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.
My doctors have usually acted the same way yours does. Telling me that other than needing to lose weight, I’m in great health. Enough said. I know that if I wanted to get some help from them I could ask, but I know that I’m following my own weight loss plan.
I did have a terrible doctor one time that totally berated me for my weight. The guy was a dermatologist who was removing skin tabs from my neck. He told me that I had them because I was so “grossly overweight.” He then said, “you know, you could lose 50 lbs and no one would know the difference.” It was shocking, insulting, and just plain mean. I tried to hold it together in front of him, because I didn’t want him to see cry, but as soon as I got to the office to pay, they tears came out. I ended up writing a letter to Kaiser and not only did I get a huge apology from the corporate office as well as the doctor, but the incident was written up in his file.
So the moral of the story is that I think it’s better for doctors to tread lightly and be sensitive. WE know we’re fat. If they don’t see an improvement in our weight (loss), then they can offer suggestions. But in no way should a doctor every treat an overweight (or obese in my case) patient the way that I was treated.
we know what I think.
there are IMO ways to gently and lovingly offer suggestions.
kindly.
and we can all tell easily from whence these “suggestions” come.
whether it is stemming from genuine concern or a place of callous misunderstanding.
alas the aforementioned TORNADO calls…
Ok, in my not so humble opinion, I believe drs should definitely recommend a healthy weight and perhaps hand out a few pamphlets with resources to get the ball rolling… However, we are all responsible for our OWN health, weight, activity, etc… drs are not our mothers, they shouldnt have to harp on us every time we go in for an appt. They assume we are educated adults, and can think & do for ourselves. I think it’s time we took some respnsibility for our own health.
My doctor is kind but it’s always a center of attraction in our discussions. That said, since she’s known me (about 10 years), I was always overweight, and had high blood pressure. She was THRILLED with me last visit, when I’d lost over 25 lbs. since I’d last seen her a couple of months before. She’s kind about it, but makes her point, too. Best of both worlds. :)
The only negative doctor I’ve ever had in dealing with my excess weight was when I was pregnant with my first child. The midwife (the doctor was actually not concerned) kept trying to use scare tactics to force me to reduce my weight during the pregnancy. Every visit she would continually remind me that I was on the road to eclampsia and a certain c-section. While I admit that I am obese and need to be careful not to gain too much during pregnancy, Her scare tactics were annoying and made me feel like I didn’t care about the health of my pregnancy. Four children later I have gained about the same amount of weight with each pregnancy and have never even been close to having eclampsia or a c-section.
My conclusion is yes doctor’s need to be concerned about the weight and let us know about possible health problems related to our weight, but they shouldn’t try to scare us into losing weight — We have to be motivated and want it for ourselves otherwise it won’t stay off.
My comment is to Bella. The dermatologist saying you had skin tags because you were overweight is absolutely ridiculous. My Mom has always had skin tags, and if she’s ever topped 135 I’d be really surprised. People are genetically predisposed to certain things and weight has little to do with it. I’m glad you wrote to the company and complained. He deserved to have his atrocious behaviour written up in his file. I just feel bad that he treated you so terribly to begin with.
Growing up I don’t really remember the Dr saying anything about my weight. he might of said something to my mom which i will ask tonight but never in front of me. As an adult I have had only one Dr. recently mention something in a forward way. But then she also mention something about my shnaggle tooth and that i should fix it with her sister who BTW was a dentist. Needless to say i didn’t go back. I think Dr. should mention it but in a helpful way not as you are the most hiddious thing ever to walk into my office. They should offer help even if it is not meds just knowledge. Maybe find out what we are doing and offer suggestion.
IMHO, if weight is causing health problems, then your doctor should discuss it with you. For example, if you have high blood pressure and losing weight may reduce it without medication, the dr should discuss that–but also give you the same treatment she would give a thin patient who had the problem. But if not, the doctor can treat it lightly like yours did-put out a feeler if it looks like the patient needs support/resources, but otherwise don’t focus on it.
Many fat people avoid going to doctors because they feel judged, or because the dr portrays all problems as the result of weight. Most people who are fat know they are fat, and don’t need a dr to tell them.
