Health | Cold and Flu | Allergies | Diseases | Treatments: Doctors don’t have to sugar the obesity pill

A lot gets said about how it feels to be overweight, but what is the psychology of having to tell someone that they’re fat if you’re a health professional? Does it feel rude, abrasive, maybe even counter-productive to do so? But perhaps neglectful and harmful not to? A survey of 1,141 GPs by Pulse magazine found that almost one third (32%) of them said that patients became offended and resentful when their excess weight was pointed out.

Of course, there are GPs who feel that “political correctness” has no place in medicine and patients should just be told the truth, however it goes down. But for other GPs, the issue is more complicated. Some wonder whether they should bring the topic up at all, even when the problem is something like knee pain, which could be exacerbated by weight. They feel that to do so would only upset the patient and have a negative impact on their ongoing relationship.

Others believe that some patients are avoiding GPs because they don’t wish to feel pressured about their weight – although the patient is frequently more upset about being overweight than by the discussion.

At this point, some might say, what’s the problem? Britain has an obesity epidemic, and if weight contributes to an individual’s health problems, it should be part of the health advice. At the moment, the NHS approach is to offer all obese patients free places in slimming clubs, and when patients are being spoken to about their weight, there are guidelines suggesting that “the tone and content of all communications is respectful and non-judgmental”. Certainly, there are compelling arguments for telling patients that they’re obese – such as helping them to avoid unnecessary medical interventions.

This last one clinched it for me – a few seconds of tension is surely better than the patient undergoing unnecessary treatment. However, like many of these more sensitive GPs, I’m loath to go along with any narrative that tries to caricature overweight people as thin-skinned children throwing tantrums.

Weight isn’t just physiological, it’s emotional. Someone talking to you about it, while probably not a revelation, would still be painful. Moreover, in Britain today, it’s improbable that any fat person is getting away with living in denial.

Only this week, there was a case where a woman wearing heels fell down nightclub steps, and the judge ruled that she had no case because she was drunk and obese. Fair enough about the alcohol, but what did the woman’s weight have to do with anything? Heels or not, if excess pounds made people fall over more readily, then western civilisation would be full of images of overweight citizens rolling about on pavements like upturned human beetles.

Nor is this behaviour confined to courtrooms – increasingly, casual fat-shaming has become normalised. Which perhaps sheds light on why some GPs instinctively feel that they need to be cautious. Far from the patient being oblivious about their weight, they’re living in a world which, one way or another, never stops pointing it out. Instead of having too little insight into their weight problem, they’re likely to have become over-sensitised.

For these people, a GP surgery may feel like a sanctuary compared to the outside world, so to have their weight mentioned there may be momentarily jarring. Framed this way, the fact that two thirds of GPs aren’t encountering offended patients is a pretty good result. However, that still leaves the farcical situation where obese people are constantly told about their weight by everyone apart from the only people who need to mention it – namely health professionals. While something has gone very wrong here, the blame doesn’t lie with sensitive GPs.