Why Doctors Don’t Discuss Weight

Doctor giving comfort to patient

It’s not rocket science to know that obesity is not healthy, so why is it some doctors don’t discuss weight with their patients?

I am no doctor, but I have asked a few, along with other health care professionals, why it is doctors sometimes do not discuss weight with their patients. There are so many preventable ailments that are directly tied to our weight, this should be a topic of every doctor visit, but it’s not.

Again, why is it some doctors don’t discuss weight with their patients?

Doctor holding tape measure

You may have gotten away with being overweight or obese for several years without noticeable health issues in the present. Because your blood pressure has been good, you aren’t diabetic and are in otherwise good health, you probably do not see that your weight is really an issue to be concerned about. That is, until you receive a diagnosis of an ailment that could have been prevented if only your doctor had discussed your weight with you.

Should you be angry with yourself, or your doctor?

Would you have even listened to your doctor if you believed your health was good despite your weight?

             Research shows that doctors don’t always broach                     the topic with their patients.

In a study published in the Journal of Preventive Medicine, researchers looked at more than 600 visits to family practice offices where 68% of the adult patients were overweight or obese. They found that only 11% of the overweight or obese patients received weight loss counseling during these visits.

Doctors rarely talk about weight concerns with patients who are overweight or obese, and when they do, patients’ experiences tend to be negative. (1) Most often, doctors avoid the topic, because their patients feel stigmatized. I can vouch for this as I have a loved one who got furious when his doctor told them him that he needed to lose weight.

There are guidelines which recommend that doctors intervene when a patient is obese. But how many patients will abide by their advice?

I believe it is pretty obvious by todays obesity epidemic, most do not abide.

Some may not want to.

Others may feel as if they can’t.

And many don’t know how where to even begin.

Many doctors don’t discuss weight with their patients because it is pretty complicated for them to treat.

This is because it involves behavior, and medication, as well as managing medical conditions that come with obesity. When a patient can’t or won’t do anything about their weight, doctors will instead spend their time by treating the ailments that come from obesity. Ailments that are preventable such as type 2 diabetes, hypertension, and high cholesterol. These ailments are preventable because they are tied directly to your lifestyle and nutritional habits. Are you willing to change how you eat?

Many people feel their doctors “Fat Shame” them.

Let’s be real here. If your doctor brings up your weight, you have a problem. They are not fat shaming you, they actually do care about you. No one should tolerate disrespectful treatment or medical fat shaming. However, if your doctor made you feel ashamed for bringing up your weight, then it’s very likely you were already ashamed of yourself.

Just because you perceive your doctor’s words to be disrespectful or shaming, it does not make it so. It could be that they need to be quite serious in order to save your life from a weight or nutrition related ailment. If you are carb addicted, what are the chances you will change your habits based on passive, sugar coated advice? You and I both know, this is not too likely.

I read this in an article on Healthline:

Graue told Healthline that these pervasive biases within the medical community are a result of ingrained misinformation within educational and cultural structures.

“As doctors, we have been indoctrinated in a system in which weight bias is rampant,” she explained.

“We have been fed greatly biased and faulty research with the conviction that ‘science’ is true and neutral,” she pointed out.

“So, we have a heavy dose of biased, weight-centric science that does not make room for the social determinants of health, and a broader system’s perspective that allows for an intersectional lens or a view informed by social justice and trauma,” Graue said.

Graue believes in approaching the treatment of people of size as one would any other patient.

Still, there are times when weight must be addressed, particularly “when the patient brings up a concern related to their weight.”

At this point, medical practitioners have “a wonderful opportunity to dispel myths around equating weight with health, share some of the science that proves that focusing on weight is harmful, and shift the conversation, depending on the setting, to healing the relationship with food and body, and/or focusing on health and well-being-enhancing behaviors, always attuned to the patient’s needs and requests.”

People in larger bodies must demand that we be treated like any patient with a BMI within the “normal range” might be”. (2)

Could anything be more ludicrous?

Should one with cancer demand to be treated as if they do not have it?

Maybe cardiac patients should be advised to not worry about other things that might happen from their condition.

Does anyone seriously believe that everyone should be treated as being equally healthy and well even when they clearly are not? That kind of thinking is not helpful in the least. In fact, it is dangerous to the individual who has a weight problem.

Doctors don’t discuss weight all the time, but they should.

Obesity is almost always caused by consuming more calories than you burn off through physical activity. We know for certain these calories often come from fatty and sugary foods. When you consume more than you burn, the excess energy is stored by the body as fat. Obesity is an increasingly common problem because for many people modern living involves eating excessive amounts of cheap high-calorie food and spending a lot of time sitting down at desks, on sofas or in cars.

Obesity-related problems

Obesity can cause a number of further problems, including difficulties with daily activities and serious health conditions.

Day-to-day problems related to obesity include:

  • breathlessness
  • increased sweating
  • snoring
  • difficulty doing physical activity
  • often feeling very tired
  • joint and back pain
  • low confidence and self-esteem
  • feeling isolated

The psychological problems associated with being obese can also affect your relationships with family and friends, and may lead to depression.

Obesity can bring about serious health conditions

Being obese can also increase your risk of developing many potentially serious health conditions, including:

  • type 2 diabetes
  • high blood pressure
  • high cholesterol and atherosclerosis (where fatty deposits narrow your arteries), which can lead to coronary heart disease and stroke
  • asthma
  • metabolic syndrome, a combination of diabetes, high blood pressure and obesity
  • several types of cancer, including bowel cancer, breast cancer and womb cancer
  • gastro-esophageal reflux disease (GERD), where stomach acid leaks out of the stomach and into the gullet
  • gallstones
  • reduced fertility
  • osteoarthritis, a condition involving pain and stiffness in your joints
  • sleep apnea, a condition that causes interrupted breathing during sleep, which can lead to daytime sleepiness with an increased risk of road traffic accidents, as well as a greater risk of diabetes, high blood pressure and heart disease
  • liver disease and kidney disease
  • pregnancy complications, such as gestational diabetes or pre-eclampsia, when a woman experiences a potentially dangerous rise in blood pressure during pregnancy

Obesity reduces life expectancy by an average of 3 to 10 years, depending on how severe it is. Remember that your doctor’s job is to care for your health. Studies show that people who talk with their doctors about weight tend to have healthier habits. Your doctor can tailor a weight loss plan specifically for you. But individualized care starts with a conversation. This conversation might need to be up to you to start, since many doctors might not.

Childhood Obesity’s Effect on Bone and Joint Health


(1) Physicians Weekly

(2) Healthline.com

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