Prejudice Against Overweight Patients: An Issue To Ponder - page 3

by TheCommuter 12,765 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


  1. 3
    Quote from Multicollinearity
    Overweight 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.
    There is "prejudice" and "bias" though. Not necessarily on a patient care level but on a level of access to general services. It is ridiculous that as health care providers that we can sit here and call overweight people "non-compliant" when many of them have been given no legitimate materials or instructions to comply with!

    Now I'm not excusing the patient from personal responsibility. But it seems ridiculous to me that people can participate in all kinds of voluntary self-ordered care (like drug rehab and psychological services) but can't get their PCP to refer them to a nutritionist or get their health insurance to pay 30 bucks a week to see a personal trainer.

    There are MANY chiropractors, physical therapists occupational therapists nutritionists etc that provide services that can improve the lives and health of the obese. Until our healthcare systems are willing to better accommodate these physical and theory based medical services I wouldn't anticipate that we can see a decline in weight related health issues.
    Last edit by 2BRN123 on Jun 21, '12
    KelRN215, VivaLasViejas, and wooh like this.
  2. 2
    Quote from brian ruff, cna
    overweight 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!
    i think we have shifted from a culture of doctors orders, and patients' compliance. that reflected prior generations' vested authority in physicians that no longer exists. now physicians and other healthcare providers are partners in creating and maintaining health. truly.

    i prefer educating and coaching from healthcare providers and patients' adherence or non-adherence, which is their choice.
    SHGR and VivaLasViejas like this.
  3. 2
    Quote from Leo*
    There is "prejudice" and "bias" though. Not necessarily on a patient care level but on a level of access to general services. It is ridiculous that as health care providers that we can sit here and call overweight people "non-compliant" when many of them have been given no legitimate materials or instructions to comply with!

    Now I'm not excusing the patient from personal responsibility. But it seems ridiculous to me that people can participate in all kinds of voluntary self-ordered care (like drug rehab and psychological services) but can't get their PCP to refer them to a nutritionist or get their health insurance to pay 30 bucks a week to see a personal trainer.

    There are MANY chiropractors, physical therapists occupational therapists nutritionists etc that provide services that can improve the lives and health of the obese. Until our healthcare systems are willing to better accommodate these physical and theory based medical services I wouldn't anticipate that we can see a decline in weight related health issues.
    Leo, I deleted my prior post as it was rambling and long. I described a scenario where a physician claimed many overweight people will be overweight no matter what they do.

    I agree there is prejudice and bias. I'm afraid, though, that fear of claims of bias will tie healthcare providers' hands when it comes to addressing the issue honestly and kindly.
    leslie :-D and 2BRN123 like this.
  4. 1
    Quote from Multicollinearity

    I agree there is prejudice and bias. I'm afraid, though, that fear of claims of bias will tie healthcare providers' hands when it comes to addressing the issue honestly and kindly.
    Their (and our) hands are already tied, unfortunately.

    Another poster previously said that a Dr. shouldn't constantly harp on someone about their weight. I think they should BUT they need to be able to refer them to someone or something or some way that the problem can actually be controlled. *sigh*

    sorry I'm posting so much, I just work in the health and fitness field currently and believe very strongly about these issues.

    Its just so hard to bear witness to the whole thing. Seeing Client A with adequate financial resources or agreeable health insurance be able to participate in our program and SERIOUSLY change their lives and then have to watch client B without those resources struggle on the eliptical reading health magazines every day not knowing if they will ever be able to turn themselves around.
    wooh likes this.
  5. 4
    How can we expect overweight/obese people to loose weight? Most can get the excercise thing figured out, but as everone can agree diet is 80% of the problem. Ph.d's, scientists/researchers, physicists, M.D's and any other professional involed CANNOT agree on what diet is best for us to loose weight AND maintain a healthy weight. But they all agree that it is not simple at all, it is in fact so complex that we can reach the moon, yet we have not been able to get this figured out.

    Society critisizes overweight people, then gives them conflicting and often incorrect advice and they try and try and try with no success, or loose weight only to gain it back and what do we do? We tell them they are fat, lazy slobs and we cut out their stomachs...perfectly healthy organs cut out in order to try to force their bodies to accept a food lifestyle that perhaps people we not ment to maintain (aka carbs and high fructose corn syrup in nearly all the food we eat). Bariatric surgery is becoming, if it is not yet, the NUMBER ONE performed surgery in the U.S.

    Why are they tired all the time? Hmm, could it be that their cells are becoming insulin resistant (aka pre-diabetic due to the overdose of daily carbs that cause huge spikes and drops of insulin), so their bodies tell them they are hungry and so they eat, but the insulin is not able to get the energy/food into their cells so it turns it to fat instead...their cells still have not gotten the energy they require so it tells them to eat MORE. They are STARVING at a cellular level. Then we tell them to eat less when they are already STARVING. We tell them they need to eat less and work out more, hence the less calories in more calories out theory, but they have only a limited supply of carbs in their liver and muscles, so they will yet again end up STARVING. This is because the body requires fuel to work and if it is not getting enough carbs because we are restricting them and we store a limited supply; basically what we are attempting to do is to get our bodies to burn FAT yet our metabolism is set to burn CARBS, so if it even burns fat it does not do it well, obviously, we don't need a scientist to tell us this, we see it for ourselves everyday. And then we wonder why we are busting our butts in the gym and starving ourselves yet we are not loosing weight?!

