Weighing in on the Surgeon General’s Weight


I was thrilled to read that Dr. Regina Benjamin is President Obama’s nominee to be the next Surgeon General of the United States of America.  Her background in family medicine and her work on behalf of her community and the poor make her an amazing candidate to be the public face of the nation’s health care initiatives. 

Unfortunately, not everyone shares that opinion.  Soon after the nomination, critics began to claim that, despite her resume and achievements, Dr. Benjamin may be "too fat" to be Surgeon General.

People are actually speculating on the dress size of the Surgeon General nominee and debating whether it is large enough to disqualify her for the position.   I’m more than aware that size matters more than health to too many people.  But this is different.  People assume that a full-figured person must rack up medical conditions with every pound.  The media also sends a lot of mixed messages about the connection between health and weight.  On one hand there are news stories fretting over women starving themselves to fit into skinny jeans.  On the other hand there are features promoting ways to slim down fast. And somehow there’s yet another hand out there raising the alarm that America is in the midst of a costly obesity epidemic

It is into that storm that the charges that Dr. Benjamin is too fat to be Surgeon General are thrown.  Critics charge that Dr. Benjamin sends the wrong message to Americans because she’s not visually thin and thus visually healthy.  I contend that that charge sends the wrong message to Americans – thin does not equal healthy any more that a deep tan makes a person "look healthy" or a full figure means a person is unhealthy.

The National Health and Nutrition Examination Survey recently released data that shows that more than half of people labeled overweight are metabolically healthy.  The study goes on to point out that examination of metabolic health — blood pressure, cholesterol, sugar levels — are better predictors for future health problems that a person’s weight alone.  I am not saying that a person’s weight cannot play a role in high blood pressure, cholesterol or unhealthy sugar levels.  What this study says is that there is not an absolute connection and that we all need to start talking health instead of weight alone.

As a full-figured woman of color I was also disturbed but not surprised that some critics of Dr. Benjamin’s weight come from the medical community.  Even before research was released connecting the quality of medical care with a person’s weight and race, I knew from personal experience that some doctors make judgments based on their patient’s appearance and then provide medical care based on those flawed judgments.  In my case, the flawed care came when I was about 40 pounds lighter and my then primary care doctor assumed that I was the picture of health.  I wasn’t…and it took a change in physicians to finally get down to the business of addressing my health concerns.  Now that I am 40 pounds heavier I’m alarmed to learn that a recent study found that 40 percent of doctors surveyed reported having a negative reaction to heavy people.  Will my weight put me at risk of receiving inadequate care?  Is the reward for not looking a certain way substandard medical care?

Another issue raised by the critique of Dr. Benjamin’s weight is whether a person’s health and weight should weigh into their qualification for a job.  Do doctors and nurses have to present a physically fit appearance, if the appearance of being fit is all there is?  One doctor quoted on ABCNews.com mentioned that she lost weight to set a good example for her patients.  But what if a doctor looks fit but is actually unhealthy? To some, health seems to matter less than the appearance of health and that just doesn’t seem like a healthy outlook to me.

Health care reform needs to include more than expanded coverage and access.  It needs to include respect and understanding, dedication and empathy.  Given the new data challenging previously held beliefs about the connection between weight and health, we might want to revise our definition of what healthy is and how it looks to align with reality.  And given Dr. Benjamin’s impressive qualifications we might want to revise our opinion of her as a nominee and hold off on making health care assumptions based on her weight.

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  • http://www.ourcommonground.com invalid-0

    Enjoyed your comments immensely. Intense and useful insights on the subject of women and health.

    Thanks

  • http://urban-science.blogspot.com invalid-0

    you are spot on. C Evertt Koop was no slim chicken, was he healthy enough? Dr. Benjamin has a round face and is buxom which makes a woman appear heavier than her scale weight. I also think weight between the sexes is perceived differently, too. Which means this weight as a qualification mess is also a latent sexist issue.

  • amanda-marcotte

    Slim doctors and nurses and bigger doctors and nurses, and I can safely say that it never occured to me to care, think about, or pass judgment.  The notion that you need to "set a good example" baffles me—who on earth thinks there’s not *enough* pressure to be thin? 

