I am frustrated by the Obesity Epidemic

My Family Medicine homework assignment, in which my rotation group discusses using Motivational Interviewing to implement lifestyle changes in our patients:

One thing that struck me was how we healthcare practitioners sometimes feel we care more about the patients’ health than the patients themselves.  I think this may sometimes be true because we are exposed everyday to the serious complications of common ailments such as diabetes, high blood pressure, high cholesterol, and smoking, especially if we work in an inpatient setting.  That is, we often see the terrible effects of stroke, heart attack, amputations, and tobacco-related cancers.  With these frequent exposures, we are reminded of the eventual potential consequences of an unhealthy lifestyle.  Patients, on the other hand, do not work in a healthcare setting.  They undoubtedly often hear about the complications from the media or from us, but they do not necessarily see it firsthand.  For the patients who do NOT have family members or friends who suffer from the complications, they may not be as “intimidated” into implementing lifestyle changes.  I know I wouldn’t be.

In fact, I feel like the milieu in Richmond may even promote certain unhealthy habits.  For example, in outpatient Internal Medicine, I had an overweight patient who was actually happy that she had gained weight, because she said most other people in her life are also big.  She implied that being big as well makes her feel more fit in.  It seems that the predominance of overweight people here in Richmond (the 3^rd most obese city in the nation) makes being overweight normal, and therefore even acceptable.  In Surgery rotation, I had a patient who had ideal body weight.  The Nurse Practitioner commented that she is "tiny."  I retorted, “She is not 'tiny.'  She is normal.  Just that everyone else is big.”  While I may have been a bit short with my comment to the nurse practitioner, as someone who has lived in cities where most people have ideal body weight, I believe the prevalence of obesity here in Richmond has actually skewed our standards and made the denizens here less aware of just how serious the obesity epidemic is.