December 28, 2018 09:33:57
Doctors lecturing overweight and obese patients with what is known as “the talk” could be causing poor care and delayed diagnoses, as the fear of stigma deters some from seeing their GP.
- One woman says she’s been constantly discriminated against for her weight, which does not reflect her healthy lifestyle
- Chronic disease doctors are pushing for wider recognition of obesity as a disease, not simply a moral dilemma
- Some patients deterred from seeing GPs after getting ‘the talk’ despite visiting for an unrelated issue
That is according to consumer advocates, who say “the talk” involves a doctor telling a patient they are overweight and explaining related risks.
Fiona Tito-Wheatland from the Australian National University said that process was often unnecessary and made overweight patients less likely to visit their GP, as they felt discriminated against.
She said some patients who were seeing their doctor for an unrelated issue would still receive “the talk”.
“Most people who are fat, know that,” she said.
“Often you won’t even get the help that you need or that you came for because the doctor will want to talk about your weight.
“It can be very painful and it can actually make it quite difficult for people to go to the doctor because they’re afraid they’re going to get ‘the talk’.”
Dr Tito-Wheatland had experienced that stigma firsthand, having been overweight since she was a small child.
“I’ve suffered discrimination all the way through my life,” she said.
“It’s that sort of perception … that I’m somehow less loving, less kind, less whatever.
“Whereas I think of myself as being a very kind and generous human being.”
Obesity treated as moral dilemma, not disease
The director of Chronic Disease Management at Canberra Health Services, Doctor Paul Dugdale, said stigma surrounding obesity could cause doctors to give poor treatment.
“For example, they might give advice about lifestyle, rather than treating the patient’s asthma,” Dr Dugdale said.
“It’s virtually the last disease that we think about morally rather than a disease process.”
The issue was the focus of a chronic disease symposium at the Canberra Hospital earlier this month, which brought together more than 100 health professionals and consumers.
Dr Dugdale said often obese patients had good eating habits and exercised often but struggled to move the weight.
He believed doctors sometimes overlooked that it was a disease.
“It’s the attitude that it’s the person’s own fault,” he said.
“We don’t believe it’s their fault if they have asthma, we don’t believe it’s their fault if they have high blood pressure but with obesity we often think the patient is at fault.
“We really have to look at ourselves as doctors and think how are we going to address the health risks that this patient faces, rather than think about them as lazy or as not eating well.”
‘Weight doesn’t equal laziness’
Dr Tito-Wheatland said she walked 5 kilometres each day and her behaviours, not her weight, reflected her health.
“I just say to everyone ‘okay hang around with me for a day and see how lazy I am’,” she said.
But she said the current “obesogenic environment” — with its easy access to food and transport — meant people had to try something different to keep healthy.
“I’m just busy and enjoying life,” she said.
“I think for a long time I felt that wasn’t my right. Then I started to understand that I could still claim a full life, even though I took up more space than some people.”