by Pam Davis, RN, CBN, BSN
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We’ve all been there, done that. You go to the doctor for a cold, an ache, really any issue, and if you’re affected by obesity, somehow that issue is tied to your weight. This can result in a pretty frustrating encounter with your healthcare provider. You’re sick, you don’t feel well, you passed both a mirror and a scale this morning, so you do realize your weight is an issue; however, it’s not the direct focus of your visit that day. Any conversations about weight and weight-loss options at this type of visit are generally not received well by you.
What about the other type of physician’s visit? The one where you’re actively seeking suggestions, advice, dare I say…treatment for your weight? The visit may go something like this:
You: “Dr. Jones, I’m really worried about my weight. It’s been creeping up for a long time, and it feels like no matter what I do I just keep gaining.”
Physician: “Well, stop eating.”
You: “It’s really becoming more difficult to keep up with the kids or to even get up and down the ramps at the Tennessee Titans games. I just get so short of breath.”
Physician: “You know I really thought the Titans were going to do better this year. How long have you had your seats?”
You: “I’ve tried everything; the cabbage soup diet, injections and even starving where I only eat one meal a day. Nothing seems to work.”
Physician: “Well, what are you going to do? Have you looked around lately? We could all stand to lose a few pounds. Take your chart up front when you check-out and remember to keep pushing away from that table.”
Wow, profound words of wisdom on how to treat a complex, multi-factorial disease process like obesity. I wish I could say the encounter above is the exception, and not the norm, but unfortunately, I’ve heard this or similar scenarios described again and again.
Before it sounds like I’m coming down too hard on healthcare providers, specifically physicians, please understand I am not. Just like there are multiple factors that affect our weight, there are multiple factors that affect our opinions and knowledgebase about obesity and obesity treatment. Very few physicians receive education on nutritional counseling in medical school. Unless they specifically choose and seek out additional training, their knowledgebase and background may be formed more by public opinion and societal norms (obesity continues to remain the last socially acceptable form of discrimination).
Part of my job is to educate physicians and other healthcare providers on the importance of:
- First, having a conversation with their patients about their patient’s weight
- Second, providing them the resources and tools to make that a constructive conversation where together they can develop an appropriate treatment plan based on the individual, their current weight and their weight-loss goals
The Conversation Isn’t Happening
In June 2011, the results of a survey sponsored by both the Obesity Action Coalition and Ethicon Endo-Surgery revealed that: “Patients and primary care physicians aren’t having candid conversations about obesity and weight-loss surgery.”
“Healthcare professionals should be having detailed discussions with people suffering from obesity about all their treatment options, including bariatric surgery,” said Joe Nadglowski, OAC President and CEO. “The survey results indicate that doctors are not speaking to patients about their weight, and the effects it can have on their health. Informed patients can proactively manage their health, weight and improve their quality of life.”
The fact that this conversation is not happening is one of the key reasons why we continue to see an obesity epidemic nationwide. In order for individuals affected by obesity to manage their weight effectively and safely, they must have this important conversation with their healthcare provider.
Your Next Step
Go to your next doctor visit armed with the most powerful tool in the world – information. Here are some tips and questions to get you prepared for your next appointment: Write down and take with you a list of all the weight-loss methods you’ve tried in the past and include how long you worked on each effort.
- What were the results (how much weight did you lose)?
- How long did it take to lose the weight?
- Did you regain the weight?
- How quickly did you regain it?
- What changes were you able to live with?
- Which changes were just completely intolerable?
Take the Your Weight Matters Challenge
The Your Weight Matters Campaign is a great place to start. By taking the Campaign Challenge, you will receive the Your Weight Matters Toolkit, which provides a list of questions for you to ask your doctor about your weight and health, as well as a list of questions you can expect your doctor to ask you – so that you can be prepared. Visit www.YourWeightMatters.org and take the Campaign Challenge today!
The best way to get control of your health and weight is to be proactive and involved in your own care. I know you’ve heard it before, but it’s very true. YOU HAVE TO BE THE LEADER OF YOUR HEALTHCARE TEAM. Research your options, and have the conversation with your physician. In fact, initiate the conversation with your doctor. If they’re not willing to work with you, find another doctor.
Remember, Your Weight Matters – whether it’s too high, too low or within the normal range, it impacts your health.
About the Author:
Pam Davis, RN, CBN, BSN, is a certified bariatric nurse and the Program Director for Centennial Center for the Treatment of Obesity in Nashville and Chairman of the OAC National Board of Directors. Pam serves on the Integrated Health Executive Council and chairs the Integrated Health Clinical Issues and Guidelines Committee of the ASBMS and the Health Systems team of the Tennessee Obesity Taskforce. Through her work at Centennial, Pam strives to educate employers and physicians on obesity prevention and treatment.