That said, my dr mentioned that he had done weight watchers and that it had helped him. My husband goes the to the same dr, and DOES have weight-related health problems, and that dr told him about Weight Watchers, too. We eventually joined, and have lost 185 lbs between the two of us.
I had a doctor who for years told me that I was perfectly healthy, even though I was morbidly obese and infertile. And that may have been true in my twenties and early thirties, but during all this time I was actively getting sicker. I don’t really see a doctor all that often (last time was more than two years ago), but the last doctor I had had a brilliant approach. By that time my excesses were starting to show up – highish blood pressure, high cholesterol, poor EKG and of course confirmed insulin resistance. He told me that he could prescribe medication for those conditions, or I could do something about them by following a healthy diet, quitting smoking and exercising and in the process losing weight. I jumped at the opportunity, and these days my numbers are much better (I have them done at a clinic). I’m eternally grateful that he made sure that I realized that my health was in my hands, without making a song and dance about it.
At almost 52, I can’t remember way back then so… I lost my weight in high school so I did not have these types of doc interactions as an adult.
I do think if health issues are at stake and/or a person needs to lose weight to prevent future issues that may show up as “pre”, something should be said in a constructive manner.
OK, I am going back to your other post for comment #3. I did put you on my blog today!!!
So many doctors aren’t good with dealing with people. Such careless comments are not good for a child to hear.
In my 10 years of obesity I only had a doctor say something about my extreme weight twice. Twice. And I was morbidly obese. One time the doctor said, “If you ate a piece of chicken for dinner and took a walk you’d lose weight.” Another time he said, “Perhaps you should lose some weight.” or some sort of nonsense like that.
Now, I would have hoped he would have been kind, but proactive. I think sometimes Doctor’s don’t know how a patient will react, so they don’t say anything at all.
If being over/under weight is causing health issues, then I think the dr should discuss it. Or, if the patient wants to discuss it with the doctor, like a healthy way to begin a diet change or exercise program or something. But I do not think that doctors should randomly be involved with someone’s weight. I was a little overweight from about 3rd to 7th grade. Not a lot, enough to get me teased a little, and have some hardship with clothes sizes but nothing the doctor ever mentioned. The other side of the coin with weight issues is being small, and that I have been harrassed from the doctor. The number two thing (the #1 was as a 6yr old and I posted it on MizFit’s blog) was in 9th grade or so, and I was on the low side of BMI and perfectly healthy, maybe possibly leaning towards being disordered but not there yet. The dr got me for a checkup or something and started in on the weight going on and on to me and my mother that I needed to gain weight and was trying to kill myself. I insisted I was not and he kept going well if you were who would you call and badgering me so much I was in tears. He also made me write down everything I ate for a few weeks, which of course made me eat less. He advised my mother to feed me mcdonalds milkshakes! This absolutely traumatized me and very possibly helped push me further on the path to my later eating disorder (which im not better from, for yrs thank goodness). Unsolicited weight advice, for over or under or ok weight is not good and can do more harm than help I think.
Interesting topic. I have never had any doctor address my weight. Perhaps because I was healthy for the most part? I am not sure. And now, even though I lost the weight, they still don’t mention the weight loss unless I bring it up. Are they paying attention to my chart? Not sure……..
I have few memories of my childhood, but I do remember every doctor I saw telling me how fat I was. I was even on a swim team. When I was in high school (and working out 23 hours a week-at high intensity) the doctors started looking into the why behind my weight. But no one got it until I was diagnosed with PCOS in my 20s. It was traumatic for me to always be disciplined by doctors….On the other hand I do think it’s important to say something….I dunno…
Doctors are people just like we all are. They don’t want to mention the things that are uncomfortable. Most of the time when one does, they either don’t care about your feelings, or they present it in that way to keep you from challenging them. At least that is my opinion. With that being said, I am very fortunate, I have a doctor who has mentioned it at every physical I have had, as well as at some other visits. In fact, my previous doctor was the same way. I count myself fortunate there. The challenge to me comes with the children. Not only are you dealing with the child’s feelings, but you are also dealing with the parent. I still think the doctor has an obligation to mention it. They need to do this with caring and concern though. I could rant about this all night, but I will stop here. Good post though.
