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Doctor, Weigh Thyself

Posted by Dr. Suzanne Koven  March 21, 2012 04:05 AM

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doctor_scale_1.jpgAccording to an old joke, a patient drinks too much when he drinks more than his doctor does. Turns out that when it comes to weight, this standard is no joke.
A recent study in the journal Obesity found that overweight physicians are less likely to diagnose obesity or counsel overweight patients about their weight than their normal weight colleagues.

This summary in the New York Times highlights the key points of the study, in which nearly 500 primary care doctors were surveyed about their attitudes and behavior regarding patients' weight. Overweight and obese physicians were less confident in their ability to counsel obese patients about diet and exercise and less sure that such counseling had a beneficial effect than thinner doctors were.

I think that perhaps the most interesting finding in this study, though, is that more than half of the physicians surveyed were overweight or obese--in other words, at the same rate as the general population.

Does this statistic surprise you? That depends on your view of excess body weight.

If you see it as a medical condition, partially inherited, possibly related to addictive behavior, you'd expect doctors to be no less likely to be overweight or obese than anyone else. In fact, given the pressures of medical practice, and a prevalence of addiction to alcohol and drugs among physicians no less and possibly higher than in the general population, you might expect even more physicians to struggle with weight issues.

On the other hand, if you see weight as purely a result of lifestyle choices, you might think that doctors, who are more familiar than most people with the health consequences of obesity, would choose to follow a diet and exercise regimen that would help them maintain normal weight.

The truth, of course, lies somewhere between these two views. Doctors battle the same unfortunate genetics, sedentary hours staring at screens, and endless temptations to eat high-calorie foods as everyone else--and our knowledge about the unhealthy effects of excess weight doesn't always translate into action when it comes to our own diets and exercise.

But can a doctor who's overweight or obese effectively counsel patients about weight?

This recent study suggests that doctors themselves don't think so. Embarrassment or denial of their own weight issues or concern that they are poor role models may be inhibiting overweight and obese doctors from addressing diet and exercise with their patients.

I wonder, though, if these heavier doctors are missing an opportunity. Studies show that dietary counseling by physicians as it's currently practiced isn't particularly effective. Maybe doctors who are overweight or obese--a condition that's obvious to their patients anyway--should acknowledge how hard it is to lose weight--and how worthwhile the effort still is.

A little more frankness about what apparently feels, to some, like a taboo topic might help both doctor and patient.

This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About the author

Suzanne Koven, M.D. practices internal medicine at Massachusetts General Hospital in Boston. She writes a monthly column for the Globe's G Health section and her essays have appeared in the More »

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