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

[Spine_CRNA]

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.

[wonderwhy]

But Addiction is still Aaddiction. Some is just more accepted than others and the fact we have the will to stop makes it not a disease.

[Ruby Vee, BSN]

But Addiction is still Aaddiction. Some is just more accepted than others and the fact we have the will to stop makes it not a disease.

Huh? Please use the "Quote" button so we at least know which post elicited this incoherent reply.

[Avid reader]

Haven't got a clue what weight and size has to do with medical care. I thought it had to do with knowledge and competence. Pretty sure that medical and nursing school had everything to do with knowledge acquisition which is what is required in the dispensation of our experience. The person who sees it differently is the one likely to be disappointed in multiple ways and not just in the TX dispensed. They possess a flawed logic re rendered services and almost always will be somewhat superficial and hypocritical. I never take such people seriously and avoid them at all costs. Is your accountant required to be attractive or simply knowledgeable about tax laws?

[Avid reader]

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.

I would say evaluate the three fingers pointing back at you when you point. What does Moore's looks have to do with the message presented? Does the Mona Lisa look different to an art aficionado if displayed in a different setting? I absolutely love judgemental people because they are so easy to own and are so unaware of their vulnerability.

A bit harsh you might say, but it's been my experience that judgemental people are responsible for most of the world's misfortunes.

[Avid reader]

For the overweight folks. Flat screen TV on the wall in front of a treadmill. Bluetooth headset. Start at five minutes and increase incrementally. In two weeks you'll be up to half an hour without duress. The weight falls off and stays off if adhered to, at least half hour 3x's weekly.

[Providence60, MSN, PhD, RN]

I want to express my appreciation for the insights and compassion offered by all who contributed to this thread. As is true in most of life, there are multiple viewpoints and perspectives and there is no "one side fits all" when it comes to topics such as this. When a patient finds themselves in a critical care situation, it is doubtful that there is any concern or attention given to the appearance, age, gender, size, shape or background of the people saving their life. Gratitude and an expectation of competency are the primary concerns for any patient at that time. That appropriate perspective can change if I am a patient seeking help from a professional for lifestyle management or looking for modeling of successful behavior change for improved well-being. In my practice, I have seen many patients who are seeking successful strategies for changing the status and condition of their health as well as inspiration for making the often difficult and challenging changes required for health improvement. It is not unlike the old adage of "do as I say, don't do as I do" that is common in parenting. With behavior change, we are often looking to be inspired by and follow the strategies of individuals who have either overcome issues we are working on or who demonstrate successful strategies in their own life to achieve their health and fitness goals. Most of us require inspiration and encouragement to be our best self and working with a role model is a positive way of achieving that. Our patients and clients look to us not only to offer them information and skills, but to also facilitate them to better health and well-being. This is accomplished not only through the physical body, but includes the emotional, environmental, spiritual and chemical aspects of our health. What I have learned as a Whole Health professional (Whole Health Training and Education - Accredited | Holistic Health Programs) is to be the change I wish to see and facilitate for my patients. This makes me a healthier, happier and more productive lifestyle professional. If I were still working in acute care medicine, I think my perspective would be the same as many of you have shared on this thread and I would be more concerned about my competency than role modeling.

[Rota, BSN, RN]

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.

Nurses (and doctors) work in a sick care industry. People are sick and want some help. If you and I are going to work in HEALTH care, then we need to be role models. We spend an inordinate amount of money to pay for chronic illnesses most of which are life style induced. As a country, we spend the most on "health"care but we rank last in health outcomes. Most people agree it is because we focus on drugs and not on prevention. The problem is this: there is no money in prevention. Sick people fuel the pharmaceutical industry, the "health care" industry, the cancer society and all those other disease related organizations. Hippocrates stated, "Let food be thy medicine and medicine be thy food". When we as a society learn to eat healthier, we will be healthier.

[Mijourney]

Great information. Great responses. Even though I struggle with weight and empathize with those that do, I feel that I am a role model responsible for helping to set healthy standards. I do agree with the previous poster that quoted Hippocrates that food is medicine. While I don't feel that one should distrust health care professionals who are overweight or obese (we do not know that provider's personal struggles), I do feel that when providing information on nutrition or weight, we should indicate that it is unsafe to be overweight or obese.

[KIMMIEKAY11868]

Weight is no joke. The stress alone is conducive to weight gain.

[Ruby Vee, BSN]

Fat shaming -- the last acceptable frontier for hatefulness.

[operations]

Honestly I just think it has shown how attempted interventions on the obesity epidemic have failed. We as the healthcare providers are the first to know of these new measures, and most people would love them to work,however they haven't been very effective. I think the things that are helping to some degree is the regulations regarding nutritional content of food. Our industrialized food is very poor quality and a lot of the toxic stuff is hidden. It's very difficult to avoid these processed foods unless you make an intentional effort, which I think is absurd! Especially for the Healthcare provider who has too many things to focus on rather than spending the energy seeking out quality foods.