Can Obese Doctors Help Obese Patients?Tuesday, March 2, 2010
This week’s edition of JAMA features a most interesting essay by Nitin Kapur, a physician associated with Yale university in New Haven, CT.
Dr. Kapur describes his interactions with a Mr C., a 5-foot 7-inch patient weighing 320 lbs (BMI=50). As Dr. Kapur points out, he himself is about the same height and carries 245 lbs (BMI=38), which led him to ponder whether he could indeed be of any help to his patient.
While Mr. C. gained his considerable stature (and continued gaining weight during his interactions with Dr. Kapur) after replacing his heroin addiction with bacon double-cheeseburgers, Dr. Kapur attibuted his weight problem to his stressful life as a medical resident and the demanding nature of physicianhood.
So here, as Dr. Kapur puts it, we have the morbidly obese drug addict and the severely obese Ivy League graduate, both struggling with their weight problem.
“So”, asks Dr. Kapur, “am I a hypocrite offering help to this patient, even though I couldn’t help myself?”
As Mr. C. continues gaining weight, Dr. Kapur begins to feel responsible and wonders it if would have been better to send Mr. C. to someone unencumbered by a 40-inch waist.
Finally, one day, Dr. Kapur asks Mr. C. whether it would indeed have been more inspirational for him to have seen someone thinner.
But Mr. C. dismisses any such concerns, responding that only Dr. Kapur could have truly understood what it felt like to be fat and that he very much enjoyed the care and had no doubt that he would eventually lose the weight.
This most insightful and touching story raises an important issue: can health professionals, who themselves struggle with excess weight, really provide help to their obese patients? Or are obese health professionals perhaps the only folks who can really understand the extent to which excess weight affects their obese patients’ lives.
What do my readers think? Does the weight of the health professionals giving weight management advice matter one way or the other?
Hat Tip to Tobias Pischon for bringing this essay to my attention.