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medpundit |
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Thursday, August 29, 2002COMMENT: Received a sardonic e-mail about the above post: Oh goodie, another knee-jerk reaction. Did you read the article? The woman lived thirty-six years just fine, then more than doubled her weigh in five years.She has been dieting and exercising for all 41 of her years. Her doctor is hopeful she will benefit. "``Over the past two years, I have worked closely with Ms. Madden to reduce weight by conventional means,'' Dr. David Ting wrote to the agency in May. ``Unfortunately, despite diligence on the patient's part, her weight has not significantly changed.''" Does that sound like she hasn't tried? 99.9% percent of overweight and obese people may deserve your scorn, but the other 0.1% may not. Yes, I did read the article, and I have to agree with the Medicaid system on this one. They have a responsiblity to be “good stewards” as they said. The patient in the article doesn’t strike me as a good candidate for the surgery. You have to be willing and able to follow a diet and exercise regimen to keep the weight off and to prevent nutritional complications. She, however, has several strikes against her. She has a “learning disability and suffers from bipolar disorder,” and she admits that her weight gain occurred “when she began eating out of boredom following a back injury.” She is not suffering from some complex endocrine disorder, only from overeating and lack of exercise. Her family physician may say he has worked closely with her and that she has diligently followed her diets, but if that were true, they would have documentation of her calorie counts and exercise efforts. They obviously don’t since Medicaid is asking her to record just this sort of thing for six months. When a doctor says he is working with a patient closely it means that he’s having her come in for regular weigh-ins and giving diet advice. Whether she’s following that advice or not can’t be corroborated. And believe me, the common refrain among the obese is that “I don’t eat anything.” I’m not scornful of the obese. I’m only scornful of the excuses they offer up to avoid personal responsibility. I’m no svelte thing myself, but I know that I owe my figure to my own transgressions. I was not knee-jerking here. I own that I do that sometimes, but I usually reserve it for the pharmaceutical industry. posted by Sydney on 8/29/2002 07:20:00 AM 0 comments 0 Comments: |
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