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Theresa Babb was 12 when a birthday present from a doctor broke her heart.
Doctors tried to figure out why the teenager was overweight. A hospitalization in Halifax coincided with her birthday.
Since flu was making the rounds, visitors were not allowed to enter the hospital. A doctor gave her a birthday card with an elephant on the front.
“I think that’s when I realized and understood as a kid that I would never get help,” said Babb, who is now in her 60s. “It didn’t matter where I went, who I spoke to. It just went like that for the rest of my life.”
Whether it was a doctor noting that her hiking shoes were just “for show” or a doctor asking her if she’d get a fat bike when she expressed her interest in cycling, Babb has often pointed out weight distortions encountered
In a healthcare setting, this happens when the provider harbors negative thoughts or false beliefs about weight, which either unintentionally or intentionally affects the quality of the care they provide.
Some of these beliefs could be that obesity is a personal choice or that obese people are lazy or gluttons.
A recent report from the Public Health of Agency of Canada states that Babb is not alone in her experience. It found that after accounting for gender, income, and other characteristics, people with higher weight were “significantly more likely” to report discrimination in healthcare.
“It’s just so devastating,” said Babb, a resident of Dartmouth, NS.
“You know, that’s the only word that comes to mind when I think about how many times I’ve walked out of a doctor’s office and just felt worse than I did when I walked in.”
The report finds that weight distortion is associated with adverse physiological and psychological consequences.
“Consequences of weight stigma can include avoidance of medical care, distrust of provider, non-adherence to medication, eating disorders, physical inactivity and poorer mental health,” the report says.
dr Michael Mindrum, who practices medicine in Nova Scotia’s Annapolis Valley, recently wrote a blog post about weight distortion and discussed instances where he was guilty of it.
“I’m sure that in the past, despite good intentions, I’ve said words that weren’t the best,” he told CBC News.
Mindrum said the medical school curriculum had not explored the science behind obesity and his residency offered no further insight. He learned about it by going to conferences and lectures.
The science behind obesity
Mindrum said weight is regulated in a part of the brain called the hypothalamus.
“It’s genetically transmitted. It’s a disease that exists in a deep structure in the brain that regulates our appetite as it interacts with an environment that tends to cause obesity in those with genetic vulnerabilities, so all of this is really out of an individual’s control. ” he said.
He said the hypothalamus also regulates other vital functions, such as body temperature, thirst, and thyroid function.
Mindrum said that while things like behavior changes, diet and exercise can lead to weight loss, they’re only part of the solution.
He wants an overhaul of obesity treatment in Nova Scotia, including additional support for anti-obesity drugs – not covered by Pharmacare – and bariatric surgery.
Mindrum said bariatric surgery reduces the risk of death and heart failure and can put type 2 diabetes into remission and lower blood pressure.
He said increasing access for bariatric surgery would pay dividends. He sees it as a necessary operation.
Weight distortion leads to people not seeking care
Mindrum said the overhaul of obesity care also means more subtle changes in health care, such as B. larger chairs and dresses in hospitals.
“Patients don’t feel welcome if they don’t feel cared for – or by the language we use – and many will avoid care and that’s the last thing we really want,” he said.
Babb said there were times when she avoided seeing a doctor because she was worried about how she would feel.
With the help of a new doctor, medication and other lifestyle changes, Babb has lost 150 pounds over the past few years.
“What works is having a doctor who is supportive and will do whatever it takes to understand what you’re experiencing,” she said.
Treatment in Nova Scotia
Earlier this year, Mindrum wrote to officials including Premier Tim Houston and Health Secretary Michelle Thompson. He explained his concerns about obesity treatment in the province and also offered to help create a strategy for obesity treatment in the province.
Tanya Penney, a senior director at the Department of Health and Wellness, responded. She wrote that obesity is a chronic disease that requires attention.
As part of Nova Scotia Health’s “Focus on Wellness, Risk Factor Management and Prevention,” the primary health care team has made wellness programs available across the province to any Nova Scotians who wish to access them. The programs focus on many areas of well-being, including physical activity, nutrition and weight management,” she wrote.
The letter also noted that Nova Scotia Health’s Obesity Network oversees resource planning for obesity services and provides information on services and treatments. She can be reached by phone Tuesdays and Thursdays at 902-473-4672.
