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Why Is Weight Gain Contagious? Monkey See, Monkey Do

Woman-on-scale-with-friends

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:

  1. 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.
  2. 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.
  3. 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*

For Shame: Physicians Deny Care To Those Who Are Obese And Pregnant

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*

Doctors Refuse To Treat Obese Patients in Florida

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*

Bariatric Bathrooms: Toilets Built For 500 Pound Patrons?

America’s handicap bathroom definition has officially left the train depot for the next station. In America, we are entitled to life, liberty and the pursuit of happiness.

Oh yeah, and bariatric rated bathrooms. I snapped this picture of a bariatric rated “handicap bathroom” at the hospital Mrs Happy delivered Zachary

A part of me feels for folks who struggle through life outside their home in search of a toilet adequate enough to do their thing. Bathrooms and toilets simply aren’t made to hold the weight or size of 300, 400 or 500 pound people and neither are the hospital toilets.

Part of me wants to believe these bariatric rated bathrooms are for the oversized pregnant women on the floor. But the rational side in me knows otherwise. America is fat. And we have the bariatric rated handicap bathrooms to prove it.

*This blog post was originally published at The Happy Hospitalist*

What Medical Condition Is The Most Costly To Employers?

Ok…here’s a brain teaser.  What medical condition is the most costly to employers?  I’ll give you a hint.  It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians.

If you guessed depression you are correct. If you mentioned obesity you get a gold star since that comes in right behind depression for both criteria…at least in terms of cost and the undiagnosed part.

Four out of every ten people at work or sitting in the doctor’s waiting room suffer from moderate to severe depression.  Prevalence rates for depression are highest among women and older patients with chronic conditions.  Yet despite its high prevalence and costly nature, depression is significantly under-diagnosed (<50%) and under-treated by physicians.

For employers, the cost of depression cost far exceeds the direct costs associated with its diagnosis and treatment    As the graphic above indicates, the cost of lost productivity for on the job depressed workers (Presenteeism) and lost time for depressed workers that are absent from the job (Absenteeism) far exceed the cost of cost of treatment (medical and medication cost).

Read more »

*This blog post was originally published at Mind The Gap*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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