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Are Fat Doctors Just Human?

Kendracampbell472x722Kendra Campbell -- I finally made it back to the USA. I flew out of the “airport” in Dominica on Saturday morning and arrived in Baltimore around midnight. As I walked through the airport to the baggage claim, I noticed two things right away. The first was the overabundance of food options: fried chicken, pizza, cheeseburgers, and just about anything one could imagine. In Dominica, there are very few restaurants, and certainly no McDonald's or Taco Bell. The second thing I noticed was the preponderance of overweight people. Everywhere I looked I saw heavy people, and even some who were morbidly obese. I couldn’t help but realize the connection. Of course, I had noticed this before when I lived in the States, but the stark contrast between Dominica and the U.S. really made it stand out in my mind. In Dominica, there are overweight people, but they are a much smaller percentage of the population.

Obesity is a popular topic in the news lately, and the medical system bears much of the financial burden of America’s expanding waistlines. Most major killers in the U.S., such as Type II diabetes, high blood pressure, and coronary heart disease, can be tied to obesity.

As a physician-in-training, I'm trying to get a grip on the problem. By the time I’m practicing, I will likely have a lot of patients who are overweight. It’s important that I understand the causes of obesity and know effective ways to treat it.

Of course, I haven't lived a completely healthy life myself. I’ve abused my body just like most people, and I’ve paid the price. Over the past few years, though, I’ve really tried to maintain a healthier lifestyle. I try to eat plenty of fruits and vegetables, and I have worked out regularly for years. I’d say that I’m in fairly good health, and my appearance reflects that. But as a future physician, do I actually have a duty to maintain a healthy lifestyle? Do all doctors have an obligation to live healthy lives and stay at an appropriate weight in order to be effective healers?

This is a very hotly debated question (as seen in the discussion following this Medscape article). I don’t have the perfect answer, but I do believe that it’s important to maintain a healthy lifestyle, and I’m also a huge proponent of maintaining a balance in life. I will definitely eat a doughnut every once in a while, and I’m already guilty of eating at McDonald's since I’ve been back in the States. I sometimes fall behind in my exercise, and I’ve gone without good sleep some nights. But, I always return to my healthy habits, even if I do splurge every once in a while.

The question is, what about doctors who don’t adopt this philosophy? Can a patient be expected to do as you say, but not as you do? Is it fair to counsel someone on healthy habits and insist that they change their lifestyle, when you don’t hold yourself to these same standards?

As for myself, I hope to continue to live a healthy lifestyle (with my admitted lapses at times), and I hope that this will reinforce my advice to patients. On the other hand, will a patient who is struggling with their weight look at me and believe that I know what it’s like to struggle with a weight issue? Would it be easier to accept instructions from a doctor who also is overweight?

Looking forward, I hope to be able to effectively communicate with my patients and let them know that living healthily is not always easy. I give in to my cravings for peanut butter pie, and sometimes I skip my daily run and veg out with a movie instead. I don’t think that makes me a bad role model, nor will it make me a bad physician someday. I think it just makes me human. Perhaps being able to see a doctor as a human, and not just a role model, is more important than the size of the doctor’s waist.

April 27, 2007 in Kendra Campbell | Permalink

Comments

Hi Kendra,

I am a foreign student studying in US. This obesity issue in America has intrigued me since I intend to study public health administration.

I've traveled Europe and lived in Korea and Japan before. And in those countries, the biggest cup size in their McDonald's is equivalent to small size in America. Plus, snack or drink vending machines do not exist in their public or private schools. So, I was really shocked when I came to America.

Although obesity is rising throughout the world, it seems the percentage of obese population is highest in America. I've also found out the power of lobbyists of fast food companies. So, I begin to wonder. Is American government being run by corporate greed when it comes to public health issues?

I am frustrated because majority of diseases and increasing health care costs in this nation can be controlled and managed efficiently if an individual is not obese. Then I question why there aren't more active engagements of US government compared to other nations. After all, US is still a powerful nation in the world.
Maybe too much government intervention infringes personal freedome, here.
Or maybe it has to do with culture.

But what I know for sure is that everything in US is sweeter, high-calorie containing, big sized than other nation when it comes to culinary culture.

I apologize that I stray away from your main point which is obese physician. Whenever obesity issue pops up, I get really excited and just want to share the thoughts.

