Why obese patients don't always get top-notch care

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"I have avoided going to a doctor at all. That is very common with fat people. No matter what the problem is, the doctor will blame it on fat and will tell you to lose weight," said Sarai Walker, author of Dietland.

Her words sum up a recent trend in healthcare: physicians' reluctance to see past an obese person's weight. A recent New York Times article dives deeper into the issue affecting more than 15 million Americans who have a body mass index of 40 or higher.

Ms. Walker's quote hints at recent research proving some physicians have negative stereotypes about obese patients, don't spend as much time with them and misdiagnose them.

Scott Kahan, MD, the director of Washington, D.C.-based National Center for Weight and Wellness, saw this firsthand. One of his patients had severe shortness of breath while walking from room to room in her home. She went to an urgent care center where a physician informed her she had extra pressure on her lungs due to her weight. Upon visiting Dr. Kahan, she discovered her breathing troubles weren't due to increased pressure — they were the cause of several small blood clots in her lungs.

Other obese patients experience different types of problems. When in need of a CT scan or MRI, heavy patients often aren't able to fit in the scanners hospitals provide, which often have limits of 350 to 450 pounds.

While hip or knee arthritis is not uncommon for obese patients, numerous orthopedists refuse to perform surgery until the patients lose weight, often because they fear Medicare reimbursement reductions or other penalties.

According to Louis Aronne, MD, an obesity specialist at New York City-based Weill Cornell Medicine, many of these problems can be solved by a change in the healthcare system as a whole.

"Physicians need better education, and they need a different attitude toward people who have obesity," said Dr. Aronne. "They need to recognize that this is a disease like diabetes or any other disease they are treating people for."

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