Obesity is not a disease

"Obesity is not a disease" First remove the external prejudice to find out the root of the problem

Don't judge quickly

I have to be honest, this new patient sitting around looking for me at the age of three and looking for me for a general health check made me uncomfortable.

Miss Vincent's size is quite petite, but her body width is morbidly obese as defined by the medical definition, her loose stomach, as if the third accessory organ is hanging between her feet, hindering her pace; Qingli's pleasant face , Completely engulf the neck and jaw layer by layer; because the waist is too large, the arm cannot naturally hang on both sides of the body.

She climbed the inspection table with great effort, and the inspection table was shocked by 159 kg. I opened the robe of the patient from behind her, trying to listen to the sounds of the lungs, but waves of fatty tissue spread out layer by layer, wrapped in breathing sounds. During palpation of the abdomen, my hands were also involved. I had no chance to feel her liver, and there was no way to find the thyroid and lymph nodes in her neck.

My job requires me not to be judged, but the reflective discomfort does not allow me to deny, and I also feel uncomfortable because of this uncomfortable. Many studies have shown that physicians clearly express prejudice about obesity, less respect for obese patients, and it is also more difficult to develop a harmonious relationship.

The optimistic person in my body used to hope that since medical professionals are so proud of their care for their patients and their disadvantages, they should respect obese patients more than others.

It's a pity that things are counterproductive. I shouldn't be so dumbfounded, just depressed. Why do doctors respond so? (Interestingly, patients have the same prejudice against doctors. No matter how much the patient weighs, they don't trust obese doctors.)

Undoubtedly, physicians often classify obesity (like alcohol and drug abuse) as self-induced. Some physicians cannot help thinking even if they are well aware of the genetics and other interfering factors involved.

During the training process, doctors are particularly indulged in various disciplines and deprivations. Therefore, they always think that as long as they are a little more active and evoke a sense of self-discipline, these health problems can be alleviated without further effort. Although the evidence is abundant and abound, The facts are just the opposite, but it is still difficult for doctors to abandon this idea.

In these obese patients, we may see what we fear, and think that if we lose the discipline of prudent tempering, it will become like this. As an adult, I worked hard to maintain my weight and posture. Although compared with many patients, my efforts were only trivial, it made me very disgusted with junk food and overeating.

Perhaps Miss Vincent reproduced my worst nightmare: once I lose vigilance and lose self-discipline, it will become her. Perhaps the problem is pure obesity.

This society advocates slender and slender figure. When it is unhealthy, even if it is clean and tidy like Miss Vincent, and her face is charming and beautiful, she is regarded as a unkempt person because of her weight.

Of course, such reactions are completely irrational, but emotion itself cannot be classified as rational. Moreover, doctors are just like ordinary people, and they are easily affected by emotions. I don’t want to be a physician who judges patients in advance by appearance. Of course, I don’t want to strengthen the stigma that obese people actually experience, but when I was examining Miss Vinson in the clinic that day, I felt constrained and couldn’t control it.

However, the more I talk to Miss Vincent, the more I can control the situation. She mentioned that she was in poor physical condition. Many diseases originated from obesity. Taking care of her body was not easy, and she was under pressure to take care of her children.

She admitted that it was difficult to control her diet, and this pressure forced her to eat more. Being overweight makes her depressed, but she is even more eager to soothe sweets. She blamed her family medical history. Her family tended to be obese, emotionally abused, and neglected.

She also said with Pan Pan that she felt ashamed to go to the gym. It was almost impossible to find a fitness suit to wear, and the road to job search was also bleak: "No one will call fat people and invite them to the second interview." She couldn't reach her back and scratch the itch.

If the child walked quickly on the street, she knew she could not keep up. The more she said, the less my emotions were. At first, I only saw an extremely obese patient. Later, I saw a mortal with a thin mind and a strong feeling. Her life was dominated by obesity and full of bitterness.

After the outpatient clinic, I reflected on my initial reaction. How is this different from racial discrimination? Is it less disgusting? Even if her physical condition is self-induced, even if it is partially, how can I agree with my reaction?

The relationship between the doctor and the doctor cannot be tolerated

Fortunately, I saw another study and felt more at ease. The study was drawn from a larger maternal sample, totaling nearly 70,000 patients. The results found that no matter whether the patients were obese, there was no difference in care between the two groups.

Although social prejudice against obesity is ingrained, and physicians and patients are all affected by prejudice, healthcare professionals still seem to be able to provide the same treatment.

However, I am not sure if this is enough. In the face of "unwelcome" patients, the doctor can swallow the sensation, cover his nose, and still give proper treatment. Although medical results are acceptable, these methods still run counter to the overarching principles of medical practice.

The most important thing in practicing medicine is to treat the patient with sympathy, but sympathy pretends not to come. Compassion needs to come from the heart and out of respect.

When we teach medical students, we often talk about empathy. The most straightforward explanation for empathy is: trying to feel the emotions of others and feeling the surroundings of life from the perspective of others.

The first time I visited Miss Vinson, the longer I talked to her, the more I could piece together her life. Although it cannot be assumed that she really knows how she feels, she can start to imagine how she feels, and can imagine how she will face the extra 90 kilograms and the pressure that goes with her.

Recently, when I saw her appearing in the clinic, I felt that I was different. The physical examination still taught me a little uncomfortable (I honestly), but I forced myself to put Miss Vincent, not this body, at the top of my mind.

My intuition is still pulling, but it feels more controllable. Perhaps this is exactly what the physician should try to do: no matter how embarrassing, it is necessary to force negative emotions out of the shadow.

In the relationship between the doctor and the doctor, there is no room for contempt. The doctor must first ensure that each patient can express himself in front of the doctor in order to provide quality medical care. If we physicians are uncomfortable ourselves, we must face it honestly; only if we face it honestly, can prejudice be dissipated.