to expect health care professionals to be realistic about obesity

[chocolatehobnobs]

I have just seen a male student nurse walk past my flat window with DP and 2 sweet young DDs. He works on a ward and is 30 stone plus ie morbidly obese. I was horrified to see him carrying a family bucket of KFC.
Last week in the operating theatre a colleague asked me why I had prescribed antibiotics for a patient when another patient having the same operation had not been given them. I replied 'because she is fat' ( longer surgery and obesity mean higher risk of wound complications and infection). She then challenged me in front of our other colleagues saying that she didn't think I should have used the word fat about a patient. I replied that we are all health professionals and all understand that fat is a plain term for raised body mass index or obese and that the patient was not upset as unconscious. She replied that as the patient's advocate she did not want the patient to be referred to as fat or have their weight discussed. I think she was upset as a morbidly obese person herself.
Honestly, I just think that if health professionals cannot accept that obesity is a major health risk and discuss it openly then what chance have we got to improve things.

Gigglepin - I definitely understand my duty of care , I was taking extra care to make sure she did not have a complication due to her obesity and am very careful to be tactful when discussing weight with a patient in relation to someone's medical condition. Other posters are clearly offended by the word fat too so maybe IABU to use this term with other health professionals - surprised that many of you find the word so offensive. I did not actually raise the issue but was answering a juniors question with a straightforward answer. My point is that health professionals should be able to be honest about obesity . Many people find the word obese just as offensive IMO and at a busy point preparing for an operation I do not have time to talk about a significantly raised body mass index. We do need to address the additional precautions to take with some patients and be upfront about it not brushing it under the carpet.
My point about a nurse buying a KFC bucket is that it is unreasonable to either eat this shit yourself it you have a major weight problem or feed it to your children. It's a really poor example to set to young children if you are a health professional. Just felt it was yet another example of the major public health problem we have.

Ok usually dont post on AIBU but this is a subject close to my heart. Do you not think though that we sugar coat it a bit by using the word obese instead of fat ? Im fat, my doctor readilly agrees I'm fat. If Im offended then surely I should do something about it rather than sit on my fat bum lulled into a false sense of security because I am only "obese" ? (Running away preparing to be well flamed )

Yanbu. Fat isn't an offensive word. It's plain speaking.

my health visitor is about 22stone (she's tall but massive) i find it very hard to take advice on healthy eating\lifestyles from her if i am honest.

"It's a really poor example to set to young children if you are a health professional"

Health professionals don't drink or smoke or take drugs or do dangerous sports or have unprotecetd sex for the same reason I guess.

(though to be fair I doubt they have unprtecetd sex in front of random people)

I think Fat will always be deemed offensive. I dont like Skinny either, thin is better.

As someone quite rightly pointed out - Fat isnt a very good description medically either. It can mean pretty much anything. Fabby thinks size 12 is fat.

Obese, morbidly obese, supermorbidly obese are surely more accurate terms although i am sure they would be upsetting too.

You DO have to be honest as a medic but you dont have to be brutal.

That may be true hairy but the OP is a medic so surely should be using medically accurate words.

Anyway plain speaking can very often = fucking rude and proud of it.

Your language and attitude is the problem. She has every right to challenge you

I was 25 stone - calling me fat or obese makes no difference to me. Row - do you really think being called obese (or if you prefer "morbidly obese") is sugar coating it? Really?!

I have never met a health professional who tiptoed around the fat/obese is unhealthy issue - in fact a great deal of my ailments were put down to my weight (incorrectly) quite firmly by medical professionals (though they struggled with finding a link between my disappearing platelets and my weight!).

YANBU one of my morbidly obese or fat colleagues used to be the registrar at the obesity clinic i was always a bit about how he could work there.

I think when discussing with another colleague saying fat is absolutely fine so long as you are perhaps a little bit sensitive when talking to patients, that said i still make mine cry all the time by saying there BMI is raised to a dangerous level i'm not sure there is an easy way to tell people they are fat. I would feel like a complete hypocrite if i was overweight.

I think euphemisms often don't help anyone - sometimes you have to be fairly plain speaking with people but of course should always be respectful.

However a conversation between colleagues is slightly different - I might discuss a patient with a colleague using terms that I wouldn't use to, or in front of, the patient.

By the way I'm not a thin person , I'm moderately overweight myself BMI 27 and size 14 - 16 and honest about it. Also - in surgery the word fat is used interchangably with adipose tisse as a noun - I personally don't find it that offensive and did not use the word as an insult just a fact.

I never say the word 'fat' regarding my patients but wouldn't use the word 'obese' either. Issues regarding the increasing weight of people in our country is complex and I'm sure thhat if there was a magic pill to make someone a size 12 - there would be a huge take-up.

Being obese must feel awful - these people aren't stupid, they know that they are hugely overweight (or 'fat') and suffer physically and emotionally because of it. I think that saying 'because of your raised BMI we should do a,b or c' is sufficient, I really don't think they need to be made to feel worse.