Posted by: smiley | Apr 28, 2007 10:08:59 AM

I don't know how many times I've been chastised by school mates for taking a drag off a cigarette... Many people feel that smoking is a huge no-no if you are in the healthcare field. Some hospitals have even adopted a no-smoking at work policy i.e. if you are caught smoking on hospital grounds you can be terminated from the job. If we are to be fair, then should we chastise colleagues who eat fast food or drink to the point of inebriation or don't have a daily workout regimen?

The healthcare community should reconsider being judgmental even towards smokers because in the end healthcare workers are humans too. Eat, drink and be merry, for tomorrow we die.

Posted by: | Apr 28, 2007 3:55:29 PM

hi kendra,

I am afraid that the overweight problem is not just an issue of physical state but also emotional and mental. It seems like eating disorders are not an easy issue to tackle.

As a medical student, I am fully aware of this problem. I agree that doctors and future doctors should be the role model of a healthy lifestyle. We have to practice what we preach.

Perhaps, some doctors care about helping others but just not themselves.

Peace.

Posted by: bellocielo | Apr 28, 2007 6:08:06 PM

I think it's important that people view lifestyle as an average and not a balance. If we display healthy habits the majority of the time, we can afford to slip now and then - as long as the average is weighted toward good habits. Trying to 'balance' lifestyle feels like trying to maintain a steady regime of diet and exercise and not deviating from it. For the majority of us, that's impractical, and it can affect us if we don't live up to our own standards.
I believe the former would be an honest and effective approach when relating to a patient.

Posted by: Adrian | May 1, 2007 6:29:18 AM

This is a rather timely issue for me. I am an MD/PhD student nearing the end of my PhD and the long hours spent studying and working in the lab and just "grabbing" something for lunch, or eating unhealthy lunches at seminars just so I don't have to worry about it has taken it's toll on my waistline. I am by no means obese, but I could afford to lose some weight. Even being only "slightly overweight", I pressure myself about how I'm supposed to be a good role model for my patients or even my family. So, I'm doing something about it, but in the meantime, will patients no take my advice seriously because I'm not in perfect shape? I'm more *fit* than many skinny people I know, whether it shows or not. I DO think it's about balance though - you can eat unhealthy food or skip a workout here and there or even have an occasional cigarette - IN MODERATION. unfortunately, most people overestimate "in moderation". Hopefully, by the time I make it back to the hospital, I'll be back on the "skinny" side of this debate!

Posted by: --- | May 1, 2007 12:45:21 PM

I've spent a lot of time talking about this very topic with several of my friends. Typing from Alabama where it seems everyone who comes to the hospital is overweight, its quite a hotbed of debate. I am not too sure where I stand on this topic because I too love Taco Bell and Pizza Hut but I also spend as much time as I can running and working out.
So the real question is should all professions be held to the standard of "Practice what you preach." Would we be okay with police officers breaking the laws that they try to enforce? Would you buy a Ford from a salesman who drives a Honda? Better yet would you trust the fat chef or the skinny one?
If a patient with diabetes and high blood pressure receives proper care from his doctor, then what does it matter whether they are overweight or skinny. So if you are concerned with the old motto of "Practice what you preach" then we should rightfully apply that principle to all professions. However, is it so wrong to demand our physicians maintain the same healthy lifestyle they want for their patients?

Posted by: HMMMM | May 1, 2007 1:04:56 PM

Physican should not be hold to a higher standard than anyone else because due to the fact they are normal people like anyone else. People develop bad happy and get comfortable in there own way. Education is the key to this problem. In addition, there are plenty of diet that definely work. I am living prof. I use to weigh 251 lbs and know I weigh 170 lbs. I am still teaching myself of how to appriciate food and not just enjoying every tasty food that I love. Awareness is very important to good heath. So if physician are not in focus on their bad behavor they will also get fat. Good news one a physican realize their overweight problem, and want to change it that should not be hard to accomplish. I can go on and on, but I will end now. I am a student Nurse in training and lifestyle change was a big thing for me. I am doing what it takes to maintain a healty diet. Thanks.

Posted by: Paulette Gayle | May 1, 2007 2:04:52 PM

I think it is also important to strive not to view a patient's weight as a moral issue. Whether we realize it or not, many of us attach a moral value to a persons weight, whether consciously or subconsciously. Most people studying medicine or hoping to study medicine in our culture come from an upper-middle class or upper class background, where weight is often seen in moral terms. Those who look fit are better people: more controlled, successful, happier, intelligent.

