A doctor is in trouble because he told a fat woman she was obese and the patient took offense
“He said he tells obese women they most likely will outlive an obese spouse and will have a difficult time establishing a new relationship because studies show most males are completely negative to obese women.
Bennett said he tells them their obesity will lead to high blood pressure, diabetes, heart disease, gastroesophageal reflux and stroke.
One patient who Bennett had seen five or six times took offense at the lecture and filed a complaint against Bennett about a year ago with the New Hampshire Board of Medicine.
Bennett says his former patient filed the complaint because ‘I told a fat woman she was obese. I tried to get her attention. I told her you need to get on a program, join a group of like-minded people and peel off the weight that is going to kill you.’
He said he had discussed her obesity before with the woman, but she continued to put on weight, becoming diabetic with gastroesophageal reflux and chest pains.”
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{ 34 comments }
If that is all there is to it, the complaint ought to be dismissed straightaway with prejudice. (I think the story will play out a little, it is too newsworthy.) That patient deserved to be admonished. Anything less would be a failure to warn the patient of grievious consequences of morbid obesity. And the social consequences are minor compared to the consequences of diabetes, hypertension and joint disease. He should have also told he that she was likely to have poorer opportunities for job promotion, and worse chances at job retention and re-hiring. Employers can’t easily fire people with serious medical problems, but they can avoid hiring those they think will have problems, and fat people have a condition they can’t easily disguise. And the EEOC doesn’t treat fatness as a handicap; if employers can dismiss smokers, they can refuse to hire the obese, too.
It sounds like this patient simply can’t handle the truth. Too bad she can’t appreciate having a doctor who is unwilling to hide it from her.
It sounds as if the NH Board lacks a backbone, or is so collectively stupid that it can’t do its job properly.
Doctors generally have no business advising patients about who will find them attractive or hire them.
He could not be wrong to tell her that obesity is a health hazard and to outline the serious medical conditions that accompany and/or result from obesity.
Its clear, however, there is more to the story ( by his own admission), and it probably wasn’t the advice about medical consequences of obesity which resulted in the complaint.
He admits getting personal and getting into matters that weren’t of his concern. A physician should not broach, without invitation form a patient, how desirable men are likely to find a fat woman if her spouse croaks. That is none of his concern and none of his business and may or may not apply to that specific female.
What constitutes berating and bullying is subjective, but his manner and tone may have been offensive and inappropriate.
Telling her she is travelling down a dangerous road and that there are specific medical consequences to obesity – that is one thing. It is advice that can be dispensed without bullying and personal remarks.
A harsh, severe, judging tone that indicates disgust towards a patient struggling with weight is not helpful or appropriate.
Even fat patients deserve to be treated with some dignity.
“informing” them that men will find them disgusting is outside the scope of a proper lecture on the need to maintain weight for good health, and also rather useless affront to dignity. (As if any woman isn’t aware that appearance affects their desirability!)
Well, your advice runs against most medical training to address the bio-psycho-social components of treatment, particularly mental disease. So you are flat wrong, there. Doctors have every right and a responsibility to remind neglectful patients of the consequences of their neglect. The patients may not like it–no one says they have to–but that is another issue. As a physician, I do not have to feed my patient’s denial.
I absolutely agree with “120 lbs” — same thing happened to my mother, who was in ill health not as a result of overweight, but who was mildly overweight as she grew older. A ‘helpful’ doctor chastised her about her weight, was rude to her, and generally made her feel so worthless that she just wanted to crawl into a hole. It did not help her deal with anything at all. The doctor was totally so ineffective in his approach that it was even counterproductive.
So you docs jumping to the defense of the rude MD, rethink. Whether a complaint was in order is another question, but the man doesn’t seem to understand or perhaps listen. Maybe the complaint will get his attention.
