Disturbing Conversation on Overweight Healthcare Workers

[FutureDNP2021]

I overheard a disturbing conversation of nurses who were saying that overweight people should not be working in healthcare. They were basically saying that patients do not respect health advice or treatment from a worker who is unhealthy themselves. I am posting this topic because I wonder if this is a shared sentiment among the medical field? Or from patients? Or has anyone experienced anything related to this? Like getting fired, or discriminated by either pateints or a facility and such? Are there ever clauses in facility contracts that employees must maintain optimal heath to represent the industry's interest? (I am in Vegas & yes casinos do enforce waitresses/dealers with a +/- 5 lbs. original hiring weight monitoring weekly). I hope this is not what nursing school meant by "take care of ourselves before we can take care of others." Honestly, I dont think like this but wonder if others in healthcare do? Is this really a "thing?"

BTW, they were referencing a theme of nurses who gained weight from emotional overeating. They were not referencing a physiological underlying condition. ~ Thank You ~

Why Are So Many Nurses and Healthcare Workers Overweight and Unhealthy?

[video=youtube_share;4W9insJ8ko0]

[WKShadowNP, DNP, APRN]

Well, I think for her it was a personal choice to be healthier motivated by many things, one of which was to be able to motivate patients.

[Code Caffeine]

I wonder if they feel the same or would even dare say the same thing about doctors. Plenty of docs have a gut, smoke cigars and spend too much time in the sun, pretty sure a few like their alcohol as well. Yes, obesity and heart disease are a serious problem but if someone is deemed well enough to do their job properly then they are in a much different category than a sickly patient in a hospital bed, it's just not comparable.

[Libby1987]

You took on all the risks of SURGERY to be a better example to patients?

Frankly, I don't care THAT much if patients don't think I'm a good example. I have information to share with them that they may or may not already have. That's called patient education. If they choose not to heed the information because they don't like my body, that is certainly their choice. It's an ignorant choice, but the choice is theirs. Whatever choice they make, I have done my part by providing them with the information. I have no obligation to achieve a body habitus that they approve of.

I think there is such a thing as going too far . . .

I'm not a proponent of cal in/cal out or fatism, but is it fair to say they're being ignorant by not heeding advice that isn't working or isn't realistic for the advisor?

[Ruby Vee, BSN]

I'm not a proponent of cal in/cal out or fatism, but is it fair to say they're being ignorant by not heeding advice that isn't working or isn't realistic for the advisor?

We do our patient teaching based upon the patient's condition, not our own, and the patient has no right to know anything about the various health conditions that contribute to my obesity. So yes, it's fair.

[sevensonnets]

Best answer yet, Ruby!

[Here.I.Stand, BSN, RN]

I'm not a proponent of cal in/cal out or fatism, but is it fair to say they're being ignorant by not heeding advice that isn't working or isn't realistic for the advisor?

The patient has no idea what has worked or not worked for the advisor, unless said advisor shares that information. I've said this before (can't remember if on this thread), but how does the pt know that the 5' 250 lb RN didn't weigh 300 lbs six months ago?

In any case....what Ruby Vee said.

[sallyrnrrt, ADN, RN]

I'm 5ft11, 67.5 yrs, 2 years ago I was at 200#.....I lost 44# in 6-8 mos....far to much, far to fast, concerned of etiology, but all diagnostics normal no pathology......no matter my healthy calorie consumption......my weight stays 160...... Looks like that is my mean body weight for my age......... I did nothing to loose weight, except a brief course with cronaxal, a mitochondrial enhancer......I have the energy most days as I did in my 30-40yr.....guess I will just count my blessings.....since no pathology found......

[sallyrnrrt, ADN, RN]

Besides still working in physician office, I do have 88ac cattle ranch......so maybe I have more active exercise than I realize........embarrassing, that my patients seemed pre occupied, with you have lost so much weight......now the acreage of my ranch doubled 18 months ago, which means more maintained......etc.....but it is what my 72 yr old engineer husband and I do for activity......I just was not trying for this weight loss, would prefer 170-180#.....

[TheCommuter, BSN, RN]

Since this thread is still going somewhat strong, I thought I would add an interesting tidbit from an insightful physician who specializes in obesity medicine. He argues that nobody is ever cured of obesity.

We can also cure many forms of cancer, where surgery or a bout of chemotherapy removes the tumour forever. Those conditions we can cure” – obesity we cannot!

For all practical purposes, obesity behaves exactly like every other chronic disease – yes, we can modify the course or even ameliorate the condition with the help of behavioural, medical or surgical treatments to the point that it may no longer pose a health threat, but it is at best in remission” – when the treatment stops, the weight comes back – sometimes with a vengeance.

And yes, behavioural treatments are treatments, because the behaviours we are talking about that lead to ‘remission' are far more intense than the behaviours that non-obese people have to adopt to not gain weight in the first place.

This is how I explained this to someone, who recently told me that about five years ago he had lost a substantial amount of weight (over 50 pounds) simply by watching what he eats and maintaining a regular exercise program. He argued that he had conquered” his obesity and would now consider himself cured”. I explained to him, that I would at best consider him in remission”, because his biology is still that of someone living with obesity.

