Prejudice Against Overweight Patients: An Issue To Ponder - page 8

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

  1. Visit  VivaLasViejas profile page
    7
    What's changed? I can offer several ideas:

    1) Portion sizes are larger than they were 30+ years ago. If you're over 45, you can remember when Coca-Cola came in those six- and 8-oz bottles. That was a serving size, and no one got fat drinking a single Coke. They got fat when the Big Gulp came along.

    2) We've automated activity practically out of existence. Now we have to do make-work exercises in order to get what used to come naturally with hanging laundry out to dry, chasing kids around, cleaning house, even getting up and changing the TV channel.

    3) We are bombarded with ads for fatty, sweet, salty, and otherwise unhealthy foods almost every hour of the day on TV, radio, even online. When was the last time you heard the slogan "Broccoli---it's what's for dinner"?

    4) At no time in human history have more foods of so many varieties been available in so many places. You may not be able to find fresh strawberries in the ghetto Safeway, but chances are they carry Mexican entrees and hot pizzas.

    5) Today's fast-paced world has created a culture of stress, which in turn has led to higher rates of eating disorders, as well as other psychiatric issues that sometimes require the use of drugs that tend to increase appetite. (Sometime I'll tell you about my Zyprexa experience and the 12 lbs. I've gained in 2 1/2 weeks. Hint: the sofa is starting to look pretty tasty, and I just ate lunch a couple of hours ago.)

    6) A very large segment of our population is aging....and with the years come unwelcome pounds, AKA the notorious "middle-age spread".

    7) Cheap, plentiful, easily available packaged foods. Need I say more?
    edmia, jadelpn, HM-8404, and 4 others like this.
  2. Visit  tothepointeLVN profile page
    2
    Quote from rubato
    Just because you were in school for nutrition doesn't make you an expert. I am a certified personal trainer and a nutritionist, but I don't claim to be an expert.

    Binge eating is in fact a disorder. And, a lot of my clients were binge eaters. They would work their butts off exercising to try to lose weight only to go home and lose all their hard work with their diets. It made them miserable and I felt horrible for them.
    See what the problem is; is that your mixing the two issues up. As a personal trainer / nutritionist people come to you because they have identified their weight / fitness as an issue to work on and you are the appropriate resource person.

    In a patient/doctor interaction as the OP mentioned the patient came for a problem not directly related to weight. It might be a secondary issue or a contributing factor but its not the reason why the person went to the Dr. Advocating for someone's health doesn't give us a right to take a paternalistic stance. Those days are over. I worked as a nurse in a public health services clinic and we had many unhealthy and overweight patients. But you have to be gentle most of the time. Tough love just means they don't come back and then who have you helped really? Them? Or yourself?
    Last edit by tothepointeLVN on Jun 23, '12 : Reason: It posted before I finished my thought
    VivaLasViejas and wooh like this.
  3. Visit  tothepointeLVN profile page
    1
    Quote from VivaLasViejas
    What's changed? I can offer several ideas:
    Absolutely its primarily an environmental issue. We didn't all suddenly become weak willed over a single generation.
    VivaLasViejas likes this.
  4. Visit  tothepointeLVN profile page
    1
    Quote from VivaLasViejas

    5) Today's fast-paced world has created a culture of stress, which in turn has led to higher rates of eating disorders, as well as other psychiatric issues that sometimes require the use of drugs that tend to increase appetite. (Sometime I'll tell you about my Zyprexa experience and the 12 lbs. I've gained in 2 1/2 weeks. Hint: the sofa is starting to look pretty tasty, and I just ate lunch a couple of hours ago.)
    Depakote = 60lbs gain in 60 days

    On the flip side Topamax = 14lb lose in as many days but it makes you stupid, your hands tingle and everything tastes like cough syrup but because of society its almost worth it. Almost it made me handwrite my letters backwards.
    VivaLasViejas likes this.
  5. Visit  Stephalump profile page
    3
    Quote from Pets to People

    But of course they would diagnose it as a type of eating disorder. The medical community is notorious for having to put a label on everything in order to validate and understand it. If someone with a degree hasn't given it a name, it can't possibly be anything important or valid. Perhaps it is not an eating disorder, in many cases (not all of course, but quite certainly the majority) but in fact it is that we are trying to force our bodies to survivie on a diet that it was never ment to utilize in the first place and our bodies are very obviously tell us so, with the huge spikes in obesity, diabetes, inflammatory bowel disease, food allergies and so on. We are omnivores by our basic biology, yes, but we are not ruminants, so why do we eat so many grains and make them practically the staple of our diet?

