The industrial scales in most doctors’ offices max out at between 350 – 500 pounds. I have two of these scales in my office, both of which carry a maximum weight of 500 pounds. I will soon be replacing one of them because of the wear and tear it receives on a daily basis.
Over sixty percent of the patients at my practice are overweight or obese and unfortunately, these numbers are just slightly lower than our country’s national average. Being overweight or obese is placing a heavy burden on our health care system because this condition is associated with well over thirty medical conditions that include heart disease, cancer, and stroke – the top three killers of all Americans. Soon, obesity will take over cigarette smoking as the single most preventable cause of death in this country.
Despite nagging, nurturing, and knocking on the heads of my patients to encourage them to implement portion control, regular exercise, and to practice good nutrition habits, my words are often replaced with a super-sized, sedentary lifestyle that is filled with high-fat and high-calorie diets and dreams of exercise.
Recently, a long term patient of mine paid a visit to my office. He is twenty nine years old and not in my nurse’s good graces as he as canceled two appointments to see the bariatric (weight loss) surgeon. Trust me – it takes a lot of time and effort to get an appointment approved by an insurance company to see a bariatric surgeon.
For the last five years my patient has “wanted to lose weight”. He has often said, “I want to lose it the natural way Doc,” but has continued to eat poorly and never exercised. His father, who passed away two years ago, was also a patient of mine and was also obese. He was plagued with health conditions that typically accompany not controlling one’s weight: type 2 diabetes, https://www.google.com/health/ref/Hypertension and high cholesterol. Reflecting on his father’s life my patient would say “I don’t want to end up like that Doc. I want to live”.
I want to believe him, but this time I could not. How could I when he tips the scales at 500 pounds plus, has not gone for his recommended sleep study which would determine whether or not he has sleep apnea (a condition also strongly associated with obesity), often misses taking his blood pressure medicines, thinks that the $200 for a three visit consultation with the nutritionist is ridiculous, and uses lack of time as his primary excuse for not exercising?
He constantly complains of fatigue, headaches, shortness of breath, along with back and knee pain, all of which he attributes to a stressful job rather than a poor diet. Additionally, the recent results from his lab tests show elevated blood sugar and abnormal liver function combined with his persistently elevated cholesterol, blood pressure, and a newly abnormal thyroid. His attitude and actions toward his personal well-being do not support what he is saying.
This situation is becoming commonplace in my practice as well as in many practices across the nation. Even among my most intelligent and well read patients, discussions about obesity-related health complications seem to fall on deaf ears.
A government sponsored study estimated that in 2008 medical spending for obesity and its related illnesses reached $147 billion. Eighteen percent of young people between the ages of 12 and 19 are considered overweight or obese in this country while sixty-seven percent of American adults are in the same boat. Discriminatory legislative policies are being proposed that will tax individuals for their weight, charge an obese person for flying, and deny them a meal in Mississippi if deemed obese by crude standards. Although unfair, the fact that policies like these are being discussed in politics is a huge indicator of how detrimental obesity has become to the national health and welfare of our country.
He is heavy, but he is my patient. If the weight does not come off, the costs go up and, more important, the quality of life deteriorates. I’m an advocate for patients and feel honored each day to be a physician in this county, despite my frustrations with health care as it currently exists. However, we must be responsible for our own health.
Quick fixes to weight loss don’t exist and the long-term complications of this disease can be devastating. Every attempt to modify our lifestyle and lose weight should be made but to do this without proper diet and exercise is close to impossible. I will continue to educate my patients and the community on health issues, but until then, I will begrudgingly invest in a new scale.