Should Overweight Doctors Lose Weight?

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Given the epidemic of overweight and obesity in the United States (and elsewhere) and ever-rising health care costs, should overweight doctors be encouraged to lose weight? Would such a move by doctors prompt their overweight patients to make better efforts to do the same?

Despite the availability of thousands of diet books and diet plans, exercise programs, special diet foods, and television shows like “The Biggest Loser” that serve as inspiration for overweight viewers, more and more Americans continue to get larger and larger. Overweight and obesity is also a growing problem among young children and adolescents, which does not bode well for their health in the future.

It seems reasonable to ask healthcare professionals who are overweight to make lifestyle changes that would improve their overall health and thus also serve as role models for their overweight patients. In July 2009, Lord Darzi of Denham, a surgeon and health minister in the United Kingdom, told The Times that doctors and nurses who are overweight should be encouraged to make lifestyle changes as ambassadors for healthy living. He noted that “I would like to see more momentum pushing how we can get health and wellbeing for our own staff in the health service.” Great Britain has a Change4Life public health campaign that promotes good diet and exercise, but Lord Darzi wants to see more emphasis placed on doctors and nurses as ambassadors for healthy living.

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In the United States, the question about the responsibility of overweight doctors to serve as role models for their patients is not often discussed. In a presentation in 2006 by Michael Dansinger, MD, then obesity researcher at Tufts-New England Medical Center and currently assistant professor in the department of medicine, he noted that many doctors have a weight problem for the same reasons their patients do: poor diet and not enough exercise. He commented that “Physicians rally against obesity, and yet, we are not doing all we can.” He went on to say that “physicians who fail to recognize and treat obesity are often the ones who personally fail to heed lifestyle recommendations, and these doctors may sometimes lose credibility with their own patients.”

In response to Dr. Dansinger’s comments, Robert M. Centor, MD, associate dean for the Huntsville Regional Medical and Director for the Division of General Internal Medicine at the University of Alabama at Birmingham, noted that “How can we recommend lifestyle changes to our patients if we do not believe in those changes strongly enough to apply them to ourselves?” He added that expecting doctors to watch their weight and to exercise “may seem draconian,” but that providers who believe this is valid advice but who fail to act on it personally are “at best hypocritical and at worse disingenuous.”

Pennie Marchetti, MD, a family practice physician in Stow, Ohio, also responded to Dr. Dansinger’s presentation. She noted that “There’s no evidence that obese patients are any more compliant with recommendations given by fat doctors, but they may read less implicit condemnation in that advice than they do when it comes from a thinner doctor.” She noted that while she was not saying that doctors needed to be heavy to provide good care to overweight patients, “It’s just that being fit and slim does not automatically make one a better physician.”

Perhaps a more positive spin needs to be taken on the issue of overweight doctors and their patients. Losing weight is difficult, which is one major reason why many people seek help from friends, diet books, TV shows, and weight loss clinics. If overweight physicians can step into the picture and say to their overweight patients “Let’s try to lose weight together,” what harm can such mutual support cause? Some patients and physicians will lose weight; others will not. Perhaps some patients will respect their doctors more. Perhaps health care will improve. And what could be wrong with that?

SOURCES:
Medscape, “Are Overweight Doctors a Problem for the Profession?” Aug. 2, 2006
The Times, July 24, 2009

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