That’s right, tell her only what doesn’t make her feel bad, because that’s more important, isn’t it, less “counterproductive” as you assume. Never mind the truth, or telling patients things they don’t want to hear, and heaven forbid anyone with professional training should ever come off to someone as an “authority”; that would be intolerable. The shock of that kind of encounter is enough to make anyone run for the pork rinds.
What amazes me is why people who think as the poster above does even bother with doctors. What a waste of time and money! And heaven forbid that you might encounter a professional with more insight into your behavioral problems than you have. That is just intolerable.
I suspect no one, not even the complainant who “got the doctor in trouble”, thinks doctors should withold medical advice about the consequences of obesity, or fail to speak with authority on the subject.
Doctors do have every right and a responsibility to remind neglectful patients of the health consequences of their neglect.
It is obviously possible to do so without offering unsolicited appraisals of a female’s dating prospects upon the (unsolicited prediction of the) death of her
spouse.
“Men will find you disgusting” is not appropriate medical counsel to an obese patient.
Lots of men find woman who smoke sexy. Using Lanier’s “vioxx-like” reverse reasoning, you should be able to sue your doctor if he tells you to stop smoking.
By the way, extremely obese woman are more likely to have difficulties at childbirth due to the extra weight. But that’s the OB’s fault, right?
“Men will find you disgusting” is not appropriate medical counsel to an obese patient.
If that kind of appraisal is the only thing that will motivate an intractable overeater to do something positive to lose weight and avoid the morbidity and early mortality of obesity, then I don’t agree with you. How we perceive what others think of us is a powerful motivator of human behavior, for good and bad. I do not think doctors should ignore this truth.
The entire advertising industry pitching products to enable our culture’s sloth and gluttony sure make use of this. Why go to the fight one-armed?
Very nice blog! We’re going to link to you from http://www.WhatsNewInHealth.blogspot.com.
Dear Anonymous 1151:
There are productive ways to tell people ‘home truths’ and there are counterproductive ways. Clearly YOUR mother never taught YOU that. Flunk Childhood AND Bedside Manner 101, did we?
I think that it is improper for a doctor to say whatever they think will motivate a patient. Should we tell patients that cigarettes will make you dumb and have mutant babies? Tell people the facts, don’t embelish. Personal subjective insults are not appropriate. However, does this merit filing a “complaint?” Why not just find another doctor? Is it really the job of the board to discipline a doctor for being an asshole?
“There are productive ways to tell people ‘home truths’ and there are counterproductive ways. Clearly YOUR mother never taught YOU that. Flunk Childhood AND Bedside Manner 101, did we?”
Anon. 1130, chill out. This is not a clinical examination room. This is not an online consultation service. You are not receiving medical advice as a patient here. This is not a “bedside”, yours or anyone else’s, and it is not an analyst’s couch for the examination of anyone’s “childhood” . This is a response thread on a blog page to a posting about a news story. Please engage in a little reality testing.
Flaming another poster, suggesting you know anything of the person, of of that person’s parenting, professional behavior, or any other aspect of that person’s life only makes you look like a shrill and irrational person, incapable of constructing a reasoned argument. If you had a point to make, your methods undermined it.
If you disagree, say so. If you can construct a reasoned response, do so. Advocacy of contrary positions is permitted in rational discourse. Devil’s advocacy is permitted, too. Ad hominem replies of the kind you made only make a reader wonder whether you are simply unable to come up with anything more reasoned. Is that true?
I’m not sure saying men will find you disgusting is such a bad thing to say at all. First off, it’s very likely to be true. Second, it’s doubtful the woman doesn’t know the major health risks of obesity already and clearly it hasn’t motivated her. Maybe telling her she’ll be unattractive to men might work. She obviously needs a good kick in the pants.
Complaining to the board will accomplish nothing, which is fine since nothing should be done in the first place. If the woman is so sensitive about her obesity a more mature and productive response would have been to decide to do something about her weight problem, rather than shooting the messenger.
Let me get this straight? Was she seeing him as a doctor or a dating consultant? He was way out of bounds in his statements to her.
