The Fat Doctor: Can You Trust Out of Shape Health Workers?

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    Can you trust a doctor who is overweight? Many people experience cognitive dissonance over seeing a healthcare professional who looks physically unfit because this professional is supposed to be an "example for the patients". I contend that this is not often a fully fleshed out critique of healthcare workers.

    The Fat Doctor: Can You Trust Out of Shape Health Workers?

    I think people who propose "Healthcare workers should be fit otherwise they can't be trusted." or "I can't trust a fat doctor." have not properly thought out the situation. The statements are front doors to a complex situation of lifestyle that is similar for those working in health promotion and those that are not. Being a health professional should not place automatically place us on a pedestal with unrealistic standards.

    Divorce the Truth From it's Source.

    First, the truth is the truth no matter the source - whether it's coming from a fit doctor or one who's 50 pounds overweight. Objective information spread from a physician successfully crosses lines of culture, language, lifestyle, socioeconomic status, ethnicity, gender, sexuality, and so on.

    Time Management.

    Second, it's perfectly plausible that the health professional is spending more time caring for others than caring for themselves. We all have 24 hours in a day. So if that nurse worked 36 hours of the past 72 hours at the hospital, then in the remaining 36 hours went home and took care of the kids, then went to sleep, then cooked dinner (again and again for 3 days), then they couldn't have been at the gym. I've yet to meet someone who's mastered being in two places at the same time...

    Elements of Lifestyle Consistency

    Third, consider the environment for being healthy. It's more than what your professional title is. Gym compliance goes down if you live farther from the gym. Imagine living 30 minutes away from it. You get dressed. Drive 30 minutes there. Work out for 1.5 hours. Shower. Drive 30 minutes -back- home. Eat/unwind at home and the total process took about 3.5 - 4 hours. That's 40 minutes more of a commitment than if the doctor could walk 10 minutes to/from the gym. This affects compliance with workouts.

    Food Beliefs

    How about beliefs about food? Imagine coming from a culture where food is a means of celebrating and showing affection. Do you think that deep seeded lifelong influence the nurse grew up in just vanishes the moment they get their nursing degree? No, it doesn't. Food is often a part of the celebration for a new college graduate. It's also a mainstay of funerals, birthdays, anniversaries, weekends, vacations, and so on.

    Imagine growing up in a household where it was acceptable to eat McDonald's regularly. In the U.S. one typically gets a Bachelor's of Nursing at 21 years old. So for 21 years, this McDonald's food belief has been embedded in that person and again, they don't just go away the moment a nursing degree is conferred on the graduate. Over 2 decades of thinking McDonald's is acceptable won't just vanish with a college degree.

    Remember growing up in this household and now add the social support system that's important in maintaining health. Your support system probably has similar food beliefs as you and that makes it hard to think differently. For example, the parent/caretaker tends to set eating and cooking habits for the entire family and they are often around for life - possibly being passed down to your children and circle of influence. Our social groups can be formed along common food beliefs as a means of likeness and a barrier towards cognitive dissonance. If you don't want to feel guilty for overeating or being non-compliant with a diet, then you will tend to eat with the like minded and avoid those who diet successfully.

    If a person makes such a claim as described above without acknowledging the whole conversation and factors I've listed: food beliefs, time management, elements of consistency, and divorcing the truth from it's source, then I believe you're talking to an unenlightened person who so readily makes foolish claims.
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    23 Comments

  3. by   VivaLasViejas
    Excellent article. It's too bad that the general public is intellectually lazy and doesn't take the time to appreciate the nuances of life with health conditions such as obesity, which is a multifaceted issue. Like you said, food is an integral part of our existence. Also, here is another point: food can be addictive. But while one can stop drinking, smoking, drugs etc. we cannot abstain from food. We have to eat to live. No, we don't have to eat Big Macs and chase them down with a quart of Coca-Cola, but if that's our usual diet, it's incredibly difficult to change.

    We have had many debates here on overweight/obese healthcare professionals, and I hope this one doesn't devolve into bickering between fat and fit. This article is well thought out, and it sets an example for the discussion that will inevitably follow. Thank you for providing a fresh perspective.
  4. by   smartassmommy
    Nicely done. Don't forget your nurse or Dr. May be a new grad who is just starting the process of losing the weight gained through college. Remember stress eating is legal, smacking ignorant people isn't.
  5. by   wafa44
    good artical . but we need to be agood health,good body, no overweight because she can work easily no complains from any problem
  6. by   newmail445
    Hi VVV,

    Thank you for the kind words and you bring up a great point about food addiction. One point I would have liked to add (now that you bring it up) is people's different responses to food. I'm aware of studies that show naturally thin people do not have the emotional response to fattening foods like fried chicken that others do. To these people, such images evoke feelings of affection and this adds another layer to how difficult it can be to change eating habits.
  7. by   marienm
    I work with someone who barely fits 4x scrubs. I suspect she might have Cushing's, but I don't know because IT IS NOT MY BUSINESS TO KNOW OR JUDGE HER HEALTH HISTORY! She's a skilled nurse, a good resource, and takes care of her patients. I hope the patients see that, too.
  8. by   Here.I.Stand
    One of my issues with this mentality is: so your nurse is 5 ft tall and 250 lbs. You have no idea about that nurse's lifestyle. Six months ago she could have been 300 lbs for all you know, now 50 lbs lighter due to a new diet and exercise routine.

