Obesity has a lot of social factors to it, too. The only cheap food is junk food, you have to drive everywhere, and your job is sedentary, and you don’t have money to play hockey… I mean, there’s a lot that goes into it. Making everything an individual medical issue is bad policy.
Have a little (or a lot of meat) on your bones is protective for bone breaks for people with osteoporosis, so you might see some leg casts on old skinny people.
But the main thing is, yes, to do a thorough workup and not stop at the first and most obvious possible cause of a symptom. The second thing to do is recognize that the person probably is a) aware of the problem and b) has all the same information you have. I’ve never been surprised by what a doctor told me, neither that I was overweight, or that I change change my diet, or that I should get more exercise. So why waste that time and also endanger the relationship with that?
I think nowadays at least we have GLP-1, which I’ve got some doubts on, but at least it’s something that’s more likely to work than Another Diet.
The problem is the doctor is a doctor. It’s the same with psychologists, the patients are depressed because their life is depressing, but the only thing the shrink can do about it is try and get them to feel better.
The psychologist isn’t making the patient the problem, simply, changing the material conditions is beyond the scope. If the patient is suicidal because they’re broke, you, as a doctor, can’t prescribe them more money. The best you can do is get them to cope with being broke, and try and put them into a mindset that will enable them to try and stop being broke. The alternative is to tell the patient “well, you’re fucked” and leave.
Likewise, if a patient has a weight problem because they live in a food desert, you, can’t follow them around and control what they eat. All you can do is give them meds for the immediate symptoms, and try and get them to make an effort to lose weight.
Obesity has a lot of social factors to it, too. The only cheap food is junk food, you have to drive everywhere, and your job is sedentary, and you don’t have money to play hockey… I mean, there’s a lot that goes into it. Making everything an individual medical issue is bad policy.
Have a little (or a lot of meat) on your bones is protective for bone breaks for people with osteoporosis, so you might see some leg casts on old skinny people.
But the main thing is, yes, to do a thorough workup and not stop at the first and most obvious possible cause of a symptom. The second thing to do is recognize that the person probably is a) aware of the problem and b) has all the same information you have. I’ve never been surprised by what a doctor told me, neither that I was overweight, or that I change change my diet, or that I should get more exercise. So why waste that time and also endanger the relationship with that?
I think nowadays at least we have GLP-1, which I’ve got some doubts on, but at least it’s something that’s more likely to work than Another Diet.
The problem is the doctor is a doctor. It’s the same with psychologists, the patients are depressed because their life is depressing, but the only thing the shrink can do about it is try and get them to feel better.
By making the problem the patient and not their life, the psychologist is actively doing harm.
But the result is that the psychologists has clients, so the psychologist gets paid, and from that comes a whole host of emotional justifications.
The psychologist isn’t making the patient the problem, simply, changing the material conditions is beyond the scope. If the patient is suicidal because they’re broke, you, as a doctor, can’t prescribe them more money. The best you can do is get them to cope with being broke, and try and put them into a mindset that will enable them to try and stop being broke. The alternative is to tell the patient “well, you’re fucked” and leave.
Likewise, if a patient has a weight problem because they live in a food desert, you, can’t follow them around and control what they eat. All you can do is give them meds for the immediate symptoms, and try and get them to make an effort to lose weight.