We all have our biases. That’s part of being human. But as a health care professional, we need to be held to a higher standard and we need to check our personal biases at the door. Far too many doctors, both in the traditional medical system and the integrative system, treat patients with obesity with distain[i]. They hold the belief that these patients are lazy[ii], undisciplined, and uninterested in their health. Regardless of a patient’s complaint, they are dismissed and told that they need to lose weight. Then, when these patients come back, at the same weight or heavier, they are tagged as ‘non-compliant’, “Clearly they don’t care enough about their health to make the necessary changes, so if they won’t take their health seriously, then why should I?” This way of thinking is leaving too many patients misdiagnosed[iii] and unheard; all the doctors see is the number on the scale. This has to change.
When I was in naturopathic medical school, the late Dr. Timothy said to me, “there is no such thing as a non-compliant patient, just poor treatment plans.” It stuck with me, and molded how I treat each person that comes into my office. As a doctor, it’s my responsibility to ensure my patient’s success. If I create a treatment plan that they can’t follow, it means that I didn’t listen to them well enough. If I didn’t account for something in their life, in their preference or in their budget then I didn’t meet them where they were. As their doctor, that’s my fault and not theirs. You see, not everybody is at the same place in this life. Not everybody has the same access as everybody else. Everybody has their own preferences on what they like to eat and how they like to move.
So how can your patients succeed when you’re only measuring the scale? When they come into your office and tell you that they are eating more vegetables, that they’ve cut back on the ‘junk’ food, and that they’re moving more than ever, but you weigh them and sigh, then they know they’ve lost. Again. And people will only rally so many times before they give up. And you know what they lose? Those healthy habits that they started to develop. They start to associate nutritious food and movement with failure. And that means that they lose out on the possibility of implementing these lifestyle changes with any long-term success. Because we are wired to avoid pain, they will begin to avoid exercise, they will avoid vegetables and they will eventually avoid YOU.
People with obesity, or even those who fall into the ‘overweight’ category, have been failing for a long time. And failing sucks. Just look at a team who can’t get ahead. Without amazing coaching, these teams stay down; the players don’t invest as much of themselves into the sport, blaming starts and their sense of worth drops. Ultimately, pride and respect slips away and the fun is gone. As humans, we like to play to win, so help your patients do just that. Give them real goals for where THEY are right NOW; in this body, in this life, and at this time.
If they show up to your office, congratulate them for making time for this appointment and making their health a priority[iv]. Ask them what you can do for them and find out what they need right now. Use the opportunity to create a safe environment where they don’t feel judged and looked down upon. Create treatment plans that allow them to win. Be kind to them, they face enough shame every time they look in the mirror. They need you to take a stand for them. Teach them how to accept and appreciate this body. That will allow their self-respect to emerge, and when you respect something, you’re far more likely to take care of it.
Until next time,
Live Life. Love Food. Be Free.