NPR promotes doctors who minimize obesity risks to protect patients’ emotions
In an effort to destigmatize obesity, NPR reported sympathetically in December that some doctors are refusing to discuss the health risks of obesity with their overweight patients, claiming that addressing obesity can lead to ”misdiagnoses.”
The story begins with the account of a Seattle woman who was advised by her surgeon to lose weight before undergoing surgery for a torn ligament in her thumb. The surgeon believed that her obesity could have contributed to her injury, which the patient herself acknowledged as a possibility. (And medical evidence supports the surgeon’s perspective.)
However, instead of considering the surgeon’s insights, the Seattle woman was outraged that her obesity was being addressed as a medical concern.
Primary-care doctors often provide “unsolicited advice” as part of their best practices. This advice is crucial in helping patients understand the epidemiology of their symptoms and recognize potential health issues before symptoms arise.
For example, if Bob is diagnosed with skin cancer after years of sun exposure without protection, his doctor would advise him to wear protective clothing and sunscreen. If the doctor fails to do so, they are not fulfilling their duty. The doctor should not worry about whether Bob might feel momentarily judged for his lack of attention to skin care.
The Seattle woman in the story finds it “freaking exhausting” to have doctors inform her about the potential negative effects of her obesity on her health. The article acknowledges that weight has long been used as a measure of health, with a higher body mass index being correlated with various conditions such as heart disease, diabetes, and certain types of cancer.
However, the author immediately dismisses this knowledge by claiming that focusing on weight can lead patients to avoid or delay healthcare, including recommended cancer screenings. Essentially, some obese patients are so sensitive about their weight that they would rather avoid going to the doctor altogether than receive accurate medical information about the effects of obesity.
The article argues that doctors often misdiagnose health problems in obese individuals due to their excessive focus on weight. However, it fails to provide convincing evidence to support this claim. Given the clear correlation between obesity and numerous health disparities, discontinuing medical attention to obesity would come with significant health costs. While one doctor interviewed claims there are “horrible stories” of missed diagnoses due to weight focus, no specific examples are given.
NPR suggests that the solution may be “weight-neutral” care or a focus on “health at every size,” which means not recommending weight loss as a treatment for medical conditions.
This approach essentially abandons one of the primary responsibilities of doctors, which is to provide patients with information on how to maintain their health. The doctor who advocates for this approach even informs obese patients who express a desire to lose weight that it is likely to fail in the long term.
While it is technically true that many obese individuals struggle to maintain healthy habits for sustained weight loss, it is morally detrimental for a doctor to communicate such a negative outlook to a patient. It would be akin to a physician encouraging a patient to continue smoking despite the elevated risk of lung cancer. Success in becoming healthier may be challenging, but doctors should not give up on their patients.
NPR tries to justify this doctor’s approach by citing a meta-analysis of long-term weight loss studies, which found that, on average, more than half of the weight lost by people with obesity is regained within two years, and over 80% is regained within five years.
However, assuming that every patient is “average” is a mistake. Just as Stephen Jay Gould argued against assuming imminent death for all individuals with a mesothelioma diagnosis, doctors should not rely on statistically ignorant logic. It is astonishing to see physicians advocating for such an approach.
The NPR article concludes by stating that people with larger bodies still deserve to be heard and respected in the doctor’s office, with their primary health concerns addressed.
If there is one phrase that should disappear from the English language, it would be “my need to feel heard.” Speak reasonably, and people will listen. But if you speak foolishness, expect to be ignored, whether out of politeness or because you simply sound foolish.
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Why is it important for doctors to inform obese patients about the potential negative effects of obesity on their health?
Hich is to provide accurate and evidence-based medical advice to their patients. While it is important to promote body positivity and prevent the stigmatization of obese individuals, disregarding the potential health risks associated with obesity is not the solution.
Obesity is a complex health issue that is linked to various medical conditions such as heart disease, diabetes, and certain types of cancer. Ignoring this correlation and avoiding discussions about weight may lead to delayed diagnoses and inadequate treatment options for obese patients. Doctors have a duty to inform their patients about the potential negative effects of obesity on their health in order to promote early intervention and prevention.
The article suggests that the focus on weight can cause obese patients to avoid or delay healthcare, including recommended cancer screenings. While it is true that some individuals may feel sensitive about their weight, it is not beneficial to withhold accurate medical information from them. Instead, doctors should strive to create a supportive and non-judgmental environment where obese patients feel comfortable discussing their health concerns.
The claim that doctors often misdiagnose health problems in obese individuals due to their excessive focus on weight lacks sufficient evidence. Without specific examples or data to support this claim, it is difficult to determine the extent of the problem and the need for a weight-neutral approach. Discontinuing medical attention to obesity without proper investigation and consideration of the potential health consequences would be negligent and could have serious repercussions.
Promoting “weight-neutral” care or a focus on “health at every size” may seem like an inclusive and compassionate approach. However, it is essential to remember that weight loss can be a necessary and effective treatment option for certain medical conditions related to obesity. Dismissing weight loss as a potential treatment option for obese patients can limit their access to appropriate care and hinder their overall health outcomes.
In conclusion, it is important to address obesity and its associated health risks in a sensitive and empathetic manner. Doctors should continue to discuss weight-related issues with their obese patients, while also promoting body positivity and a non-stigmatizing environment. Dismissing the medical significance of obesity and avoiding discussions about weight could lead to missed diagnoses and inadequate healthcare. It is crucial for doctors to fulfill their responsibilities and provide accurate and evidence-based medical advice to their patients, regardless of their weight or body size.
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