Saturday, November 7, 2009

How Bariatric Surgery Can Gain You Respect

A recent study from Johns Hopkins showed that doctors treat obese patients with less respect as compared to their non-obese patients:
Scientists reporting in the November issue of the Journal of General Internal Medicine say they found that the higher a patient’s body mass index (BMI), the less respect their doctors had for them.

Mary Margaret Huizinga, MD, MPH, of Johns Hopkins University School of Medicine and lead author of the study, says she came up with the idea for the research from her experiences working in a weight loss clinic.

She says that patients who'd visit would, by the time they left, “be in tears, saying 'no other physician talked with me like this before,'" and had failed to listen.

“Many patients felt like because they were overweight, they weren’t receiving the type of care other patients received,” she says in a news release.

She and colleagues looked at data on 238 patients and 40 physicians. The average BMI of the patients was 32.9.

A person with a BMI of 25 to 29.9 is considered overweight, and 30 or greater obese.

In the study, patients and physicians filled out questionnaires about a doctor’s visit. They were asked questions about their attitudes and perceptions of one another at the end of their encounter. Physicians were asked to rate the level of respect they had for each patient compared to “the average patient” on a 5-point scale.

The patients for whom doctors expressed low respect, on average, had a higher BMI than patients for whom the physicians had high respect, the researchers report. The researchers note that the findings don’t show a cause/effect relationship between BMI and physician respect. Their study also didn’t investigate patients’ health outcomes.
For more on this, Medscape: Doctors' Lack of Respect Weighs on the Obese.

Clearly, getting bariatric surgery will not only help directly in terms of disease burden but will also improve how you are perceived by health professionals and society at large. Ideally, doctors should treat all of their patients equally, with dignity and respect. However, doctors for better or worse are human as well. They have their own perceptions and biases, which can affect how they provide care in a detrimental manner. As this report indicates, being overweight can cause doctors to hold certain beliefs about their patients, in terms of the patient's attitude or commitment to change, leading the doctors to unconsciously change how they treat those patients.

Bariatric surgery can help change those perceptions. By helping patients who are unable to lose weight on their own get over the hump of weight loss, bariatric surgery can change the external morphology, or body shape, of a patient in a quick and dramatic manner. This change may alter perceptions by healthcare physicians, who may then be better able to look past their patient's weight in order to address other health issues. Instead of weight being a perceptual roadblock, bariatric surgery can help the patient-physician team on the right path to lifelong health.

Should doctors discriminate or disrespect overweight and obese patients? Of course not, but the reality is that it occurs. While obese patients may have sadly come to expect such callousness from the public at large, no one should have to endure disrespectful or suboptimal care at the hands of someone they place their trust in. A morbidly obese patient should be motivated to consider any options available, including weight loss surgery, to take control of their lives and commit to living healthily. Whether you choose lap band or gastric bypass or some other procedure, the important thing is that you have taken the first step in taking charge of your health and your life.

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