Prejudice Against Overweight Patients: An Issue To Ponder - page 3
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... Read More
Jun 21, '12Obese people are like smokers, if they are over 20 then they have already been told about all of the bad effects and what they have to look forward to later in life. Any health care practitioner would be stupid to sit down with a 40 yr old obese patient or smoker and think anything they say will make a difference. Typically it takes a major event in life for someone to make a change as drastic as losing a lot of weight or stop smoking.
Jun 21, '12Quote from HM-8404Really? Telling someone about the bad effects doesn't teach them.how to change it. How many 20 year olds know how to play kickball. Compare that number to how many know the difference between a protein and a carbohydrate...what a polyunsaturated fat is... What muscle groups are supposed to be worked together. If we continue to provide the people in our country with irrelevant education, we have no choice but to expect poor results.Obese people are like smokers, if they are over 20 then they have already been told about all of the bad effects and what they have to look forward to later in life. Any health care practitioner would be stupid to sit down with a 40 yr old obese patient or smoker and think anything they say will make a difference. Typically it takes a major event in life for someone to make a change as drastic as losing a lot of weight or stop smoking.
Jun 21, '12What I had been led to believe was the Atkins diet was completely opposite of what I have found by researching it myself. The more I find on it the more it is similar to Paleo. Congrats on your weight loss and maintaining it, that's awesome!
I have the occasional two slices of turkey bacon with breakfast or on a salad, but try to keep it limited, because it's still a processed food.
I started on the Paleo transition period last week and have lost ten pounds already! I know that is just water weight so far, but I feel great, still have plenty of energy for working out and running around with my little ones. I really hope this works, it just HAS TO!! I've researched it down to the studs (still have a few questions I am looking into) and it makes SENSE on so many levels. I have tried so many different things in the past, I loose 20lbs here and there but it never stays off long. I am tired of never finding any clothes I like to wear; I usually end up very depressed and in tears when I go shopping. Sure I can get some cut clothes at the shops that cater to those who are overweight, if I want to spend $40 on a top! I am so tired of being tired all the time! My huny has introduced me to lifting weights and I love it (real weight lifting, not 5lb little weights for 100 reps; I benched 135 last week and have moved up in weight so that for certain excercises I need straps so I can hold the weight, this is because the muscle I am working can move much more weight than my hands are capable of gripping, such as back or leg muscles), unlike my cardio which I have to push myself to do and I am constantly trying different routines (like HIIT, crossfit, etc) to keep it exciting. I can see the muscles, feel them, and I notice a big difference in my body, but the fat is covering up all the definition! I can be working out and feel great, but then I look in the mirror and see my fat covering up all my hard work and it's very disheartening.
All my life I have wanted a garden and a farm. So far I only have a few chickens and a little garden, but it's a start. I love going out and checking on my garden and feeding my chickens; I love to watch them scratch around then stick their little fluffy butts sticking up in the air while they peck, very relaxing just to sit and watch them.
But back to the OP's topic, weight loss is a very complex thing involving many, many factors. It simply cannot be addressed in a 5 min visit with your M.D, who probably knows the minimum on diet and weight loss; even many nurses are not very educated on diet and excercise, all the different types and varieties, so you can find what best fits the patient.
I saw a documentary the other day about the prejudice involved with overweight people. They discussed how obesity was the last socially accepted prejudice, and that people often felt not only OK with saying mean things to overweight people, but in fact felt that they SHOULD say these things, because the overweight people were fat, lazy and ignorant and need to be told that they need to change...horrible. If it was soooo easy to loose weight, if it was all soooo simple, do you think so many people would be consenting to have their bodies cut open and health organs cut away so that they can spend the rest of their lives eating much from a 30ml medicine cup? And even then, that does not always work, look at Ricki Lake, and many others who's bariatric surgery has failed them.
Could it be....could it just possibly be, that the food we are trying to force our bodies to metabolize healthily is not the food we were ment to eat? Carb products (flour, high fructose corn syrup, grains, breads) are nothing but cheap fillers that give us short term energy, don't fill us up and leaves us hungry and tired 2 hours later, lead to insulin resistance, lead to fat storage and so on and so on.
Jun 21, '12Quote from Leo*Do you really think a 20 year old does not already know being overweight is bad for them? Has not already been advised to lose weight? Has not had someone in the health care profession tell them to substitute fruit and veggies for high fat foods like Big Macs and fries, and drink more water and less soft drinks?Really? Telling someone about the bad effects doesn't teach them.how to change it. How many 20 year olds know how to play kickball. Compare that number to how many know the difference between a protein and a carbohydrate...what a polyunsaturated fat is... What muscle groups are supposed to be worked together. If we continue to provide the people in our country with irrelevant education, we have no choice but to expect poor results.
