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US Obstetricians and Gynecologists Weight In On Ethical Obesity Care



ACOG_Logo.svg_This month the the Committee on Ethics of the American College of Obstetricians and Gynecologists released a position statement on obesity that advices its fellows to be prepared to meet the challenges of women with obesity with compassion and without bias.

The statement offers the following recommendations and conclusions:

  • Physicians should be prepared to care for obese patients in a nonjudgmental manner, being cognizant of the medical, social, and ethical implications of obesity.
  • Recommendations for weight loss should be based on medical considerations.
  • An understanding that weight loss entails more than simply counseling a woman to eat less and exercise more and a willingness to learn about the particular causes of a patient’s obesity will assist physicians and other health care professionals working with them in providing effective care.
  • Physicians can serve as advocates within their clinical settings for the necessary resources to provide the best possible care to obese women.
  • It is unethical for physicians to refuse to accept a patient or decline to continue care that is within their scope of practice solely because the patient is obese. However, if physicians lack the resources necessary for the safe and effective care of the obese patient, consultation or referral or both are appropriate.
  • Physicians should work to avoid bias in counseling regardless of their own body mass index status.
  • Obesity education that focuses on the specific medical, cultural, and social issues of the obese woman should be incorporated into physician education at all levels.

The entire statement is available here.

It would certainly be nice to see similar statements from other professional bodies (e.g. orthopedic surgeons).

Hopefully, these recommendations will soon be reflected in clinical practice.

@DrSharma
Edmonton, Alberta

3 Comments

  1. I am glad that this document makes it harder for OBGYNs to openly discriminate against their patients. But the fact that this represents any sort of improvement is incredibly sad. The concept that substantial weight loss is possible for all if they try hard enough runs through the entire document. The idea that lifestyle is the only cause of obesity runs through the entire document. Social and economic concerns are mentioned because of the way they can impact lifestyle; no other etiologies of obesity are considered. The authors mention the idea that stigma has been promoted as a way to fight obesity and respond to that idea by saying, “If elected, this strategy needs to be undertaken within a larger framework…”

    This may be an improvement, but it’s not good enough.

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  2. Sorry – I should have said “some OBGYNs” or “certain OBGYNs” when I referred to discriminating against their patients — I don’t think it’s all.

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  3. I agree with what C said, and would add that there’s no mention in that document/set of standards of the possibility of not recommending obesity treatment, but instead, attitude shifts towards self-love, self-acceptance, improved body image, and/or awareness and participation in movements like Health at Every Size and Fat Activism. I’d like to see there be room made for a practitioner to actually suggest the option of NOT working to change one’s body, but one’s thoughts, feelings, emotions and philosophy instead. Or in addition.

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