How would you react, if during a regular doctor’s checkup, your physician told you that you were obese? That’s what the U.S. Preventive Services Task Force has suggested in a new set of recommendations. It says all adults should be screened for obesity and patients with a high body mass index should receive intervention.
This intervention could involve behavioral management activities, like setting weight loss goals or talking about ways to improve the patient's health through diet and exercise.
Art Caplan, an expert on the subject, is a bioethicist and head of division of medical ethics at NYU Langone Medical Center.
"It really gets involved with how far can a doctor go, ethically, to persuade you to try to lose weight," Caplan says. "We really want to make sure that we do something about this obesity crisis, and your doctor's on the front line trying to do that, but in a way the question is how far can they go and what weapons can they use to get behavior change."
The bioethicist explains what he calls a shift towards a more "directive style", where doctors take more initiative in prodding their patients towards healthier choices, rather than simply relaying medical information from a neutral point of view. He sees this as a favorable change, and points to his own struggle with weight. "I think having more directive, a more ethically charged relationship with a doctor is important," Caplan says.
Substantia Jones is the founder and photographer of Adipositivitiy, a body acceptance campaign to demystify the fat body. "There is a definite threat of harm if the doctor's relationship with the patient is interrupted with shaming language or judgment that can put the patient's health in jeopardy," she says.
"The explosion in weight and the toll that it's taking is beyond dispute," Caplan says. "There's no doubt that you can be thin and sick and fat and healthy, but fat is not good in the long run. The damage that [being] overweight does is not necessarily to your 20 or 30-year old, but you see it in the exploding rates of diabetes, arthritis, and heart disease."