Background
The incidence of obesity has been steadily climbing, with the most recent report from the CDC showing that over 39% of adults and 19% of children in the United States are obese. This is also a known readiness issue for the military, as demonstrated in the charts below:
To date, despite efforts on multiple fronts, treatment strategies to help people maintain a “healthy” Body Mass Index (BMI, a measure of weight for a given height) and decrease their risk for various associated illnesses has been largely unsuccessful, and in some cases, counter-productive. Meanwhile, a hyperintense focus on weight and body image pushes some to more extreme dieting or exercise measures, resulting in extreme weight loss or fluctuating weight patterns which may pose long-term consequences that we don’t yet fully understand.
While obesity is known to be a complicated, multifactorial disease, both laypeople and medical personnel alike often demonstrate, in words and deeds, a strong bias against those who are obese. In the medical setting, this undoubtedly affects the way we interact with, diagnose, and treat patients who are obese. As Dr. Simon Auster astutely points out, “Obesity is [one of] the last socially acceptable prejudices in this country.” Conversely, clinicians often see patients struggling with being underweight as people deserving of their help, concern, and protection.
This session offers each of us the opportunity to reflect on our own reactions to an individual’s body mass index, and to examine our biases and assumptions and how they might impact how we care for future patients.
Assignment: Prior to the small group discussion, bring notes that address the following:
- What are your reactions when you encounter someone who is overweight or obese. To what extent do the following impact that reaction:
- the cause of their obesity
- co-morbid health conditions
- the age and/or socioeconomic status of the individual
- personal relationship of the individual to you
- What are the sources of those reactions? These sources may include:
- your own experiences with those who struggle with weight
- your beliefs about the causes of and treatment for obesity
- your own emotions related to food, eating, and exercising
- the assumptions you have about the motivations of those who are obese, or who struggle with disorder eating.
- 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.
- Identify how those reactions might influence, both positively and negatively, your care of a patient who is obese or struggling with weight.
- Reflect on what you’ve learned about yourself in this process, and consider future actions around enhancing the positive and mitigating the negative implications of your reaction(s).
