| You've read about all the health risks of being | | | | weight. |
| overweight, including heart disease, type 2 diabetes, | | | | Being too heavy can even get in the way of |
| certain cancers and even early death. But there are | | | | effective cancer treatment according to the experts. |
| surprising risks to your health from those added | | | | The most likely culprit is underdosing, basing |
| pounds that are not nearly as well documented. | | | | chemotherapy drug doses on the patient's ideal |
| Some recent studies have found that overweight | | | | weight, rather than their actual weight. |
| woman: | | | | Trials usually only include women of average weight, |
| - Might have a harder time getting health insurance, | | | | so doctors don't have a good handle on the doses |
| or have to pay more for it. | | | | for larger women. And since these drugs are quite |
| - Are at higher risk of being misdiagnosed, or getting | | | | toxic, no one wants to take chances with the dosing. |
| an inaccurate dosage of a drug. | | | | Doctors have known that obese women are more |
| - Are less able to find a fertility doctor who will help | | | | likely to die from breast or ovarian cancers. Especially |
| them get pregnant. | | | | troubling then is the finding that obese women are |
| - Are less likely to have cancer detected early. | | | | less likely to get Pap smears than women of normal |
| Current numbers have just about 70 million American | | | | weight, but the screening lapse isn't all on the women |
| women considered overweight, which makes for a | | | | here. A University of Connecticut study of more than |
| lot of patients who may not be getting the care | | | | 1,300 doctors found that 17% were reluctant to do a |
| they need. | | | | pelvic exam on an obese patient; the number jumping |
| Overweight or not, these findings should have | | | | to 83% if the patient herself seemed hesitant about |
| everyone taking note, and taking steps to be sure | | | | the exam. |
| you get the quality healthcare you deserve. | | | | That should NEVER happen. |
| Overweight or not, being mistreated or dismissed by | | | | But you can't blame it all on doctors as being |
| your doctor because of your weight is unacceptable | | | | overweight can obscure illnesses like heart disease |
| - you don't want that person in charge of your | | | | and some types of cancer. All those extra pounds |
| medical care. | | | | bring added strain to joints and pain you might not be |
| "Our culture has enormous negativity toward | | | | having if you were thinner. |
| overweight people, and doctors aren't immune," | | | | What's more, large patients don't always fit into the |
| explains Harvard Medical School professor Dr. Jerome | | | | small spaces of diagnostic scanning machines. |
| Groopman, M.D., author of How Doctors Think. "If | | | | Computed tomography (CT) and magnetic resonance |
| doctors have negative feelings toward patients, | | | | imaging (MRI) and even X-rays and ultrasounds aren't |
| they're more dismissive, they're less patient, and it | | | | able to deliver as clear a picture, and without that, |
| can cloud their judgment, making them prone to | | | | imagine your doctor driving blindfolded as he tries to |
| diagnostic errors." | | | | treat you. |
| When it comes to just how many diagnostic errors | | | | Ultrasounds are particularly vulnerable to added fat; |
| are due to a patients' weight, there are no hard | | | | the beams can't penetrate the tissue if you have |
| numbers to attest to the problem, though it's long | | | | more than 8 centimeters of subcutaneous fat. |
| past time for the medical community to take a hard | | | | Naturally this affects more women since ultrasounds |
| look at the biases that might be affecting the | | | | are used to spot uterine tumors and ovarian cysts, |
| treatment they give overweight patients. | | | | not to mention to check on the baby's health during |
| Data on diagnostic errors for the general population is | | | | a pregnancy. |
| sobering. "Doctors make mistakes in diagnosing 10 to | | | | Researchers have also confirmed false positives to |
| 15 percent of all patients, and in half of those cases it | | | | mammograms in overweight and obese patients. |
| causes real harm," Groopman says. | | | | This leaves a doctor with little to go on except the |
| Carrying too much weight does bring legitimate | | | | symptoms you mention and intuition. That isn't the |
| concerns to the operating table, and those with high | | | | best option in the emergency room. "If we can't get |
| BMIs often find that surgeons are reluctant to offer | | | | the imaging because of a patient's weight, and we |
| a procedure to very overweight patients as they | | | | are concerned about a pulmonary embolism or |
| make for longer, more difficult operations. | | | | appendicitis, for example, we have to go ahead and |
| Hospitals too, who track data on surgical complication | | | | treat based on our clinical impression," explains Dr. |
| rates may warn doctors off more high risk cases in | | | | Archana Reddy, M.D., a practicing emergency room |
| order to preserve their standing with insurance | | | | physician. |
| companies. Patients may be denied procedures like | | | | Certainly the health risks of being overweight are |
| cardiac catheterization, organ transplants of kidney or | | | | something we all need to be aware of when it |
| liver, knee surgeries and more because of their | | | | comes to medical care. |