Compassion or reality for obese patients?

steelydanfan · Mar 6, 2011

Obesity is a problem in this country. It seems there are a lot of easily hurt feelings on here from people who are being defensive about their weight, but the truth is we became nurses to help people. It does not help people to ignore the elephant (no pun intended) in the room and allow them to suffer serious health consequences as a result. It does not help society for everyone's insurance costs to go up. It does not help people with anxiety to be stuck in a plane seat with another person spilling over the armrest and taking up their personal space. These are just realities. I'm sorry if you feel offended by these statements, but they are just truthful and sometimes the truth is offensive because we don't want to hear it... Education and encouragement can take place without judgment or cruelty. It's just a matter of finding the balance between compassion and reality!

You know, you can't see diabetes, you can't see HTN, you can't see lung cancer. But you can sure as heck see obesity. And it affects people in airplanes, people in movie theaters, people on buses, nurses in hospitals.

I think it might come down to "If you want to kill yourself with bad habits, fine, but I take exception when your poor choices affect me". That's why public smoking is banned in most states. And smokers are treated as lepers most everywhere.

And THAT is why people are not so tolerant of obesity. Because thier choices DO affect the public. YOUR overeating costs ME money in heathcare dollars. And in having to park further away from where I want to go because of the 7 new handicapped spaces demanded because YOU can no longer walk 50 feet.

When Michelle Obama can be ridiculed for promoting healthy eating as a" Food Nazi", one has to seriously think about this nations priorities.

FranEMTnurse, CNA, LPN, EMT-I · Mar 6, 2011

If you think that anorectics are treated with anything resembling respect, spend a shift on an inpatient eating disorder unit. They are dehumanized just as, if not moreso than, the obese.
If anything, use the discussion to point out how neither population is treated with dignity, but both should be. Please do not assume that people on the other end of the eating disorder spectrum somehow have it better off in terms of how they are treated.

How true. I once saw an anorexic female who looked in a cooler, picked up a bag of vegetables, and then put it back in the cooler and walk away. My heart went out to that poor girl. I know that severe weight loss eats at the heart muscle and can life threatening heart problems and other issues as well.:redbeathe

Horseshoe, BSN, RN · Mar 6, 2011

oh, well then she's just wrong. i don't think there is any data to support the hypothesis that obesity can a healthy status. eventually, there will be consequences, even if they are not evident in the otherwise healthy young person.

or perhaps you are wrong about someone who is physically active with healthy blood markers.

if you care to educate yourself, read the obesity myth: why america's obsession with weight is hazardous to your health by paul campos. some of the data may very well surprise you. it sure shocked the hell out of me.

from the article obesity, health, and metabolic fitness by glenn glasser, ph.d, associate professor of exercise physiology at the university of virginia:

health and longevity: being fit more important than being thin
all this evidence suggests that as far as one’s health is concerned, lifestyle is far more important than body weight. this goes for longevity prospects as well, as the ongoing--since 1970--aerobics center longitudinal study at the cooper institute for aerobics research, in dallas, texas, demonstrates (10, 13). data on more than 32,000 men and women indicate that the fittest men and women have the lowest death rates--regardless of what they weigh. in other words, a heavier-than-average person who is physically fit has a better chance of living a long life than does a thin couch potato. furthermore, a separate analysis of nearly 10,000 of the men in this study who performed at least two exercise stress tests separated by an average of about 5 years (thereby allowing the researchers to evaluate the impact of changes in physical fitness on subsequent death rates), revealed that improving physical fitness level reduced death rates during the 5+ years of follow-up. men who were initially classified as unfit (defined as being in the bottom 20% of fitness levels for a given age), but who--via increasing physical activity--improved their fitness level by the second fitness examination, reduced their mortality rate during the subsequent 5+ years of follow-up by 44%. most significant in terms of the weight debate was the fact that the improved longevity prospects were not at all dependent upon weight loss. results from the ongoing harvard alumni study (33) provide similar results: sedentary harvard alums who increased their level of physical activity experienced a 23% reduction in all-cause mortality rate. because alums who lost weight were no better off healthwise than those who did not lose weight, the reduction in all-cause death rate observed in the more physically active men was in no way attributable to slimming down.

