Despite the fact that there are twice as many obese adult Americans today as there were 20 years ago, you may not be seeing that many more obese patients in your practice. That's because emotional barriers may lead obese patients to delay seeking needed medical care, including routine services like Pap smears and breast and pelvic exams.
According to the Weight-control Information Network, or WIN, some of the barriers that prevent weight-sensitive patients from making appointments include:
- fear of disparaging or negative comments from staff resulting from past disrespectful experiences,
- failure to lose weight since the previous exam, and
- lack of proper accommodations and size-appropriate medical equipment and difficulty performing exams.
WIN, a joint project of HHS and NIH's National Institute of Diabetes and Digestive and Kidney Diseases, aims to provide the general public, health care professionals, members of the media and Congress with up-to-date, science-based information on weight control, obesity, physical activity and related nutritional issues.
When you see obese patients in your practice, you may wish to steer them to WIN resources that can offer them realistic tips and goals for healthier lifestyles. Publications for patients include “Active at Any Size,” "Improving Your Health: Tips for African-American Men and Women" and "Helping Your Overweight Child."
WIN also provides publications geared to clinicians, such as “Medical Care for Obese Patients,” "Longitudinal Assessment of Bariatric Surgery" and "Prescription Medications for the Treatment of Obesity."
In addition, WIN is currently creating an informational insert based on the Department of Agriculture's recently revised “Dietary Guidelines for Americans” that will in the future be included in all of WIN's publications. An added bonus: Many WIN publications are available in Spanish.
To ensure your practice is welcoming to obese patients, try these tips.
- Provide sturdy, armless chairs and high, firm sofas in the waiting room.
- Provide extra-large gowns and wide, bolted-down tables in exam rooms.
- Have large (greater than 34 cm) blood pressure cuffs on hand, as well as tourniquets and vaginal specula capable of accurately assessing obese patients. And lay in a supply of extra-long needles.
- Weigh patients only when necessary and do so in private on a scale with adequate capacity.
- Avoid the term obesity, instead using terms such as difficulties with weight and being overweight.
Above all, treat patients with respect and don't be judgmental. Rather than launching full tilt into a discussion that may make them uncomfortable, ask them if they’d like to discuss their weight or health.