    How can, what 50% (or more?) of the US population have an eating disorder? Just think about that for a moment...everything has changed within the last 30 or so years; obesity is a very new epidemic. So what has changed?
    I understand what you're saying, but I do need to point ours that I was referring to morbidly obese pts, not overweight pts. Morbidly obese pts are the minority. I defer to Viva for the answer to what has changed. A LOT has changed, and it's impacted our waistlines and our health.

    As far as the constant medical diagnosing goes, yes, we label everything. But in psychology, we rarely label anything that doesn't cause distress or upheaval to the pt. For instance, homosexuality is no longer in the DSM because it isn't a natural detriment to one's life. Binge-eating is a struggle, a health concern, and can consume one's life. Eating Chinese food for breakfast, pizza for lunch, and BK for dinner, all in typical sizes? That's not a disorder. That's a lot of bad habits.
    Last edit by Stephalump on Jun 23, '12
    VivaLasViejas, anotherone, and Fiona59 like this.
  6. Visit  tothepointeLVN profile page
    1
    Eating Disorder diagnoses for the obese aren't that common unless the person is seeking it out for some reason. I can't recall if I seen ED NOS on a patients chart other than a patient that has/had some variant of anorexia/bulimia that didn't fit the traditional diagnosis.

    What is your professional background? Psychologist? Nurse? I'm trying to figure which discipline you belong to so I can better interpret what you are saying without getting the message crossed.
    anotherone likes this.
  7. Visit  Pets to People profile page
    1
    Quote from VivaLasViejas
    What's changed? I can offer several ideas:

    1) Portion sizes are larger than they were 30+ years ago. If you're over 45, you can remember when Coca-Cola came in those six- and 8-oz bottles. That was a serving size, and no one got fat drinking a single Coke. They got fat when the Big Gulp came along.

    2) We've automated activity practically out of existence. Now we have to do make-work exercises in order to get what used to come naturally with hanging laundry out to dry, chasing kids around, cleaning house, even getting up and changing the TV channel.

    3) We are bombarded with ads for fatty, sweet, salty, and otherwise unhealthy foods almost every hour of the day on TV, radio, even online. When was the last time you heard the slogan "Broccoli---it's what's for dinner"?

    4) At no time in human history have more foods of so many varieties been available in so many places. You may not be able to find fresh strawberries in the ghetto Safeway, but chances are they carry Mexican entrees and hot pizzas.

    5) Today's fast-paced world has created a culture of stress, which in turn has led to higher rates of eating disorders, as well as other psychiatric issues that sometimes require the use of drugs that tend to increase appetite. (Sometime I'll tell you about my Zyprexa experience and the 12 lbs. I've gained in 2 1/2 weeks. Hint: the sofa is starting to look pretty tasty, and I just ate lunch a couple of hours ago.)

    6) A very large segment of our population is aging....and with the years come unwelcome pounds, AKA the notorious "middle-age spread".

    7) Cheap, plentiful, easily available packaged foods. Need I say more?
    And lets not forget the main ingrediant in all of these new, supersized, delicious, unhealthy foods that are in our face everywhere we turn...and thats CARBS! I have been paying much more attention to this because I am looking for things without carbs for snacks and meals and....there are none! Or atleast only in the fruit and veggie and meat aisles. How sad is that? Every where I look carbs, carbs, carbs. Even the foods advertised as healthy have high sodium, high fat or still have a decent amount of carbs.

    Very confusing for people who don't know what to look for and are constantly getting confused information on what is actually healthy.
    Last edit by TheCommuter on Jun 23, '12 : Reason: quotation blocks
    VivaLasViejas likes this.
  8. Visit  hiddencatRN profile page
    1
    It's possible to be respectful to patients without having to be supportive of unhealthful aspects of their life. Being overweight is unhealthy. It's not the only way to be unhealthy, but I thing saying nothing and providing no education or resources on weight reduction does the patient a disservice.

