You arrive at your doctor's office and you dread going into the examination room. You know you are carrying too much weight and you've tried to lose the belly fat but every diet brings failure. You know he's going to say something to you about this ongoing health issue and you are really sensitive about your "failure to successfully conquer this burden of weight." You just don't even want to talk about it...
Doctor says, "Hello Mrs. ______, what brings you in to the office today?"
You hear, "Hello Mrs_____, I see you are still quite overweight."
Doctor says, "I see that your blood pressure is a bit high and your fasting blood sugar level indicates that you may be at risk for diabetes."
You hear, "Well you are obviously doing nothing about your weight so of course you've developed high blood pressure and you are well on your way to developing diabetes - don't you get it??
Doctor says, "I'm wondering if there is some way we can address your weight and maybe help you to lose even 10 or 15 pounds, so that we avoid full blown diabetes or hypertension."
You hear, "You are so fat and I doubt you can even get off 10 pounds but you need to do it somehow and quickly."
Sometimes we are so caught up in the misery of our situation, in this case being overweight, that we actually hear things that are truly not being thought of or said. And we then foster anger when, in fact, the impetus to our anger was never ever there. Case in point - your doctor is there to be an advocate and educator. He is there to tell you when health issues are a direct result of habits and behaviors within our control. A doctor who does not broach that subject is in fact, a poor doctor. If he thinks you will over-react or take his words the wrong way, he will be a .....poor doctor. He won't want to bring up a discussion that he knows may offend you or even cause you to move on to another doctor. So somehow you need to be able to have a discussion about weight, even if you choose to make your own informed decision to do nothing about it. The doctor's office is the place to have the discussion, with a few parameters in place that can help to make the conversation about this emotional subject a bit easier, because in truth - to not have the conversation can be quite hurtful. You can feel as if the doctor has given up on you, or worse, thinks you are powerless and weak.
According to a recent New York Times article both doctors and patients are frustrated with the "weight game." According to one survey, only 39% of patients have been told by a healthcare provider that they are indeed obese. Of those that were told they are obese, 90% were also told by their doctor to lose weight - but most had already tried or were trying. Most doctors who have obese patients do not bring up the weight issue at every visit - which is probably necessary. So how can this dialogue improve?
Next up - rules for the health practitioner