Over at We Are The Real Deal MizFit posted about an encounter with her toddler’s pediatrician. The pediatrician addressed the little girl’s weight in a very unprofessional way by making remarks in front of her about how big she was. I don’t think the active, strong, awesome child of MizFit has a problem, but Mr. Pediatrician brought up her size regardless.
Reading about the incident brought back all the pediatrician visits from my childhood. Believe me there were a lot of visits. Yearly physicals, trips for most colds, and the 3 week period where I basically lived at the doctor’s office because I had poison ivy, chicken pox, and shingles at the same time (they had no idea what was wrong with me for about 2 weeks). But in all those visits my pediatrician never once said anything negative about my weight. He was always one to play it down, actually.
When I started to gain more weight than my brothers – around the time I started reading more and playing less – my mother began asking if I was overweight. She worried. Sometimes I worried (I was noticeably bigger than a lot of girls my age). But my pediatrician never worried. “Oh, she is fine! She is at the higher end but still average. No need to worry or do anything differently.” He stuck with this story until I stopped visiting him, even though I was clearly flirting with danger. He always reassured my mother who in turn reassured me and proceeded to give me whatever I wanted, which by the time I hit middle school turned out to be extra food.
The doctor’s reassurance that I was perfectly normal was nice but I wonder now what would have happened if he had addressed the fact that I was clearly getting bigger and needed to eat less and play more.
I’ve never had a doctor that has openly addressed weight. In fact, most of them seem reluctant to do so. However, I’ve heard horror stories about doctors that openly mock overweight patients, refuse to believe they exercise, and more. But I have never experienced it. Even as an adult with a BMI that classifies me as morbidly obese my doctor will barely address the issue.
Last time I visited for a physical my doctor told me everything looked fine and I was healthy. At the end of the discussion about me being the “easiest patient” because I never have any problems, he looked at his clipboard and said, “You know the only thing I would tell you, as you know, is we could work on your weight. But other than that you are great!” We had briefly addressed the overweight issue when I first became his patient and since then it has always been a nonissue that he mentions at the end because he feels a responsibility to mention it. When I replied, “I know,” he looked relieved and dropped the issue. The weight discussion is always addressed now as a slight problem in my otherwise doctor approved healthy and active life.
When I think of this last visit I wonder if he should have said more. Thankfully he knows and believes I am quite active and try to be healthy despite my weight battles. He knows that I’m still obese because I have an unhealthy relationship with food, and so far being obese hasn’t caused any major heath problems. Even so, I wonder if he should not have recommended something to help me manage my food issues. I wonder if he should have said something, anything more. He seemed ready to address the issue because it is a bullet point on my chart, not because it is actually something he wants to help me deal with.
All this has me wondering: what is a doctor’s obligation to someone who is overweight? Do they mention it? Ignore it? Offer help? And when does that responsibility kick in? Do they initiate conversation with an overweight patient or wait until they are obese or worse? Do they bring up the conversation without any regard to a patient’s feelings? Or like my doctors do they place my feelings above the importance of discussing the problem with a big dose of reality?
Have you had a bad experience regarding the weight talk with your doctor? Or a good one? I’m curious how other doctors handle it and how we think they should bring up the subject.