June 7th, 2011 by Lucy Hornstein, M.D. in True Stories
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Say you’re a bariatric surgeon. You’d think Americans would be beating a path to your door. After all, this is the land of Instant Gratification! Who wants to just eat less for the better part of a year to lose 50 lbs when one can be cut open and have one’s gastrointestinal anatomy rearranged — resulting in the necessity of eating less, but why quibble — to lose that same 50 lbs (or more)? Changing lifestyles is boring; surgery is exciting!
Funny how it turns out that in order for the surgery to succeed long-term, patients have to commit to lifestyle changes anyway. In fact, before any reputable bariatric surgeon will operate, patients have to demonstrate their dietary commitment by actually losing some weight on their own, prior to surgery. What I don’t understand is why people then go ahead with the damn surgery anyway? Logically, it’s almost like you have to prove you don’t need it before you can have it. Hey, I’ve never said I understand people.
Perhaps overcoming this paradox is the explanation for the behavior of a certain bariatric surgeon, brought to my attention by a mutual patient. Read more »
*This blog post was originally published at Musings of a Dinosaur*
June 5th, 2011 by Dr. Val Jones in Opinion
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I just learned (yes, I’m a little late to the party) about the Body Shop anti-barbie controversy from a post on Facebook. The ad to the left has been banned from most countries, because it was believed to be in bad taste. For me, it raises some very interesting questions.
First of all, it’s been my experience that the media has been relentless in its portrayal of feminine beauty as being a dress size zero. This is an unattainable goal for most of us, and a very narrow view of what is truly attractive and physically healthy. I can’t imagine how many young girls feel deeply flawed when they compare themselves to Barbie et al. If unchecked, that self-doubt and insecurity can become a lifelong self-esteem issue or worse. Eating disorders are becoming more and more common, and carry with them the highest mortality rate of any mental illness.
That being said, I’ve often had mixed feelings about the few “love your body as it is” campaigns* that have tried to push back against the rail-thin ideal. While we all have different body types, it’s still not healthy to be obese. Just as our favorite pets are born with different natural shapes (Chihuahuas, Whippets, Golden Retrievers, and Great Danes), we humans are different sizes too. But that doesn’t mean it’s “ok” to be excessively fat. Read more »
May 31st, 2011 by admin in Health Tips, Research
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One of the big health news stories of 2007 was a study showing that your friends influence the size of your waist (and the rest of your body). Like any study, it raised as many questions as it answered, including why this happens. A new study from Arizona State University looked into that question by testing three pathways by which friends might influence one another’s body size:
- Collaboration. Over time, you might start to share the ideas of the people close to you after talking with them about what the proper body size is. Then you might choose your food and exercise habits in order to reach that body size, whether that means eating more food to look like your plus-sized friends, or less food to look like your thin ones.
- Peer pressure. You feel bullied into trying to look like your friends and family members. They make you feel bad about your body, so you go about eating and exercising to look like them.
- Monkey see, monkey do. You change your habits to mirror those of your friends without necessarily thinking or talking about an ideal body weight. Alexandra Brewis Slade, PhD, one of the Arizona State researchers, gave an example of this pathway that most of us can relate to: You’re at a restaurant with friends and the waiter brings over the dessert menu. Everyone else decides not to order anything, so you pass, too, even though you were dying for a piece of chocolate mousse cake.
All three of these pathways are based on the idea that loved ones share social norms, the implicit cultural beliefs that make some things okay, others not. Read more »
*This blog post was originally published at Harvard Health Blog*
May 31st, 2011 by Linda Burke-Galloway, M.D. in Opinion
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How does one teach compassion? Either you have it or you don’t. A recent article in the Los Angeles Times made me cringe. In South Florida, fifteen ob-gyn practices out of 105 polled said that would not take care of a pregnant woman who weighed more than 200 to 250 pounds. The article goes on to describe two ob-gyn business partners who cited malpractice issues and fear of being sued as a reason for excluding obese women in their practice. So, what’s next? Will pregnant women be denied access to care based on bank accounts or zip codes? Where their children attend school? Whether they own a pet? Where do we draw the proverbial line?
One of my most frustrated moments in clinical practice was dealing with an imaging center who had cancelled my patient’s ultrasound procedure because they were “afraid she was going to break their table.” The patient was excited about her first pregnancy and wanted to do everything in her power to have a healthy baby. The first time I met her, she was almost apologetic about her weight. Most obese patients are. My staff had to locate an imaging center that was not only willing to accept the patient but her Medicaid insurance as well. No one should not have to endure that level of humiliation.
Whether we like it or not, Americans are obese and as physicians, we have done very little to reverse that process. I learned more about nutrition from Weight Watchers® then I did in medical school. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
May 17th, 2011 by John Di Saia, M.D. in Opinion
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In a nation with 93 million obese people, a few ob-gyn doctors in South Florida now refuse to see otherwise healthy women solely because they are overweight. Fifteen obstetrics-gynecology practices out of 105 polled by the Sun Sentinel said they have set weight cut-offs for new patients starting at 200 pounds or based on measures of obesity — and turn down women who are heavier. Some of the doctors said the main reason was their exam tables or other equipment can’t handle people over a certain weight. But at least six said they were trying to avoid obese patients because they have a higher risk of complications.
Source: visiontoamerica.org/719/report-doctors-refusing-to-treat-overweight-patients/
While I have not specifically “refused to treat” obese patients, I have in a few cases recommended against surgery or recommended weight loss and re-evaluation later. Than again I am not in primary care and do understand what these OB/GYNs are saying. Obese patients do represent more risk when it comes to surgery and that would of course cover pregnancy and child bearing.
Take into account that Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
