Friday, July 18, 2008

obesity weighs heavily on my mind

I was reading the NY Times online today, catching up on news of the world around me. In the past 10 days or so, there has been a series of articles about doctors counseling patients about weight loss ( I was definitely intrigued by the headlines, as I was recently told that I was mean to my overweight patients; I am honest with my patients. What was more interesting to me than the articles themselves were the comments. The basic idea is that overweight and obese people know they are overweight and don't need another lecture. I can see that, although in my office it tends to be the parents who already know their children are overweight, and are often overweight themselves. But I still feel that it is important to show the child (depending on the child) and the parent(s) the growth chart with the BMI plotted. Maybe in doing so, I am being too harsh. Yet, I feel that if my concern is health, I need to address the topic in a frank way. I do ask families how I can help, and I try to refer them to a nutritionist, if available; when necessary, I check a lipid profile. I can think of other things I would like to do, like change school lunch menus, get kids in daily physical education classes from kindergarten through 12th grade, and teach parents how to cook in a healthful way, but we don't have the resources. I do as much as I can to offer solutions, like cutting out the ramen noodles and flaming hot cheetos! But I also ask parents not to keep unhealthy snacks in the house. Just the other day, I had a parent tell me that it makes her 107 pound five year old son sad when she goes to the grocery store and doesn't come home with ramen noodles, and I suggested that that was OK that he was sad, that she could perhaps just make them as a treat once in a while. My patients know though that I am their loudest cheerleader when they start exercising and watching what they eat, even if they don't lose weight right away.


Cindy said...

Hey, Alex!
I know exactly where you're coming from. This is a very frustrating aspect of practice. I just don't understand it. I have had some patients get offended when told their kid is too heavy, not to mention F-A-T. Most people seem to be oblivious to the threat of type II diabetes.They seem to view it as a very remote possiblility, even as I'm looking at their acanthosis nigricans. "I can't keep him away from the snacks and soft drinks," they say. Wake up, People. Who's buying the junk food? Sometimes I wonder if they just think we're exaggerating and we're crying wolf.

Alex Cvijanovich said...

Hi, Cindy!
Thanks for your comment! Nice to know someone is reading is and knows where I'm coming from. Funny thing is that even the parents who already are experiencing the effects of their obesity don't see the problem with their kids being overweight!!!

Wallace Obese Looser said...
This comment has been removed by a blog administrator.