Tuesday, January 3, 2012

A Weighty Issue

 I checked out a new blog today and saw a blog post after my own heart. My fellow Recovery Room nurse put into words a conversation I have had with several patients. At http://recoveryroomriley.blogspot.com/2012/01/worn-out-joints.html this nurse talks about how an obese patient cannot for the life of her figure out why all of her weight bearing joints are deteriorating and need to be replaced.
I have noticed this same thing with many of my patients. They do not understand why they need to get their knees and/or hips replaced, why they are hypertensive, why they have lower back pain. Many do not even realize that they are obese. Are their physicians not discussing this with them? Now keep in mind that I am not talking about the pleasantly plump individual or the person who has "a little more to love". The patients to whom I am referring are truly in the category of obese, sometimes morbidly so. And it is not just the patient's health that is affected. Every time they pull a 400 lb patient up in their bed or transfer a 350 lb person from a stretcher to a bed, health care workers sigh in relief when their backs emerge unscathed.
  How do we  get the collective American waistline to shrink a bit? This gentleman at CNN compares the response needed for this issue to the war on smoking and even more so to the campaign to reduce highway fatalities  cnn.com.        
  Now my muffin top has grown from barely noticeable to semi-in-your-face over the holiday season, so I am  certainly not immune to the pleasures of pumpkin pie, fudge, and cookies. However, seeing the debilitating health issues that my obese patients face absolutely does help motivate me to not let my weight get too out of control, kind of like old ladies with broken hips inspire me to take my calcium. It is hard in a world where processed, sugary and fatty food is less expensive than fresher, more nourishing choices to always do the healthy thing. However, if we can just get ourselves to the the healthy thing a little more often, I think we could make some giant gains...or giant losses in this case.


  1. hi rnraquel,

    I myself have also been through this same senario multiple times and have seen these patients just not get it! In our world today, no matter how much they talk of obesity/childhood obesity, they are still not doing enough to promote a healthy AFFORDABLE lifestyle! Just the other day I went to the store for fruits and veggies and it was over $75!! When I could have easily gotten much more processed for for less. It is sad and scary to me to see the 'size' of the American population.

  2. I notice the CNN article doesn't mention active transportation, though it mentions the time we spend in cars. I've also noticed that using a bicycle for transportation and fasting one day a week keeps me from having to watch my diet.

    There are more people who want to ride bicycles for transportation than feel safe doing so. Promoting more inclusive road design and educating ourselves as drivers about the rights of cyclists on the road, hell even acknowledging that we have a right to use every public road, these are significant ways to combat this enormous problem.

    And it is a big, fat problem :D

  3. I'm glad to see, in your post and in the comments, people aren't just bashing the fat patients but are also considering the difficulties in making healthy choices.

    I'm not in the human medical field but I am overweight with chronic pain. I do have physical causes of my pain (backed up with MRI proof. It's not fibro LOL). But, I know my pain would likely be reduced by losing weight and I really do try. I've managed to lose 40 pounds from my heaviest but I seem to be stuck there and don't really know how to "fix" it.

    I have insurance and would love to have gastric bypass (although I know that's controversial) but it's not covered. In fact, NO weight loss programs are covered by my insurance. For a period I went to a nutritionalist (or is it nutritionist?) and had to pay out of pocket, which got prohibitive. If I go to my GP, and I even discuss weight loss, the visit will not be covered. My GP wanted me to try a medication for weight loss but, again, not covered by iinsurance and the cost was more than we could handle. Sadly, my insurance is through my husbands employer AT A FREAKIN HOSPIITAL. His employer, who is a hospital, does not recognize the benefits of covering any type of weight loss assistance for it's employees and their dependents. Mind boggling, IMO.

    I would love to be able to eat more fresh fruits and vegetables, and more organic foods, but the cost of those foods, for a family of 5, just aren't feasible right now for us. I do the best I can, when I can, but I wish I could do more.

    Something else that I see happening to me personally, and I've talked about with overweight friends/family, is that we often feel like we're not taken seriously by medical professionals. I know I'm fat. I also know that doctors hear patients all day who deny that being fat is any of their doing. But even when there are reasons to suspect that maybe there is an underlying medical reason that it is so difficult to lose weight, it's not taken seriously,. I've often felt like doctors have blown off my concerns because they see a fat girl and think I'm fat just because I'm fat. I've been to at least 3 doctors and brought up concerns about possibly having a thyroid deficiency and none have really investigated any more than running bloodowork which comes back low normal. There has to be some reason that I'm always cold (If its below 70 degrees I am literally shivering), always tired, hair falling out in clumps, etc. Also, I have PCOS and, besides when I was trying to get pregnant, it has never been addressed or treated. I've been treated like it's just a thing I need to deal with when it's pretty well stated that PCOS makes it difficult to lose weight (not impossible, but more difficult).

    I'd venture a guess that the majority of patients who are fat know that they are and don't want to be. Unfortunately I've found that it's not always as easy as just making healthier choices and having more will power and it doesn't help when we are made to feel "less than" by medical professionals. All that does is make us stop seeking medical treatment for problems, either related to, or unrelated to, our weight.