RP101 – Obesity (June 2017)



Session Readings

 

Background

The incidence of obesity has been steadily climbing, with the most recent report from the CDC showing that over 35% of adults and 18% of children in the United States are obese.  This is also a known readiness issue for the military, as demonstrated in the chart below (and this is only for those who are seen for a visit and are diagnosed as being obese):

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To date, despite efforts on multiple fronts, treatment strategies to help people maintain a “healthy” BMI and decrease their risk for co-morbid illnesses has been largely unsuccessful, and in some cases, counter-productive.   While obesity is known to be a complicated, multifactorial disease, this recognition has not translated into a generally compassionate view of those who are obese.  In fact, lay people and medical personnel alike often demonstrate in their words and deeds a strong bias against those who are obese, affecting the way they interact with, diagnose, and treat patients who are obese.  As Dr. Simon Auster astutely pointed out during this session in 2012, “Obesity is [one of] the last socially acceptable prejudices in this country.”

This session offers each of us the opportunity to reflect on our own reactions to obesity and those who are obese and to examine our biases and assumptions and how they might impact how we care for our patients.


Panelists:

  1. Dr. Jessica Servey, Col (ret), USAF, is the Associate Dean for Faculty Development at the F. Edward Hebert School of Medicine and an Associate Professor in the Department of Family Medicine.  Her experience includes services both stateside and overseas in both clinical and academic roles.
  2. Schadaq Torres, LCDR, USN, is a Class of 2018 Graduate School of Nursing Student at the Uniformed Services University. She is currently completing Phase II of her DNP program at Naval Hospital Bremerton.
  3. Dr. Bennett Solberg, LCDR (ret), USN, is a Project Manager at the Center for Medicare and Medicaid Innovation.  He has three masters degrees and a PhD in health sciences. He is a former USU Professor of Preventive Medicine and Biometrics.

Assignment (R.S.I.P. paper)

  • Reaction: Identify 2 or more reactions to panelists and 1 or more reaction to the supplemental materials as they pertain to the topic of obesity. Write your reaction as a single word or phrase followed by the trigger from the panel or resource to which you had that reaction.
  • Sources: For each of your reactions, identify the sources of that reaction.  Be specific when identifying these sources, describing the experiences that formed your personal context. Note: Many find that the most effective way to do this is to reflect on experiences sequentially through your life – starting with the norms and lessons you learned in your family of origin and the community in which you grew up, then those you had in your teenage years, and then those in your adult lifetime.  In most cases, we have a number of sources for a given reaction.  For this session, sources may include:
    • your own experiences with those who are obese
    • your beliefs about the causes of and treatment for obesity
    • your beliefs and values regarding living with obesity
    • the assumptions you have about the motivations of those who are obese.
    • how you perceive obesity to be viewed in the family/community in which you grew up
    • how you perceive obesity to be viewed in the medical and/or military community
  • Implications: For each of your reactions, analyze the positive and negative implications of your reactions for patient care – how might they impact the care you deliver to your patients?
  • Plan: Develop a plan that you can implement now that will allow you to enhance the positive and mitigate the negative implications of your reactions.  The plan does not need to be grandiose – it simply needs to be an actionable plan that you can implement in the next week.  As you develop this plan, consider the sources of your reactions (your personal context) and why that plan is likely to work for you.
this american life logoTell Me I'm Fat Let's change our perspective on how we view being fat.
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Project ImplicitProject Implicit A series of implicit association tests that offer insight into our implicit biases.
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medium_logo_detailThe Easiest Way to Lose 125 Pounds Is to Gain 175 Pounds Gain insight into one man's path to weightloss, and better understand the challenges, struggles, and barriers - psychologically and physically - to make this journey a success.
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ESPNYou Can’t Quit Cold Turkey by Tommy Tomlinson Jared Lorenzen set the record for passing touchdowns at the University of Kentucky and later won a Super Bowl ring with the New York Giants. His last stop was with the Western Kentucky River Monsters, where at well over 320 pounds, he played quarterback. In this story and video, he shares his perspective on his challenges with weight.
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The Problem with Skinny Shaming A look at the difference between the bias against people who are "too skinny" vs those who are obese. They are not the same thing.
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academic-medicine-logoAre medical students aware of their anti-obesity bias? Medical students have a significant implicit anti-fat bias and two-thirds of those with this bias are unaware it exists. How might this impact the care they, and others in the healthcare community, deliver?
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YouTubeStory Time – What’s it Like Being So Fat? Synopsis: People ask me questions related to my size all of the time. So I thought I could answer them here in this story time video, talking about my personal experiences of a lifetime struggling with obesity.
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Session originally created by: Adam Saperstein | SOM/GSN, Uniformed Services University | Director, Reflective Practice | Family Medicine