     

    There’s more to eating right and exercising than weight control.  People say this, but they don’t usually think of specifics.  But I have a very specific example of how a doctor framed these things without reference to weight when I was a kid.  I had severe childhood asthma, which can create a lot of despair about being permanently crippled against having a full, active life as you age.  And my pediatrician told me that he was also born with severe asthma and then showed me his marathon running medals.  Which lifted me up considerably.  

     

    Lesson?  When we’re so busy focusing on weight above all other considerations, we actually forget that health—as well as exercise and nutrition—is a complicated issue with lots of facets.

  • crowepps

    I don’t think there’s anything ‘latent’ about the sexism here — we wouldn’t be hearing a word about weight if the nominee was male.

  • invalid-0

    Where are you getting that more than half of overweight people are metabolically healthy? You may be right from a statistical standpoint but you come off as misleading. I went to the NHANES site and looked this up:

    http://www.cdc.gov/nchs/data/nhsr/nhsr013.pdf

    Sixty-five percent of obese–not just overweight–men had symptoms of metabolic disturbance. Not less than half. Merely overweight men fared better, but still had metabolic syndrome more often than people of normal (statistically speaking) or under weight.

    I am not saying that fat people are bad people. I’m fat. At least a hundred pounds over, in fact, thus falling squarely into the obese category. That’s not my objection.

    I also understand that slender people can have metabolic syndrome. Gotcha. In fact a while back I read a Men’s Health article on that very subject, written by a guy with that very problem.

    But.

    One of the things that drives me *bats–t* about the fat acceptance movement is its refusal to consider that it’s kind of not natural for people to be so huge they find it difficult to move. Metabolic syndrome is not an inevitable sign of aging, it is a biochemical injury. So to tell fat people that there is nothing wrong with us when nobody in the FA movement is testing our fasting blood labs or checking our blood pressure or assessing our family history is kind of irresponsible.

    That said, I look forward to the day–if it ever arrives–that we check EVERYONE for these metabolic disturbances, because it has been documented that fat tissue and lean tissue become insulin-resistant at different rates in different people, and the syndrome is equally damaging no matter how much you weigh. We would save so much money in diabetes, heart disease, and cancer prevention, it would not be funny.

    As long as we look to energy storage first as a front-line assessment of a person’s health, though, that’s not going to happen. So, again, I’m with you there. I just wish people would stop telling me there’s nothing wrong with me, because I know for a fact there is. I don’t care what some shallow Mr. Twit thinks of my looks, I care that I get tired more easily and don’t sleep well and react too strongly to glucose sources in my diet, among other problems. And type 2 runs in my family. This is nothing to play around with in the name of politics. The real tragedy is had I remained thin I would have had the same risk and I would not have understood what was happening to me. So in a way we fat people are lucky. We get that visual warning. Too bad we’re also punished for it.

  • invalid-0

    You’re right about that. Vast majority of the time, unless a guy’s putting off cosmic Kick Me vibes or something, guys usually don’t mess with other guys who are fat.

    Even fat guys feel free to judge fat women. I’ve seen it with my own eyes, not even hearsay. I’m like, who the hell are you, the next Adrian Paul? Puhleeze. And yet, I’ve dated fat guys, and never thought badly of them for their weight. Shoot, the father of my daughter has a big ole gut and a beard. He loses a bit more hair color and he’ll be able to play Santa at the mall.

    That said, I think sexism’s only part of the answer where Koop was concerned. While cardio (called aerobics back then) was getting hugely popular and people were talking up weight loss, there was also a bit less judgment of people who were overweight. Or, it was distributed differently. Kids might make fun of you on the playground but there wasn’t this huge public conversation about how bad it was to be fat. Actually the exercise craze was more about avoiding heart disease, just as the low-fat fad was at that time.

    So call it a combination of sexism and different values about health. The Eighties were different on more levels than just music and fashion. At that time you could even have homely news broadcasters on TV and folks were perfectly OK with it. Now they all have to be pretty, even the guys.

  • independentminded

    Now they all have to be pretty, even the guys.

