The Fat Doctor: Can You Trust Out of Shape Health Workers?

Can you trust a doctor who is overweight? Many people experience cognitive dissonance over seeing a healthcare professional who looks physically unfit because this professional is supposed to be an "example for the patients". I contend that this is not often a fully fleshed out critique of healthcare workers. Nurses Announcements Archive Article

I think people who propose "Healthcare workers should be fit otherwise they can't be trusted." or "I can't trust a fat doctor." have not properly thought out the situation. The statements are front doors to a complex situation of lifestyle that is similar for those working in health promotion and those that are not. Being a health professional should not place automatically place us on a pedestal with unrealistic standards.

Divorce the Truth From it's Source.

First, the truth is the truth no matter the source - whether it's coming from a fit doctor or one who's 50 pounds overweight. Objective information spread from a physician successfully crosses lines of culture, language, lifestyle, socioeconomic status, ethnicity, gender, sexuality, and so on.

Time Management.

Second, it's perfectly plausible that the health professional is spending more time caring for others than caring for themselves. We all have 24 hours in a day. So if that nurse worked 36 hours of the past 72 hours at the hospital, then in the remaining 36 hours went home and took care of the kids, then went to sleep, then cooked dinner (again and again for 3 days), then they couldn't have been at the gym. I've yet to meet someone who's mastered being in two places at the same time...

Elements of Lifestyle Consistency

Third, consider the environment for being healthy. It's more than what your professional title is. Gym compliance goes down if you live farther from the gym. Imagine living 30 minutes away from it. You get dressed. Drive 30 minutes there. Work out for 1.5 hours. Shower. Drive 30 minutes -back- home. Eat/unwind at home and the total process took about 3.5 - 4 hours. That's 40 minutes more of a commitment than if the doctor could walk 10 minutes to/from the gym. This affects compliance with workouts.

Food Beliefs

How about beliefs about food? Imagine coming from a culture where food is a means of celebrating and showing affection. Do you think that deep seeded lifelong influence the nurse grew up in just vanishes the moment they get their nursing degree? No, it doesn't. Food is often a part of the celebration for a new college graduate. It's also a mainstay of funerals, birthdays, anniversaries, weekends, vacations, and so on.

Imagine growing up in a household where it was acceptable to eat McDonald's regularly. In the U.S. one typically gets a Bachelor's of Nursing at 21 years old. So for 21 years, this McDonald's food belief has been embedded in that person and again, they don't just go away the moment a nursing degree is conferred on the graduate. Over 2 decades of thinking McDonald's is acceptable won't just vanish with a college degree.

Remember growing up in this household and now add the social support system that's important in maintaining health. Your support system probably has similar food beliefs as you and that makes it hard to think differently. For example, the parent/caretaker tends to set eating and cooking habits for the entire family and they are often around for life - possibly being passed down to your children and circle of influence. Our social groups can be formed along common food beliefs as a means of likeness and a barrier towards cognitive dissonance. If you don't want to feel guilty for overeating or being non-compliant with a diet, then you will tend to eat with the like minded and avoid those who diet successfully.

If a person makes such a claim as described above without acknowledging the whole conversation and factors I've listed: food beliefs, time management, elements of consistency, and divorcing the truth from it's source, then I believe you're talking to an unenlightened person who so readily makes foolish claims.

Specializes in CCU, MICU, and GMF Liver.
One of my issues with this mentality is: so your nurse is 5 ft tall and 250 lbs. You have no idea about that nurse's lifestyle. Six months ago she could have been 300 lbs for all you know, now 50 lbs lighter due to a new diet and exercise routine.

My other thing is really, how much lifestyle counseling do we do, really? I never do. Are you really going to discount allllll of a nurse/dr's teaching on your BP meds, your child's ear infection, your new CA dx/treatment plan, all of those numbers we watch in critical care settings, the Beer's List and why we don't want Grandma taking Benadryl for sleep...... just because of the adipose tissue on that dr/nurse's body? That makes ZERO sense.

Anyway I enjoyed reading this article. It seems like most of what we read on this topic is "we are supposed to be examples of good health." I dunno, I'm quite healthy myself; I do the Insanity workout (mostly to keep in shape for the occasional high-altitude vaca), I eat very little sugar, I only indulge in 1-2 EtOH beverages on vaca or holiday parties, I don't smoke. What I don't do is say to the family of that critically injured pt "My name is Here.I.Stand and I'll be his example of good health today." :sarcastic:

RIGHT! Often patients only see a -snapshot- of a worker's health. Not how much better they may be relative to a year ago.

