What Exactly Do Doctors Learn in Medical School About How to Treat People With Obesity?

If you’ve ever gone to a physician for, say, a sprained ankle or UTI, solely to sit by means of a chat about your weight earlier than getting remedy suggestions, it’s possible you’ll surprise precisely what medical doctors study obesity throughout medical college.

After all, obesity is extremely frequent: 42 p.c of adults in the U.S. have obesity, in accordance to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

And it’s sometimes thought of an vital health marker: Obesity is linked to critical, power circumstances—together with sure cancers, kind 2 diabetes, and heart illness—that lead to untimely and preventable deaths, in accordance to the Centers for Disease Control and Prevention (CDC).

That stated, weight is just one metric. Having obesity does not robotically imply you are in poor health—simply as having a low weight doesn’t equal good health. In truth, different health indicators beside weight can typically reveal extra about your total health.

The causes of obesity are advanced, and infrequently outdoors of an individual’s management: While what you eat performs a job, so do genetics, sleep habits, bodily exercise, and what’s often called social determinants of health (aka, non-medical components, reminiscent of financial insurance policies, racism, and local weather change, that play a job in an individual’s health), in accordance to the CDC.

And obesity remedy, which is usually glibly boiled down to consuming much less and transferring extra, is extremely difficult, typically requiring a way of life overhaul or remedy for long-term success.

Given obesity’s prevalence and the intense health penalties tied to it, it appears proper that it needs to be a significant matter in medical faculties. Yet medical fatphobia and bias round obesity, together with language that locations blame on individuals with obesity in a means that doesn’t sometimes happen with different health circumstances, is much from unusual.

For our Real Talk Rx collection, we requested readers to ship us their greatest health questions after which posed the commonest to a panel of medical doctors. Many readers questioned how a lot of medical doctors’ medical coaching was devoted to the precise wants of individuals with obesity, and what precisely they realized about it. Here’s what the consultants had to say.

How a lot do medical doctors study obesity in medical college?

“As someone who completed med school, and also was on faculty for a medical school for several years, I can tell you there’s a lot more that needs to be done in the way of medical education about obesity.

From my personal experience going through medical school, I think there is unintentionally implicit bias or stigma that gets attached to obesity. And some of that is because the research on obesity is just not as complete as it is for some other medical conditions that we learn about in medical school.

Some would argue the reason why the research in obesity is not as robust is because of biases that obesity is a personal failure or personal decision. We’ve known for a long time that’s not true. Now, the research is catching up and demonstrating that. Personally, I love [helping patients with] weight management, but a lot of what I learned about weight management I learned after medical school.

I don’t think medical training does obesity justice. I don’t think it starts to call into question the sort of social nuances and social determinants of health that affect obesity. I’m looking forward to seeing where future medical education goes, because it’s time to catch up.

It’s really hard to get rid of the stigma that in some way, what a person eats is a personal choice. Because it is, to a certain extent — a person is putting food in their mouth. But that doesn’t account for what sort of food is available in their environment. It doesn’t account for what foods they can afford or are important to them culturally or what sort of advertising about food they are being inundated with 24/7.

We are learning more and more how the endocrine system changes once a person’s weight starts to go up. And then once those changes are underway, it becomes even more challenging to change your weight. It’s a vicious cycle. The more we learn about the mechanisms behind obesity, hopefully, the less of a social or personal issue it seems like. I hope people can appreciate it more for the scientific issue that it really is.”

“I don’t think medical training does obesity justice. I don’t think it starts to call into question the sort of social nuances and social determinants of health that affect obesity. I’m looking forward to seeing where future medical education goes, because it’s time to catch up.” —Alexa Mieses Malchuk, MD

“I don’t think there’s anything lacking. In medical school, we learn anything and everything about obesity, especially because we’re being trained to serve in America. We learn everything from the psychosocial perspective to the physiological perspective, the pathophysiological perspective on what obesity entails, where it comes from, like a cultural standpoint, how it develops, and what it does to the body.

BMI is a standardized way to categorize people, but we’re moving away from these categories, because it gives a goal-oriented society anxiety. There are a lot of demographic factors—your ethnicity, your geographical location, your lifestyle—that determine what your BMI is.

BMI is not a really good indicator, just in and of itself, of your health status. There are cholesterol levels, triglyceride levels, and many [other] parameters that we look at that give us a snapshot of your internal environment.”

“The standard medical curriculum reviews the causes of obesity, treatments for obesity, and the complications from obesity. So we do receive a fairly comprehensive understanding of risks and how to treat it. It’s incorporated as part of an overarching education on other health issues.

Most medical school curriculums do teach their students how to interact with compassion and to treat the individual and not their disease. I will say, though, the American medical system really does need much better training on nutrition and how to live a healthy lifestyle. We do a lot of education on how to treat the complications of obesity, but we don’t do a really great job in teaching physicians—and then subsequently teaching our patients—how to prevent obesity.”

The takeaway

Our consultants agree: During medical college, future medical doctors study obesity, together with its causes, danger elements, and remedy choices. But a number of the medical doctors we spoke with felt extra could possibly be achieved, not solely to prioritize stopping obesity, however to present judgment-free care that is free from bias and acknowledges an individual’s weight just isn’t due to their selections alone.

‌Confused about your health? Get solutions to extra frequent questions in our Real Talk Rx collection.