We should not care about Regina Benjamin’s weight

Regina Benjamin has impressive qualifications to become our next Surgeon General. She’s a primary care physician in Alabama who has spent considerable time treating the poor. Certainly a better choice than celebrity neurosurgeon Sanjay Gupta.

We should not care about Regina Benjamins weight But it’s unfortunate that there has been so much controversy about her weight.

Rob Lamberts has the best take I’ve read on the issue, and he comes to Dr. Benjamin’s defense:

Racist and sexist people put down others because of the fact that they are different than themselves. But the moral judgment against the overweight and obese is not meant to be a judgment against something inherent in the other person; it is a judgment against their character, their choices, and their weaknesses. The implication is that they are somehow either smarter, stronger, or just plain better than the overweight. The implication is that the other is weak and they are not.

There is a word for this attitude: hypocrisy.

Emily Walker, over at MedPage Today, similarly lashes out at Dr. Benjamin’s critics, saying, “I feel that the criticisms of Dr. Benjamin’s weight are rooted more in our society’s enjoyment of critiquing the appearance of women in public positions, and less about concern that her nomination sends the message that being overweight is okay.”

So, for those who think that Dr. Benjamin’s weight matters in any way, I suggest that they first look at her background, and see how she strongly advocates for patients.

I’d think that would be a significantly more important quality to have when picking our next Surgeon General.

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  • http://www.kipesquire.net KipEsquire

    As I recall, C. Everett Koop was not exactly slim either.

  • Deirdre

    A recent study says overweight women live longer than underweight women, so the criticism is even more irrelevant.

  • Anon

    Physicians on this blog are generally highly critical of the overweight. So why is crticism of an overweight physician unwarranted?

  • http://www.thehappyhospitalist.blogspot.com Happy Hospitalist

    She’s not even fat.

  • Kim

    I think the controversy over her weight has nothing to do with her and everything to do with Obama’s critics wanting him to look ineffective and foolish. He already gave them round one with Gupta, if they can convince the public that the candidate in round 2 is also inappropriate as well it helps to further undermine confidence in his judgment.

  • http://blogs.Strat-Cons.com Xavier Tello

    Oh… please!
    Would it be OK if she were smoker?
    I think we’re making (or at least the American society is) the typical double-standard mess here.
    Obesity is a health and epidemiological problem worldwide. Millions of dollars are lost annually due to obesity morbi-mortality and it is the most common cardiovascular risk factor.
    But at the American way at its best, suddenly, a documented health problem falls into the political-correctness arena. “It’s about discrimination” “It’s about Obama’s detractors”.
    No it isn’t.
    It’s about the public image of a person that has to be a health leader.
    Dr. Benjamin could be a fine physician, but she is overweight; is she going to lead national anti-obesity policies and health programs?
    BTW: Everett Koop was not overweight, he was a navy officer a sportsman and one of the first of the anti-smoke advocates. He lived until age 92.
    There are even voices that claim that this is about “beauty perception” and discrimination as if politics (American politics) would ever be a top-model (male and female) scenario.
    The big problem in the USA is that there are always partisans in all subjects, so questioning the “logic” behind picking an overweight person to a top health position becomes wrong.
    For me (and I think a good number of anti-obesity advocates), this is about credibility.
    Again: Would it be OK if she were smoker?

  • http://www.futurewaredc.com Chuck Brooks

    Not clear why ‘treating the poor’ is a recommendation, express of implied. Perhaps there’s too litte to do in the gray lady’s neswrooms these days.
    Chuck Brooks
    FutureWare SCG

  • JS

    @ Xavier Tello, just fyi C. Everett Koop is still alive at age 92. Have you heard otherwise? Dr. Benjamin has excellent qualifications for the position. We, the public, do not know about her medical background and family history which may contribute to her body shape and size and as such should not be making judgments based on that.

  • http://blogs.Strat-Cons.com Xavier Tello

    @JS Yes. Something wrong with my writting (and thinking)… I’ve intended to say: He lives at 92 (I can say english is not my first language but it would just be a stupid excuse…).

    I’m not trying to judge Dr. Benjamin. I’m only saying that in terms of fighting one of the mayor health problems in America, you need a convincing advocate; regretfully, for preaching with own example, the image does count.

    What was wrong with Dr. Steven Galson?

  • Doc99

    It’s difficult enough to accept Healthcare advice from a smoker as it is. I have little concern about Dr. Benjamin’s weight, but if you’re going to label Obesiity a disease, then it’s a weighty issue indeed.