and these surprising paragraphs:

health hazards of obesity exaggerated
despite all this evidence suggesting that lifestyle is far more important than body weight in terms of health, and that it might be more prudent to focus on getting people fit and healthy rather than trying to make them thin, the weight loss industry still barrels along like a runaway freight train. aside from the cultural obsession with slimness, health professionals have done much to sanctify this quest for a lean body--primarily by fueling a medical rationale for fat phobia: obesity is a major killer. the most blatant--but unjustified--example of this scare tactic is the widely publicized claim that obesity kills 300,000 americans every year. former u.s. surgeon general c. everett koop asserted as much when he launched his shape up america! campaign in 1994. since then, this figure has taken on a life of its own, appearing in scientific and medical journals (1) and mentioned repeatedly in the media--each time reminding us of the “fact” that obesity is the second leading cause of preventable death in america.
the problem, however, is that there is absolutely no way to prove this assertion. in fact, the most frequently cited source of this statistic, a 1993 article in the journal of the american medical association (28), shows just how misinterpreted this statistic actually is. the article, titled “actual causes of death in the untied states,” attributes the 300,000 deaths per year to “diet/activity patterns”--not to obesity. obesity is a physical trait; diet and physical activity are behaviors. to equate them not only is unjustified, it is absurd. while poor diet and lack of physical activity may lead to obesity, the truth of the matter is that the studies used to generate the 300,000 figure looked at the health impact of poor diet and sedentary lifestyle across the entire weight spectrum, not just among fat persons. [there are a great many less-than-healthy couch potatoes with poor dietary and exercise habits who--via luck of the genes--will never be fat.]

source:

http://www.thinkmuscle.com/articles/gaesser/obesity.htm#emphasis%20on%20weight%20loss%20misdirected%20and%20hazardous

i would never encourage anyone to become overweight or obese. however, just as not every smoker gets lung cancer, not every fat person is unhealthy. even more notable, being thin is absolutely no indicator of health. physical fitness (yes, it's possible to be fit and fat) and hyperinsulinemia and resulting insulin resistance (yes, also present in thin persons) are the two most important predictors of health and longevity (or lack thereof).

Esme12, ASN, BSN, RN · Mar 7, 2011

I think it boils down to the same hyper-PC environment we have created. Everyone wants to do whatever they want and have everyone not notice. Better yet they want to tell people what to think. If you are five feet tall and weigh 50 lbs people will STARE. Same if you weigh 300. If you are average looking people won't look at you and see a supermodel and TREAT YOU ACCORDINGLY. That's life. You think a hot 20 year old who goes to Victoria's Secret is treated the same as a 40 yo mother of three trying to feel good about herself? Try it sometime and get back to me. Thats why that second bolded sentence is in your post. You KNOW you were treated differently then. You don't want people to treat you FAIRLY, you want them to treat you like you are still PRETTY. And for those screaming "it should bee 100% equal in medical care" have never worked in a facility where the medical directors wife or kid have been admitted. Or perhaps a celebrity. I have and that is America. We worship money, fame, good looks, and talent and people are treated accordingly. Get over it, move, or change.[/quote]
By the way........I am pretty...... just fat and purple. I used anorexics as an example when another poster made references to anorexia and that they preffered an anorexic because they were easier to reposition in bed. I just want to be treated respectfully. I am just trying to give a personal journey of enlightment that after 32 years of full time acute care nursing employment...... I had NO CLUE how rude we've become as a culture. I was stunned at how difficult the system is to navigate and how uncaring it has become. I was blind to it's true nature when I was on the inside, now disabled and looking from the outside......I am sad and ashamed at how we,the medical profession, are failing. I was shocked and dismayed at the behavior. Rude, degrading desparing remarks......snide comments and ridicule. I used to chastize as a supervisor to knock it off and keep you voices down, that All patients should be treated respectfully........my experience at present is that they are not.
I started my journey into illness looking one way and treated one way.........hundreds on milligrams of steroids daily, an electris wheelchair and 18 months later.........I am talked to differently, treated differently, spoken to as if I am an imbecile.......and you know what????? I am just as smart as I was before I got sick. Is it Becasue I am purple? Because I am in a wheelchair? Because I am fat? I am extremely dissappointed in the behavior of those who went into this profession to help people........I hear the snide remarks......all patients do. This is not at just one facility as I go to many in a attempt to seek remission. People! LEARN TO WISPER! Say please and Thank you! Smile for heavens sake! But I guess this is the hear your personal business at the top of your lungs on the phone at the grocery store in line generation. WE hear things Not just about me but about other patients as well. Patients can hear you.......every single word. KEEP YOUR VOICE DOWN!!!!
I am not saying it should be equal because it isn't........I just think myself,and all patients, deserve to be treated humanely and respectfully. Frankley I really don't care what you think of me! I was just trying to make a point to have compassion for our fellow man. That you get more bees with honey. THINK BEFORE you speak. To treat ALL as equal as if they have intellegence,hearing and feelings. To stop discriminating against anyone be it skin, race, religion, sex, sexual preferance,weight, hair color,eye color..........Whatever it may be. Be kind to your fellow man. You reap what you sow.
We worship money, fame, good looks, and talent and people are treated accordingly. Get over it, move, or change.................. Yes, society does worship money fame and good looks.......but remember every day you grow older, grayer,saggier and more wrinkles will come. You have NO idea what your future holds. What goes around comes around my friend..... you reap what you sow........I am just trying to make a point that any discrimination is wrong. BULLYING, of ANY kind is wrong......
Oh and........I am over it, I am happy where I am (just disappointed) and we, as humans, are changing everyday....getting older, grayer, and fatter .............as far as this conversation, for today, I cry UNCLE!:twocents:

