Fat Doctor: An Obese Physician Reflects on Life in the Clinic and at Home

Nicholas Genes, MD, PhD

Disclosures

April 12, 2006

Fat Doctor -- Yes, she's fat, and she's a doctor, but she's much, much more.

Obesity and its consequences is probably the most contentious issue in general practice today. There are plenty of physicians and patients writing on their Web-logs about the importance of exercise and a healthy diet, but until now, one perspective has been missing -- that of the Fat Doctor.

Writing under the pen name of Big Mama Doc, the blog "Fat Doctor" unabashedly tackles the difficulties and discomfort that can come with patient care, when the doctor is less than the model of health. The results can sometimes be inspiring or discouraging, but her writing is always compelling.

Fat Doctor hosts Grand Rounds
April 18, 2006

For instance, on the topic of good documentation after counseling sessions, Big Mama Doc wrote:

"With my own obese patients, I counsel them to eat less, move more, join a gym, read the right books, journal their feelings, and get therapy. And then I can document that I did my best even though I know they will eventually eat themselves to death. My doctor knows the same about me, but her chart looks good."

On other occasions, however, her introspection is more positive:

"I have worried in the past that my own obesity would be an impediment to my helping other people conquer their weight problems. Instead, my patients seem to respond well to my admission that I fight this battle daily, and sometimes fail, but am trending toward better choices. We are comrades in this war, a band of big brothers. Many of my patients are winning their individual battles. I celebrate with them and they inspire me."

Although at times Fat Doctor seems like a chronicle of one woman's attempt at weight loss, its origin last fall relates to a (still unexplained) stroke that Big Mama Doc sustained:

"After my stroke, I was seriously messed up in the head, both physically and emotionally. The use of my arm came back to almost full function within a couple of months, but the fear and sense of loss have been difficult to conquer. I've kept personal journals off and on. They helped me figure out who I am and work out solutions to problems. I figured the blog could do the same thing. Also, I figured if I died young, my son would have something to read when he is older to know who I was. Sick, sure -- but true."

She says she's always been word-oriented, but her writing avoids the ponderousness and verbosity that plagues many bloggers. Big Mama Doc's succinctness may be something she learned in journalism school, or in the course of writing for women's magazines. Her style has quickly brought her a devout and passionate following -- fellow physicians, weight watchers, "the fat-acceptance folks," and many more. Many have been supportive of her efforts, both for herself and her patients. Others have been hostile -- but then again, obesity is a loaded issue.

And, to be sure, the fat doctor doesn't only have fat patients. She's got her share of demanding patients and teaching moments. Big Mama Doc also has a lighter side that emerges occasionally, as with a Diet Coke haiku.

But when writing about her own struggles, Fat Doctor blog truly soars. And while it's okay to root for her success and still get attached, deep down, she doesn't really think she'll change. "When I lose weight, I'll still be Fat Doctor," she says. "I think once fat, forever fat, even if the fat person is wearing a healthier body. A lot of being fat -- perhaps most of it -- is in the mind."

Readers can get a better feel for the mind of Big Mama Doc when Fat Doctor hosts Grand Rounds, the weekly collection of the best in online medical writing. The links to other blogger's sites, featured on Grand Rounds, draw thousands of readers from all over the world. Follow the link to Grand Rounds (the link will go "live" on April 18) to find out more.

Be sure to browse her archives -- but do her a favor and weigh her words carefully. "If my blog were to ever inspire someone to change his or her life in any way," she says, "that would be great. If it were to help me feel more in control of my own life, that would be great, too."

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