Wednesday, February 6, 2013

obesity

i have a post i started last night but i felt so strongly about a subject i saw today that i'm putting it on the back burner, although it will tie in well with today's post.

today, i watched a news story about new jersey governor chris christie, a self-admitted overweight gentleman who was even recently on david letterman to poke fun at his own weight and brought out a donut to eat as a gag. christie is also an aspiring 2016 presidential candidate. there was a piece on him on CNN and they asked the opinion of a former white house doctor on his health, to which this doctor responded she was afraid he would die in office because of his obesity.

governor christie responded today to her remarks with a few choice words, some of which included that she "should shut up" and she was "completely irresponsible".

http://www.huffingtonpost.com/2013/02/06/chris-christie-connie-mariano_n_2631944.html?utm_hp_ref=politics

http://www.cnn.com/video/?hpt=hp_t2#/video/politics/2013/02/06/sot-christie-tells-doc-to-shut-up.news-12-new-jersey

i heard the first part of the news story as i was cleaning up my apartment and i knew by the build up the doctor would make some remark about how bad his weight is for his health. any physician would say the same thing, white house doc or not.

i was disappointed then by governor christie's response.

i was expecting him to have a positive response to these doctor's remarks, perhaps for him to acknowledge his longstanding problem with obesity and his plan to take steps to improve his health today. there was none of that. instead, there was uncalled for vitriol directed against this very reasonable professional, who really was showing genuine concern for christie.

i was disappointed that christie threw away this opportunity to address the huge problem this country has with obesity and set a positive example for millions of america struggling with the same weight problem, as might be expected of a future presidential candidate.

i was disappointed by his negativity and his stunning denial about the real issue, his obesity. he says in his response that dr. mariano has never examined him to render a professional opinion, but governor christie should know that the physical exam starts with simple observation. if a patient of his size walks in the room, any doctor begins thinking about all the health problems that are in store for a morbidly obese gentleman such as himself. even any medical student can rattle off at least 10 conditions associated with obesity. let's try:

1. hypertension
2. hyperlipidemia
3. diabetes mellitus
4. coronary artery disease
5. stroke
6. peripheral vascular disease
7. liver disease
8. obstructive sleep apnea
9. cancer (breast, endometrial, or colon, to name a few)
10. arthritis

this story really resonated with me, i guess because i was hoping for more. i was expecting something uplifting. i wanted so much for governor christie to be a role model for our nation to tackle our obesity epidemic. this may be hard to understand, but it truly makes me sad when i see an obese patient because i can only imagine all the complications that will eventually ruin, or end, their life. and then to see a politician attack my profession, to cast doubt on our intentions in voicing our opinions? i commend dr. mariano for having the candor to speak in a constructive manner about governor christie's health and weight. i wish that he had thought the same.

13 comments:

  1. Your disappointment is expected for someone going into the medical field that people don't take this more seriously. Christie's "biggest" problem regarding his health is his denial -- he has to get over that first before he will try to tackle the issue. I think if he makes a serious run for the republican nomination in 2016, we will see him make an attempt to lose weight starting in 2015. But the sad thing is, unless prompted by a medical emergency, it will be more for political reasons than health concerns.

    Also, being a bit chubby myself, I can understand the difficulty of changing years of bad eating habits and not getting enough exercise.

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    1. changing habits is the hardest things we have to do as doctors and something we are really unsuccessful at encouraging patients to do. we need more jedi mind tricks.

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  2. I don't expect him or want him to lose weight but the least he could do is acknowledge his medical condition and agree that it is not healthy for America to be obese.

    If he is happy they way he is then why try to change him?

    I didn't click on any of your links but I don't think that doctor had any right to talk about Christie or discuss her medical opinion about someone who is not her patient. That doctor should have refused to do the interview.

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    1. he might be happy being fat but there are so many serious health risks he's setting himself up for that i hope he does try to change.

      and i would disagree that doctors not directly involved in a patient's care should be allowed to make comments, much the same way lawyers, analysts, and politicians are asked to comment as authorities on their particular subjects.

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  3. The other problem with Dr Mariano's opinion is that she has ties to Hilary and there is speculation that the ground work is already being laid to make Christie a less attractive candidate in 2016 because of his weight. Dr Mariano opined that he could "die in office". It is my understanding that Christie was angered because his young son saw the interview, became upset and asked Gov. Christie if it was true that he would die soon.

    We all know the risks associated with obesity. Christie's a smart guy...he's well aware of the risks...We can discuss them as a public health threat. But to hold a single individual up for personal scrutiny in such a public venue and for perhaps ulterior motives was not the most responsible way nor was it a very "kind" way of addressing the issue

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    1. i wasn't aware of any hilary connection and certainly i would think less favorably of the doctor if that was her motive. but she said she's even a republican and made the same statements. and i'm really surprised that christie took his son asking if he was going to die soon because of his obesity as anything BUT a wake up call that his lifestyle is unhealthy.

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  4. The stress from taking on the presidency can worsen underlying medical conditions, including those linked to obesity: high blood pressure, heart disease, etc. Although Dr. Mariano's comments could have been put more tactfully, her concerns are valid.

    To the anonymous poster: given that other presidential candidates or politicians have had their medical histories questioned by the media (McCain's skin cancer; Joe Biden's age), it would be more surprising to not address Christie's obesity in the public political forums.

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    1. i think the problem doctors have is that we aren't allowed to be blunt with our patients. well, some are, but oftentimes things get sugarcoated, and literally america's obesity has been sugarcoated. when i'm an attending and i can actually make candid remarks i will straight up tell my patients that they are fat and will have x y and z problems because they are fat. we dance around the problem too much because we don't want to hurt the patient's feelings but we as americans are eating our way into more and more health problems and it's really just sick.

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  5. I agree....Christie should have responded better. How about, "yes, I know I'm overweight and it's hard to lose weight as most of the population knows."

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    1. i definitely think that if he acknowledged his weight problem and identified himself as just another american that would have made him instantly more likable!

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  6. That is disappointing to hear. Obesity is a bigger problem than people would openly admit because they don't want to hear about it.

    Obese patients are really difficult to do surgery on and have so many post-op problems.

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    1. i'm sure you've had to retract your fair share of fat pads in surgery...tiring no?

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    2. Yeah . . . retracting the pannus is annoying. Retracting the abdominal cavity with almost literally the weight of your body as you lean back - now that's something. Ugh.

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