FAT DOCTORS

Here is a study out of Johns Hopkins that says fat doctors are not as likely to diagnose their fat patients as “normal” weight doctors:

http://www.nature.com/oby/journal/vaop/ncurrent/full/oby2011402a.html?cid=xrs_rss-nd

Here are two articles, both of which parrot the party line that it must be bad that fat doctors are less likely to offer diet tips, but are otherwise very different. The first (a short paragraph in the middle of a one-pager at nytimes.com) adds some skeptical snarkiness, while the second adds an extra helping of fat hate, horrifyingly advocating that all fat doctors should lose their jobs.

http://www.nytimes.com/interactive/2012/03/18/magazine/the-one-page-magazine.html

http://technorati.com/lifestyle/article/fat-doctors-less-likely-to-help/

First, I HATE it when people with a certain BMI are described as “normal”.  To me it smells of bias.  It just triggers my skepticism for the rest of it.

What I find disturbing in the research abstract is this:

A higher percentage of normal BMI physicians believed that overweight/obese patients would be less likely to trust weight loss advice from overweight/obese doctors (80% vs. 69%, P = 0.02). Physicians in the normal BMI category were more likely to believe that physicians should model healthy weight-related behaviors—maintaining a healthy weight (72% vs. 56%, P = 0.002) and exercising regularly (73% vs. 57%, P = 0.001).

In other words, the thinner doctors have a prejudice against fat doctors.   (And gee, do you think those prejudices carry over to their treatment of fat patients?)

If nothing else, wouldn’t you think doctors might want to listen to what fat doctors have to say about being fat?  You know, professionals that have the actual experience?  Maybe thin doctors don’t trust the advice of fat doctors, but as a patient, I certainly would rather discuss being fat with someone who knows that there is no way to turn a fat person into a thin person.  And maybe fat doctors have a better (personal) understanding that fat people can also be healthy people.

The study shows that fat doctors are less likely to diagnose a patient who weighs the same or less than themselves as “obese” and less likely to discuss weight loss treatment.  What the study does not appear to show is whether or not fat doctors discuss healthy behavior that is not weight focused.

I’m not saying that fat doctors are all great – I have personally had my experience with a fat healthcare professional who clearly hated her own fat body.  (see My Fat Ass and RNP from Hell, http://wp.me/pB0rE-7o).  And I currently have a thin doctor who is not perfect but is willing to listen and allows me to participate in my healthcare decisions.

But I think this study shows less about the medical treatment one receives from fat doctors and more about the prejudices of thinner doctors; and those prejudices are what needs to be studied and addressed.

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5 thoughts on “FAT DOCTORS

  1. “…allows me to participate in my health care decisions” ? How do people come to accept such skewed reasoning as a good thing?

    When I was aging out of a pediatrician’s care, my wonderful doc gave me some thoughts to live by in hiring docs as an adult. The most important were these:1. Doctors are repairmen; if you get one who thinks of himself as something more, dump him; he’s clearly too big for his britches.2. Like all other hired repairmn, docs are being allowed the privilege of coming into your home (body), where you LIVE, to do their jobs, but ultimately ALL decisions about what they do and how they do it are made by the homeowner. YOU make your
    health care decisions; your doc is there to help you implement them, not to tell you what they should be. He’s entitled to express his opinion, but decision making is up to you. After all, you hired HIM, not the other way round.

  2. Hmm, yeah, I’d be interested in the possibility of reverse bias in thin doctors. I’ve met thin laypeople who defined ‘overweight’ as ‘bigger than me’, and there are probably doctors who also think like that – there’s a well-known saying (only half a joke) within medicine that a heavy drinker is ‘someone who drinks more than their doctor’, so I’d be surprised if weight wasn’t perceived in the same way.

    I’d also like to see this extended into other medical areas. Are thin surgeons less willing to operate on fat patients? Are thin midwives less confident about their fat patients’ abilities to give birth without complications? If this were found to be the case, it begs serious questions about where fat patients’ supposed health issues are really coming from.

  3. I AM a (moderately) fat doctor. Not fat enough to get laughed at most of the time, but fat enough that victoria secret doesn’t carry my size stockings. Let me tell you there is bias against me. My partners hate that I took down the BMI charts and that I won’t tell my patients to lose weight. I do discuss exercise with people all the time, and advise against too much saturated fat, and suggest limiting sodium, but I don’t advise weight loss. why? because it’s a silly, potentially dangerous thing to do, that’s why. I am a proud supporter of HAES and it’s a really hard thing to be as a doc. Oh, and it’s not just the other docs. Patients have literaly gotten up and walked out on me because I won’t prescribe calorie restrictions or tell them how much to weigh.

  4. We should be worrying about the competency and decency of physicians, not their weight status. I have been mistreated by enough physicians in my life. Its good to see that some physicians, like Ann above, are willing to stand by their principles. Such is sorely lacking these days in professional communities

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