Take it from an opposite point of view. He decided to “shock her vanity” as a way to convince her to lose weight. He tells her she will likely outlive her obese husband, and then remain without a partner because men will find her disgusting. What if this woman had two lovers on the side, as well as the obese husband…does she then dismiss the doctor as fraudulent because he is wrong?
Is the doctor an expert on what ALL men find disgusting? He should have stuck to what he knew and not moved into conjecture. He should have stuck to the medical facts that obesity causes “XYZ” diseases. Telling her it would affect her love life is NOT a medical fact. It is simply his prejudice, and was inappropriate.
Most men find big busted women more attractive. Does this doctor tell his patients facing mastectomy that men will find them disgusting?
The recommendation was that this doctor should take a course in communication, not that he should lose his license. Obviously he has a communication problem. The problem was, he had to admit he had a communication problem to resolve this. He was offended by this. Imagine that. Being offended by what someone recommends.
Hard to take that blunt medicine doc?
Oh brother.
He probably would have saved himself a whole lot of grief by just discharging this lady for woeful noncompliance. The clumsy effort to persuade by offering speculation about her future–all of which may be likely to happen, BTW–is likely futile, even if well-intentioned. Maybe to direct her to the nearest bariatric clinic, a dietary counselor and a physicians referral service is all she deserves. No physician is required to maintain a professional relaionship when the patient ignores sound advice and expects only to be told things they want to hear.
I sure wouldn’t want this patient in my practice.
You know what? Fat people are worthy of respectful treatment too. I’m so tired of the dismissive attitudes of medical professionals toward us.
The automatic assumption of lazy, slovenly behavior seems to give some the brazen audacity to forget human compassion and courtesy. The disdain I read in some of these comments SICKENS me.
Had I walked into a doctor’s office with an issue concerning weight loss – my weight being dangerously low, my inability to gain – I ASSURE you that doctor would take the issue seriously and test for underlying treatable causes. Not so with obesity. There is an automatic assumption of fault and with it comes judgement and dismissal.
Anyone else think perhaps these kinds of lawsuits are at least in part to blame for the insanely high cost of medical care in this country? I mean, if calling an obese woman obese is offensive, what exactly constitute being sensitive? Should we all go around and lie that being obese is okay? Do most people actually think obesity is not a problem in this country?
I am not defending anyone’s action here, but let’s face it, was the problem so bad that she needed to file a lawsuit? How often do people file a lawsuit for being insulted or offended? If you went to the local gym, and was called fat by trainer or clerk, would you sue that person too? If some kid came along and commented how big you were, and you were offended by it, would you sue the kid’s parents? If you were to rent a car, and because of your size, you cannot get in the economy cars comfortably, would you sue the rental company for not accomodating your needs?
When will obese people get off their high chair and realize that the rest of tax payers should not have to subsidize for the problems arising due to their obesity (in not just the higher medical cost that obese population will inconcur but to subsidize them in product costs for all the lawsuits and to pay for the wasted legal system – the judges, clerks, rent on the build, maintainance on the court, security, etc,etc)?
There are some people who’s weight gain is due to medical conditions. But the vast majority of the obese people are big because what they eat is more than what they burn. Do you realize how much carolies are in a bag of chips? In your latte? In a can of soda? In your “salad” with cheese and tons of that greasy dressing?
You want to get fat, remain fat, and die fat? That’s just fine by me. But don’t go around wasting resource (medical, legal, and otherwise) that are subsdized by all tax payers if you don’t want to at least face the fact that being fat is a problem and you need to do something to address the problem.
5′7″ 250lbs is obese. Maybe she wouldn’t have to go see the doctor as often if she went to the gym once and a while or skipped all the doughnuts. I think the doctor is absolutely correct our society is slowly becoming fatter and fatter, someone should try to put a stop to it why not our doctors…
For everyone who thinks the doctor should be reprimanded or needs to take a course on sensitivity or communication… How about the woman simply find another doctor?
