White fat, black art

A Canadian friend recommended the show White Coat, Black Art from CBC Radio. I have enjoyed several of the shows. There’s one on burnout, which is supposedly worst in ob/gyn. She wanted me to listen to the show on obesity. (Link to mp3 of “Fat Doctors”.)

I was kind of napping while I listened, but I played it twice and I think I got most of it. I think they thought they were showing “both sides of the issues” by having advocates for bariatric surgery, and someone who lost weight through diet and exercise. But, it was a very judgmental show. No one argued that not all obese people need to be fixed, either with surgery (which they started the show with) or diet and exercise, which the other two segments suggested.

I was struck by some of the people in the support group. Like, the one who was talking about how you could never tell a heroin addict to just take it 3 times a day in small amounts, but we expect people with food issues to self regulate food consumption. I am happy the doctor at the bariatric center emphasized that no one chooses to be morbidly obese, and no one gets morbidly obese by making poor choices.

I also kind of related to the doctor at the end who talks about being overweight and struggling with weight loss and her self image, which I am sorry to say. I feel a lot of self hate and guilt (and I have gained even more weight. I am afraid to weigh myself.)

I loved it when she said she secretly thinks “I would hate to live like that” when people give her weight loss advice and discuss strict, boring diets. I admit, people tell me about getting their “butts kicked” by their spinning instructor, and it makes me wonder if sedentary life isn’t worth it. But, I felt better about myself when I was in better shape. I like many types of exercise. It doesn’t hurt to fit in my clothes, either.

I guess it made me feel a lot of self hate, but I didn’t realize it at the time, because I am surrounded by that attitude constantly. I was just reading a maternal mortality review (pdf) today, and they were analyzing trends of BMI and maternal complications. But, I know this is a multi faceted issue. Obese women get more unnecessary interventions, including more inductions and more cesarean sections. And, the maternal mortality rate is much higher for African American women, who are more likely to be obese when of childbearing age.

I am afraid I may get passed over for a residency spot because I am obese. Spots are competitive, and are based on interviews and personal interactions with people on the team at the site. I know some people don’t think obese people make good doctors, some people think a person who is forty and obese may not be a good investment for four years, since I may succumb to some sort of fat complication, die young, and be a waste of their training. And even more people have unconscious negative reactions to fat people. We do worse in interviews, period.

Anyway, thanks for the recommendation. It was definitely worth the listen and gave me a lot to think about.


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6 responses to “White fat, black art

  1. Spring

    Yes, I was disappointed with the podcast overall as well. I forgot about how they compared regulating eating to regulating another addiction. I have heard that before, and as an ex-smoker (as I know you are), it would be so incredibly difficult to take say, 4 drags off a cigarette, extinguish it and then tell yourself not to smoke again for a few hours while your body screams “NICOTINE!!”

    I think part of the trouble with obesity and it’s complications when it comes to research is that it isn’t separated out by other factors. Such as, is the person obese, exercising regularly and eating healthy food? (yes, that exists) or is the person obese, inactive and eating mainly non-nutritious food? I am assuming the health implications for the latter are lumped in with the health implications for the former.

    • MomTFH

      Yes, there are healthy obese people and unhealthy skinny people. And, I know from my smoking history the surefire way to start smoking again is to have one drag or bum one cigarette.

  2. Wow. good luck with that. That is tough. Try not to get overly crazy about a residency spot. I know I could get overly crazy that is why I am telling you to be gentle with yourself. I will keep you in my prayers to get a nice residency spot.

    • MomTFH

      Thanks I will try not to worry about it too much, but watch out. It’s two years away, so my self doubt will probably show up here again.

  3. Paige

    Firstly, I’d never describe you as obese.

    Secondly, overweight or not, you’ve got more charisma, intelligence and ability to discuss important issues than almost anyone else I know. Get you into an interview and you will rock it.

    • MomTFH

      Thanks. I am officially obese, not even just overweight, according to my BMI.

      I think I can “overcome” the obesity bias when I interview with my abilities and charm (ha!), but some of these places have 600 applicants for 6 positions. I will be doubting everything about myself during the match process.

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