    Think on this....our body requires essential fats and essential proteins but we DO NOT require any essential carbs. Then why are carbs our main food/energy source? Plus carbs give us short term energy and fat gives us long term energy. Think about long distance runners, they are fat burning machines, that is why they are so darn skinny! Don't say they carb load, because our bodies can only hold around 100g of glucose in our liver and around 300 in our muslces. Also sled dogs, they are omnivores just like us, yet they can run all day on fish, meat and fats. Also, forget the nonsense that the brain MUST have carbs, the brain works perfectly fine on ketones as does the rest of our body, and our muslces can store fat for energy just as well as they can store glucose. And let's not forget the nonsense about ketosis, it is NOT ketoacidosis, which is an entirely diffent metabolic problem.

    The obesity epidemic starting in the 1980's when a researcher (using only the data collected that backed up his claim, not ALL the data that showed his claim was not true across the board but in fact had a lot more factors involved than simply fat intake; this is a huge problem in research studies, they have to be taken with a grain of salt) claimed that fat and cholesterol where the cause of cardiac and health issues. The media took it and went wild with it and everyone changed the way they ate. What did we replace the fats with? Carbs, lots and lots of carbs and high fructose corn syrup (the generic replacement of sugar cane). I saw a presentation where an M.D (who is pro high fat, low carb diets and has successfully treated his clients who are diabetic, overweigt, etc.) showed data collected on the obesity rate in the U.S starting in the 1980's. It showed only a handful of states that had a >10% obesity rate, and low and behold we replaced fats in our diets with carbs and it showed the rates from then til somewhere in the 2000's and we are now at around half the states being >30% obese, and no state being under >10%. Yet "they" say it's FATS that are making us fat, hmmm.

    And before you argue that people are getting more fats in their diets, that's a load of bologne, just read labels. I do it all the time trying to find "healthy" stuff to eat (found that's a waste of time, because if it comes in a package, it's not going to be healthy...if it's low sugar they add more salt and sugar substitutes, if it's low salt they add more fat. I can by canned corn that has no added salt, or I can buy it with no added sugar, but I can't buy it without both). Carbs are in everything and I don't just mean a little, I'm talking 15 to 45 grams or more in a serving! And fat is usually minimal, surprisingly, reese's cups for example has twice as many carbs as fat per serving. Look at a big mac meal at mcdonald's...it's 56% carbs, then 35 % fat (unhealthy fats at that) and a minimal amount of protein at 9%. But everyone clings to the idea of the fat issue, not looking at all the additional carbs that a person gets throughout the day with donuts, cereals, icecream, sandwhiches, bread with dinner, etc.

    The Primal diet (many different versions, and it's not Atkins) is something I am have been researching lately. I am overweight and have tried so many different diets and none work. I can go to the gym for hours and kill myself til I can barely walk the next day because I enjoy working out. I have lost 20lbs here and there but it never sticks. But I refuse to give up. If the advice I am getting is not working and is not adding up then it's time to switch it up. I had always heard bad things about the Primal diet (not a high protein diet but a high fat, mod protein, low carb diet) until I started looking into it myself. It is hard to wade through all the false information, but I have looked up research studies, listened to M.D's, Ph.d's, etc who are pro on this diet and if I consider Occan's Razor, because it makes SENSE to me, then it just might be the right answer. Primal is eating all natural, non-processed or pre-packaged foods, so basically lean meats, healthy fats (avacado, coconut, EVOO, nuts), fresh vegetables and fruits, no added carbs (can get around 100 or so a day and still stay in ketosis). So you still get plenty of fiber, pleny of nutrients. I have started my own garden, bought chickens for meat and eggs, collect the berries the surround my house and bought a blueberry bush. Next year I plan to add even more with an indoor micro greens garden (it's hard to grow lettuce type stuff outside), enlarge my garden, etc; I would love to get a goat for milk and cheese! For the winter I plan to freeze and jar some fruits and veggies. It is saving me a lot of money at the store, because fruits, meats and veggies are expensive (not to forget the pesticides, and my issue with getting food that looks ripe yet doesn't taste like it!), yet I can get a lifetime supply of high fructose corn syrup and carb stuffed products for a fraction of the cost, and we wonder why poor people struggle with obesity and health problems. So this diet also appeals to me in the way that I have always believed that clean, natural foods are healthy, and it gets me back to nature and animals by tending my own garden and farm, which is excercise in itself for mind and body!

    FYI, I had always thought Dr. Atkins had "died from his diet" as we all heard in the media, but in fact slipped on a patch of ice and hit his head and later died from brain hemorrhage complications. His medical report listed that he had a "history of heart disease and HTN", which he did...he had a HISTORY of these conditions, which is why had started the Atkins diet. The physician treating him at his death said he was in excellent condition, no clogged arteries, etc were found on his autopsy. Crazy what we hear and believe til we find out for ourselves, huh?
    Last edit by Pets to People on Jun 21, '12
    SHGR, TheCommuter, not.done.yet, and 1 other like this.
  6. 2
    Atkins works beautifully when done correctly. Sadly few actually read the book, which stresses HEAVILY the importance of vegetables and fruits. Most people just start eating bacon and steak, don't eat any vegetables at all, don't bring fruit back in after the initial two week period the way they are supposed to....and then get sick and say Atkins is a failure.

    I lost all my weight on Atkins. I have kept it off 10 years now. Atkins is basically a whole foods diet. You go extreme to kickstart and then gradually reintroduce the body to whole foods. And nobody should be eating much bacon on it. At all.
    VivaLasViejas and Pets to People like this.
  7. 3
    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.
  8. 0
    Quote from HM-8404
    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.
    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.
  9. 3
    What 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.
    Esme12, not.done.yet, and VivaLasViejas like this.
  10. 2
    Quote from Leo*
    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.
    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?

    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?
    anotherone and DroogieRN like this.


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