  • Another opinion

    Here’s a thoughtful blog on the topic from Dr. Rob http://distractible.org/2009/07/26/stone-throwing/

  • A surgeon

    Why is it assumed that taking care of the poor automatically makes you better qualified than a brain surgeon?

  • http://www.familydocs.org/blogs/fp-forum Carla Kakutani MD

    Thanks for writing about this. The snide remarks began flying right after her announcement. Would a white male with an “ivy league” background and the same body habitus have to read the comments of strangers harping on his weight? I doubt it.
    Sour grapes and sexism is what’s at work here.
    PS the overlap of public health and family medicine is far greater than that of public health and neurosurgery. And taking care of the poor gives you a deep understanding of the amazing health disparities rampant in our “best healthcare system in the world”. The Surgeon General doesn’t need to address the health needs of the well heeled and well educated. They don’t need any help!

  • Doc99

    Respectfully, Dr. Kakutani, if they’re going to label obesity as a crisis, they need to start acting as if it’s a crisis. Otherwise, as with the President, it’s just so much blowing smoke.

  • Katie

    When I first heard about the weight controversy, I expected to see a picture of the mom from “What’s Eating Gilbert Grape” and instead I see a picture of a plump, but healthy looking accomplished woman with a warm, welcoming smile.

    While she is no size 2, her hair, skin and teeth look healthy and she is radiant.

    Could she stand to lose !0% of her body weight? Of course, most of us could and maybe she will while serving the country as Surgeon General.

    Picking apart the appearance of women is such a pasttime in the US to the point where people don’t realize they are often conflating health with thinness. There are plenty of “slim” persons who are quite unhealthy, ones who engage in unprotected sex, don’t use sunscreen/sunbathe, do not get any physical activity or smoke.

    Generally, it is only the chunky/obese/oh-dear-god-that’s-a-biggun who have their lifestyle choices scrunized so intently.

    I know because I am one of those seemingly healthy people, and I am most definitely NOT. I smoke, don’t always remember my sunscreen, rarely exercise (like once a month or less) and am just “lucky” to be very slim. People often think my sister (who is about 30lbs heavier, runs 3miles a day, eats a very healthy diet and hasn’t had a weight fluctuation ever) is a lazy one, when, in actuality it’s me!

  • SIllIMMD

    we’d lose a lot of healthcare workers if normal bmi was a prerequisite!

  • Morganstein RN, BSN

    Most of the nurses on my unit are overweight to morbidly obese. It’s quite shocking. What’s more shocking is they do not get much push back from patients about it.

    I work on a med-surg unit where bulk (no pun intended) of the patients are getting lap-band or other weight loss surgeries!

    Besides, Dr. Benjamin looks like every pediatrician my kids have ever seen in terms of size, shape and demeanor.

  • Kim

    Anyone who thinks this is solely about showing a politically-appropriate image in the face of the obesity epidemic has clearly not been watching the mainstream press. If that was the real concern, clowns like Michael Karolchyk wouldn’t be appearing as “experts” on mainstream TV news.

    In any case, I’m not clear on what special qualifications to address the obesity epidemic a slender practitioner has. In my experience, slender practitioners have not had any particular lock on factually correct diet and exercise information, and I can’t imagine that thinness provides any more insight into broader societal factors contributing to obesity rates such as poverty.

