Despite rising obesity rate, doctors shy about talking to patients about their weight

Steve Mertl
National Affairs Contributor
Daily Brew

We're bombarded regularly about Canada's burgeoning obesity problem but apparently our doctors are reluctant to tell us to lose weight, according to a survey.

An article in the journal Chronic Diseases and Injuries in Canada found less than one-third of overweight people had ever been advised by their doctors to drop some pounds - unless they asked.

The article's three researchers said a third of the 2004 respondents were classified as overweight and 20 per cent as obese.

"In the 12 months before the survey, 48 per cent of overweight and obese respondents reported asking their physician about weight loss, while 30 per cent reported that their physician advised them to lose weight without them specifically asking," the report said.

The researchers were looking into how the 2006 Canadian Clinical Practice Guidelines for managing and preventing obesity related to what Canadians were actually experiencing in doctors' offices.

The results were "a further indication of the widely held societal view that obesity is an issue of personal responsibility rather than a medical problem," the researchers wrote.

The article's lead author, Sara Kirk of Halifax's Dalhousie University, told the Ottawa Citizen the survey also found 40 per cent of overweight or obese respondents described themselves as "about right" when it came to their weight.

It's part of the "normalization" of excess weight, she said.

Almost 60 per cent of adult Canadians are either overweight or obese and experts say that figure could reach 70 per cent by 2026 unless things change.

Severe obesity - people with a body mass index of 40 or higher (25 is considered healthy) is mushrooming, having tripled over the last three decades, the Citizen reported.

Despite the scary stats, Kirk said obesity is poorly addressed by the medical community.

"We don't manage this problem well, we don't provide people with what they need in order to manage their weight successfully and we have very negative attitudes toward people who have a weight issue," she said.

Of those surveyed, 58 per cent said they'd tried to lose weight in the previous year but only 21 per cent sought help from their doctor.

When they asked for help, the were told to exercise, diet, join a weight-loss program or take meal replacements or supplements.

Only four per cent of obese respondents were told about surgical options, even though surgery is considered the most effective long-term treatment for severe obesity.

"Family physicians, or any of the health professionals, really don't want to talk about weight," said Kirk. "They don't know how to start that conversation. Often they start it with a flippant remark that can do more damage than good.

"There is a whole layer of weight bias and stigma which is incredibly ingrained in our society that means that people aren't getting the support they need."

Medical professionals need to learn how to discuss weight with their patients in a sensitive, non-judgmental way, Kirk told the Citizen.

Family doctors may not have time to counsel patients at length but they are the gatekeepers for other services, such as dietitians, fitness experts and psychological counselling, she said.