Specializes in CCU, MICU, and GMF Liver.
Being force feed too many calories most days does tend to make us overweight.

Oh wait. We usually put the food into our own mouths.

Sixty-nine percent of the nation is overweight, and most of them by choice.

We choose to consume one extra 100 calorie cookie;

We choose a large fries;

We choose regular milk;

We choose not to exercise on our days off.

Use small food & life changes, plus a little exercise to keep theweight off.

Save 100 calories a day to lose 11 pounds per year. Yes, life is that simple.

Add exercise form say "5K Fitness Run" (substitute walk for run) and you'll see steady results and stick to a better lifestyle.

Pretty soon, your patients will not give you a peculiar look when you give advice about how they can reduce their LDL, or heart attack risk, reduce their BP etc.

Holt,

Nice addition to the conversation. I agree we have a deep responsibility to our own health. To reiterate, my intent with the article was to present a more well-rounded discussion as to why out of shape health workers can still be valid communicators of health promotion and not to provide excuses to be used when faced with the discomfort of hypocrisy in patient care.

I have been a nurse for over 40 years now and have been overweight all my life despite following g all types of reducing diets to taking herbal teas, doing regular exercises and at times dropping carbs in the name of following doctor's advise but all in vain!:

I believe that my bodyweight is an inherited thing from my dad as he was overweight the whole time I knew him before he passed on at age 105 years! My mom was a slim lady , though she passed on at a tender age of only 6 2years due to a mismanaged health problem!

Throughout my nursing career all those 40 plus years , I have never heard of any discrimination against my being overweight from my patients or work Coleagus! Am shocked to hear somebody connecting being overweight with being a doctor or any health peoffesional!

Anyway , opinions are not facts and it is good that others may also tell their experiences!

Specializes in Transitional Nursing.
good artical . but we need to be agood health,good body, no overweight because she can work easily no complains from any problem

You can be overweight and still be healthy - "good body"

You can be fit and have a back problem "bad body"

Being in good health isn't a luxury everyone has and certainly doesn't mean someone who isn't can't be a nurse.

Specializes in CCU, MICU, and GMF Liver.
You can be overweight and still be healthy - "good body"

You can be fit and have a back problem "bad body"

Being in good health isn't a luxury everyone has and certainly doesn't mean someone who isn't can't be a nurse.

Indeed there are many young nurses who aren't overweight that complain of back pain from moving patients around and take Motrin for relief.

Specializes in ER.

You make some excellent points. I certainly agree that a good doctor or nurse can help motivate others regardless of his or her own physique, whether by example, contrast, or caring. A person's size alone will not determine that provider's ability.

For some reason though, your title made me flash back to Michael Moore's "Sicko." (2007) It was a great movie in so many ways, calling out the failings of our healthcare system on several levels. But I found myself repeatedly distracted by Michael himself, a grossly overweight guy who looked like he was one cupcake from a coronary lumbering around in front of the camera narrating for two hours. It wasn't just a matter of trust. He made some excellent, believable arguments. But, there was an unavoidable credibility gap, a mixed message: "You want us to fix healthcare, but you're breaking the most basic rules." In the end, it appeared that he was blaming the government and the system for his lifestyle choices.

Specializes in CCU, MICU, and GMF Liver.
You make some excellent points. I certainly agree that a good doctor or nurse can help motivate others regardless of his or her own physique, whether by example, contrast, or caring. A person's size alone will not determine that provider's ability.

For some reason though, your title made me flash back to Michael Moore's "Sicko." (2007) It was a great movie in so many ways, calling out the failings of our healthcare system on several levels. But I found myself repeatedly distracted by Michael himself, a grossly overweight guy who looked like he was one cupcake from a coronary lumbering around in front of the camera narrating for two hours. It wasn't just a matter of trust. He made some excellent, believable arguments. But, there was an unavoidable credibility gap, a mixed message: "You want us to fix healthcare, but you're breaking the most basic rules." In the end, it appeared that he was blaming the government and the system for his lifestyle choices.

Interesting perspective on "Sicko"! I've not seen it, but it does create cognitive dissonance when trying to establish an authority figure's credibility; whether they're a doctor or movie director.

An interesting perspective would be how the out of shape healthcare worker feels telling people to be healthier. Personally, I know quite a few staff members who -do- feel hypocritical and withhold effective patient education because of it.