I don't like to admit it, but I tend to blame a person and think less of him or her if s/he is overweight. Everyone knows it's bad for you to carry extra weight, so why can't they just eat better and exercise a bit? They must have less self control, a poorer work ethic than the rest of us. Worse, they might just be ignorant or unintelligent and, in the midst of today's excess of nutritional information, simply not know what's good for them.

The truth is that our country's excess weight sits, for the most part, on the bodies of those not traditionally burdened with excess: the poor. This paradox reminds me that I have to look further than a person's diet to understand their weight. On the one hand, food is a necessity, and if I see something like McDonald's as the only way I can afford to feed my family, I'll do it. There often are not grocery stores or produce markets in poor areas. People literally have to travel over 5 miles, often on a bus, to go shopping. When you're a single mom working 2 jobs, making dinner can be a major challenge, let alone going grocery shopping. And, the populations that tend to be poor (Latin American and African American people) have genetic make-ups and metabolisms that are well adapted for a feast-and-famine lifestyle, not the constant abundance of today.

On the other hand, food is far more than mere nourishment-it's a family affair, it's comfort, hospitality, ethnic identity. To refuse it can feel like denying your identity, and it can come off as rude or elitist. People use food to identify with and belong to a group (think Thanksgiving dinner, or the church picnic), and no one wants to be outside the group. This doesn't mean we should ignore weight problems, just that we should acknowledge the complexity of the problem.

I know that this is very off-topic, and I apologize. I got on this train of thought from one phrase in the article-a question about doctors maintaining "appropriate" weight in order to be good healers. I'm sure that it was meant as appropriate for a person's size, or appropriate to maintain health. But I can't help but notice that the opposite of appropriate is inappropriate. Rhetoric can be very powerful, even if only within our own minds. Inappropriate can mean rude, improper, unacceptable, wrong, even disgusting. These ideas have strong negative moral components; i don't want to be thinking in those terms about my patients.

I don't know what this has to do with overweight doctors. I think we should hold ourselves to the same standards that we hold our patients: if we advise them to maintain a healthy weight, we should try to do the same. by the same token, if we view a certain level of fitness as "appropriate" for a doctor, our patients can be held up to the same standard. Good health is no less appropriate for them than for us.

Posted by: | May 1, 2007 2:15:52 PM

Hi
As a fellow student doctor, I can attest to a constant personal conflict between the need to "practice what you preach" and being plain old human. The obesity problem in America is out of control, and it's not limited to physicians.
There are a few important points to raise pertaining to the issue:
1) Physicians are people too. Far too often, doctors are placed on a superhuman pedistal where they are expected to know and be more than is humanly possible. A degree on the wall does not make you superman. We all have flaws and shortcomings. Being a doctor is a JOB, just like being a fireman or a lawyer or a police man.

2) Some would argue that being overweight places physicians in a role that could be more encouraging to overweight patients because they can more easily identify with the struggle to shed pounds. It is our job to let patients know how to enjoy a healthier lifestyle; it is NOT our job to take on a holier-than-thou mentality. Rather, we should take on a "we're in this together" perspective. When you consider that our role is to empower patients with health education rather than to tell them what to do, it becomes a lot easier to understand that we should not be expected to uphold a "standard" lifestyle.

Posted by: Candice | May 1, 2007 2:26:55 PM

Maybe this is just me but I'd feel a bit funny going to a dermatologist with tons of acne, or a Lasik surgeon who wears thick glasses.

Posted by: | May 1, 2007 2:48:53 PM

Unfortunately, Americans treat their bodies like rental cars. Too many times, the consequences really don't come into consideration until it is too late and the patient is admitted to the hospital.

Posted by: Liza | May 1, 2007 3:22:03 PM

I am a dietetics student who enjoys reading Medscape articles, and reading the student blogs. Due to my field, obesity topics always catches my eye. I know that if I were to visit a dietitian who was obese or overweight and they were trying to tell me to change my lifestyle, I would have to laugh. I think the same goes for anyone who deals with lifestyle changes whether it be a MD, dermatologist, etc. You should practice what you preach.

Posted by: Jessica | May 1, 2007 3:31:41 PM

all doctors are human, some less than.

Posted by: | May 1, 2007 3:35:39 PM

Hello, I just have to say that unfortunately I am an obese medical student and will likely be an obese doctor. I have always struggled with my weight and have to say that I have added 70 pounds through med school and child bearing. Although I am ashamed of my weight and try diligently to lose it, I do not think it will make me a bad doctor.

