Addressing a significant gap in medical education, a recent study from the University of Georgia highlights the urgent need for better nutritional training for doctors. Presently, medical education overly emphasizes weight and BMI, often leading to unfounded anti-obesity biases and overlooked eating disorder risks.
"Mainstream medicine is still very focused on linking weight to health," remarked Kearney Gunsalus, lead author of the paper and an assistant professor at the Augusta University/University of Georgia Medical Partnership. Researchers argue that equating higher body weight with health problems is misleading and that weight loss is not always the solution.
Recent findings show that being overweight does not necessarily mean being unhealthy. This revelation calls for a shift from BMI-focused assessments to more comprehensive measures of cardiometabolic health, including blood pressure, cholesterol levels, and insulin resistance. These metrics provide a far more accurate picture of an individual's health.
For instance, nearly half of overweight Americans, by BMI standards, are metabolically healthy, while one-third of those in the "healthy" BMI range are actually unhealthy. Even advancements in treatments, like obesity surgeries and medications such as Ozempic and Wegovy, show health benefits independent of weight loss. "If the benefits precede and appear to be independent of weight loss, we need to shift the conversations physicians have with their patients to focus more on health and not weight loss," said Dr. Ellen House, co-author of the publication.
Moreover, current medical training often overlooks the pernicious effects of weight stigma. Weight stigma unjustly associates obesity with moral failings and ignores crucial biological and systemic factors. These factors range from the availability and affordability of healthy foods to access to safe exercise environments. This skewed perception can result in less empathetic care and poorer health outcomes for overweight patients.
"Physicians will miss the asthma, they'll miss the cancer, because they attribute symptoms to weight when weight isn't what's causing the patient's concerns," House noted. Negative experiences with health care, rooted in such biases, can deter patients from seeking medical aid in the future, exacerbating their health issues.
Reframing doctor-patient dialogues to emphasize healthy behaviors rather than weight is pivotal. Encouraging actions like increased physical activity and avoiding the binary labeling of foods as "good" or "bad" can significantly improve patient health outcomes. As Gunsalus puts it, "If I could wave a magic wand and have doctors do one thing differently when interacting with their patients, it would be to start from the assumption that every patient wants to be and is capable of being healthy."
