Dispelling nutrition myths, ranting, and occasionally, raving


Should doctors be treating obesity?


Image “Bigger than your head” by Mandy Jansen on Flicker. Used under a creative commons licence

I was thinking about Western medicine the other day and how all too often it seems that the approach is to treat the symptoms rather than to determine the cause and to try to remedy that. That got me to thinking about our approach to obesity and how, in a sense, having doctors (or any medical professionals) treat it means that we’re treating the symptom rather than the cause.

Yes, there are many causes of obesity. But when we boil them all down it really comes to our environment and collective lifestyle as a society. The way our lives are set-up it’s a battle to avoid becoming overweight or obese. Our jobs, our food system, our neighbourhoods, our social activities, our sleep habits, etc. are all contributing to the ever climbing obesity rates.

Sure, many medical professionals are fighting the good fight. Some are trying their best to help their patients learn to reengineer their lifestyles to lose weight. Some are pushing for changes to our built environment. But these battles are large and weren’t intended to be fought by MDs, RDs, and RNs. None of us learned how to design communities, to build grocery stores, or to structure offices while we were in school.

The real battle needs to be fought by government officials, engineers, designers, and planners. These are the people who can get to the root of the problem. Maybe as healthcare professionals we can help direct them to the sources of the issue. We can also continue our efforts to treat the symptoms as they surely deserve some tending to. However, until we can create some sort of coordinated widespread interdisciplinary approach to curbing obesity we’re just going to be continuing to give out bandaids to those in our care.

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The politics of weight loss

I was exploring a website for a political candidate the other day and was rubbed the wrong way by a statement I read: “I hope to act as a role model for losing weight(I’ve got some lbs to drop)”. Why did this statement bother me? No, it was not the typo, these things happen. It was the fact that this was considered an issue in a political campaign. Who does this candidate want to be? The next Rob or Doug Ford? Ugh. I’m all for political figures setting a good example. However, I don’t think that weight, or weight loss, is relevant to a political campaign. Yes, it’s great if anyone wants to make lifestyle changes to improve their health. I just don’t care when it comes to an election campaign. How does your weight loss affect me as a citizen in your district? As a voter I don’t care how much you weigh. I want to know where you stand on issues like active transportation, greenbelting, city planning and design, and backyard chickens. Unless your weight loss plan includes changes to the built environment so that everyone will benefit I don’t want to hear about it in your campaign platform.


Should doctors treat obesity?

A thought provoking question was recently posed by the Globe and Mail: Is it futile to treat obesity? The article quotes a doctor who thinks that because there is such limited success in treating obesity and such a negative emotional burden that comes along with weight loss efforts (and failures) that we should shift our focus to helping patients become more accepting of their size. Another doctor quoted in the article presents the opposing argument: doctors should still be trying to help their patients to become as healthy as possible even if it is often a battle in futility. I think that we need to incorporate both approaches and also treat the real cause of obesity which does not lie with the patient nor the doctor.

If a patient is experiencing negative health issues which can be ameliorated by weight loss then the doctor should clearly be suggesting that they should lose weight and providing them with necessary tools to do so. Now, as the article says, benefits from weight loss can be seen with as little as a 5% loss of body weight. We’re not saying everyone has to go out and lose 100 pounds and start doing fitness modelling. We’re just saying that if you can better manage your diabetes (or stave off development of diabetes), or cholesterol, or blood pressure, etc. then you should probably be advised on how to do so. Especially if the treatment doesn’t involve medications and involves such side effects as: improved mood, better sleep, increased energy, improved mental acuity, etc. At the same time, we need to be more accepting of the fact that health can come at many different sizes and we don’t all have to have washboard abs to be healthy.

That’s the role for the doctor, as I see it. I would also suggest that the tools they provide their patients for weight loss involve other health care professionals such as dietitians (of course!), psychologists, and fitness experts. But, to really treat obesity we need to change the world in which we live. We need to live close enough to our places of employment so that we can easily get to and from work using active transport (i.e. our feet, bikes, skateboards) or at least public transit. We need to stop relying on restaurants and meals “cooked” out of boxes. We need to redesign our environment so that the healthy choice is ALWAYS the easy choice.