Yes, obesity can be sorted with the correct diet and increasing physical activity but it really isn't that simple otherwise e wouldn't have this issue.

I've strugled with my own weight over quite a number of years, I never went above a size 16 but it has given me an insight on how difficult it can be. I found a simple solution for me that works over the last couple of years and am now a 12 but I actively researched info regrding diet/health/psychology a lot and came to my own conclusions.

YABU - if you wouldn't use the word 'fat' in your notes, you shouldn't use it in a professional conversation either.

I think the word fat is unequivocal and easily understood. The word obese has been medicalised and therefore become more acceptable. I agree with the OP. Saying to someone they are 'morbidly obese' is not as effective in terms of behaviour change as saying 'you are so fat that it is making you ill'. Adipose tissue (or 'fat' in fact!) is an endocrine organ all by itself and has huge effects on the whole body. This is not just about looking good in a swimming costume.

People are in denial or feel powerless to do anything about their addiction to eating just as they can be with smoking. (I know senior nurses in my trust who look after lung cancer patients and then go outside for a fag.) I think we should use the word fat more often. I don't ask people if they are 'dyspnoeic' or whether they feel 'nauseated' - I ask them if they are breathless or sick.

Disclaimer: I am currently post-natally fat and doing WW whilst on maternity leave so that I can go back to work without feeling like a hypocrite.

It is ridiculous how the word fat is becoming an offensive word to some people. It's just a descriptive word. It is not derogatory, it means nothing.

If I were fat, I would much rather be called fat than obese.

"Whale of a Child" - I thought that was hilarious

People get offended too easily.

I am surprised at your attitude to be honest. As a health care professional I would of thought that you would be aware that describing somebody as fat does sound derogatory. You do sound like you have an issue with overweight people, you seem very judgemental. I wonder what why you are judging others? I too am a HCP and would dream of calling somebody fat as it sounds, well horrible really.

As a HCP, you must be aware that there is very little evidence that obese and morbidly obese people can successfully change their shape and that, in fact, it may well be the case that efforts to shift fat actually result in people beginning a vicious cycle of losing/regaining which causes them to become fatter and fatter as the years go on and putting themselves at greater health risk than if they had chosen to settle to be a few lbs overweight. At a BMI of 27 yourself, you could easily fall into this trap yourself.. and you would be just as judged for eating sprouted mung beans ("who does she think she's kidding? clearly she eats more shit than that!") as the HCP with the KFC.

I think YABU. Obesity is a health risk, it's true, but it is also something that people feel free, in this politically correct age, to mock and deride people for and often speak about them as if they were less than human and a drain on resources. My mother and sister are morbidly obese and as anyone who has lived with people who are will tell you, they probably spend years more of their lives eating low calorie foods than the average naturally thin person, only to rebound and have net weight gain, all the while feeling miserable and hating themselves. Undereating is not really a solution to overeating yet it is the one that HCPs advise on the basis of virtually no evidence that it actually works!

It's a thorny area but I would use professional language at work and if you work in the NHS you know that "fat" as an adjective is not acceptable in a clinical environment if you wouldn't write it in your notes.

whatever term is used instead of fat will probably come to sound as derisive as 'fat' does to some people.
Personally I think the word obese sounds more insulting.

I work in theatres and if I hear staff say innapropriate or unprofessional things about patients, I challenge them. it does not matter if a patient is unconscious, we as hcp's should still treat patients with dignity and respect. I would like to think if I needed an operation I would be treated with respect by staff, fat or not.

This is a medical situation though.

Medics use words that may sound shocking or offensive to us but are medically accurate.

Describing someone's weight in terms of grades of obesity is more helpful than just saying fat isnt it?

Or not?

Fat has become one of those words that is usually sort of spat out rather than said. The OP seems to have just said it but perhaps it has too many negative (other than medically negative) connatations to be used formally?

If you eat more than you burn off you will be fat = simples = eat less and exercise more. The rest is down to self discipline and emotions which really isn't simples. As a professional I would refer to the charts and BMI if discussing weight and discuss the aim for a healthy weight/ BMI. I used to work in theatres and also witnessed (mainly Drs/ Consultants) people being disrespectful of weight issues. Usually if they were trying to do a laparoscopic procedure because it is difficult with excess fat. There I said it

In my opinion if they op was willing to write ' patient given antibiotics due to being fat' in the post op notes then it would be ok to refer to the patient to a junior colleague in this way. If not then she should perhaps discuss clinical decisions with juniors in a different way.

What do you call it though?

DD aged 10 had a lovely figure slim, tall, but well-rounded and firm according to all who saw her, but she couldn't fit into clothes aged 11-12.

People forget that children SHOULD have bones showing and look a bit skinny. DD would have looked great if she had been a woman grown but she wasn't, and didn't need to be carrying weight around her tummy.

I adjusted portion-size for DD's meals and within six months she was back to where she should be.