Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A case for changing the way we talk about obesity

Jill Becker, MD
Conditions
July 16, 2021
603 Shares
Share
Tweet
Share

You are finger.
No, I have fingers.

You are leg.
No, I have legs.

You are pancreas.
No, I have a pancreas.

You are fat.
Hmm …

Now let’s try this with disease processes:

You are diabetes.
No, I have diabetes.

You are cancer.
No, I have cancer.

You are anorexia.
No, I have anorexia.

You are obese.
Hmm …

It is a fact that most people feel shame about “having” fat. It is uncommon to hear people with other disease processes saying things like, “I am hypothyroidism.” Yet, we consistently hear people referring to themselves as “fat.” This is not said in a boasting manner, either: “Hey, I’m so excited; I’m fat!” Instead, it is said as if it is their identity and as an apology for existing. “I’m fat and ugly.” Or, “I’m fat, I’m disgusting.” What these people have internalized from society is, “I’m fat. I have no worth.”

Last week a lovely, elderly gentleman with obesity and type 2 diabetes came into the office to review his lab results. His hemoglobin A1c (a long-term measure of blood sugar) was elevated. We discussed what that meant, why it was important, and a number of changes he could make to best support his health.

“I thought you were going to yell at me.” He said. I suspect I appeared a bit bewildered because he then explained, “All of my other doctors yell at me.” That got me thinking about the way we convey information, and often our inherent biases, to our patients.

Let’s look, for a moment, at what might be considered the opposite of obesity.

Anorexia is characterized by a distorted body image and a compulsion not to eat, often associated with mental or emotional issues. Ultimately, this disorder can lead to severe health issues and death.

How about obesity? Obesity is characterized by a distorted body image and a compulsion to overeat, often due to mental or emotional issues. Ultimately, this disorder can lead to severe health issues and death.

What advice and treatments do we offer the patient with anorexia? Often we suggest counseling, behavioral interventions, dietary education, and empathy. What advice and treatments do we offer our patients with obesity? Some physicians offer the same types of opportunities. Many harbor, and occasionally express, condemnation and judgment.

The professors at my medical school went to great lengths to teach their students not to identify patients as their disease. We were taught to say “the person with diabetes,” not “the diabetic.” By disassociating the individual from the disease, we were reminded that the person has a disease, and that they were not the disease. Even so, I don’t recall ever hearing the words, “the person with obesity.” It is a subtle distinction, but an important one – not only for the provider but for the patient, as well. People with obesity need to know that they are seen as people, not as their disease.

Back to the elderly gentleman I referred to earlier. It is unlikely that all of his physicians yell at him. However, he has internalized the message that his caregivers are angry at him. It is very difficult to establish trust and a physician/patient alliance in that setting if we are not aware of how we come across to our patients. Physicians have a great responsibility when it comes to educating ourselves, in addition to our patients. Society, in general, judges people with obesity as lacking in self-control rather than having a disease. Unfortunately, far too many physicians view this condition in the same manner. In these cases, our patients can suffer for our lack of education and our lack of empathy. In this way, we violate the edict to “first, do no harm.”

Jill Becker is a physician and can be reached at her self-titled site, Jill Becker, MD.

Image credit: Shutterstock.com

Prev

A morning code blue for a COVID patient

July 16, 2021 Kevin 0
…
Next

What you need to know about the updated benzodiazepine boxed warning [PODCAST]

July 16, 2021 Kevin 1
…

Tagged as: Obesity

Post navigation

< Previous Post
A morning code blue for a COVID patient
Next Post >
What you need to know about the updated benzodiazepine boxed warning [PODCAST]

More by Jill Becker, MD

  • Federal legalization of cannabis: What does it mean for patients?

    Jill Becker, MD
  • The benefit of video appointments in the world of cannabis medicine

    Jill Becker, MD
  • Cannabis stigma continues to impede patient care

    Jill Becker, MD

Related Posts

  • Who’s really to blame for the obesity epidemic?

    Peter Ubel, MD
  • Let’s talk residency: COVID edition

    Angela Awad and Catherine Tawfik
  • A physician joins TikTok to talk sex education

    Jennifer Lincoln, MD
  • Atul Gawande’s prescient 2012 TED talk

    Natalie Hodge, MD
  • Why do we think obesity is caused by lack of exercise and not junk food?

    Martha Rosenberg
  • The British are unafraid to talk about rationing. That’s something to admire.

    Richard Young, MD

More in Conditions

  • Proposed USPSTF guideline update: Advocating for earlier breast cancer screening at age 40

    Hoag Memorial Hospital Presbyterian
  • The rising threat of lung cancer in Asian American female nonsmokers

    Alice S. Y. Lee, MD
  • Urgent innovation needed to address growing mental health crisis among children and families

    Monika Roots, MD
  • The importance of listening in health care: a mother’s journey advocating for children with chronic Lyme disease

    Cheryl Lazarus
  • The unjust reality of racial disparities in pediatric kidney transplants

    Lien Morcate
  • The surprising medical mystery of a “good” Hitler: How a rescued kitten revealed a rare movement disorder

    Teresella Gondolo, MD
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
  • Recent Posts

    • Proposed USPSTF guideline update: Advocating for earlier breast cancer screening at age 40

      Hoag Memorial Hospital Presbyterian | Conditions
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the WHO’s pandemic accord is critical for global health care

      Elizabeth Métraux | Policy
    • The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

      Robert Pearl, MD | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 10 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • When You Know Better, Do Better for People With Disabilities
  • Could Semaglutide Help Curb Addictive Behaviors?
  • 'If the Narcan Isn't Working, Give More' and Other Myths About Naloxone Use
  • CDC: Children's Brain Infections Rose Last Winter, But Remained Rare
  • Inside the Fight Against Burnout Amid the Chaos of War in Ukraine

Meeting Coverage

  • Cardiovascular Risk Models Still Fall Short for Arthritis Patients
  • De-Escalated Surgery Suffices for Low-Risk Cervical Cancer
  • More Evidence Backs Gout Benefit for Gliflozin Agents
  • Reaction to FDA's Approval of Upadacitinib for Crohn's Disease
  • CDK4/6 Extends Reach Into Early-Stage Breast Cancer
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
  • Recent Posts

    • Proposed USPSTF guideline update: Advocating for earlier breast cancer screening at age 40

      Hoag Memorial Hospital Presbyterian | Conditions
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the WHO’s pandemic accord is critical for global health care

      Elizabeth Métraux | Policy
    • The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

      Robert Pearl, MD | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A case for changing the way we talk about obesity
10 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...