One major problem I see is society is hurting young girls by trying to boost their self esteem. They tell them they "beautiful just like they are." That is a good thing to teach children, but don't overlook the health problems they face later in life if they don't get their weight under control.
Why are we so quick to condemn smokers and take up for the overweight?
Jun 21, '12Because losing weight is not as easy as not drinking soda and not eating high fat foods. As I said before in my first post, if it were that easy, it wouldn't he such a problem.
Jun 21, '12I treat overweight patients the same as non-overweight patients. I do urge them to lose weight for their health. And I do admit I get mad when they refuse to help with transfers, expect you to do all ADLS for them, turn them, lift them, or get mad when you tell them you have to wait to get help lifting/turning them (I'm very small and can't kill my back lifting these people) but I don't treat them poorly. Just get annoyed at the back strain or if they refuse to help and are just "dead weight"
I am not overweight but have struggled with issues with weight in my past. I understand it's a sensitive topic. If I am in with a cut and the doctor says "well you need to lose/gain weight" I'd see why there would be offense taken.
I had a patient once complain of back pain all the time. She was non-mobile due to it. She was also chairbound because of her extreme weight. I offered her some advice on posturee, she told me she could not do that because of the pain and the roundness of her large, obese abdomen. I offered her some dietary advice that might help her lose some abdominal girth and help with the posture and the pain, she wasn't mad and I don't feel I was disrespectful.
No one chooses to be fat. Some people do eat to deal with mental/emotional issues. Others have other health problems that cause the obesity. Others, still, just don't want to exercise and eat poorly. Doesn't make them bad people.
We need to confront the obesity problem, but while remembering that patients have feelings. Should I sugarcoat the truth? No, obesity will cause you pain, joint problems, heart problems, etc., etc., and the list goes on. Should you lose weight if you're overweight? Yes. Do you need to feel bad about it? No, just take positive steps to help yourself, that's all I ask. Oh. and that you don't choose to go in your depend instead of get up or asking for assistance, than refuse to help turn yourself while I'm moaning in pain turning you. Just my $.02.Last edit by JZ_RN on Jun 21, '12 : Reason: added
Jun 21, '12A rose is a rose is a rose. Called by any other name, it is still a rose. Obese patients are obese. Call it whatever you want, obesity is an epidemic nationwide. And yes, no matter how justified people may try to make their case sound, it is NOT healthy. Obesity is linked to a MULTITUDE of health problems. I think, however, that the stigma attached to obese patients is the classic example of an MI patient post cabg asking his wife to sneak in pizza and hamburgers (personally seen this happen in my CVICU). Obesity (like smoking) has many negative consequences. And most often, as in most cases in life, those who yell about it the loudest are those who need to lose weight.
And yes, I like many americans, tend to judge a book by it's cover. If you work in my CVICU, and you're 120# overweight, and you go into a patients room to lecture them post cabg on the benefits of losing weight, I and the patient both are going to pretty much ignore you. Prejudice has no place in healthcare as a provider. But we have gotten to the place in america that people can't handle pure simple honesty...
Jun 21, '12Quote from StephalumpYes it's not a license to be rude. Weight and poor health are always tied together. You can be fit and fat and skinny and unhealthy.So there's nothing to be said for "preventative health?"
Jun 21, '12Quote from Leo*Yes it does take more than just that. Prevention is much easier than correction. It has to start as children. Stop filling their bottle or sippy cup with Coke. Cook them vegetables instead of a Happy Meal. Give them a dang apple or banana rather than a handful of cookies.Because losing weight is not as easy as not drinking soda and not eating high fat foods. As I said before in my first post, if it were that easy, it wouldn't he such a problem.
Growing up I think my family went through salt faster than a gallon of milk. When we sat down to eat the first thing everyone did was reach for the salt shaker, before taking a bite. I weened myself off of salt while in the military. Today I use my salt shaker about as often as I do my oregano. I only drink water with dinner, have a Mt. Dew about 3 times month, don't eat anyplace with a drive-thru window, and buy a pack of cookies a month. At the end of 1 year I lost 25 lbs. and I was not even trying to lose weight. That was 3 years ago and my weight has stayed the same.
Jun 21, '12Quote from HM-8404Is it really my responsibility to keep my mouth shut if it's assumed that someone has "heard it before?" I have a good diabetic friend who took terrible care of his disease for years - I'm pretty sure he was told to watch his diet and monitor his blood sugar at EVERY physician's visit.Obese people are like smokers, if they are over 20 then they have already been told about all of the bad effects and what they have to look forward to later in life. Any health care practitioner would be stupid to sit down with a 40 yr old obese patient or smoker and think anything they say will make a difference. Typically it takes a major event in life for someone to make a change as drastic as losing a lot of weight or stop smoking.
