Prejudice Against Overweight Patients: An Issue To Ponder - page 2
by TheCommuter 12,522 Views | 106 Comments Senior Moderator
Weight discrimination is the treatment of someone in an unfair manner due to the person's size. Even though extremely thin individuals are occasionally treated poorly due to their size, overweight and obese people are the most... Read More
- 1Jun 21, '12 by strawberry_chicaI have struggled with obesity and have lost a significant amount of weight. It is good for doctors to speak about weight but not to dwell on it. Like another poster said, we know we are fat and know the risks. I had one gyn who brought up my weight EVERY single time I went there. It seemed to be her solution to all my problems even though some of my problems I had when I was a more normal weight. Needless to say I do not go there anymore.
- 4Jun 21, '12 by gatheringwaterIn nursing school, an instructor told me to include a psych eval in my care plan for an obese patient because, "nobody gets that fat without mental problems." The patient weighed less than me.
Yes. Prejudice against overweight patients exists in the nursing profession. I wonder if this would help.
- 3Jun 21, '12 by beast master RNin 20 years people will being saying why didnt we do more to stop obesity . People dont realize in 20 years 50 percent of tghe population wil be obese , not overweight.... obese , im making it my own personal responsibly now to not be apart of that stat
- 9Jun 21, '12 by StephalumpQuote from tothepointeLVNSo there's nothing to be said for "preventative health?"
But the advice to lose weight has no direct relation on the problem they went to see the doctor for. If the doctor said losing weight would help x condition or prevent y condition then that would be fine
But simply saying losing weight would make "life" easier is not. Life as in people liking you as in finding clothes. What? Non specific and non helpful. Btw 279lb was my exact weight this morning and my "life" is fine. My health is good and all that other good stuff.
And the "for the good of their health" is not a good reason to discriminate. People usually pay in some form or another for the Dr so it's a service its not a invitation to run their lives.
- 8Jun 21, '12 by woohI think it it comes up in the context of overall wellness, good. "How are things in general? Energy? Sleep? How have you been eating? Getting any exercise? Stress?"
When it's the ONLY piece of wellness information offered, or it comes in the context of: Patient: "I have a headache." Provider: "You should lose weight." Not good.
Especially since I think all of the other wellness things have a huge impact on weight. If you aren't sleeping well, your raising your stress hormones which increases weight, and you're going to look to food to supply the energy you lack from lack of sleep. If you're under stress, stress hormones.
If you're lacking energy, you can't exercise. Now part of the lack of energy may be from a lack of exercise. But I had a while that I could not get through a workout. Finally realized that I was really anemic. If my healthcare provider just told me to exercise, it would have been just another frustration. I was trying to workout. I couldn't do things that I could do just a few months prior. It took one of my coworkers pointing out to me how pale I was for it to finally click that I'd been eating ice and having restless legs like crazy. All signs of iron deficient anemia. Once I took a couple weeks off from trying to workout, focused on my diet and getting more iron, I was actually able to workout. If I'd kept up just trying to workout, exhausting myself even more, I wouldn't have accomplished much, because as little as I could do wasn't giving much in the way of results. I got that taken care of and now that I can work out, I don't dread it as the most frustrating time of day. Which means I stick with it.
"Just lose weight" isn't helpful. Looking at creating an overall wellness plan that will help someone lose weight is.
- 9Jun 21, '12 by Ashley, PICU RNPhrasing is everything. You can address a weight issue without saying, "You're fat." Addressing the reasons for the increased weight is different and more effective then just addressing the weight itself.
It's the difference between:
Patient: "My back has been hurting me."
Doctor: "I think you would feel better if you exercised and didn't weigh so much."
Patient: "My back has been hurting me."
Doctor: "Lets talk about your daily routine and exercise habits. Maybe we can identify a few lifestyle changes that might help with this pain."
In the first example, the doctor is making the patient's weight the issue. It comes across are more judgmental, because it doesn't really offer any practical help for the problem. It also doesn't involve the patient in the discussion, but is simply the doctor giving their opinion.
