Sunday 24 April 2016

Need Healthy Diet Advice? Rely on Your Doctor?

By Lorie Eber

Your treating physician would seem like the go-to expert if you’d gained weight and needed some healthy diet advice. After all, aren’t doctors supposed to be stewards of their patients’ health and wellness? The iconic Hippocratic Oath requires physicians to uphold the following tenant: “I will prevent disease whenever I can, for prevention is preferable to cure.” Even the Affordable Care Act has jumped on the prevention and wellness bandwagon. But the reality is that medicine works on a disease-based model and the mandate to help patients lead a healthy lifestyle is being roundly ignored by physicians today. Poor eating habits and sedentary lifestyles eventually lead to chronic conditions like high blood pressure and diabetes. At that point physicians are in their comfort zone and happy to prescribe a lifetime of medications. Don’t you think there something seriously wrong here? 
The medical powers that be understand the serious health implications of unhealthy lifestyles. The American Medical Association characterizes obesity as a disease, while the Centers for Disease Control has categorized obesity as a national epidemic. There is a surfeit of scientific evidence to support their position. Being overweight or obese has been associated with a plethora of diseases including heart disease and stroke, high blood pressure, diabetes, a variety of cancers, gallbladder disease and gallstones, osteoarthritis, gout, sleep apnea, and asthma. Yet the medical profession passively stands by and shirks its duty to keep us healthy.
My anecdotal experience in coaching overweight clients confirms the reluctance of treating physicians to inform them that carrying extra pounds is a health hazard. Most report that their doctor didn’t even mention their weight. Even those whose doctor had the temerity to broach the topic came away frustrated because no practical weight loss advice was delivered, nor was a referral made to a weight loss specialist. My clients have all been on the yo-yo diet rollercoaster far too many times and are hungry for expert advice on how to change their lifestyles once and for all. 
Statistics confirm the scope of this alarming scope of this dereliction of duty. An analysis of government health surveys containing data on 5,500 people revealed that one-third of obese patients and 55 percent of those who were overweight had never been told by their doctor that they were overweight. You may assume that these patients knew that they needed to lose weight, but you’d be mistaken. Since two-thirds of the population is now overweight or obese, many people don’t realize that they are not leading healthy lifestyles simply because carrying around extra pounds has become normalized. Many of us still hold the medical profession in high esteem. The health surveys demonstrate that we do pay attention to what our doctors tell us:
“If a doctor did comment on a patient’s weight, it seemed to make an impression. Nearly 20 percent of obese people whose doctors hadn’t brought up their weight described themselves as “not overweight,” compared with just 3 percent of those whose doctors had addressed their weight. Obese and overweight patients who discussed the issue with doctors were also more than twice as likely to have tried to lose weight in the previous year.”
Lest you label me a doctor hater, I also want to call out the medical schools for falling down on the job. A Nutrition in Medicine survey of medical schools showed that only 30 percent of those institutions require even a single course in nutrition. As a result, 50 percent of medical school graduates characterize their training as inadequate and feel ill-equipped to assist their patients with weight loss. 
When surveyed, doctors admit their failure to counsel their patients about the health implications of being overweight. According to a Yale University survey, only one in three physicians is willing to talk to his or her clients about the very real health implications of being overweight or obese. 
Physicians offer other justifications for not raising this perhaps politically incorrect, but medically necessary, topic, including:
• They have negative attitudes toward their overweight patients 
Let’s dispense with the excuses and start addressing this national epidemic. For all the caring physicians out there, I offer these suggestions:
1. Learn about nutrition and healthy diets,
2. Adopt healthy lifestyle behaviors so you can be a good role model,
3. Refer your overweight patients to certified nutritionists and wellness coaches who are trained to assist with lifestyle change, and 

4. Be brave enough to do the right thing and tell your patients that excess weight is a health hazard.

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