I think it seems like a difficult (yet very interesting) topic because bringing it up doesn’t necessarily mean they can influence the patients’ behaviors and induce behavior change. Some doctors or health professionals are very knowledgeable in their area yet they cannot convince their patients or clients to do what is better for their health.
When I am saying this I am thinking about my nutritionist who is not only knowledgeable but also a nice person and becoming a good friend. Yet half of the time I question what she says to me in counseling and want to rebel against the restrictions that she have given me. i.e., is it really necessary to measure how many grams of rice I am having at every meal? Is 0kcal jelly the only snack I can ever have? What if I am doing this for life and not just a 3-month period diet thing?.. even with health professionals they say things that are easier said than done..
at my yearly appointment, when i was at my heaviest, my doctor was not subtle about my weight whatsoever. i already felt selfconscious. i felt gross in my own skin, and i feel gross anytime i need to go to my yearly appt anyway. she definitely did not sugarcoat anything. she asked how much i exercised, and i think i said something like, “well, i know i should exercise more often, but i do every once in a while.” (yea, right.) she asked, “do you know how often you should be working out?” i said i don’t know (i was scared of her at this point!). “EVERY DAY,” she said, almost angry with me. funny thing is, she wasn’t a skinny woman either.
anyway, three months later i began my healthy journey. i think her scare tactic planted a seed in my brain. i didn’t like it. i don’t think she needed to be mean about it, but i think it helped me.
Irene aka Fithungrygurl@ I am much concern with your point of view .
I told my doctor I was frustrated with the slowness of my body in losing weight and he said that to lose weight I’d have to give up carbs like the South Beach Diet. I wrote him off as a senile idiot and did my own research to find what would work for me. Thankfully he has since retired. ;-)
The only doctor I have seen in years is the chiropractor who does my physical every other year. Haha.
Over the years I’ve had my weight mentioned by different health professionals – but I never felt like they were mean; I’m not sure if this is because I expected them to say something, or if it’s because they really were not mean about it.
I was disappointed though last month when I went to see my present doctor who I’d only seen a few times before. I was the one who started on the weight and asked if there was any way at all he could support me if I tried to lose weight. What I was hoping for was perhaps some advice and monthly weigh ins or something like that for accountability. Not only did he not even think about that, he appalled me when he said there was none since weight loss meds are not covered by my medical aid! I was hugely disappointed and just wrote him off as a colds and coughs only doctor who only makes money by prescribing cough drops and pain killers. So I won’t be seeing him again. Or maybe I will after losing a noticeable amount to see if he’ll mention it.
As a child I didn’t have overweight, it started with me when I started living together when I was about 25 years old.
My current doctor never said I have to lose weight. But then again, in the 15 years that I have this doctor (it’s a she) I might have seen her two or three times. I’m never ill.
But I think that a doctor should tell someone who’s too heavy about the dangers of having overweight and help him or her by suggestions how to get a healthier life. Especially since overweight is one of the biggest problems in the USA en lot’s of European countries. And yes when a child is too big for his or her growing curve I think it’s the doctor obligation to inform the parent who the handle this and what’s the best thing to do.
the only bad moment i remember (i may have blocked some out) was the endocrinologist who just kept giving me pills and then suggested gastric. I thought that was strange given i was at the time only 50 lbs overweight. I would love to find a better endocrinologist but there aren’t many nearby and I’d have to take some time off of work to see one, which I should do. I need a referral first though, of course.
A couple of years ago, when I was in my late teens, I went for a yearly check-up with my family doctor and I guess that since I had no issues with privacy or whatnot, and he was a friend of my mom’s from work (healthcare centre), my mom decided to sit in with me. I mean, obviously, I knew I was already obese and needed to lose weight (contrary to what some doctors think, fat cells do not in fact replace brain cells as your weight goes up).
After weighing me, he starts by saying “Hey, [Mother’s Name], you’re very fit! Do you cook her the same stuff as yourself? [To me] Well then, you must be eating more junk food on your own! How else is it that your mom is 130 pounds and you’re 200?! Look at her! Your mom is at the perfect weight and you’re OBESE. You know what I think the problem is? You’re watching too much television and not helping her enough with the housework! My kids have no tv in the house! I jog to work every day!….” [and on and on he ranted].
Man…it’s a good thing I have thick skin, and a good relationship with my mother.