Absolutely I agree with the doctor! What’s the matter with New Hampshire for even thinking about reprimanding the doctor for TELLING THE TRUTH? Fat is fat and results in unhealthy consequences. Hooray for the doctor for calling it what it is.
If the Board chose to take action against a physician then there is most likely more to the story than simply a doctor saying, “you’re fat.” Keep in mind there are other physicians that sit on the Board. If anything the Boards tend to side with the docs more often than not – so that leads me to believe there probably is more that we just don’t know about that situation.
There may be more too it, but probably not much. If the doctor’s tactics didn’t work, he probably would have have quit using them long ago. One news story indicated that he was happy to see people whether or not they had any money or insurance – that doesn’t sound like something an asshole would do. I think this woman overreacted to what she heard, likely because the words rang true, and she was no more able to handle it like a responsible adult than she was able to fight off all those Twinkies that keep throwing their soft little sugar-coated bodies in her face.
There is NO CHANCE that anything will happen to this doctor, and nothing should – mark my words.
There is nothing wrong with appealing to a patient’s vanity or the social handicap they may face because of a particular condition. I have often told my 2 ppd male smokers about the microvascular effects and resulting impotence that comes with a youth spent smoking. I will tell parents of children who have “unsightly birthmarks” on their face to consider removal of this before the child is school aged. It is the sad truth, but people are judged most of the time by their outward physical appearance. Should he have mentioned the poor dating prospects of an obese woman – probably not. However, should he be disciplined at the state board level – certainly not.
We as physicians are supposed to be one of our patient’s allies and sounding boards. We are too soon entering an era where the patient is paying for our signature on a script pad, and not our professional advice and opinion. The easy way to handle this is to send the patient to a diabetic/nutrition counselor, bariatric surgery center, psychiatric service, PT rehab center and return visits to your office with a diabetes log and exercise/food log every 2-3 weeks. If a patient can do all those things great, but sadly most of our patients would rather sit on the couch and eat junk food. There is no ownership in a patient’s healthcare, they sign no contract and make no promises to the doctor to do their best to be healthy. I have a conversation with my patients at thier first visit, we outline all their health and life problems, and then I try to explain to them what I can and can not help them with. I make them realize that they are responsible for a portion of my success in treating them. It also allows me to talk to my patients on a personal level few other providers dare approach.
The good doctor should have been a little more gentle with his patient’s fragile ego, but sometimes tough love works better than a sugar coated hand-holding reprimand. I am glad to hear there are physicians who are not afraid to confront patients about their health problems head on.
What about the code of medical ethics? Doesn’t it challenge every physician to “provide competent medical care, with
compassion and respect for human dignity and rights.”
Yeah?
And does that apply to FAT patients too? Or just everyone else?
Ha! Cracks me up reading these comments… you assume about chips and doughnuts and lack of excercise. You don’t know ANY of that from this article! Shame on you.
As for the moron who went on and on about law suits, this person didn’t file a law suit – she filed a complaint.
I thought that doctors were challenged to “first, do no harm”. Well, studies PROVE that in all the mistreatment of obese patients by medical professionals, it serves only to make them less likely to seek medical care. Women are much less likely to come in for their annual pap smears or mammograms because doctors are such asshats.
Hey, you medical people reading this– TAKE SOME OF THE RESPONSIBILITY here. Have some humanity. Maybe consider living up to your own principles about how to treat patients.
If this woman is offended then she should go to another doctor. This doctor should NOT have to apologize and I hope he does not. He has done nothing wrong except warn her in certain terms that if her eating habits do not change she will die causing pain to her loved ones.
In todays society everyone wants to have recourse to litigation or cause unnecessary steps to admonish this doctor. The medical board should be ashamed of themselves for wanting this doctor to apologize to this woman. The medical board owes Doctor Bennett an apology.
When are these people going to wake up from this idiotic political correctness and a rewriting of American History.
America is not bad. It is GOOD. The best country ever to exist on the face of the earth.