I do confess that advising people to loose weight is hard to do when you can not set an example yourself. I do agree that it makes me more sympathetic to people who are struggling with weight loss, something most of you can not possibly imagine if you have never been in that place yourselves. It is very easy to tell someone, "you need to just eat less and exercise so you can loose weight". It is another thing all together to actually accomplish that goal.

Like another poster said, there are many things that go into the fact that a person is obese other than eating. I am by no means making excuses, and I do beleive that we as physicians should set an example for our patients, but being overweight is not the only way we set bad examples. We tell our patients to eat well, exercise, don't smoke, don't drink in excess, get lots of sleep, don't have too much stress, eat low cholesterol food, eat low sodium....the list goes on. Can everyone honestly say that they never do the things that we recommend to our patients. I do not think so and if you can...well than you must be very proud. Everyone has their vice and our job is to educate our patients about those issues, they are ultimately the one who has to take the responsibility.

Posted by: Rachel | May 1, 2007 3:47:16 PM

This topic has nothing to do with "practicing what you preach." It has everything to do with what you believe in as a doctor. Throughout our medical school careers (and I'm nearing the end of mine), we have been beaten over the heads with the ramifications of obesity on someone's health and quality of life. I believe we have a duty as professionals to uphold all the practices that we enforce on our patients to hold true within our own lives. This is especially true here in America (and I've grown up in the US). Unfortunately, obesity is not a disease, it's a lifestyle. If we as doctors fall into this "lifestyle" then we too are contributing to these problems, not helping them. I do believe there is a strong government influence from corporate America which supplements the carbonated beverage companies and fast food restaurants. In the end, fat begets fat, though. We have to start with the parents to influence the children.

We can't fight it if we don't believe in it. We are the most powerful country in the world, so what. We're also the fattest. I have always found time to study, eat properly, exercise, indulge when I lose a little self-control and jump back on the healthy diet bandwagon without any problems whatsoever.

We also have to be equally effective motivators to those who are trying to adapt these new lifestyles, and we came speak and motivate much more effectively if we have the experiences from our own lives to draw from.

Obesity will always be a lifestyle first (it wasn't nearly the problem it is today 20 years ago, but last time I checked there aren't that many "new" diseases from 20 years ago to explain the obesity epidemic here in the US) and teaching parents to adapt this lifestyle and teach it to their children is going to be the most important step we can take as physicians. Practicing what we preach is exactly what we adopted when we took the Hippocratic oath upon entering medical school and to forget that now would go against everything the profession stands for.

If WE AS DOCTORS can't be strong, who will our patients look up to for true support, motivation, and real-life answers to their problems obesity related problems? We would fail them as healers.

It's like treating the 70 year old, 50 pack year history smoker during an acute attack of COPD. Yeah, we can treat the attack, but we can't treat the disease. It's already done it's damage because we weren't good enough role models in the first place to motivate this patient to stop smoking. Just like obesity.

It all comes down to moderation. There are no
"overnight" fixes for obesity. You have to work for it, but it can be done over time if you follow simple rules like decreasing your intake, over time, and exercising 30 minutes every other day. Simple rules, each and every one of us should be following if we're recommending it to our patients.

It's who we are and part of our obligation.

Posted by: Donnie | May 1, 2007 3:48:52 PM

I've been following the discussion over at Medscape regarding whether overweight doctors can be appropriate role models, and as an overweight medical student I must put my foot down and say that medical judgment should not be used as a cover for moral judgment. It is time to accept the person and work with them, rather than condemn them for their failings--and, whoa, guess what? Doctors are people too! (Some of them would argue to the contrary...) Do I think that being overweight is unhealthy? Of course--what student of science wouldn't? But what so many people do not understand is that weight is so much more than intake and output. It is social, emotional, political, sexual, financial--tell me, would you as a physician tell someone to just stop eating so much if you knew that your patient's only psychological refuge was food? Would you insist on them exercising daily, when there was nowhere safe for them to walk, or after working two jobs to feed their families? Would you feel at all compassionate to the fact that so many patients with weight problems, including myself, HAVE tried, and yet they are treated by many in the medical establishment as if the lack of compassion and cooperation from their doctors was deserved. I challenge everyone to find an overweight person in this country (US) who has never been on a diet, never forgone dessert or second helpings, never bought gym memberships, someone who says, 'I have always been happy as a fat person.' I have HAD IT with people who smugly toss off the statement, "Well, just eat less and move more." Now, I have heard that from doctors thin and thick, and I accept it better from the former because, well, they just don't know any better. Maybe that's the real controversy here. I certainly won't be telling my patients, "Oh, it all comes down to willpower" as I waddle out of the exam room. But I will be telling them exactly what I AM doing for my health, and how they can incorporate some of the same concepts into a model that suits their lives. Taking the oath gives me no obligation whatsoever to be a perfect human being, but I have all the obligation in the world to work WITH my patients as we all move forward in health and happiness.

