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Sunday, November 28, 2010

Are Fat People to "Blame"?

There is a current "conversation" among medical professionals about the increase in the number of obese patients, and the stress their size is putting on these professionals. Hospitals and other health care facilities are often not equipped to handle larger size people, and nurses and others feel the physical stress on them is unfair. The idea is these fat people "should just lose weight". After all, isn't it true that fat people are ALL unhealthy and should just eat less and exercise more?

NO, this is NOT always true. There are healthy overweight people, and unhealthy thin people. Being overweight is a risk factor for some chronic illnesses like heart disease and diabetes. It is NOT a guarantee that the overweight person will develop these illnesses.
Here is more on the topic of overweight people and the health care system, from my colleague, Ragan Chastain. See her website at www.danceswithfat.com.

It seems that this is predominantly a matter of "blame". Yes, health professionals might argue, it may be more difficult to work on the elderly or the immobile but they "can't help it". Doctors, nurses, aides and techs may feel justified in complaining about fat patients because they feel that they could "just lose weight". Regardless of the truth of that argument, patients are not treated in hypothetical land and the patient in front of you can't lose weight right now, so a real problem still exists.

I would suggest that the two most important issues here are medical professionals' safety, and patient safety and dignity. Therefore, it's not professionals against patients, it's professionals and patients against a problem and that problem is the fact that hospitals are not properly equipped to deal with the patients in front of them, and are therefore failing to provide an appropriate standard of care and dignity to those patients, and a safe work environment for their employees and contractors.

Rather than turning on each other, I would argue that health professionals and patients should join together and press the hospitals and treatment facilities for the things that they need - equipment, staffing etc. to care for the patients who they have. If patients of size are becoming an increasing issue then that simply speaks to the need to address the problem from the facility level.

As far as weight being a problem that health professionals have to address: My argument would be that even if it would solve the problem, there is nothing yet proven to achieve long term weight loss; and that heaping shame and blame upon people for whom you have no viable treatment option is irresponsible and highly unlikely to result in an outcome of greater health - physical or mental. Excuse the metaphor but it seems to me that the current practice of prescribing caloric restriction is the same as if Viagara were only successful 5% of the time but doctors kept prescribing it and blamed 95% of the guys for not trying hard enough. Not to be cliche but based on the evidence a Health at Every Size approach is much more responsible.

Are Fat People to Blame?

There is a current "conversation" among medical professionals about the increase in the number of obese patients, and the stress their size is putting on these professionals. Hospitals and other health care facilities are often not equipped to handle larger size people, and nurses and others feel the physical stress on them is unfair. The idea is these fat people "should just lose weight". After all, isn't it true that fat people are ALL unhealthy and should just eat less and exercise more?

NO, this is NOT always true. There are healthy overweight people, and unhealthy thin people. Being overweight is a risk factor for some chronic illnesses like heart disease and diabetes. It is NOT a guarantee that the overweight person will develop these illnesses.