In "a bold step to improve
his health and to inspire other family physicians
and patients," Dr Jeff Levine of Hillsborough, New
Jersey, was a contestant on NBC's The Biggest
Loser in 2005 and has managed to drop nearly
200 pounds.
Photo credit: courtesy
www.drjeff.tv |
"Eat right and get some exercise."
It's an increasingly empty platitude for a growing number
of growing Canadians. An estimated 5.5 million adults
are implicated in the obesity 'epidemic.' The odds are
good that there are more than a few doctors among this
heavy-set cohort.
Hauling around extra pounds is
a health liability for anyone. But if it's a doctor
who's developed so-called 'tight white coat syndrome,'
are they a liability to patients who come to them for
sound advice?
Some research suggests they are.
"If you have docs with higher body
mass indexes, they are going to be less likely to talk
with their patients about weight," says Dr Erica Frank.
The UBC family medicine prof has been investigating
the link between how doctors treat themselves and how
that affects the way they treat their patients. She's
currently gathering data for a study on the health of
Canadian physicians. In an earlier JAMA study,
she found that "practising a healthful behaviour oneself
was the most consistent and powerful predictor of physicians
counselling patients about related prevention issues."
She also found that patients considered
docs who shared these habits and showcased the trappings
of a healthful lifestyle in the consulting room - a
bike helmet and an apple - were more motivating and
appeared more credible than those who did not.
BIG
FAT LIE
But some of her fellow physicians reject the insinuation
that they are somehow letting their patients down.
"I discuss healthy lifestyles constantly,"
says Dr Moe Lerner, a GP in a Winnipeg clinic with a
high percentage of patients from the lowest rungs of
the socio-economic ladder, "I would be remiss if I didn't."
Dr Lerner is obese himself. He
won't detail how heavy he is but allows that he was
an avid tennis player until he reached 350 pounds. "I've
gained and lost weight many times, I have the credibility
of experience." He laments there are not enough hours
in the day to treat the growing number of patients he
has with adult onset diabetes related to obesity.
He describes how many people with
weight problems have sought him out after humiliating
visits to other doctors insensitive to the emotional
vulnerability that comes with being overweight. Recent
Yale research found that even professionals specializing
in treating obesity harbour an anti-fat bias.
"You don't choose to be fat," says
Dr Lerner. He insists there's an important distinction
between counselling a patient on how to maintain an
ideal weight and the much more elusive goal of shedding
the pounds to achieve and maintain that weight. "It's
easy to say 'I'm a role model because I'm skinny.' You'd
really be a role model if you were fat and you lost
100 pounds and kept it off."
Brad Hussey, a spokesperson for
the Canadian Obesity Network (CON), says he has not
yet met a doctor affiliated with the CON who is either
obese or has boasted that he or she has overcome a serious
weight problem.
NO
SECRET WEAPON
Dr Yoni Freedhoff knows all about it. He's treated a
number of physicians at his Bariatric Medical Institute
(BMI) in Ottawa, a private practice that combines medical
and nutritional counselling with exercise regimes to
help patients lose weight. He's also struggled with
his weight in the past ("I had to lose 15 pounds after
I got married," he says). But the drive to open the
clinic grew mainly from the frustration with the limits
a regular practice put on preventive counselling. "I
had 15 minutes a month to talk to someone to be the
doctor, the dietician, the psychologist and the motivational
coach."
Since he opened BMI four years
ago, he estimates about a dozen of the roughly one thousand
people who have taken advantage of his services have
been physicians. He says it's unfair to expect that
docs should have the instinctual weapons needed to win
their own or others' battles with weight.
"I do always wonder whether or
not some physicians might be embarrassed that they have
weight to lose and they somehow feel that they should
know how to deal with that," says Dr Freedhoff. "If
they were not taught how to deal with their weight or
their patients' weight, how and why would someone expect
that they could magically do it."
For the record, Dr Freedhoff himself
doesn't belong to a gym because he says it would take
up too much of his time. Rolling around on the floor
with his kids, pushing the mower around his yard and
the odd triathlon suit him fine.
GREAT
EXPECTATIONS
All three docs are agreed that prevention has to be
the foundation for the campaign against the obesity
epidemic.
Dr Frank is convinced that physicians
must lead the way. "It makes a lot of sense to encourage
our physicians to be healthy because it improves the
health of the general population and it makes us more
avid preventionists," she says.
And if by focusing on living healthfully,
doctors will spare some of their patients the slide
toward obesity, then, say Drs Lerner and Freedhoff,
showing a little more compassion toward those who have
already fallen will make the healthful living pill easier
to swallow.
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