Why Your Doctor Won't Tell You that You're Fat

Obesity is on the rise, and mention of it makes headlines on the evening news and magazine covers regularly. It's easy to just nod our heads at the statistics: that obesity-related illnesses like heart diseases, stroke and even cancers are more likely to kill our children than a car accident.

It's a very different thing to take those stories and statistics personally to you and your family. Sure, you know that your 12 year old is chunky and that your husband has a spare tire and you have middle-aged spread. But it takes more than elastic waistbands sometimes to spur us to lose weight.

Typical of Americans, we expect our doctors to step up and tell us when we are fat. And then we get insulted when they do.

In August, Time magazine reported on a recent survey released by researchers at the Mayo Clinic in Rochester, Minnesota. According to this survey, only 1 in 5 obese people were listed as obese on their medical charts. The study charted more than 2500 obese patients who went to their doctors for a checkup, and most failed to leave with a weight loss plan.

Generally, if it isn't on the chart, the subject didn't get discussed. And people who discuss weight management with their doctors are more than twice as likely to develop a weight loss plan than those whose doctors remained silent.

Communication between doctor and patients gets stressed often. Usually it is patients who clam up about health problems, a nagging ache or pain, or a bad habit like tobacco use. So why are doctors keeping quiet when it comes to fat?

Sometimes, the doctor senses that the patient is in denial and not motivated to change, so opts not to say anything. Some doctors may feel that their patient will be embarrassed at the big "O" label placed on them. And in these days of managed health care, time restraints can stand in the way of a meaningful dialogue between doctor and patient. Lack of a relationship between health-care provider and patient is an issue, too. It's easier to mention an impending weight problem if you've been seeing that patient for the last 10 or 20 years.

And when it comes to children, the issue becomes more weighted. In the same Mayo Clinic survey cited above, less than 1% of pediatric patients are diagnosed with obesity, even though statistics show that approximately a third of America's children have a significant weight problem.

The reasons for a pediatrician's silence regarding children's weight can be manifold. No doctor wants to unduly damage a growing child's self-esteem , or create an undue obsession with weight and body image. Some doctors prefer to say that we need to focus on growing up and not out, or that their weight is a couple years ahead of their age to avoid embarrassing their patients, and the parents.

It's easy to understand a pediatrician's reticence on the subject of fat when you sense the parent's impending attack at the first hint of the "F" (fat) word or the "O" (obese) word. But a sincere discussion of weight with an emphasis on healthy lifestyle is a must if we want to stem the rising tide of childhood obesity and the accompanying health risks.

In a perfect world, patients and parents would see the problem and ask for help. But if they don't, doctors need to work on increasing their comfort levels with bringing up fat.