Saturday, January 30, 2010

Obesity is Unhealthy : For Reasons You Might Not Think

A recent report on revealed an unpleasant truth in medicine, but one I've known about for years. It's shocking, but it's true: Being a woman who's more than 20pounds overweight may actually hike your risk of getting poor medical treatment. In fact, weighing too much can have surprising -- and devastating -- health repercussions beyond the usual diabetes and heart-health concerns you've heard about for years.

According ther the article, studies have found that if you are an overweight woman you:

• May have a harder time getting health insurance or have to pay higher premiums

• Are at higher risk of being misdiagnosed
• Are less likely to find a fertility doctor who will help you get pregnant

• Are less likely to have cancer detected early

Fat discrimination or obesity bias is part of the problem. A recent Yale study suggested that this bias can start when a woman is as little as 13 pounds over her highest healthy weight.

Our culture has enormous negativity toward overweight people, and doctors aren't immune. Dr. Jerome Groopman, a Harvard Medical School professor and author states "Our culture has enormous negativity toward overweight people, and doctors aren't immune," He is author of a book called "How Doctors Think." "If doctors have negative feelings toward patients, they're more dismissive, they're less patient, and it can cloud their judgment, making them prone to diagnostic errors."

With nearly 70 million American women who are considered overweight, the implications of this new information is disturbing.

When Jen Seelaus, from Danbury, Connecticut, went to her doc's office because she was wheezing, she expected to get her asthma medication tweaked. Instead, she was told she'd feel better if she'd just lose some weight. "I didn't go to be lectured about my weight. I was there because I couldn't breathe," says the 5-foot-3, 195-pound woman. "Asthma can be dangerous if it gets out of control, and the nurse practitioner totally ignored that because of my weight."

Seelaus's nurse made a classic diagnostic error, according to Groopman. "It's called attribution, because your thinking is colored by a stereotype and you attribute the entire clinical picture to that stereo­type. Because obesity can cause so many health problems, it's very easy to blame a variety of complaints, from knee pain to breathing troubles, on a patient's weight. That's why doctors -- and patients -- need to constantly ask, 'What else could this be?' "

There aren't statistics on how many diagnostic errors are due to weight, but the data for the general population is disturbing enough. Researchers at Rice University and the University of Texas School of Public Health in Houston found that as patient BMI increased, doctors reported liking their jobs less and having less patience and desire to help the patient.

Whether they know it or not, doctors' attitudes may actually encourage unhealthy behavior.

Feeling dissed about their weight can make some women turn to food for comfort. "Stigma is a form of stress, and many obese women cope by eating or refusing to diet," Puhl says. "So weight bias could actually fuel obesity."

Studies have also found that overweight women are more likely to delay doctors' appointments and preventive care, including screenings for cancer, because they don't want to face criticism. "It can be frustrating to treat obese patients," admits Dr. Lee Green, M.D., M.P.H., a professor of family medicine at the University of Michigan in Ann Arbor. "I spend most of my time treating the consequences of unhealthy lifestyles instead of actual illnesses.

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