Esme12, ASN, BSN, RN · Mar 7, 2011

If you think that anorectics are treated with anything resembling respect, spend a shift on an inpatient eating disorder unit. They are dehumanized just as, if not moreso than, the obese.
If anything, use the discussion to point out how neither population is treated with dignity, but both should be. Please do not assume that people on the other end of the eating disorder spectrum somehow have it better off in terms of how they are treated.

That is exactly my point....... :cool:

CNABESS · Mar 7, 2011

I come from a family of obese diabetics. My mother literally ate herself to death last year. at 4'11" tall, she weighed 212 lbs most of her adult life. Yes, food was her drug of choice for her depression and mood swings. She self medicated with brownies on a regular basis. She was the most unhealthy person I have ever known. Her last 3 years were spent going to dialysis treatments and 3-4 hospital stays each year. I would love to see some real education for obesity. Something like what they do on the show "The Biggest Loser", where the MD. shows exactly what the excess fat is doing to your insides and how it is affecting your health. No amount of judgement and badgering will change a persons behavior, but perhaps a person can make an educated decision about their health if given the correct and honest info.

I noticed that my mother's MD. NEVER talked about her need to lose weight. Perhaps because he was in the same condition. I feel that medicine needs to take a serious approach to over-eating and obesity, and not leave it up to exercise gurus. It is both a physical and mental health issue.

My mother was not only the unhealthiest person I have ever known, she was also the most intelligent, funniest, most talented and creative person I have ever had the privilege of knowing. I miss her terribly.

metal_m0nk, BSN, RN · Mar 7, 2011

You don't want people to treat you FAIRLY, you want them to treat you like you are still PRETTY. And for those screaming "it should bee 100% equal in medical care" have never worked in a facility where the medical directors wife or kid have been admitted. Or perhaps a celebrity. I have and that is America. We worship money, fame, good looks, and talent and people are treated accordingly. Get over it, move, or change.

I have no idea how you look, but there's a whooooooole lotta ugly in that paragraph...

Conqueror+, BSN, RN · Mar 8, 2011

I have no idea how you look, but there's a whooooooole lotta ugly in that paragraph...

:yawn: Yes. the ugly truth. Thank you for editing my post to suit your comment. Everyone wants to be super PC these days and it doesn't help anyone. I am not skinny and 20 but I KNOW THAT. I think people cheat themselves when they go through life expecting people to change. You should treat all of your patients well but when I don't receive that treatment I confront it and move on. You'll `go crazy otherwise.