@Caroline
O.M.G. See, that is the kind of thing that makes people hate and avoid doctors. Even if he was your mom’s friend he was YOUR doctor and should never have gone off like that in front of you. I hate hearing stories like that, but I’m glad you have both a thick skin and a good mother/daughter relationship.
I’ve never had a doctor address my weight, and to be honest I was a little surprised when he made no remark upon the fact that I have amenorrhea and that it might be related to my weight.
I think that doctors should probably address weight issues, but only if the patient brings it up or if the patient’s weight is causing them problems in lifestyle activities. I don’t think that discussing weight for toddlers is the right thing to do at all, however. Unless the child is severely impeded by their weight (which I doubt many are).
It’s rather problematic because weight issues are such a touchy subject. While doctors know plenty of science, I don’t think that they’re taught enough people skills to deal with these issues during med school.
After reading all the responses, I believe that most doctors will only address obesity/overweight if it is causing some other issue. In my case, when my cholesterol went up (in my 30s) my doctor suggested trying diet and weight loss to get it back in the healthy range. I tried half-heartedly and went on Lipitor, which helped greatly, even though I was still obese. Then I lost 50 pounds, was exercising a lot, and my ratios were fantastic. With my doctor’s permission, I decided to stop the Lipitor and my cholesterol went up again. So we determined that my overall number wasn’t dependent on my weight/diet, but my ratios are, so exercise and diet can still help. But I digress…
I have never had a doctor make a big deal about my weight. It’s usually me that brings it up and my doc (who I’ve been seeing for ~10 years now) says that as long as I am healthy and exercising, she’s not all that concerned.
I have never seen doctor for weight loss.
When I was flirting with 350 lbs, I asked my doctor for some help. I begged her to reccommend a dietician or nutritionist who could help me figure out some kind of eating plan and help me get on track. I didn’t even know how to figure out how many calories I should be eating.
She looked very uncomfortable and told me that she didn’t work with anyone, it wouldn’t be covered by OHIP (universal health-care program in Ontario, Canada) and that I would just have to find someone on the internet. She practically fled the room, like the hounds from hell were on her heels.
I went home more discouraged than ever. It took me months before I asked someone for help with this again. I’m not blaming her for being uncomfortable, but since I’m the one who brought it up, I am blaming her for refusing to aid me in anyway.
@Sagan
They should have People Skills 101 and Bedside Manner courses in med school. Seriously. And it should cover topics like this.
@Karen
It is definitely a subject most doctors seem to want to glance over unless it affect something yes. You are so right. But as soon as it causes a problem they must speak up. But if they know the weight will eventually cause that problem do they not have a responsibility to address the weight issue? Is preventative medicine not a possibility?
@Tara
NO! I can’t believe your doctor did that! It is her JOB to find you the help you need to get healthy. Doctors are always referring patients for things. She should know at least one dietitian in your city. I can’t believe that she wouldn’t help you. I’m so sorry you had to deal with that but glad you eventually reached out for help elsewhere!
I recently went for my annual physical and my doctor recommended lap-band surgery. No discussion of exercise or diet plans or anything. Just the name of a surgeon.
Oh wow. I have a story for you. I’ll blog about it sometime this week and add linkbacks to you & Mizfit. It’s hilarious when I look back. I’ve learned to either laugh or cry, and I’d rather laugh, but still, it was unprofessional.
I think that to a large degree, doctors, whose responsibility is to have our health in mind, should mention (tactfully) if weight or certain trends represent a danger. But when it comes to children, I think they should address it with the parents because children are so easily influenced and body image issues start so young. The parents can then try to incorporate healthy changes or lead by example. That’s just my opinion.
Yes, my pediatrician shamed me about my weight. I was 16 and weighed 160 (at 5’7″, I was not overweight). I then had nightmares about going to the doctor and avoided going at almost any cost. Today, I have a supe nnice, extremely kind doctor who did bring up my weight and offer suggestions for things I can do to manage it. He is such a good, kind, careful, and encouraging physician and he talks about my weight in such a supportive and compassionate way that seeing him makes me feel inspired and hopeful, not shamed or resentful. He understands that it’s anextremely difficult problem and one that is resistant to almost every intervention, except weight loss surgery.