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Are Doctors’ Orders Less Likely To Be Followed If The Doctor Is Overweight?

A recent, 358-person survey conducted by researchers at Yale University (and published in the International Journal of Obesity) suggested that patients may be less likely to follow the medical advice of overweight and obese physicians. Survey respondents were 57% female, 70% Caucasian, 51% had BMIs in the normal or underweight category (31% overweight and 17% obese), and were an average age of 37 years old.

Respondents rated overweight and obese physicians as less credible than normal weight doctors, and stated that they would be less likely to follow advice (including guidance about diet, exercise, smoking cessation, preventive health screenings, and medication compliance) from such physicians. Although credibility and trust scores differed between the hypothetical overweight and obese providers and normal weight colleagues, the respondents predicted less of a difference between them in terms of empathy and bedside manner. Respondents said they’d be more likely to switch physicians based on their weight alone. There was no less bias against overweight and obese physicians found in respondents who were themselves overweight or obese.

The study authors note that this survey is the first of its kind – assessing potential weight bias against physicians by patients of different weights. Previous studies (by Puhl, Heuer, and others) have documented weight bias against patients by physicians.

While the study has some significant limitations (such as the respondents being disproportionately Caucasian, thin, and female), I think it raises some interesting questions about weight bias and physicians’ ability to influence patients to adopt healthier lifestyles.

Considering the expansion of pay-for-performance measures (where physicians receive higher compensation from Medicare/Medicaid when their patients achieve certain health goals -such as improved blood sugar levels), being overweight or obese could reduce practice profit margins. If patients are less likely to follow advice from overweight or obese doctors, then it stands to reason that patients’ health outcomes could suffer along with the doctors’ income.

I’m certainly not suggesting that CMS monitor physician waist circumferences in an attempt to improve patient compliance with healthy lifestyle choices (Oh no, did I just give the bureaucrats a new regulatory idea?), but rather that physicians redouble their efforts to practice what they preach as part of a commitment to being good clinicians.

Some will say that the problem here is not expanding provider waistlines, but bias against the overweight and obese. While I agree that weight has little to do with intellectual competence, it does have to do with disease risk. Normalizing and destigmatizing unhealthiness is not the way to solve the weight bias problem. We know instinctively that carrying around a lot of extra pounds is damaging to our health. It’s important to show grace and kindness to one another as we join together on the same health journey – a struggle to make good lifestyle choices in a challenging environment that tempts us to eat poorly and cease exercising.

To doctors I say, let’s fight the good fight and model healthy behaviors to our patients. To patients I say, show grace to your doctors who carry extra pounds – don’t assume that they are less competent or knowledgeable because of a weight problem. And to thin, female, 30-something, Caucasian survey respondents I say – Wait till you hit menopause before you judge people who are overweight! ;-)

FDA Sends Warning Letters To California Surgical Centers For Misleading Advertising Of The Lap-Band

The U.S. Food and Drug Administration today announced that it has taken action against eight California surgical centers and the marketing firm 1-800-GET-THIN LLC, for misleading advertising of the Lap-Band, an FDA-approved device used for weight loss in obese adults. The FDA issued Warning Letters to Bakersfield Surgery Institute Inc.; Beverly Hills Surgery Center; Palmdale Ambulatory Center; Valley Surgical Center; Top Surgeons LLC; Valencia Ambulatory Center LLC; Cosmopolitan Plastic & Reconstructive Surgery; San Diego Ambulatory Center LLC; and to 1-800-GET-THIN because Lap-Band is a restricted medical device that is misbranded as a result of misleading advertising by these groups. In the letters, the FDA warns that billboards and advertising inserts used by recipients of the Warning Letters to promote the Lap-Band procedure fail to provide required risk information, including warnings, precautions, possible side effects and contraindications. The FDA also is concerned that the font size of information related to risks on the advertising inserts is too small to be read by consumers.

Source: fda.gov/NewsEvents/Newsroom/PressAnnouncements
/ucm283455.htm#.TueG3YY1aZY.facebook

We have blogged on 1-800-Get-Thin and Lap-band surgery in general before. Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Drug Shown To Protect Obese Mice From The Diseases Of Obesity

I usually choose not to write about the “new new scientific thing” that gets picked up by the press,  because early research is usually not reproducible and good science takes a long time to validate as true.  But since we know that mice and rats that are kept on low-calorie diets live 30% longer (and healthier) than their fat cohorts, I was interested in a new research compound, SRT-1720,  that was shown to protect obese mice from diseases of obesity.  Fat mice lived 44% longer if they were given this drug.

The “designer” drug works by Read more »

*This blog post was originally published at EverythingHealth*

XXXtreme Calories Dishes: What Not To Eat

It’s no secret that the U.S. has a weight problem and with chain restaurants serving up meals with thousands of calories in a single dish, it’s easy to understand why. Watch “CBS Doc Dot Com” to see which meals you should try to avoid — or at least share.


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The Epidemic Of Sedentary Behavior

“I never worry about action, but only about inaction.”  — Winston Churchill

Winston Churchill was right: Experts are saying sedentary behavior is an epidemic, with the resulting health effects potentially devastating.

Lack of muscular activity is associated with higher incidence of obesity, cardiovascular disease, diabetes and cancer, as well as a heightened risk of death. And this is regardless of one’s level of structured physical exercise, according to the authors of an article published [recently] in the British Journal of Sports Medicine.

The team from Stockholm, Sweden, says that sedentary behavior has become synonymous with lack of exercise, but that this is inaccurate and misleading. Rather, sedentary behavior should be defined as whole body muscular inactivity. Read more »

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