And this is how I would prove my point.

Imagine he and I tried to put on 50 pounds in the next 6 weeks – I would face a real upward battle and may not be able to put on that weight at all – he, in contrast, would have absolutely no problem putting the weight back on. In fact, if he were to simply live the way I do, eating the amount of food I do, those 50 lbs would be back before he knows it.

His body is just waiting to put the weight back on whereas my biology will actually make it difficult for me simply put that weight on. This is because his set-point”, even 5 years after losing the weight, is still 50 lbs higher than my set-point”, which is around my current weight (the heaviest I have ever been).

Whereas, he is currently working hard against his set-point, by doing what he is doing (watching what he eats, following a strict exercise routine), I would be working against my set-point by having to force myself to eat substantially more than my body needs or wants.

That is the difference! By virtue of having had 50 lb heavier, his biology has been permanently altered in that it now defends a weight that is substantially higher than mine. His post-weight loss biology is very different from mine, although we are currently at about the same weight. This is what I mean by saying he is in remission”, thanks to his ongoing behavioural therapy.

Today, we understand much of this biology. We understand what happens when people try to lose weight and how hard the body fights to resist weight loss and to put the weight back on. This is why, for all practical purposes, obesity behaves just like every other chronic disease and requires ongoing treatment to control – no one is ever cured” of their obesity.

Arguments For Calling Obesity A Disease #3: Once Established It Becomes A Lifelong Problem | Dr. Sharma's Obesity Notes

[Libby1987]

We do our patient teaching based upon the patient's condition, not our own, and the patient has no right to know anything about the various health conditions that contribute to my obesity. So yes, it's fair.

When I read this stance from so many defending their weight struggles but not seemingly giving their patients the same understanding and allowance, (I don't believe an acute care nurse, or really most nurses, get the opportunity to know the entire backstory on every patient's weight struggles) I don't think that's entirely equitable.

People get stuck for a lot of reasons, I don't think "ignorant" is a fair blanket statement for others outside of those you believe have justifiable reasons. Maybe their reasons are just as justifiable and hearing an obese anyone give diet advice might further affect their confidence in their own ability to be successful.

I don't know why it seems to be a given on this site that obese patients or others with dietary issues are predjudiced against obese healthcare providers, versus lacking confidence and feeling defeatist about weight loss and failed diet restrictions in general .

[Ruby Vee, BSN]

When I read this stance from so many defending their weight struggles but not seemingly giving their patients the same understanding and allowance, (I don't believe an acute care nurse, or really most nurses, get the opportunity to know the entire backstory on every patient's weight struggles) I don't think that's entirely equitable.

People get stuck for a lot of reasons, I don't think "ignorant" is a fair blanket statement for others outside of those you believe have justifiable reasons. Maybe their reasons are just as justifiable and hearing an obese anyone give diet advice might further affect their confidence in their own ability to be successful.

I don't know why it seems to be a given on this site that obese patients or others with dietary issues are predjudiced against obese healthcare providers, versus lacking confidence and feeling defeatist about weight loss and failed diet restrictions in general .

Fat bashing is nothing new on this website. Even on this thread, if you've read the entire thread. I think it's fairly safe to say that the people the OP was describing, if not the OP herself, is prejudiced against fat care givers. That's the primary topic of the thread -- whether or not nurses should be employed as nurses while fat.

If someone chooses to ignore the patient teaching I provide because of the way I look and not because of some real or perceived deficit in my knowledge base, that's an ignorant choice. It is their choice to make, but it is an ignorant choice. I know the patient's medical history; he doesn't know mine, nor does he get to. In healthcare today, we don't have the time and resources to delve into every last factor that causes someone to be an unhealthy weight. Providing information about healthy diet and healthy exercise is the best we can do. And we can refer them to some sort of counseling for further delving into the history of their weight struggles.

I'm just providing the teaching; I'm not an evangelist for dietary change, healthy weight loss or whatever. I'm a nurse. If a patient chooses to ignore my teaching for whatever reason, that's his choice. I can move on to the next patient, next task. I don't have an emotional investment in converting anyone.

[Palliative Care, DNP]

You took on all the risks of SURGERY to be a better example to patients?

Frankly, I don't care THAT much if patients don't think I'm a good example. I have information to share with them that they may or may not already have. That's called patient education. If they choose not to heed the information because they don't like my body, that is certainly their choice. It's an ignorant choice, but the choice is theirs. Whatever choice they make, I have done my part by providing them with the information. I have no obligation to achieve a body habitus that they approve of.

I think there is such a thing as going too far . . .

No I said one of the reasons. I had increased ICP due to neurological issues related to Chiari Malformation. Bariatric surgery has been a wonderful thing for me. I no longer have increased ICP. My headaches and eye pain are no longer constant. I feel better all around. When considering my options however I did consider the fact that it would also be a better example for patients. You don't have to agree but it has been nothing but a positive experience for me.