What I Wish My Doctor Really Knew: The Voices of Patients With Obesity

Janyce Johnstone; Cherie Herredsberg; Les Lacy; Peg Bayles; Lynn Dierking; Arla Houck; Margaret Kilpatrick; Luanne Kramer; Karen Mason; Carla Mendez; Frank Schrotberger; Christie Befort

Disclosures

Ann Fam Med. 2020;18(2):169-171. 

In This Article

Abstract and Introduction

Abstract

Few health care professionals receive comprehensive training in how to effectively help their patients with obesity. Yet patients are often wanting, needing, and looking for help when they go to the doctor. We, as a group of patients with obesity, share our common experiences and needs when going to the doctor from a place of honesty and hope, with the assumption that clinicians want to know what their patients really think and feel. Our "wish list" for a treatment plan may represent an ideal, but our hope is that our language will speak to clinicians about how they can help their patients manage their obesity.

Introduction

Obese—what a cruel word. "O-be-si-ty"—the condition of being grossly fat. A medical diagnosis to describe us. We know it is a medical term, but it can still feel like a cruel word. It's the stigma, the sense that it's a character defect.

We are a group of patients with obesity. Among us are men and women in our early 40s to late 70s, a mix of professionals (including teachers, nurses, dental assistant, farmers, homemakers). But we are individuals with one common denominator: we struggle when it comes to weight management. It has been a lifelong struggle for many of us. Several of us are cancer survivors, and more than a few of us face health complications related to the "condition." We are fighters when it comes to our obesity: we win some battles and lose some battles, but we understand it really is a battle.

We make up a Patient Advisory Board for a primary care randomized trial called RE-POWER (Rural Engagement in Primary Care for Optimizing Weight Reduction).[1] At one of our meetings, we spent a half day sharing our own experiences and desires in getting help with weight loss from our primary care doctors. We did this in response to a 2017 report that outlined, for the first time, educational competencies for health care professionals in the prevention and treatment of obesity.[2] The report was the product of a consensus-building process involving representatives from 24 professional organizations including the American Academy of Family Physicians. The competencies highlight the importance of patient interactions, (eg, "use patient-centered communication, discuss obesity in a non-judgmental manner, employ strategies to minimize bias and discrimination"). We noticed, however, that patients themselves were not involved in the process of developing the competencies, and there are varied patient stories that remain hidden. This matches our experience in talking about our weight with our doctors (or our experience in not talking about it)—the discussions are often not as personal, honest, and resourceful as they might be.

If we had to summarize what we want clinicians to know, the most important "competency" if you will, it is this: we want you to know how to look at us, to see each of us as a person. We want you to see us as a person as opposed to an obese person with a certain BMI and a series of conditions. We know firsthand what it's like for obesity to be treated as an individual failing, a character defect, or a personality flaw. We know all about failure. But we are asking for your help to climb out of the bodies we're in so we can do the things we want to do in order to be ourselves. We need a full-court press from the medical community to help us succeed, and a treatment plan that gets monitored and taken seriously like treatment plans for other conditions.

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