Do Some Doctors Make Lame Excuses for Childhood Obesity?

Scottish health centre waiting area, June 2012

Lately, Childhood Obesity News has had doctors on its mind. Many medical professionals seem to feel stuck between a rock and a hard place. To prevent or recover from obesity, patients need more help, and doctors know this. Yet they feel inadequately prepared to offer such help. If, as medical students, they did receive a little training on the subject, it would have been the same old “diet and exercise” formula.

And the advice about a healthful diet is easy to forget. Case in point: The picture on this page is titled “Scottish health centre waiting area.” And its subtitle is “June 2012.” In other words, after years and years of efforts to raise awareness of the childhood obesity issues, the professional waiting room is stocked with a junk food vending machine, looking all dark and eerie and alluring.

The more nuanced thinkers realize that the obesity epidemic might not be so easily summarized, and understand that there might be more to it than meets the eye. Even they don’t know where to turn. Or if they do, it might mean they turn toward a theory that sounds nonsensical to the medical establishment.

For instance, take the idea that food can be addictive. To some, that is weird enough on its own. Then consider how the “hooking” of a person can be achieved in multiple ways. In one scenario the food itself, a substance containing sugar, fat, etc., can light up the brain just like cocaine. In another scenario, the motion of conveying popcorn from the bucket to the mouth can be a Body Focused Repetitive Behavior. It’s just something to do, to displace bad feelings, and the fact that calories are involved is almost irrelevant.

We saw how some choosey obstetricians/gynecologists in Florida are refusing to take on overweight patients, be they pregnant or no. According to reporter Bob LaMendola, the reasons given by these doctors are that “they are not experts in obesity” and “don’t want to begin seeing heavy women and then have to send them to specialists if they later develop problems.”

Oh, really?

With all due respect to the reluctant doctors, this could be interpreted as a lame excuse. General practitioners refer patients to specialists. It’s what they do. Even specialists refer patients to other specialists, every day of the week. Indeed, omitting to send a patient along to the right specialist could result in a lawsuit down the road. Eliminating some category of patient from the pool is the worst possible remedy for that problem.

LaMendola writes:

So far, the weight cutoffs have been enacted only by South Florida ob-gyns, who have long complained of high numbers of lawsuits after difficult births and high rates for medical-malpractice insurance. More than half go without coverage… Doctors also are allowed to drop patients, if they believe they lack the medical skills to properly treat them. They must send notices and refer them to other doctors.

See? They end up making a referral anyway, but sooner rather than later. Another reason, perhaps the most incontestable one, is sheerly pragmatic. Western medicine relies increasingly on such mechanical techniques as ultrasound imaging, and the machine doesn’t work so well through layers of fat.

Your responses and feedback are welcome!

Source: “Some ob-gyns in South Florida turn away overweight women,” Sun-Sentinel.com, 05/16/11
Image by Neate Photos (Greg Neate).

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