Thinking About The Fat Trap

One of the most fascinating courses I took in graduate school was called the Epidemiology of Obesity, where we looked at the obesity epidemic from “cell to society.” What we know about the whys of obesity are minute compared to what we don’t know. A huge number of factors play into whether someone gets or stays overweight or obese and a pill and a small lifestyle shift is unlikely to reverse it permanently. This article by the New York Times reviews some of the newest research on obesity and weight loss.

Competitive runners are funny about weight. We can say to another runner (and it happens all the time) that we are heavy or fat, when we are likely sporting a BMI on the low end of healthy. Our acceptable weight range is +/- no more than a couple of pounds. In the off-season, many of us carry an extra five pounds, then have to fight to get back down to race weight.

I often joke that I need an in-season and off-season wardrobe. Only it’s not really funny. I put a dress on yesterday that I intended to wear for New Years Eve, only to find that it doesn’t fit and is approximately as flattering as a garbage bag. As such, it can be hard for me to be understanding towards those who struggle with their weight. For my obesity class, I wrote my final paper on physician attitudes towards obese and overweight patients (the abstract is below) to begin the process of assessing how my own attitudes might affect the outcomes of my future patients.

Many runners have had their own experiences with weight loss through running. It’s common to run with someone who was a runner or other athlete in high school/college who found themselves middle aged and heavier than the wanted to be. It’s also common to come across someone who found running to be the activity that they found the most weight loss and maintenance success.

What’s your weight loss story? How does running play into that?


The Weight of Care: Measuring Physician Attitudes towards Overweight and Obese Patients

Since the beginning of the obesity epidemic, concerns have been raised about physician bias towards overweight and obese patients. Early studies concluded that medical professionals were more likely to describe obese patients as “bad” or “lazy,” than patients of normal weight. If physician bias has not significantly improved since these early studies, the implications for patient care and patient self-efficacy are grave.  This review synthesizes findings from five geographically and methodologically diverse studies.  The selected studies were evaluated against the following research question: Do physicians view obese patients more negatively than normal weight patients and does this affect recommendations for care and physician expectations for success? Two of the studies reviewed partially affirmed the research question.  The three remaining studies refuted the research question. Four key findings emerged: 1) Physicians who viewed overweight or obese patients more negatively were more likely to attribute obesity to behavioral causes.  2) Even with generally positive experiences, patients reported barriers to conversations about weight and a sense of discrimination. 3) Physicians have low expectations for successful treatment and many reported low self-efficacy in treating obesity. 4) Patients whose providers discussed weight management were more likely to be actively trying to lose weight. The implications of these findings are twofold.  First, obesity specific training is necessary to better educate physicians on the causes of and benchmarks for obesity.  Second, physicians need to clearly and regularly communicate information about treatment to patients.  Additional research is needed in minority communities and in the connection between attitudes and patient care.


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