    I just took care of a very young (low 20's) patient who had a boil on her thigh that developed in to a pressure ulcer due to her weight. This person now needs follow-up with plastics and wound care. I've taken care of morbidly obese children, who in addition to having major health problems directly related to their weight, likely face social problems among their peers with all the psychological sequela that causes.

    It is completely appropriate to tell patients that they need to lose weight. (Or quit smoking, or eat a healthier diet, or exercise, or follow up with a dermatologist about that suspicious spot on the skin). Sometimes truth is unwelcome and uncomfortable. But ignoring sensitive subjects because it might "hurt feelings" does our patients a major disservice.
    anotherone likes this.
  9. Visit  Stephalump profile page
    1
    Quote from tothepointeLVN
    Eating Disorder diagnoses for the obese aren't that common unless the person is seeking it out for some reason. I can't recall if I seen ED NOS on a patients chart other than a patient that has/had some variant of anorexia/bulimia that didn't fit the traditional diagnosis.

    What is your professional background? Psychologist? Nurse? I'm trying to figure which discipline you belong to so I can better interpret what you are saying without getting the message crossed.
    My background is in clinical psychology and I have a long standing affiliation with the National Eating Disorders Association - I started volunteering as a recovering bulimic when I was 19 or so.

    Not talking in terms of nursing here...saw a reference to DSM and I switched over lol. I wouldn't think you'd see it frequently on a non-psych chart unless the pt is/was being treated elsewhere.
    anotherone likes this.
  10. Visit  tothepointeLVN profile page
    2
    No worries I slip back into shoe talk any chance I get mid nursing discussion (used to own my own dance shoe company)

    What I was MOST concerned about was someone made the correlation that most obese people were "addicted" to food. To me thats insulting to people with obesity and makes light of people who DO have addiction or disordered eating issues. So I wanted to nip that in the bud.

    I think that the NANDA definition is probably the best. Food Intake Imbalance : Greater than bodies requirements.

    Imagine if psych illnesses were treated with tough love. "Yes well your problem is your crazy you need to try being less crazy." So simple yet so ridiculous.

    As mentioned above I became obese literally overnight. It's mind boggling sometimes.
    jadelpn and wooh like this.
  11. Visit  anotherone profile page
    0
    The only personal stories welcome on these type of threads are : thin person who admits that s/he eats a lot, by anyone's definition, 2000cal+ and never exercises. or a overweight person who has some thyroid /medication issue who RUNS `10 miles a day and is still fat etc......... never can anyone say I am fat because I EAT more calories than I should and do not exercise enough to burn them off or I am thin because I eat 1200 cals a day and exercise hours a week. Like I said before, I have been fat and thin and in between. The thin part was not easy or some genetic blessing. I exercise/d HOURS everyday, was often hungry, and ate 1200 cals OR LESS. and 1200cals comes quick- 13 chips are 120 cals, some cream and sugar for my coffee can be 90cals or more and I would have a few cups a day. The addiction view point comes from somewhere( did not pull it off the sky) and some personal experience. it exists whether it is part of DSM V or not , does not change MY VIEWS. Has anyone else not found themselves eating and eating and thinking, "hmm this is bad, i should stop " and not been able to? any feelings of comfort or euphoria after eating sweets? what if this happened not just once a year or 4-5 times a year but everyday. there is some loss of control there. Isn't that binge eating? what happens to binge eaters that don't throw up, abuse laxatives or over exercise? I think that the amount of people doing that is larger than we think becuase of under reporting and the shame associated with it.
  12. Visit  tothepointeLVN profile page
    0
    I can't even begin to read that until you edit it and put some formatting and capitalizations. Otherwise it just comes across as a string of rants.
  13. Visit  anotherone profile page
    0
    Quote from tothepointeLVN
    I can't even begin to read that until you edit it and put some formatting and capitalizations. Otherwise it just comes across as a string of rants.
    Which is what it is.


Nursing Jobs in every specialty and state. Visit today and find your dream job.

Top
close
close