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February 16, 2010
In Today's Issue
- Overweight? Shocking Proof that it may not be your fault
- Health Repercussions Of Being Overweight
- The Biggest Loser's Twins Proven Weight Loss Techniques
Overweight? Shocking Proof that it may not be your fault
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Health Repercussions Of Being Overweight
Dear Reader,
You've read about all the health risks of obesity, including heart disease, type 2 diabetes, certain cancers and even early death.
But there are surprising risks to your health from those added pounds that are not nearly as well documented.
Some recent studies have found that overweight woman...
- Might have a harder time getting health insurance, or have to pay more for it.
- Are at higher risk of being misdiagnosed, or getting an inaccurate dosage of a drug.
- Are less able to find a fertility doctor who will help them get pregnant.
- Are less likely to have cancer detected early.
Current numbers have just about 70 million American women considered overweight, which makes for a lot of patients who may not be getting the care they need.
Overweight or not, these findings should have everyone taking note, and taking steps to be sure you get the quality healthcare you deserve. Overweight or not, being mistreated or dismissed by your doctor because of your weight is unacceptable - you don't want that person in charge of your medical care.
"Our culture has enormous negativity toward overweight people, and doctors aren't immune," explains Harvard Medical School professor Dr. Jerome Groopman, M.D., author of How Doctors Think. "If doctors have negative feelings toward patients, they're more dismissive, they're less patient, and it can cloud their judgment, making them prone to diagnostic errors."
When it comes to just how many diagnostic errors are due to a patients' weight, there are no hard numbers to attest to the problem, though it's long past time for the medical community to take a hard look at the biases that might be affecting the treatment they give overweight patients.
Data on diagnostic errors for the general population is sobering. "Doctors make mistakes in diagnosing 10 to 15 percent of all patients, and in half of those cases it causes real harm," Groopman says.
Carrying too much weight does bring legitimate concerns to the operating table, and those with high BMIs often find that surgeons are reluctant to offer a procedure to very overweight patients as they make for longer, more difficult operations.
Hospitals too, who track data on surgical complication rates may warn doctors off more high risk cases in order to preserve their standing with insurance companies. Patients may be denied procedures like cardiac catheterization, organ transplants of kidney or liver, knee surgeries and more because of their weight.
Being too heavy can even get in the way of effective cancer treatment according to the experts. The most likely culprit is underdosing, basing chemotherapy drug doses on the patient's ideal weight, rather than their actual weight.
Trials usually only include women of average weight, so doctors don't have a good handle on the doses for larger women. And since these drugs are quite toxic, no one wants to take chances with the dosing.
Doctors have known that obese women are more likely to die from breast or ovarian cancers. Especially troubling then is the finding that obese women are less likely to get Pap smears than women of normal weight, but the screening lapse isn't all on the women here. A University of Connecticut study of more than 1,300 doctors found that 17% were reluctant to do a pelvic exam on an obese patient; the number jumping to 83% if the patient herself seemed hesitant about the exam.
Continues below...
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Health Repercussions Of Being Overweight Continued...
That should NEVER happen.
But you can't blame it all on doctors as being overweight can obscure illnesses like heart disease and some types of cancer. All those extra pounds bring added strain to joints and pain you might not be having if you were thinner.
What's more, large patients don't always fit into the small spaces of diagnostic scanning machines. Computed tomography (CT) and magnetic resonance imaging (MRI) and even X-rays and ultrasounds aren't able to deliver as clear a picture, and without that, imagine your doctor driving blindfolded as he tries to treat you.
Ultrasounds are particularly vulnerable to added fat; the beams can't penetrate the tissue if you have more than 8 centimeters of subcutaneous fat. Naturally this affects more women since ultrasounds are used to spot uterine tumors and ovarian cysts, not to mention to check on the baby's health during a pregnancy.
Researchers have also confirmed false positives to mammograms in overweight and obese patients.
This leaves a doctor with little to go on except the symptoms you mention and intuition. That isn't the best option in the emergency room. "If we can't get the imaging because of a patient's weight, and we are concerned about a pulmonary embolism or appendicitis, for example, we have to go ahead and treat based on our clinical impression," explains Dr. Archana Reddy, M.D., a practicing emergency room physician.
Certainly something we all need to be aware of when it comes to medical care.
To your good health,
Kirsten Whittaker
Daily Health Bulletin Editor
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Sources:
http://www.cnn.com/2010/HEALTH/01/21/
obesity.discrimination/index.html
Dr. Jerome Groopman, M.D., author of How Doctors Think:
http://www.jeromegroopman.com/
Dr. Archana Reddy, M.D., a Chicago-area ER physician:
http://www.drreddymd.com/
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