However, staff could approach education from a perspective of empathy i.e. "Trust me, I know how difficult it is to quit smoking. I started when I was 18 and I also know how bad it is for you. I have trouble just walking up the stairs to come here."

This was a very nice article and it was so refreshing to hear the positive comments and perspectives of other writers. Health care workers who are overweight continue to have a professional responsibility to educate patients on weight loss, management of diabetes and cholesteral, etc. It may mean the difference between life and death. My father has been skinny all his life and has had heart disease since his 30's. People like him, and many others at risk, deserve education from overweight health workers the same as slender workers. It does not matter. I also find that I benefit from hearing other person's struggles with their weight or other health issues and what has worked for them. You don't always have to learn from your own mistakes if you can learn from someone elses. In addition, you learn more from teaching than being taught. Every time you share knowledge with your patients, you reinforce it for yourself.

Saying all that, I must admit that most of our weight issues in this country is related to what and how much we eat. I was stick skinny until I became an NP and enjoyed daily rep lunch meals. At first I was delighted, until my clothes became tight. And night shift workers and those under a lot of stress are at high risk for gaining weight.

I don't know if there are any studies related to the OP's orginal comments, but it will be very interesting to get a feel for widespread sentiments.

Specializes in CCU, MICU, and GMF Liver.
This was a very nice article and it was so refreshing to hear the positive comments and perspectives of other writers. Health care workers who are overweight continue to have a professional responsibility to educate patients on weight loss, management of diabetes and cholesteral, etc. It may mean the difference between life and death. My father has been skinny all his life and has had heart disease since his 30's. People like him, and many others at risk, deserve education from overweight health workers the same as slender workers. It does not matter. I also find that I benefit from hearing other person's struggles with their weight or other health issues and what has worked for them. You don't always have to learn from your own mistakes if you can learn from someone elses. In addition, you learn more from teaching than being taught. Every time you share knowledge with your patients, you reinforce it for yourself.

Saying all that, I must admit that most of our weight issues in this country is related to what and how much we eat. I was stick skinny until I became an NP and enjoyed daily rep lunch meals. At first I was delighted, until my clothes became tight. And night shift workers and those under a lot of stress are at high risk for gaining weight.

I don't know if there are any studies related to the OP's orginal comments, but it will be very interesting to get a feel for widespread sentiments.

Excellent points made Stepney! Yes learning from other people's experiences is quite effective.That's the value of reading books for example. We learn from the author's mistakes.

I also agree it's true that teaching is more effective than being taught for your reason but also because it's more active. Teachers have to manipulate the information by learning various approaches for each patient learner.

I guess I'm going to be the bad guy here. I lived in Hawaii for a couple years and culturally food is very important. As a result obesity and diabetes are rampant so I get that part. However, when you're coaching a person on lifestyle to help manage their disease it's not just about imparting factual information. You are actually trying to get the patient to change their behaviors. That's when you get into a sticky situation. If your patient is looking at an obese person who is trying to engage them and setting weight loss goals, well, they probably aren't going to take you seriously. There are plenty of thin seemingly fit people that are a mess on the inside due to lifestyle issues. The patient doesn't see it and it's not likely that nurse would have chosen health coaching as a specialty.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I think obese healthcare workers can be trusted like lean ones; I don't think trust is part of the equation.

However, they set a bad example when they are supposed to be role models.

No where in my job description does it say that I'm supposed to be a role model -- except that I'm to practice exemplary nursing skills to model good, safe nursing care to new employees, students and what not.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I guess I'm going to be the bad guy here. I lived in Hawaii for a couple years and culturally food is very important. As a result obesity and diabetes are rampant so I get that part. However, when you're coaching a person on lifestyle to help manage their disease it's not just about imparting factual information. You are actually trying to get the patient to change their behaviors. That's when you get into a sticky situation. If your patient is looking at an obese person who is trying to engage them and setting weight loss goals, well, they probably aren't going to take you seriously. There are plenty of thin seemingly fit people that are a mess on the inside due to lifestyle issues. The patient doesn't see it and it's not likely that nurse would have chosen health coaching as a specialty.
Again -- our job is to give the patient the information they need; it's not my job to "convert" him to a healthy lifestyle. That would be for a lifestyle coach or a health coach or whatever. My job -- saving your butt after you've had a complicated surgery -- does not require looking a certain way. Thank the gods!