In the second example, the doctor involves the patient in the discussion and makes the focus about lifestyle factors that an be adjusted in order to help with the problem and make the patient healthier overall. It's much less likely to come across as judgmental and biased.
I think this philosophy of phrasing can be applied to many situations when discussing weight, such as when discussing health with teenagers. Many teenage girls feel an obligation to be skinny, like the magazine models and are afraid of gaining weight. When our educational sessions with these girls, focusing on weight, BMI and obesity can further reinforce the idea that gaining weight is bad and they need to be skinny. If we focused on the lifestyle choices that result in better health (balanced diet, regular exercise) instead of on the weight, I think our teaching could be more effective.
- 1Jun 21, '12 by Thujoneoverweight patients do tend to be non-compliant with some physician orders. if they complied with an order like "exercise 5 days a week and eat this diet" then they would most likely lose weight. however, i do think that most people, whether they are overweight or not do comply with taking medications. most people in america view overweight and obese people as unattractive, not just in the health care setting, the cause of this is out of the hands of us healthcare workers, and more up to the zeitgeist of the time which, in today's time, is highly influenced by the media. the awkwardness of someone is totally subjective. many people say that physicians are some of the most socially awkward people out there, so what right do they have judging that trait in others? in the end though, it is common courtesy to not say offensive things like that. you can think it all you want, but when you speak it out loud, you run risk of not only offending someone, but also lowering their self-esteem which may cause some people to eat excessively and put on even more weight!
- 2Jun 21, '12 by 2BRN123Exercising 5 days a week and changing your diet are not enough. The patient needs to be educated.
If nutrition and human exercise physiology were such simple concepts to understand and execute, then obesity wouldn't be the problem that it is. If they were things that people could just read a pamphlet about and simply integrate into their lives, then personal trainers wouldn't need licenses to practice and colleges wouldn't offer bachelors and masters degrees in the topics to prepare people to do the job.
The reality is:
Many people who struggle with weight, do work hard and do not experience results. I see this every day where I work. Months and months on end coming into the gym to put in the work and experience marginal or non existent results.
Anecdotally and in my personal experience, those who experience significant and meaningful results are those that see personal trainers, nutritionists and physical therapists. Not to say that obseity cannot be challenged without professional help, because it can, but long term results typically aren't anticipated without some kind of guidance.
The problem herein lies, while health professionals may be able to identify that a person has issues with weight, there is little they can do about it aside from alert the patient to the fact and give them basic counseling. In my experience many health insurance companies, despite the recommendation or order of a Dr, get combative when a patient tries to control their weight with methods that the health insurance company would have to contribute to, regardless of the fact that it may help control the patients other healthcare costs.
The burdon of one of our most basic but most difficult to manage health care practices has been placed solely on the patient both financially and in access to care.
The exercise routines of MANY individuals, not just overweight people are hopelessly flawed. Incorrect form, in conjunction with incorrect diet execution or ideas is a hindrance to millions of people who are trying to change their lives.
Honestly, there is little that a PCP can do to legitimately counsel a patient as to how they can experience significant weight loss, without the participation of other entities to help get the job done.Last edit by 2BRN123 on Jun 21, '12 : Reason: sorry so long.
- 5Jun 21, '12 by MulticollinearityOverweight patients need to be addressed with respect, and healthcare providers DO need to be aware of their prejudices and bias. That said, I fear we are getting to a point of overly-politically correct enabling approaches where the issue will not be able to be addressed with overweight patients without "bias!" and "over-weight prejudice" being called.Last edit by Multicollinearity on Jun 21, '12
- 0Jun 21, '12 by Pets to PeopleQuote from rita359I understand what you are saying, but the way he addressed it was unprofessional...I can just imagine the tone it was said in. That approach does not address the pt's issue in any way.Issues, Issues. Now a doctor telling a patient it would be good for her to loose weight is discriminating against that person. OR is he addressing an issue in addition to the issue the patient presented for. I read somewhere that a lot of obese patients say they have NEVER had their weight addressed by a physician or nurse. If medical professionals don't address this issue who will?