New guidelines urge doctors to screen patients for obesity

A government panel of medical experts released a new set of guidelines that encourages doctors to screen their adult patients for obesity and offer behavioral intervention to promote weight loss.

The U.S. Preventive Services Task Force created the guidelines as a way to address the country’s growing obesity epidemic, suggesting that more doctors should be calculating their patients’ body mass indexes.

More than one-third of American adults are obese, according to the Center for Disease Control and Prevention. In 2008, medical costs associated with obesity were estimated at $147 billion.

The guidelines have sparked a debate in the medical community over how far doctors should go in recommending treatment to overweight patients. Should they recommend behavioral changes such as healthier eating and increased exercise?

Art Caplan, a bioethics professor at New York University, thinks it is. He says doctors are no longer viewed as neutral observers who simply relay medical information. They’re now expected to play a more instructional role in their patients’ lives.

“I think having more directive, a more ethically charged relationship with a doctor, is important,” Caplan said.

But not everyone agrees. Substantia Jones is the founder of Adipositivity, a photography project she started to promote body acceptance. She says the new guidelines lack supporting scientific evidence and would ultimately do more harm than good.

“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 said. “It can make them reluctant to return or even seek any future medical care.”

Jones admits to being overweight, though she says she’s never had any health problems as a result. 

While many overweight people remain healthy in the short term, Caplan says, the long-term effects of obersity are beyond dispute. Left untreated, it often leads to health problems that may not show up until later in life, including diabetes, arthritis and heart disease. 

“There may not be anything today, but if you don’t do something about it there’s going to be something tomorrow,” he said. “The real issue is, can the doctor form an alliance with a patient that will allow them to sort of discuss weight without making someone feel humiliated to the point where they’re not going to come back?”

Doing so may be easier said than done. Caplan says doctors need more time to talk with patients and better methods for establishing behavioral changes.

“All this conversation is great, but if it doesn’t lead to anything, you haven’t gotten anywhere,” he said.