Obesity and Iatrophobia

Doctors and other medical professionals make tremendous sacrifices and devote years of their lives to learning the necessary skills, to achieve the credentials they seek in order to serve humanity. And yet they often “miss the boat” when it comes to dealing with patients who are obese or headed toward obesity. Too often, the result is that patients stay away from the very people who are ostensibly there to help them.

Sometimes, all it takes is one traumatic experience to turn a person off for years, to the point where they will put up with any amount of pain and dysfunction rather than make an appointment to strip down and put on an exam gown. For Tracey Folly, the first painful incident in her youth was not even the doctor’s direct fault, but an adjacent complication.

The first person to officially label her obese was a pediatrician who referred her out for testing, to see if her thyroid was in good working order. When the lab bill came, her mother was understandably upset by the expense, and of course, a child feels guilt for contributing to the family’s financial burden. But the insurance company was adamant, because “obesity is not a disease.”

Once burned, twice shy

For that and other reasons, as soon as she reached 18, Folly took advantage of her adult status to swear off annual checkups for many years. When romance entered her life, she went to see about contraception. The exam started, reasonably enough, with a pap smear. This procedure brought on a truly phobic reaction of “complete and total breakdown during the examination… crying, screaming, and hyperventilating.”

Documenting a patient’s vital signs is important, and the alert follower of Childhood Obesity News will recall, from yesterday’s post, how another writer advises putting off the blood pressure reading until the end of the visit, when the patient has had a chance to calm down. But in Folly’s case, on that particular occasion, after a 24-carat panic attack, it was the exact wrong thing to do:

[S]ince they didn’t check my blood pressure reading until after the exam, the nurse practitioner declined to give me birth control pills, which were the one and only reason I had subjected myself to such humiliation and torture in the first place.

Of course, this resulted in her adopting less reliable methods, which could have led to an unplanned pregnancy that would have created a whole new set of problems. The boyfriend situation was already precarious and anxiety-producing, since he was of the controlling type and liked to keep a tight rein on every aspect of his girlfriend’s life, except, oddly enough, her eating habits. All the resulting recent stress had been channeled into even more pervasive food abuse, and a 50-pound weight gain. Clearly, the needs of this vulnerable young woman came nowhere close to being met.

Your responses and feedback are welcome!

Source: “What My Doctor Doesn’t Know About My Obesity,” Medium.com, 02/26/20
Image by Jeff Eaton/CC BY-SA 2.0

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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