Prejudice Against Overweight Patients: An Issue To Ponder - page 4
by TheCommuter 12,530 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
- 7Jun 21, '12 by JZ_RNI 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
- 8Jun 21, '12 by RyanCarolinaBoyA 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...
- 4Jun 21, '12 by HM-8404Quote 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.
- 2Jun 21, '12 by StephalumpQuote 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."
- 3Jun 21, '12 by StephalumpQuote 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
- 1Jun 21, '12 by Pets to People[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?
- 1Jun 21, '12 by GitanoRN Guideneedless to say, the overweight issue affects so many of us, not only our patients but the medical staff as well. on the other hand, i agree to some point regarding preventive medicine, which is part of the answer unless you happen to have a medical condition plus a family history of obesity, which then it is easy said than done. having said that, when i use to be a staff nurse every time a obese pt. came along they would give me that assignment just because i'm a male, and most of the time the pt. themselves would tell me that they were aware of those nurses that didn't want to take care of them because of their dead weight of 312pds. and they also said to me "gitano i'm sorry that you have to put up with me" at this level, we are facing a battle across the nation regarding obesity and the fast food industry with their "biggie size or super size me" motto is not helping the situation, we need to bring awareness to this phenomenon. however, we as a society tend to be so political correct these days in order not to offend anyone or in fear to be sued, that we tend to pass the bucket....just saying