Sorry...I get riled. But in a good way. Please, please, be compassionate towards your patients, your colleagues, and yourselves. :)

Posted by: Amy | May 1, 2007 4:59:59 PM

I'm sorry, but the dietititians pre-High Fructose Corn Syrup warned of this epidemic. We are reaping what we have sown.

What do you feed a hog to fatten it up for market? Corn. What is in practically EVERY food manufactured in the USA? Corn. How do I know this? I'm allergic to corn.

It is impossible to completely avoid corn since it is even in the prescription medications that are given to people. Monsanto and ADM are the major contributors to the obesity epidemic. Not lifestyle. At least, not anymore.

Posted by: MLO | May 1, 2007 5:03:00 PM

I was a fat kid. I started dieting in the third grade (back in the early 80s, mind you.) I've been dieting ever since. And, guess what? I'm a fat medical student. It doesn't matter that my HA1c is about 5%, my blood pressure is much lower than my fellow students, or that my cholesterol pannel is to die for. I'm fat, and I know a lot of other students and physicians view me that way, and assume I have all the "fat" medical issues. I've come to terms with that, and, frankly, don't care.

I have a reason for not caring. You see, I have done a lot of clinic work, and have dealt with a lot of obese patients. The wonderful thing is that they are all comfortable with me. People are open and honest with me. When I do a physicals on obese patients, they aren't ashamed. They don't feel they need to hide anything from me. They know that *I* know what they are going through, that I know what it is like to walk in their shoes. They know that when I say "I know losing weight is hard" that it isn't a line. And, you know what? They return to clinic a month later, and have actually adheared to their diet and exercise programs. And we all celebrate their victory together.

So, yeah, I'm a fat medical student. My patients still respect me, listen to what I say, and work with me in the interest of their health.

Posted by: Lee | May 1, 2007 5:17:01 PM

I believe the answer is quite simple. If you chose to be a part of a profession that represents and claims perpetuation of health and well being, then you should strive to achieve the mental and physical image that supports your education and directives to patients. It is rather a question of whether you support the paradigm of pharmaceuticals as the end all means in addressing disease and it's symptoms/systems it affects, or if you approach disease at the root of the cause and treat the patient as a whole, which would incorporate diet, lifestyle factors and educating patients on future preventative measures. If you chose the later, it requires time devoted to true understanding and education beyond that of pathology and pharmacology, to nutrition, supplementation, toxicology, and exercise physiology. Regardless of how busy we are as physicians or medical students, exercise, stress management, proper nutrition and supplementation should not be comprised or negotiable (these are the times of greatest need)...it comes down to priorities. I wouldn't believe a word out of an obese doctor's mouth, as I would not train with a fat personal trainer. Smoking is nothing short of stupid and an infringement on others rights to health. Education is not enough to stand alone; it takes initiative for change and commitment to the development of discipline. Grant it some patients are difficult and will not listen, but your chances are better at reaching them if you practice what you’re preaching and teaching. In most industries, if you do not adapt to the changing trends, you have defeated yourself. Take heed, the new breed of doctors are both fit and educated in conventional and alternative medicine!

Posted by: Kelli | May 1, 2007 5:39:49 PM

I believe it is widely understood that to be obese can result from many different factors including genetics, mental health, income, schedule, or simply not having had a good example to model good habits. The last of these is where physicians as role-models comes into the debate. It is not necessarily within everyone's grasp to be skinny. However, it is within the patient's, as well as the doctor's, grasp to make changes and be proactive where health is concerned. It is not a legitimate excuse for anyone to not strive for improvement because they are "only human". Rather, I wonder why doctors don't exercise some good, old-fashioned community building, ideally getting involved themselves, by perhaps setting up group workouts, events, seminars with healthy food run by rotation, etc. Maybe a physician has his/her own reasons for being overweight, but it is not images of models on magazines or of your super-fit doctor that motivates people to lose weight. It's going through the effort with someone else. This is the kind of example doctors should be setting.