     
    That’s one hell of a big laugh, as far as I’m concerned.  I bet all those supposedly pretty-looking TV news broadcasters (both male and female) wear tons of  make-up and dye their hair to make themselves look pretty.  Phoney is what that is, imho.

  • invalid-0

    Really well said. Dr. Benjamin is clearly well qualified for the position and I think allot of the comments were just BS Talking Head stuff to fill time and space in the media.

    That said, one of those that originally spoke on her behalf referenced the many serious medical situations that her relatives had lived with inspired her to go into medicine. I may be wrong, but I believe she had a brother that died in his 40’s, right? Given the family history she clearly should be concerned about her weight, particularly the risk of diabetes.

    I also worry about the FA movement. I know it must really be difficult for heavy women (and men) and I’m sure they get sick of thinking about it. I’m concerned that they just “give up” because there is this community that says don’t worry about it. I don’t want to sound like I’ve got a problem with heavy people, because I don’t. I just hope it doesn’t cause long term health problems for some.

  • http://www.netvibes.com/pharmacy-store invalid-0

    all this speculations about weight are really stupid!

  • invalid-0

    While I don’t mean to attack or judge people who struggle with their weight, I have to disagree with the author’s premise that overweight and obese people can also be “healthy.” Obesity is just plain bad for every system in the body. Even if the overweight person exercises, just carrying around so much extra weight strains the heart and injures weight-bearing joints like the knees and hips. In addition to being at greatly increased risk of diabetes, heart disease and cancer, obese people are also at increased risk of osteo-arthritis. They require joint replacement surgeries at much younger ages than normal weight people do. Who do you think pays for all those joint replacement surgeries? We all do in increased health care costs.
    People who tell the obese that they are just “big-boned,” or that they can also be fit and healthy just contribute to their denial. As long as our society denies that overweight is a problem, obesity will continue to kill us and drive up our health care costs. We need to acknowledge that this country has a weight problem and strive together for a solution in a supportive and non-judgemental way.

  • invalid-0

    First off, eating crap food and not getting enough exercise is bad for everyone. Cut line. Appearance has nothing to do with it.

    Secondly, Anonymous, how do you suggest I lose weight? I dance for at least two hours five nights a week, walk at least two miles each day for work, and eat so many fruits and vegetables as part of my diet I kind of freak myself out. And yet, I am considered “obese”, and my weight has never dropped below 240 pounds. No matter what I eat, no matter how active I am. Meanwhile, I have excellent blood pressure, excellent bloodwork results, the whole bit. So I’d really, really like to know how I’m unhealthy when every lab test and measurement points to the opposite, and how if weight is so bad, how I’m supposed to get rid of it.

  • independentminded

    President Obama himself chain-smokes cigarettes. Y’all think that’ll help him, his wife, and his two young daughters? I don’t.

  • independentminded

    Have you tried, or considered trying, a somewhat more strenous aerobic exercise, such as bicycling or swimming at least twice a week in addition to your other exercises? Just curious. Hope I’ve been of some help here.

  • invalid-0

    Hey, this is from the same Anonymous as posted above.
    Congratulations, Wench, on your good blood pressure, cholesterol and other numbers. But even though your labs are good, that extra weight is putting a strain on your joints, and that will only get worse as you get older. I know what I’m talking about because my mother who is overweight has severe osteoarthritis and can barely lift herself from a chair. She suffers a lot and I would not wish that on anyone.
    Congrats for consuming lots of fruits and vegetables. It sounds like you do get some exercise and that’s good. But like Independentminded says, it takes sustained, strenuous aerobic exercise to burn enough calories to result in weight loss. Have you ever considered nutritional counseling? It’s possible that your diet contains some extra hidden calories you can shave off without feeling deprived. Also, try portion control. Even healthy foods contain calories–and you may be eating too large portions.
    I’m not attacking you, I mean you well. I hope you stay healthy and are able to lose weight! :-)

  • stop-hair-loss-guide

    Funny how people who are not ‘fat’ or ‘obese’ seem to know about the best ways to lose weight… and they always talk to you like it never occurred to you? You’d think with the economy and health care reforms issues, people have less time to come up with silly discussions like this. President Obama appointed her on the basis of her qualifications. She must have had her share of people picking on her weight..Let the woman work!