Why America's Current Healthcare System Can't Fix “Fat”
The United States has an abundance of great medical doctors and healthcare providers. Yet, obesity and metabolic disease, the most significant of health challenges that face our country and which is uniquely virulent in this country, seems to baffle the system. Why is that? If we can put a person on the moon, why can't we solve obesity?
As with any complex problem, there isn't a singular solution. Let's start by acknowledging the fact that obesity is a disease. Even though it's a disease, it's not a “billable diagnosis,” according to insurance companies. The diagnosis of obesity is not reimbursed by insurance companies, even though it impacts the body in many ways, including; heart disease, fatty liver, diabetes, worsening asthma, sleep apnea, rheumatoid arthritis, and thirteen types of cancer. It makes sense to treat the root cause of such diseases before it can have such devastating results, plus it's a much more cost-effective approach. Still, insurers tend to take a short-term view because they know their policyholders will move on to another carrier (often with their job) within five years. So, there's no financial incentive for them to cover treatment. This is a harsh view of a significant component of our healthcare system, but let's face it, they function like any other business guided by profits.
Another huge factor, that has been long-standing in the healthcare industry, is good old-fashioned discrimination. Often people who have not experienced this, can find this shocking or hard to believe, however I have witnessed it too many times and my patients have recounted it far more times than I can count… Some doctors view obesity not as a disease, but as a character flaw. There are many complex reasons leading to these long-held biases, such as not understanding the physiological problems and metabolic disruptions that make it so difficult to lose weight and more. Or, they question patients why they aren’t working harder to make changes, when most of my patients are working hard to do this. These kinds of doctor-patient interactions lead to a shaming environment and patients feeling uncomfortable with their provider, making them less likely to seek medical treatment for other healthcare issues, and thus less likely to lose weight. Multiple studies show that implicit physician bias can lead to poor health outcomes.
If a patient had a mole on their skin that was changing shapes and colors, they would more than likely seek medical treatment right away. But if they knew from previous experience, that the doctor would make them feel bad for getting the mole, potentially blaming them for getting such an “ugly mole”, they might skip treatment altogether. Avoiding seeing the doctor could have disastrous consequences in the case of a potential skin cancer. It’s equally problematic for a patient to avoid their doctor due to weight shaming. Everyday patients have diagnoses being missed because physicians insist on blaming symptoms on extra weight, rather than taking the time to evaluate the patients thoroughly.
This pattern breaks my heart because there are solutions for every patient. I've heard patients' stories of how they felt shamed and blamed in another provider's office. Then, I have seen these same people emerge victorious through our program. Proving that you can have a new lease on life with a team that has a compassionate approach, is truly caring, and a comprehensive plan.
As long as the medical industry continues to see obesity not as the disease it is, insurance companies continue to refuse to cover treatment for weight issues, and our society as a whole maintains long-held, unfair, and unfounded biases towards obesity, our “traditional” and current healthcare system isn’t going to be the solution to full wellness and true health that we all so deservingly need.