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    Thursday, August 10, 2006

    Fat Doctors: Do doctors have to be skinny? (requires registration)

    Here's a flip side to that question - how good are doctors- or anyone- at assessing obesity? Often it's a matter of aesthetic preferences:

    While the anthropometric measures are strong predictors of physician evaluations of obesity, between 13% and 19% of the respondents were classified in ways that could not be predicted from the anthropometric measures. Moreover, personal and status characteristics were related to physicians' evaluations of obesity. Women, especially White and taller women, were more likely to be evaluated as obese than would be predicted from the anthropometric measures-African American women were less likely than their White counterparts to be so classified. Physicians' evaluation of obesity was least consistent with measured obesity for older respondents. Indeed among men, age was the most important status characteristic shaping physician evaluations: older men were more likely to be evaluated as obese.

    I've seen this in action, and women seem to suffer the most. I recently recieved a letter from a consultant who actually listed obesity as one of the problems of my patient. The only thing is, her BMI was 24, well within the normal range. But, she has wide hips. The consultant must be a breast man.

    And lets face it, most doctors don't calculate the BMI before judging someone fat. They just make a judgement call. An often inaccurate judgement call, as it turns out.

    (Full disclosure: I am fat myself, by any definitition of the term.)

    posted by Sydney on 8/10/2006 07:44:00 AM 1 comments


    Ah, but I do calculate BMI before making a diagnosis of obesity. More often I do the calculation to reassure patients that they are not fat (ie, the woman who announces as she steps on the scale, "I know I need to lose weight." The problem is that she is often not satisfied with her BMI of 24.)

    I too, am obese. And I am female. Does that make me less inclined to throw the term around? How about including physician BMI in that analysis. Are skinny doctors more likely to call patients fat? I have found that they seem more likely to minimize the difficulties of weight loss, especially to women.

    By Blogger #1 Dinosaur, at 7:12 AM  

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