors are so focused on curing the immediate issue at hand that they ignore long-term changes patients should try. For example, my father in law suffered a stroke last year. He was treated to remove the blockage, prescribed medications to control clotting and blood pressure, sent to rehab to work on the (thankfully minor) problems he developed with walking and memory, and was pretty much sent on his way. At no time did the doctors mention anything about weight loss, nutrition or exercise. Even the rehab facility didn’t bring it up, expcept for the exercises he should do to regain strength. Not to mention, much of the food he was served at the hospital and rehab facility seemed unhealthy with lots of refined carbs. How is the patient supposed to learn how to eat right?
      With my husband’s encouragement, he has lost a little weight and works out some now.

    2. Andy Bellatti said on October 15th, 2009

      You make some excellent points, Holly. Even though the situation you describe is like countless others I have heard, I continue to experience the same sense of disappointment and astonishment every time I hear of something like this.

      I have heard some doctors say things like, “Come on, do you really think a 65 year old person is going to change their habits?”. Yes, I do think they can and will. Even if it’s just one or two eating habits they can appropriate and change, that still can make a world of difference.

      I am glad to hear your father-in-law has adopted a healthier lifestyle. It is an atrocity that it can not be attributed to anyone he interacted with during his diagnosis and recovery.

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