Obesity as a disease: breaking good news
As a family doctor, I have had many difficult conversations with my patients. I have witnessed the devastating impact a single word can have. Words such as disease or cancer can forever alter a persons view of life and the future.
Discussing “Bad News” is a complex task that many healthcare practitioners navigate with skill and sensitivity every day. Our experience enables us to convey information with compassion in a manner that is understandable to patients. The clinical view may be worlds away from what it means to an individual, for whom it is unique in the context of their life.
“Bad News” is a relative term. A diagnosis that may be life-changing for one person may be inconsequential for another. When it comes to my experience in managing obesity, I have come to learn that “Bad News” can sometimes be “Good News”. When we diagnose asthma or diabetes, we do not consider it “Good News” but equally we do not blame, and define patients with these medical conditions. People living with obesity are treated differently. They are stigmatized by the myopic and oversimplified view that obesity is a lifestyle issue, a personal choice, or even a moral failure. As a society, we blame and shame people because of their weight. When I talk to my patients about the root causes of obesity - the impact of genetics, the brain, hormones, and our environment - their eyes widen. When I tell them that it’s not their fault - their face brightens. When I tell them that this is a real and treatable disease, it as though a weight is lifted from their shoulders. Their entire life they have been told they lack willpower and just need to “eat less and move more”. So, although it might seem strange, telling someone they have the disease of obesity is often received as “Good News”.
Identifying obesity as a disease counterbalances the negative attitudes and stereotypes that people living with excess weight endure, from themselves and others. It does not remove the personal responsibility to address this chronic disease and seek safe effective treatments, as we would with other non-communicable diseases. By diagnosing the disease of obesity, healthcare professionals acknowledge the root causes and take the first step to ensure that it is not ignored on an individual and institutional level.
We have a duty of care that, to date, perhaps we have not been willing to address. We must empower people with knowledge and embolden them to advocate for the provision of evidence-based services and investment in chronic disease management for obesity. No longer should weight be discussed as a door-handle issue. Nor should it be dismissed with merely an instruction to lose weight with no useful treatments offered. Like other diseases, obesity has a major impact on the health and quality of lives of those affected, it deserves treatment. A diagnosis of obesity can be a positive event, a positive consultation, a positive conversation. It can be life-changing.
Written by Dr Michael Crotty (@DrMCrotty)
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