Is fat a dirty word?

LATE AFTERNOON, GP’s OFFICE, OBESE PATIENT & WIFE STRUGGLE TO FIT INTO CHAIRS.

GP: clicking through results on computer So, I’ve found it difficult to get to the bottom of your shortness of breath. Your lung function tests have come back okay, + you don’t appear to have a virus or bacterial infection. Heart looks alright. Your blood pressure is being managed well. But you’re still getting symptoms?

Pt: just when I push myself too hard. You know, walking up stairs.

GP: Okay.

Pt: Yeah.

GP: Mmm.

*pause*

GP: Well, we can keep looking…

My brain: HE’S OBESE.

The consultation continued & at no point was the patient’s weight, diet or lifestyle addressed. It was at this point, that I realised that the GP I was on placement with was also overweight. I hadn’t noticed it before but suddenly the (large) elephant in the room was pointing at the fact that maybe weight loss wasn’t being mentioned because of the GP’s own weight?

I’m wondering what percentage of GP’s do push weight loss on patient’s as a first line treatment. This probably sounds extremely naive + green of me, but in a country that has recently overtaken the USA in terms of an overweight population, then shouldn’t we have more focus on…er…losing said weight?

This patient may go home thinking that their weight in not an immediate danger because the doctor didn’t mention it. But my heart just bleeds for the years of substandard quality of life/health that he has lived because of his weight. I feel strongly that excess weight IS a disease-state & should be treated as such. As doctors, I feel there is a responsibility to help patients achieve their ideal healthy weight. I’m not talking, turning everyone into paranoid anorexics but if you read any WeightWatchers or Slimming magazines (my mum used to be a WeightWatchers Leader) the majority of people being profiled say that their wake up call was from their doctor.

On the other hand, for all I know, the GP had tried unsuccessful for the last ten years to get this pt to lose weight. That must be disheartening. But, with my naive optimism, I’d like to think people would still try.

If obesity or weight loss ever becomes a health care specialty, it’s an area I’d really like to work in. I find the determination & psychology behind extreme weight loss inspiring. But then again, I could easily become the doctor who gives up & just stops mentioning it…

[Via http://shesmedicallyblonde.wordpress.com]

• What is the best Health Insurance plan for me and my family? What ...