I don’t think ALL doctors are asshats. I think THIS one is.
My doctor is marvelous.
“Most men find big busted women more attractive. Does this doctor tell his patients facing mastectomy that men will find them disgusting?”
That is a completely irrelevant and impertinent example. Mastectomy is done as a treatment of a life-threatening disease. No one expects any patient to do anything preventative about breast cancer, and mastectomy, while disfiguring, is a difficult but necessary choice, under the best of circumstances.
Obesity is completely different: first, it is preventable. Second, it is treatable. Third, it is reversible. And last–unlike the mastectomy example–all of these differences are under the control of the patient. Obese people get that way by overeating; there simply is no other way. Dissembling about many causes and social factors surrounding obesity is really just a way of enabling and denying responsibility of the obese person. No decent person blames the person with breast cancer
for her disease. The same is not true for the obese person, unless that person is so mentally impaired that they cannot be seen as responsible for their actions. Sorry to say, but but control of obesity does contain an implied moral component, and the people making the judgments based on that aspect of the disorder are for the most part not doctors. That much should be obvious to anyone with any knowledge of our culture. Is it wrong then for a patient’s doctor to point that out?
I believe many of you are missing the point. Doctors certainly have an opportunity and even an obligation to address the issue of obesity with patients. I don’t believe there is a question there.
The issue at hand is whether they should be compassionate and respectful of the DIGNITY of the person. This man was not.
It’s that simple.
“The issue at hand is whether they should be compassionate and respectful of the DIGNITY of the person. This man was not. “
That is your judgment. Apparently others have a different opinion. Just because someone dislikes what they are told, or is told something they don’t want to hear doesn’t automatically qualify the message as an affront to “dignity”. There is a lot of cheap trade in “dignity” these days, most of it pandered by enablers of lazy and irresponsible behavior who see opportunity to grandstand rather than lead.
Tough message to this obese lady, but largely true. Too bad she isn’t much for having insight into her own behavior; far easier to squeal about affronts to dignity than to dig into the hard turf of personal responsibility. There is always a peanut gallery of “supporters” and enablers.
I anxiously await the moment when we learn more about this, when this woman speaks out, when we hear the full scope of the complaint and why the medical board did take it seriously.
I’m amazed at how many assumptions have been made about her when we know so little.
There is a lot missing in this story. Thus far, we’ve heard the doctor speak and be interviewed. That’s only one side of the story.
As a formerly “obese” woman…a currently “overweight” woman…, I would like to say that this difficult battle is not won by seeking out those who say,”You are just fine the way you are, Honey.” My greatest motivation to continue the fight comes from those honest people who say, “You don’t know what you are missing by not losing that weight.” I welcome a doctor who doesn’t mince words, but gives me every reason possible to lose weight.
Yeah, I told you we were missing a lot from this story.
Read this and tell me how you feel:
http://www.rutlandherald.com/apps/pbcs.dll/article?AID=/20050831/NEWS/508310344/1024/NEWS04
“Obese people get that way by overeating; there simply is no other way.”
Okay, it’s a little scary to me that a doctor — or perhaps one pretending to be one? — would make such an egregious statement.
Ever hear of weight gain as a result of taking prescription Prozac? Xanax? Lexapro? Wellbutrin?
Ever heard about the doctors who WON’T TELL their patients about the possibility of weight gain as a side effect because they’re afraid the patients won’t then be “compliant” and take their medications?
You’ve had NO ONE in your circle of friends or family take their antidepressant (or bipolar, or hell, prednisone or other steroid-based medication, for that matter) and put on 50 pounds in a matter of months??
Get a grip on your unresearched, prejudicial BS and come out of denial, please. YOU CAN’T look at someone and know without further observation WHY they’re overweight — no matter how much it would serve your dangerously narrowminded and superficial worldview to do so.
And people wonder why we’re losing economic ground to China. No one can THINK and REASON in this country.
Bloviating blowhard.
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