    My other thing is really, how much lifestyle counseling do we do, really? I never do. Are you really going to discount allllll of a nurse/dr's teaching on your BP meds, your child's ear infection, your new CA dx/treatment plan, all of those numbers we watch in critical care settings, the Beer's List and why we don't want Grandma taking Benadryl for sleep...... just because of the adipose tissue on that dr/nurse's body? That makes ZERO sense.

    Anyway I enjoyed reading this article. It seems like most of what we read on this topic is "we are supposed to be examples of good health." I dunno, I'm quite healthy myself; I do the Insanity workout (mostly to keep in shape for the occasional high-altitude vaca), I eat very little sugar, I only indulge in 1-2 EtOH beverages on vaca or holiday parties, I don't smoke. What I don't do is say to the family of that critically injured pt "My name is Here.I.Stand and I'll be his example of good health today."
  9. by   3ringnursing
    My previous PCP (and dear friend) was an old school MD that practiced until his death in 2012 at the age of 78. He had been of various weights during the time he was my PCP, however his weight had yo-yo'd after a hip replacement.

    He allowed me to volunteer in his office doing Medicare payor lists to keep my RN license active while I was on medical disability retirement and I noticed something: he was so loved by his patients (some of whom had been in his practice for over 40 years) that people brought in food gifts daily to show him their love and appreciation - homemade yummies are extremely difficult to ignore.

    That being said, despite his weight he was a skilled practitioner who kept me alive at times under extremis circumstances and I trusted him with my life, as did my family. I know if I was too sick to go into his office that he would have come to see me at my house - who does that any more? In fact, it would not have changed my trust for him no matter what his weight was. He was difficult to replace, and I miss him greatly. They broke the mold after he was born, and I feel extremely lucky to have had him care for me.
  10. by   Concerto_in_C
    I think obese healthcare workers can be trusted like lean ones; I don't think trust is part of the equation.

    However, they set a bad example when they are supposed to be role models.
  11. by   Doumbia
    Interesting article and great comments. One thing not mentioned in article or in comments is the effect of long-term stress hormones- elevated levels of cortisol correlate with insulin resistance, weight gain, diabetes etc. Nurses in particular are affected by this. My personal feeling is that health and weight loss/gain etc are an ongoing struggle for all of us, not just patients.. a little compassion all round goes a long way here. Having said that though, first thing I thought of when I read this article was a conversation I had with a patient who had recently worked very hard to lose 40 or 50 pounds and exercise. She was in her early 50's. She said the "tipping point" for her was sitting in her PCP's office, facing being put on statins and BP meds, and the nurse, who was close to 100 pounds overweight, counseling her on the meds. She said the nurse told her "well, the meds are no big deal" as if it was just the expected course of things for one's life.. and in that moment she thought, for herself, "NO." She didn't want it to be the course for HER life. So yes, IMHO, it can affect the delivery of our message. (But there are other reasons to doubt messages from healthcare providers, for patients, lol... like telling patients that stress control is important, while we put up with working conditions that do not allow us meal or bathroom breaks, working chronically understaffed to save money for management, working hours that are too long... stress kills, and we are horrible examples for our patients. I personally think this is one of the biggest dirty secrets of healthcare, NOT whether a particular nurse or doctor has a struggle with weight).
  12. by   Holt147
    Being force feed too many calories most days does tend to make us overweight.
    Oh wait. We usually put the food into our own mouths.
    Sixty-nine percent of the nation is overweight, and most of them by choice.
    We choose to consume one extra 100 calorie cookie;
    We choose a large fries;
    We choose regular milk;
    We choose not to exercise on our days off.

    Use small food & life changes, plus a little exercise to keep theweight off.

    Save 100 calories a day to lose 11 pounds per year. Yes, life is that simple.
    Add exercise form say "5K Fitness Run" (substitute walk for run) and you'll see steady results and stick to a better lifestyle.
    Pretty soon, your patients will not give you a peculiar look when you give advice about how they can reduce their LDL, or heart attack risk, reduce their BP etc.
    Last edit by dianah on Mar 10 : Reason: Terms of Service
  13. by   newmail445
    Quote from smartassmommy
    Nicely done. Don't forget your nurse or Dr. May be a new grad who is just starting the process of losing the weight gained through college. Remember stress eating is legal, smacking ignorant people isn't.
    Haha and yes, very true. The prep leading up to a professional job in itself is stressful.
  14. by   newmail445
    Quote from Here.I.Stand
    One of my issues with this mentality is: so your nurse is 5 ft tall and 250 lbs. You have no idea about that nurse's lifestyle. Six months ago she could have been 300 lbs for all you know, now 50 lbs lighter due to a new diet and exercise routine.

    My other thing is really, how much lifestyle counseling do we do, really? I never do. Are you really going to discount allllll of a nurse/dr's teaching on your BP meds, your child's ear infection, your new CA dx/treatment plan, all of those numbers we watch in critical care settings, the Beer's List and why we don't want Grandma taking Benadryl for sleep...... just because of the adipose tissue on that dr/nurse's body? That makes ZERO sense.

    Anyway I enjoyed reading this article. It seems like most of what we read on this topic is "we are supposed to be examples of good health." I dunno, I'm quite healthy myself; I do the Insanity workout (mostly to keep in shape for the occasional high-altitude vaca), I eat very little sugar, I only indulge in 1-2 EtOH beverages on vaca or holiday parties, I don't smoke. What I don't do is say to the family of that critically injured pt "My name is Here.I.Stand and I'll be his example of good health today."
    RIGHT! Often patients only see a -snapshot- of a worker's health. Not how much better they may be relative to a year ago.

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