  • patrick garrett

    Oh for pity’s sake. People, I am looking at you who think this woman is overweight, put the flame throwers down and back up. There is a question that needs to be answered here. What is the treatment for “overweight”? By treatment I mean this–if your patient has a case of bacterial pneumonia, what is the treatment? Now before you answer, think on this, what is the success rate for obesity treatment? How does it compare to your successful treatment of pneumonia? Is overweight equal to obesity? How overweight is too overweight? Do you know of anyone who has struggled with weight issues who want to be overweight. Is it a question of willpower?
    And can we please get over the idea that anyone in a government office has to “look” a certain way. The picture of the woman in question–does she look unhealthy? Is she unhealthy? For those of you who answered in the affirmative, how the hell do you know? What are her cholesterol levels, does she have diabetes, if she does is it related to her weight? Anyone who thinks they know a person by a photograph is just not worth listening to. The real issues with a person’s weight is multifaceted at the least. People with weight issues have had enough of being judged as lazy, weak willed, unhealthy, and destined to an early grave if they do not have the “proper” BMI numbers. When you can explain why a diet of mostly meat and fat, can cause weight loss, then maybe you could offer some people with genuine weight problems some effective treatment. As it currently stands the number of successfully treated patients with weight problems is horrible. The amount of abuse and prejudice overweight people face is enough to depress anyone if they had to experience it for a month. These people with long standing issues of weight have, in many cases, dealt with society’s treatment of them for all their lives. And now, on a medical weblog, someone is being defended because they are competent to do the job, but the person is controversial because her weight is not up to some artificial normal. i would have thought that we have grown passed this by now. I had thought that the issues of weight are complicated and not as simple as once thought. When will the health care community notice that the human body has a subtle control mechanism controlling weight. People can weigh the same for years, then changes occur, and weight changes. Can anyone say with certainty that the proper way to get your weight to fall in to the magic BMI number, is just to do…fill in the blank. Hell there is no real understanding of why America on the whole is getting heavier year after year. Is it high fructose corn syrup, do we just eat too much, is it normal to live your life with the constant feeling of being hungry? How is the French paradox explained? How do they do that? Is it just exercise that is lacking? How much exercise is enough? Should it be normal to be able to run 26 miles in about two hours? Should that be the standard? What if you have an injury?
    The point is the issue of weight and its control is complex and not well understood. The evidence is beginning to make the calories in versus calories burned hypothesis seem too simple. Burn more calories than you take in and you will lose weight, does little to explain plateaus. Why do they occur. And given that people who have dealt with being heavier than their peers for all of their lives, how do you think a plateau affects them? Here they have worked hard, measured every portion carefully, and have succeeded, for a time, only to find that the program has stopped working. It causes depression, but then giving the patient antidepressants can cause weight gain. And now the problem becomes more complicated.
    Can we just agree that appearance is no substitute for competent, compassionate, and intelligent candidates for any job? For a change could we at least try it?

  • patrick garrett

    And one more thing: if medicine had an effective treatment for obesity, how do you explain Oprah Winfrey’s struggles. She has the ability to get the finest care available, she can afford to have people to cook for her, she has the ability to have a state of the art gym anywhere she wants it. She has been successful in losing weight in the past. Yet it remains a struggle for her. Imagine how much more difficult it is for a doctor who works with the poor, likely working in excess of 60 hours per week, may have to eat what she can when she can because of her dedication to her profession not allowing what would be consider a “normal” home life. I don’t know about you, but I imagine her patients are willing to take her as she is–a competent , caring, DOCTOR. Not an overweight, lazy, slothful person who is overweight out of ignorance, or laziness, or lack of will power. I would put it to you that anyone who can put in the effort it takes to become a doctor, and by all accounts a good doctor, make lack many things, but will power and the ability to work hard would not be in that list.
    If anyone knows of any cures for the problem of being overweight, there are desperate people who want to hear from you, as soon as possible.

  • Marie

    One thing many people forgot is traditionally the Surgeon General becomes an Admiral of the US Public Health Service, one of the uniform service branches. There are wwight/height and physical fitness (1.5-mile run, sit-ups, push-ups, etc.) standards for officers. It would be completely unfair to those who have been denied promotion because of weight and/or other fitness issues if Dr. Benjamin were to waltz in as the head of this branch.

  • http://www.linkedin.com/in/achievementstrategies Marie C

    What a lovely looking woman! I obviously don’t know what her innards look like, but she appears to be healthy.

    This subject and some of the responses just remind me of how downright mean and judgmental people can be.

    There is no doubt there is an unfortunate level of obesity in our country. But there are a myriad of causes and sources that have little to do with self control or character flaws.

    Our culture does not value or effectively teach and support nutrition. Rather than being compassionate and addressing the root causes, we demonize people who are essentially victims of poor eating and a knowledge deficit.

    Then there are the people who do eat well but have excess weight for other reasons. Patients on oral steroids come to mind.

    Or people like me. I eat normally, average portions, rare sweets, no snacks, no soda, no fried food, all by preference. Yet I am overweight. Because Multiple Sclerosis has left me unable to walk the four miles several time a week that I used to. So I started swimming. Until I fractured my shoulder in a fall, an injury that has immobilized me with intractable pain for eighteen months.

    Some people in my situation might never have gained an ounce. But the combination of my particular metabolism, coupled with medications that are also inclined to add weight, have left me a winner of the fat lottery.

    I suppose some of the people who look at me and the weight I have gained have the same unkind and sanctimonious thoughts that are expressed about Dr. Benjamin. What a bad example! they may think. Ugh, no self control! they may think. Look at how she’s let herself go! they may think.

    And I suppose there will never be a cure for the other epidemic in our country, smug, unsympathetic insensitivity.