I understand the difference between a bias against overweight PEOPLE and simple concern for a patient, and I'm not at all ok with rudeness, but I don't see why obesity should be treated unlike any other glaring health issue.
Yes, it's more complicated than eating right and exercising. I'm taking health problems out of the equation because your physician should already be aware of that aspect, but people have self control issues. They have emotional eating issues. They face poverty. They simply don't understand HOW to eat healthily. They don't have a support system. They have a busy schedule that doesn't lend itself to cooking and exercising. We're all intelligent people, we all know this stuff.
But aren't we supposed to be problem solvers? Plan makers? Encouragers? We can't solve problems if we keep our mouths shut because we don't want to offend anyone. Once again, there are OBVIOUSLY ways to phrase things that are inappropriate, and levels of badgering that are counterproductive. I just don't agree that it's in the job description to shrug and say "whatever."
Jun 21, '12Quote from tothepointeLVNThis argument has been done to death. We all know someone's grandmother smoked until she died in her sleep at 105 years old.
Yes it's not a license to be rude. Weight and poor health are always tied together. You can be fit and fat and skinny and unhealthy.
We all know someone's aunt had a glandular problem that caused her to be obese but she still ran marathons and never had a health problem in her life.
The point of preventative health is pinpointing issues that are likely to be a problem in the future. Obesity is likely to be a problem if not controlled. Smoking is likely to be a problem if not abandoned. Thus, grandma and aunt have nothing to do with anything.
Preventative health care is the future. The only way we're going to be able to cut costs is to "make sure" people aren't getting sick to begin with. Should be interesting, to say the least.
Edit: I just want to temper this by saying I'm being a bit dismissive because I don't think those examples have much bearing on the point, not because I don't see them as valid. Personally, I have adrenal insufficiency. It kept me quite thin (and quite sick) for a long time, but my regime of twice daily steroids has filled out my waistline and then some. It was depressing and I struggled a lot, but they best thing a doctor did for me was sit down with me for 30 minutes. He explained the science of the Atkins diet to me, walked through a list of supplements that would speed up my metabolism and lower my fat absorption, and gave me some really awesome tips on how to beat the fat. I want to be like him when I grow up <3Last edit by Stephalump on Jun 21, '12
Jun 21, '12[QUOTE=RyanCarolinaBoy;6622813]I think, however, that the stigma attached to obese patients is the classic example of an MI patient post cabg asking his wife to sneak in pizza and hamburgers (personally seen this happen in my CVICU). QUOTE]
Well of course they sneak food in. It is a big pet peeve of mine that people fail to see how unhealthy and unappetizing food is that is presented in the hospital environment. It tastes like cardboard, looks like it's been siting around for days and it is presented in an environment that is not easy to eat in. On top of this, during a time of stress is not the best time at all to get someone to change their habits aka their diet. They will of course seek comfort food in a scary and unfamiliar environment. It takes a lifetime to start these bad eating habits, they are not going to be changed with just ten minutes of pt education, giving them only food they don't want to eat and/or limited food choices and shaming them when they make the wrong choices...the rule of thumb is that it takes 6 months to make a habit and 6 months to break it.
If they can take on good eating and excercising habits and maintain them without cheating for a full 6 months, the chances are they will not revert back to their old habits without something major interferring (death in the family, etc.).
And as someone else on here says, just eat vegetable, just eat a banana, etc. It's just so easy to say "just go do this and this", when there is so much more to it than that. Many people first of all struggle with the food costs that come with eating healthy whole foods and meats, it is very expensive and food stamps only go so far. Many do not know how to stretch that money. Many are given bad advice every where they turn and give up frustrated. Many do not know how to prepare and cook veggies in a way that still makes them tasty. A big, big problem is their home environment. They may have made the decision to change, but they may be surrounded by friends and family who will do their absolute best to make it as difficult as possible, because they themselves refuse to change. How often do we see and obese person, and his/her family is also obese? Oh, basically all the time.
Saw a show about a man trying to loose weight because he was severely obese and had many health problems. He lived with his mom and her family was around a lot. They were all fat, and when he would bring in something healthy to eat, his mom and aunt would bring in mcdonald's and eat it in front of him, all the time making fun of his food and telling them how delicious the big mac was as they stuffed it in their faces. At every turn they fought to bring him down, his own family, the people who should be behind him 100%, yet family is usually the first to try and trip you up. How many of your pt's may be in this same situation?