TiddlDwink · Mar 8, 2011

Our society has become a politically correct herd of cowards and you see the result of that everywhere.

Boy oh boy oh boy, I wish I had said that! Since I didn't, I wish I could give you like a million Kudos!

pedicurn, LPN, RN · Mar 8, 2011

I come from a family of obese diabetics. My mother literally ate herself to death last year. at 4'11" tall, she weighed 212 lbs most of her adult life. Yes, food was her drug of choice for her depression and mood swings. She self medicated with brownies on a regular basis. She was the most unhealthy person I have ever known. Her last 3 years were spent going to dialysis treatments and 3-4 hospital stays each year. I would love to see some real education for obesity. Something like what they do on the show "The Biggest Loser", where the MD. shows exactly what the excess fat is doing to your insides and how it is affecting your health. No amount of judgement and badgering will change a persons behavior, but perhaps a person can make an educated decision about their health if given the correct and honest info.
I noticed that my mother's MD. NEVER talked about her need to lose weight. Perhaps because he was in the same condition. I feel that medicine needs to take a serious approach to over-eating and obesity, and not leave it up to exercise gurus. It is both a physical and mental health issue.
My mother was not only the unhealthiest person I have ever known, she was also the most intelligent, funniest, most talented and creative person I have ever had the privilege of knowing. I miss her terribly.

I'm so sorry for your mother :heartbeat

We have the same growing health issue in Australia

Obesity is a massive health issue and we (health providers) have allowed its common feature - emotional/psych dimension; to cower us into silence.

It's blimming manipulative when a p't threatens to become upset if the weight problem is approached.

Meanwhile we cater for it with our bariatric wheelchairs and beds, longer IV cannulas. We may even have to make new larger scanners. Our health workers risk injury. And the costs threaten to blow out our health budget.

I don't think there is another health issue that we tippy-toe around to the extent that we do for obesity.

None of what I just said is discriminatory

rngolfer53 · Mar 8, 2011

I think we all learn some of our behaviors by trying to avoid feeling guilt. Think about all the lessons we learn growing up. I remember feeling "bad" about standing up my girlfriends when we had plans for a girls night out and suddenly Mr Wonderful calls at the last minute and wants to take me to dinner. We learn our behaviors by experiencing the feelings associated with them. At the age of 16 I would have dropped my friends and went out to dinner with Mr Wonderful,..by the time I was in my 20's I probably would have called my friends and begged to change the night or meet them later. We learn to be responsible and accountable partially to avoid those guilt feelings when we aren't!
I would love to see some of your research. I work in the ER and yes it's very frustrating to be expected to coddle patients who refuse to help themselves, especially the patients we see several times a month. I'm not sure I'm doing them any favors by ignoring the smoking, excessive drinking, drug abuse, obesity, etc. Recently we had 2 young adults who were having hallucinations and seizures after smoking something similar to K2, that they purchased at a local convenience store. The parents of one of the young men were livid that this stuff was making their Son so sick. They were talking about finding out who made the product, hiring a lawyer,...yadda yadda. Is the best thing to do in this situation to pat everyone on the back and agree with all they have to say? I think it's my responsibility as a nurse to educate my patients and give them all the facts I can that will allow them to make responsible decisions and choices. When they chose to make poor choices I still take care of them, but re educating is part of that care! Sugar coating the real issue isn't in the patients best interest. It might make them feel less awful at the moment but is doing nothing to empower the patient to be healthier!

There's a difference between being sensitive to the feelings of patients, and being afraid of their feelings.

The first requires tailoring the necessary message in such a way to minimize the discomfort the patient may feel, while still recognizing the message must get sent.

Being afraid of the patient's potential feelings means we abandon our duty to deliver the message because it may cause pain.

Jenni811, RN · Mar 8, 2011

In honor of this thread, I had a cheesesteak and mozzarella sticks today. Granted, it took me all day to eat the lot, but I ate it.

Yum!! Way to keep something positive in this thread.

I splurged on Panera Bread today for lunch, and it was delicious.