As I turned on the morning news the other day, the attention grabbing “teaser” headliner was about a physician in Shrewsbury, Massachusetts who refused to treat anyone weighing more than 200 pounds (link below). If you haven’t heard it, the recap is that an internal medicine physician has decided to reject all new patients weighing over 200 pounds. She indicates that her staff has been “hurt” by handling these heavier people (not sure what she means by this), and that those patients already in her practice and weighing 200 pounds were grandfathered in. She further notes that some of these grandfathered patients proceeded to lose weight after her office policy was implemented. The physician further states that there is an excellent university affiliated medical facility nearby which is much better suited to being able to handle very large patients. This scenario seems to beg the question, “is this a new trend in the medical profession?” Will the United States evolve to medically managed weight loss centers for all people classified as obese?
Mayor Bloomberg restricts soda pop, Michelle Obama encourages us to plant vegetable gardens, but what can individuals and society really do to take responsibility? This will become even more pressing of a concern to individuals if primary care physicians begin to refuse treating heavier patients on a wider scale. If those heavier people are required to find access to health care in settings equipped to handle their special needs, this could also potentially handicap the weight loss process even more-if possible. Right now, we are failing in managing our weight as a nation, just as we are failing at balancing our national budget. We did not come to this point because of one problem. We are a society that is not generally inclined to move: we stay inside for safety reasons (like dodging bullets), we sit in front of computers all day, we play video games rather than dodge ball, and we eat out constantly. While eating out is a great treat, doing so too often really insures your energy intake is too high which translates to weight gain. Unless you are training for a marathon or triathlon, you still need to critically manage your energy intake if you are going to manage your weight. All too often, those that workout regularly still forget the energy content (meaning calories) of the food they consume. So, again, what are some solutions?
I do not have a simple solution because there is not necessarily a simple solution to a laundry list of factors causing this national crisis. Our current societal complexities seem to set us up for obesity at this point. Both physicians and patients need to take responsibility for slimming down the nation. Apparently, it is perfectly legal for this physician to screen her patients according to weight limits. If this is her prerogative (and it’s her practice), she should make a point of offering some other options to her patients. While she was relying on a nearby medical facility affiliated with a teaching hospital, she and other physicians should have business cards of dietitians, therapists, and trainers and refer to those professionals! And, patients need to take responsibility as well. There is no magic solution here. The message to move more and eat less is perceived as “boring” by many. And to many, this simple message is not really simple. After all, how much should one really eat and move in order to both prevent and manage obesity?
What can we do as a nation? Please provide input to this question directly on my blog. I look forward to your comments.