Why Some Doctors Become Fattists
How do I start this… I want to say that most doctors are fattists because we single out fat patients and we ‘blame’ them for a lot of their medical conditions. It’s important for our scientific minds to have a cause and effect. That’s how medicine makes sense to us.
When a patients gets lung cancer, a heart attack, develops chronic pain, develops insomnia or becomes obese we start down the path of determining the cause. Did you smoke? Did you live a sedentary unhealthy life? Are you depressed? Are you overworked and stressed? Did you stop exercising or eating more?
We don’t hate our fat patients. And I use the word fat here because I don’t want to use the terms overweight, obese, morbidly obese. Substitute chubby, plump, well-rounded, curvy or thick-boned if fat offends you. We don’t hate them but we have come to associate certain maladies with such patients. Many of us also witness these individuals being unwilling to take responsibility for being fat.
As clinicians we are frustrated because our patients complain to us about their weight. Yet a physician is not the person that you should go to for weight loss advice. Blasphemy right? Dr. Mo… what are you smoking? That’s EXACTLY what the doctor is there for, to discuss one’s health issues with. Nope, sorry I don’t agree.
Society has forgotten something very basic… namely the benefit of society. The patient should and must have a network of friends and people that they can be a part of. If available a parent, a grandparent or close friends, family. If not then go get involved in a retirement committee, you will get more advice as a patient that’s sound and time-tested than you will get from most docs. If grammy can tell you how to go about losing weight (eat less, get more exercise) then you should not depend on a doctor.
The Doctor’s Burden Of Dealing With Obesity
When we see your knees buckle under 289 lbs or when we can’t see your pharynx no matter how hard we press down with the tongue blade and you repeatedly ask why your energy is low, why you have such poor sleep, high blood pressure, or a bad cholesterol profile then what do you expect us to say? Docs feel at times tortured by such patients. The ones that repeatedly come to the doctor asking the same question and hoping for a different answer. We are forced to either stroke their ego and say what they want to hear to keep them as patients or we are forced to persistently remind them of their BMI. After a while all they hear is that their BMI is high and they soon start disliking us as doctors.
It’s a cycle that leaves doctors a bit jaded. Many docs feel exhausted by such patients. Even your financial adviser would give up on you if you come to every session more and more broke than the last.
The Cycle of Caring And Blaming
Unlike what my primary care colleagues tell me, I don’t believe that we as doctors have had any meaningful success in getting our patients to lose weight and keep it off. But, I don’t care how cold-hearted or mean a doctor comes across, if a patient genuinely wants to know what to do about their weight that doctor will step in and help.
So we as a group definitely care, but we don’t know how else to convince our patients to lose weight and we are sick and tired of our patients not taking responsibility for it. We also see the big picture of such patients becoming a liability at some point should they develop something that we miss.
I posted something recently that may actually help me in my future practice. Read it and post what you think below.