Can You Fit Me In? Caring For Obese Patients

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Are obese patients getting the right kind of health care? Can You Fit Me In? Our contributor, Doctor Jeffrey D. Breckenridge continues to educate us on the right way to treat overweight patients.

Obese Patients

Caring For Obese Patients

“Until the pain of staying the same is greater than the pain of change, chances are we will not change.” Dr. Lloyd C. Blue (Dallas, Texas)

Although, this quote was originally made in a church setting, the human principle still applies; people will not change unless they are forced by discomfort.

In my previous post I shared my personal experiences with “Weight Bigotry” in the healthcare system. Understandably a few people found it shocking that doctors and nurses could pre-judge, criticize and even secretly make fun of their  obese patients. But never forget; “All people are human!” including doctors and nurses.

It frustrates me when there are no armless or extra-large chairs in the waiting room I can fit…

Sadly, my bringing to light this issue of “Fat-Insensitivity” will not result in a country-wide change in attitude. America enjoys making fun of “fat people.” Look at syndicated television; we relish taking jabs at overweight people.  From “Porky”, Timmy’s hungry friend on “Lassie”, to Mr. Bookman, the janitor on “Good Times” being called “Buffalo Butt” to uproars of laughter seems to be the order of the day. Even to today’s “The Biggest Loser” where obese contestants are “motivated” (AKA abused and exploited) to lose weight on television. Weighing the contestants in unflattering bikini tops (women) to men being topless to expose their redundant skin folds, as if the scales would not work with them fully dressed.

A study at the University of Pennsylvania of 600 primary care physicians demonstrated that more than half viewed obese patients as being awkward, unattractive and non-compliant (Ulene, 2010). Still another study at Yale University showed that, “24 percent of nurses said they are “repulsed” by obese persons” ( Puhl & Brownell, 2001).

The world will not change its treatment until we stop allowing them too. Dr. Martin Luther King, Jr. said, “A man can’t ride your back unless it’s bent.”  Fat Americans have been playing the role of the “jolly, passive, side kick” far too long. Low self-esteem has been translated into learned powerlessness, to the point that we just accept what’s offered to us; no matter how humiliating, how offensive or how inadequately our needs go unmet.

Regrettably the idea of treating others the way you would like to be treated does not translate to thoughtful behavior in the United States. We as consumers have not only the right, but the obligation to educate providers if our needs are not being met.

My being overweight is obvious. Discussing it every appointment is hurtful

If and when I do or say something right in the office I am frequently asked, “Why has no one taught me this before? or “Why didn’t my previous doctor tell me this? or explain that?” My answer usually is, “Maybe they didn’t know you didn’t know!” Many times patients get upset and just transfer their care. No one knows why; except maybe their immediate circle of friends. We do not complain until tempers have flared and people are walking out the door.

Offices must be taught what overweight patients need and / or desire. They must learn there are consequences to neglecting their overweight clientele.

In America, there seems to be no greater motivator than money. We as healthcare consumers have a say-so as to where our dollars go. Even if you have no intent of returning to the office, it is little effort to compose a respectful note to the office manager or physician stating:

  • “It frustrates me when there are no armless or extra-large chairs in the waiting room I can fit comfortably.”
  • “It embarrasses me when the nurse weighs me in the hallway and says my weight out loud.”
  • “It is impossible for someone my size to give “a clean catch” urine, in a small cup, on a closed-end toilet seat. Is it possible to give me a toilet-hat to collect the sample without me asking?”
  • “My being overweight is obvious. Discussing it every appointment is hurtful. Let’s talk about it if there are “new solutions”, but it is not necessary to point it out every visit.”

Suggestions such as these are honest, respectful and constructive. Although I am aware some providers do not like being questioned, any reasonable office manager or physician should acknowledge the legitimacy of these comments. If they don’t then the patent must decide whether to stay with that provider or not. The bottom line is that communication was attempted in regards to get your needs met, and an effort was made to maintain the doctor – patient relationship. Know this; some offices will never change until they feel the “sting” in their bank accounts, and that may mean finding another provider who will listen and provide the care you need.

It is impossible for someone my size to give “a clean catch” urine, in a small cup, on a closed-end…

We must do better when it comes to healthcare for obese patients.  We are all humans regardless of our size or shape.  Please share your suggestions in the comments section and we will add them to this commentary.

From contributor Dr. Jeffrey D. Breckenridge

Bibliography

Dr Martin Luther King Jr. (1929-1968). American Baptist Minister and Civil-Rights Leader.

Karen N. Peart. (2001, October 8). Obese People Suffer Bias from a Variety of Social Sources, Including their Own Physicians. Office of Public Affairs at Yale University.

Rebbecca Puhl and Kelly D. Brownell. (2001, December). Bias, Discrimintaion, and Obesity. Obesity Research, pp. 788-805.

Ulene, V. (2010, December 13). Doctor And Nurses’ Weight Biases Harm Overweight Patients. Los Angeles Times, pp. http://articles.latimes.com/2010/dec/13/health/la-he-the-md-weight-bias-20101213.

 

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17 Responses

  1. So much misconception so much pain spread, when we pre-judge and make fun of people due to their appearance. Thanks for highlighting this point!

    • mardenec@hotmail.com says:

      Julie you are so right. When we start to treat others the way we would like to be treated, the world will be a better place

  2. I get tired of every time I go to the doctor every medical condition that I have is because I am overweight. I know that i’m overweight and I don’t need a doctor to constantly remind me of it. Thank you for finally bringing this to light for me.

    • mardenec@hotmail.com says:

      Dawn I am so sorry to hear. I think too many doctors feel that they do not need to be sensitive

  3. Rosey says:

    It seems like people would just use common sense. I know that is not always the case though, and I am sure it hurts so many times to those on the other end of it.

    • mardenec@hotmail.com says:

      Rosey, if we would only treat others how we would like to be treated…sigh

  4. Ronnie says:

    A few years ago, I walked into a doctor’s office and before he even greeted me he looked at me in disgust and said “You’re obese” and spent the rest of the session criticizing every part of my body. It was an awful experience and completely out of line (I never returned to him). The experience with him had me feeling miserable, not inspired to change my lifestyle.

    • mardenec@hotmail.com says:

      Sigh….Ronnie I am glad you did not return to that doctor. Thank you for sharing

  5. We still have a long way to go when it comes to these things, but what disappoints me is that these people in the hospitals should know better than to be so rude. They understand that these people need medical attention and help and treating them this way won’t help save them.

    • mardenec@hotmail.com says:

      Carol that is the part that shocked and annoyed me as well. You can help without being rude and insensitive.

  6. Elizabeth O. says:

    I don’t think overweight patients are given the treatment that they deserve both in terms of medical care and simply being treated as a human being. It’s not about adjusting, it’s about respect and people especially who are trained to save lives should know that.

    • mardenec@hotmail.com says:

      Elizabeth that is what it boils down to…simple respect..regardless of size

  7. Czjai says:

    The situations mentioned are very hurtful. I wish health care providers would know better. 🙁

    • mardenec@hotmail.com says:

      Czjai….they do know better, they are just being insensitive and rude

  8. Scott says:

    I think it is much better than what it was just a decade or so ago. Look at the success of shows like Mike & Molly!

  9. Liz Mays says:

    I definitely believe people’s feelings are hurt regularly in situations like this, and people bite their tongues instead of saying something that might stop that person from doing it to someone else. We do need to stop allowing the shaming.

    • mardenec@hotmail.com says:

      Liz, I totally agree with you. I don’t understand why people have to be so mean.