Doctors Fail When They Shrink from Obesity Discussion
> 7/19/2006 2:36:02 PM

In her article "Who Are You Calling Fat?" from today's Washington Post, writer Sandra Boodman looks at a troubling issue in the fight against obesity: often, doctors are afraid to use the word fat. As it turns out pediatricians and general practitioners have all sorts of excuses for why they don't talk about weight issues with their overweight patients. We wouldn't want to hurt the kid's feelings, we don't know how to help him, there's no time, insurance companies won't cover treatment anyway.

It seems like the only thing that everyone can agree on is that our children are in trouble. Childhood obesity has been increasing at an astounding rate. We also have strategies to help fight the problem. Obesity is a chronic disease with a variety of causes, so when doctors allow patients to walk through their office without a mention of weight issues, they are essentially allowing them to continue to live with an untreated disorder. Some doctors do make weight an issue, but still see many barriers to proper treatment.

Reginald Washington, a pediatric cardiologist in Denver who is co-chairman of the AAP's task force on obesity, said the CDC's "warm and fuzzy" labels obscure the health crisis personified by the children who are routinely referred to him for treatment of high blood pressure and high cholesterol.

"I think until people realize they have to change, they won't," Washington said, adding that one reason childhood obesity "is so out of control is that no one wants to talk about it."

Washington said he has been accused by parents of callousness or an inability to understand the problem when he tells them their children need to lose weight -- criticisms he rejects. Many parents, he added, are too fat themselves and are unwilling to make changes to help their children lose weight.

"There's a lot of denial," Washington said, adding that parents have told him they can't buy healthier foods because their children refuse to eat them, or they don't want to remove the TV set from a child's bedroom because he or she will get into trouble doing other things.

In her piece, Boodman talks about how ignorance can be a factor and often cultural and economic issues can come into play. Nevertheless, the fact of the matter is that if these doctors have children in their office and do nothing to raise discussion of obesity, they are failing at helping that patient.

The Post does give some good news. The Children's National Medical Center in Washington has been developing a special clinic that will tackle obesity head on with "individual and group treatments for children and their families" as well as "a nutritionist, a cardiologist, an endocrinologist and a personal trainer." In the short term, creating these types of clinics may be pricey, but the long term benefits and savings will be enormous.

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