Recently, I had a conversation with a friend about her weight. By medical definition she is obese, with a BMI above 30. She wonders what that really means. She has a healthier body image than most women I know, and with the exception of not fitting into J. Crew pants, doesn’t feel her weight hinders her in any way. Doctors will say, “Make sure you are watching your weight,” but they don’t actually tell her she is obese. She thinks they are afraid of hurting her feelings, just as her mom was when she was a kid.
She is right about the doctors being timid. Shame on us. She has also heard that BMI is an insurance company trick constructed to provide an excuse for denying coverage. She is wrong about that. Obese people have a much higher risk of becoming ill. We have a responsibility to our patients, and it is not to avoid offending them. It is our job to provide them with the information they need to make healthy choices. Obesity is not about appearance. It is about wellness. My friend is young and does not have any medical conditions. I also have friends who are healthy and smoke. I have no problem telling them, repeatedly, their increased risk of developing cancer and vascular disease. Why is there such hesitation to warn someone of the risks inherent in being overweight?
PC has no place in medicine. Of course, there are kind ways to approach difficult topics. If someone is overweight and fine with it, they shouldn’t be made to feel bad. Vogue and SlimFast have that covered. They should, though, know the risks associated with a high BMI so they can make educated choices. If someone is unhappy with their weight, taking the focus off aesthetics and putting it on health can be a great weight loss tool. Many people get frustrated very quickly when they don’t see results in the mirror. The knowledge that they are improving their health can be powerful.
Obesity increases your risk of:
1. Cardiac disease and vascular disease, stroke and hypertension.
2. Type 2 Diabetes which carries the risk of eye problems, neuropathy, infections, kidney and heart disease.
3. Joint and Back Problems including hip and knee pain, arthritis, and chronic low back pain.
4. Cancer, including breast, uterine, colon, kidney and esophageal.
5. Mental health problems, including depression, low self esteem and social isolation.
I applaud men and women who are happy with their bodies – in this appearance obsessed culture, that is a feat in and of itself. Being happy with the way you look (even if you are obese) will temper some of the psychiatric risk factors, but unfortunately, it will not protect you from the other health risks. I like the way I look much better when I am tan, but this does not negate my increased risk of developing skin cancer. There is a sign in my bar. It reads, “Eat, Drink and Be Fat and Drunk.” If only it were that easy.