Health Policy, In the News, Interpersonal Communication , ,

Obesity: It’s all your fault!

Or is it?

An NPR story this week describes the problems both doctors and patients encounter  in discussing patients’ growing waistlines. Some of those problems stem from the stigma associated with obesity that has been blogged about here at Upstream. Because obesity is so often seen as an individual moral failing, doctors understandably don’t want to feel like they are accusing their patients of being lazy or overindulgent. Conversly, patients can feel like they’ve failed their doctors if they have been unable to lose weight since a previous visit.

The truth is, gaining weight is pretty easy in this country, and geting rid of it is extremely difficult. Individual responsibility is certainly a necessary component of weight management, but one of the many external barriers to weight loss is the the way it is talked about. The focus tends to be on the individual and not the environment: the choice of dinner at McDonald’s versus the number of McDonald’s in a neighborhood; the choice to not exercise versus the number of parks in a city or the safety of the streets; the choice to not cook fresh foods when one was never taught how to cook vegetables and grew up eating chicken nuggets.

Obesity is such a difficult issue because in spite of the vast numbers of environmental and structural barriers, it still often comes down to the choices people make. However, those choices can be a lot easier if patients believe that their doctors are on their side. Many doctors may not even be aware of the vast difficulties facing individuals who are struggling with a weight problem. The NPR story points out that few doctors are taught about obesity in medical school, even though it may soon become the number-one health burden on our society.

The rise of obesity is indeed a moral failing. It comes from a failure in our society to value the things that will promote health and happiness. It comes from our failure to fund healthy school lunches; our failure to keep all neighborhoods safe and attractive; a failure to provide comprehensive, skill-building, life-long health education; a failure to reign in a commercial media machine that creates a religion out of mass consumption; and finally, it comes from our failure in blaming the people who are victims of a society that has failed them in so many ways.

In a country that valued those things, a doctor and a patient might not have to skirt around such a serious health issue.

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