Posted by: doolallyallya | May 1, 2007 7:20:25 PM

"I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous...While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times!" - Hippocratic oath. But Hippocrates also said that physicians should be "robust," just as he had stated recommendations for the proper length of a surgeons fingernails. Though I agree that we should respresent good health as role models, there is another view: that a "robust" doctor is a comforting image to an already stressed patient. If one is treated by an immaculately dressed, perfectly shaped physician, they may feel inferior and unable to relate. In the end, every patient has their own perception of competency, whether due to the treatment they recieve or the way their doctor presents; we should be happy and competency will follow.

Posted by: rsinger | May 1, 2007 7:33:04 PM

I agree with some of Racheal comment that the patient is responsibily for the information that they received from their doctor. So if the doctor is overweight and telling the patient to stop smoking, drinking, eat right, and even exercise to prevent illness in the future. The ultimate decision is up to the patient to comply with the doctor specialty when it comes to medical advice and not trying to change their bad habbits won't make it any better. The doctors are their to give information, but it up to the patient to accept for changes in their lives. So if the doctor who is overweight is dealing with his/her issues at some point in time they will take care of their own problem and should not be question on their own health.
Thanks

Posted by: Paulette Gayle | May 1, 2007 7:51:28 PM

I really enjoyed reading all of these discussions from everyone with various backgrounds. What struck me was that regardless of your sizes, you are all students/professionals who CARE! You understand that the situations that a patient lives in may be more complex than simply "will-power". A person's physical appearance makes for an effective first glance "marketing", but to appreciate the worth of the caregiver takes more than that--it takes a professional who is willing to motivate, problem solve and provide support to the patient who NEEDS and WANTS your help--and that's a big commitment from both parties. It's unfortunate that it is often difficult to look past stereotypes. Kudos to you who achieved or are maintaining a healthy lifestyle. Kudos to you for trying and who persevere. You offer patients an opportunity to relate to those of you who were and were not successful in that one aspect of your life. You have so much to share from your experiences.

Posted by: Agnes | May 1, 2007 7:57:27 PM

Paradoxically I believe have had more success with communication around weight issues with patients BECAUSE I stuggle with my own. I've managed to lose a large amount of weight over the last several years. I can talk about this in terms of my own experience -- what has worked for me and what hasn't. I can laugh with them about it, comisserate with them about just how difficult of a task substantial weight loss is. News flash-- I hated going to the the doctor when I was obese and so do most patients. Just ask your heavy patients if they appreciate their thin "fit" upper middle class doctors, who have most likely never had the experience of having had a large amount of weight to lose, giving them advice on weight loss. Your chances of "reaching patients" increases with empathy. humor, and an approachable, caring demeanor. Most fat patients don't identify with, and are not inspired by, marathon running physicians. This lends no credence to your comments that they've gained 5 pounds since you last saw them and "tsk tsk you really should lose some weight." They know what you think of them. They know you judge them. The idea that overweight doctors are somehow remiss in their duty to patients and their commitment to medicine is the most preposterous thing I've ever heard. Not to mention disgusting and offensive to people who care deeply for their patients and work very very hard. This is fat-prejudice, thinly disguised. I would bet my life that if someone compared weight-loss success among patients of overweight vs. thin physicians, they would find no difference whatsoever.
Something to think about priveleged young doctors....there is no human being that is without character flaws. For the overweight person, their very personal struggle is completely exposed. Can you imagine if whatever it is that you are ashamed of, whatever you do that you wouldn't want anyone to know about, was laid bare for all the world to see? How lucky you are that no knows that you secretly binge drink on the weekends, are knee deep in credit card debt, smoke cigarettes, dont practice safe sex, are addicted to pornography, have racist or homophobic thoughts, lie, steal, cheat, manipulate, spread gossip, . And if you stay lucky....noone ever will. Let he is without sin cast the first stone people.
Reserve your judgement for those who might possibly deserve it - murderers, child-molesters, rapists - rather than dedicated physicians with excess adiposity.

Posted by: Regina | May 1, 2007 8:21:18 PM

AMEN, Regina.

Posted by: Amy | May 1, 2007 9:32:22 PM

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