Doctors, obesity and the new surgeon general

America’s newly nominated surgeon general, Dr. Regina Benjamin, is African-American, a native of Alabama, and has long experience working with patients in poor and rural communities.

She has dealt with setbacks. Raised in poverty, she and her family used to travel to the Gulf of Mexico to catch crabs and shrimps to eat. In 2005, Hurricane Katrina damaged the clinic she founded in Bayou la Batre in rural Alabama. Shortly before the clinic was scheduled to reopen, it was destroyed by fire. Undaunted, Dr. Benjamin continued to see patients in the local hospital and in their homes.

She’s highly accomplished. In 1994 she was listed as one of Time magazine’s most promising leaders under 40, and last year she was one of 25 people who were awarded a "Genius" grant from the MacArthur Foundation. She is the first African-American woman to be elected to the American Medical Association board of trustees and the first African-American woman to become president of a state medical society (Alabama) in the U.S.

I think I like her already.

She’s also, um, kinda fat – a detail that has been dissected by critics and bloggers in a way that speaks volumes about America’s obsession over the body mass index. Check out the snarkitude among the commenters on this otherwise neutral article in the Washington Post:

Obesity is by far the most important public health epidemic facing our nation today and this issue should not be made light of in favor of other skills. We should all have doctors who model the lessons they teach. I would never accept an obese practitioner as my personal physician, so why are we accepting an obese surgeon general?

And that was one of the more civilized comments. (I’ll overlook, for the time being, some of the other comments disparaging Dr. Benjamin’s experience in what one elitist referred to as "podunk" rural clinics.)

Even one of the letter-writers at the Star Tribune of Minneapolis weighed in today on the issue.

Is it OK for doctors to be overweight? This has been a matter for debate. At least one study has found that patients have more confidence in a doctor who isn’t overweight. The writers conclude:

Doctors who actively try to lead healthy lifestyles are more likely to counsel their patients about healthy behavior. Medical students ought to take lifestyle advice themselves and shape up if they want patients to take them seriously.

The flip side to this argument is that physicians may be more likely to understand a patient’s struggles with losing weight if they’ve struggled themselves.

There also seems to be a double standard at work. The girth of one’s physician happens to be visible, so it’s an easy target. But what about physicians who have a hard time handling stress, or who struggle with depression, or drink too much, or don’t eat enough vegetables? Are these physicians any better at being good role models? Or does physician behavior only matter if patients can see it?

The Shapely Prose blog delivers a feisty analysis of Dr. Benjamin’s nomination to the surgeon general’s post:

… this does mean that there’s a chance, however small, that Dr.  Benjamin understands that fat is not automatically inimical to health. And her position as a doctor in a poor rural area probably means that she is more sensitive to the effects of poverty on health and food access, and might understand that lack of access to good nutrition or unbiased health care or leisure for activity – not fat bodies themselves – are problems to be solved. That’s a chance I didn’t expect us to get.

There are also some good perspectives in the comments.

My favorite commentary, however, comes from noted bioethicist Arthur Caplan, who puts the focus where it belongs:

Critics seem to believe it’s ironic that the nation’s top doctor would be overweight, and it’s led the most nattering of nags to conclude that she should not be picked for prom queen, er, I mean, surgeon general.

You would think the entire population of the blogosphere had suddenly reverted to the seventh grade.

You don’t have to be thin and perfect to be a good physician, Caplan argues. In fact, many people are likely to identify with Dr. Benjamin, which could help more Americans connect with her and her agenda as surgeon general. He concludes, "I don’t know about you, but a doctor who chooses to care selflessly for the poor and who has the respect of her peers as a good clinician is a doctor whom I am willing to listen to – even if she wears a plus-size lab coat."

Dr. Benjamin’s nomination is awaiting confirmation hearings in the U.S. Senate. Most observers think her appointment will take place without a hitch, but we’ll see what happens.

In the meantime: You go, Dr. Benjamin!

Photo credit: Bill Starling, Associated Press.

One thought on “Doctors, obesity and the new surgeon general

  1. We are so inundated with images of tiny little women, squeezed into size-2 apparel – magazines, television… teenage girls are bombarded with images of itty bitty women with perfect skin,teeh, and hair… and so-called “Reality TV” doesn’t help matters with producers choosing to cast, typically, skinny young women (no matter how many personal or mental issues they may have) for the programs. The fact is: the average size of the Amercian woman is a size 12. And, so what? The truth is, obesity is not always a self-induced issue. A person’s gene pool plays a factor in body development – not everyone has a high gear metabolism, and no amount of dieting and excersize can change genetics. And, obviously, doctors are human, like the rest of us. If this society can accept the bad behavior of our political and community leaders by claiming; “hey – they’re only human”, then the Surgeon General nominee’s weight should not overshadow her qualifications for the job.

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