Reply to Insensitive Drs at Childrens (overweight child)

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]
OP -

In the interest of full disclosure, I should say that I am a pediatric sub specialist (doctor), but I do not work at Children's.

I do not think that the doctors had the intent of insulting you or your child. They did not say she was "fat" or "ugly". They offered a nutrition consult because she is actually severely obese (her BMI is 39.5, and morbid obesity is anything over 40). They documented her abdominal exam as being soft and obese because it is - this implies that her belly was soft (which implies no serious internal pathology) but might have been difficult to palpate the internal organs (liver, spleen) due to her size. Another way we write this on a physical exam is "exam limited due to body habitus". This can pertain to many aspects of the physical exam, not just abdominal exam. Also, while it is certainly embarrassing to be measured for the MRI, they obviously had a concern so they did it. I am sure that no one was standing around discussing how someone could make your daughter feel worse about her weight than she already does. Finally, while it is great that she has lost 35 pounds, the doctors had no way of knowing that (unless you told them) and this would still not change any of the above because despite that weight loss, she remains severely obese. If you feel that you were insulted, you should take to a representative from the hospital, but it seems that the doctors were only doing their job - in documenting and recognizing a very serious health concern even though she was admitted with something else.

It is great that you are trying to maintain her self esteem. I am sure she is a beautiful girl. However, the facts are that you and your daughter are severely overweight.While hormone imbalances can certainly contribute, medically speaking, they are generally not the only cause. If she were my patient, I would discuss her weight with you at EVERY visit because it is a SERIOUS HEALTH CONCERN. She is at risk for type II diabetes, cardiovascular disease, joint disease - just to name a few - at a young age. It seems that you are both trying, but you need to keep going. From the point of view of a pediatrician, I do not actually care about YOUR weight - just in the way it impacts HER weight (just like if were a smoker I would not care so much unless you had a child with asthma).

I can tell you that when I see an obese child, it makes me sad for many reasons -and I think most pediatricians feel the same way. First, I am sad because of the social stigma that obesity carries. Being a child (esp adolescent) is difficult enough socially - gaining acceptance and fitting in. Second (and most importantly) I am sad for the medical implications. Thirds, as a woman, I am sad because I know it is a lifelong struggle - something that will always be an issue in the child's life. Fourth, especially when the child has obese parents, I am sad because the family is either in denial or makes it more difficult for that child to lose weight because of their own eating habits and physical activity. 100% of the time it would never occur to me to intentionally embarrass or shame the child (but I would recognize that any discussion of the issue would of course be uncomfortable). Just because it is uncomfortable does not mean that I would not address it.

You need to make this a priority for your daughter (and yourself) - not because she will be more beautiful but because she will be MORE HEALTHY. If you do it together, you will support each other and likely be more successful (the whole basis of weight watchers). Good luck to you both.[/quote]

OP, what a lot of people are trying to tell you, in more or less sensitive language (the best I quoted above), is that your DD's weight loss should be your number one priority. You will have to accept that her ego and yours will be bruised in the process. I do not say self-esteem, because I am convinced that it is better for your daughter's long-term self-esteem and self-image to be shocked now by others' reactions, including the professional reactions of the hospital staff, in order to motivate a change, than to be obese life-long.

In other words, you are missing the forest for the trees. The mortification you thought you both underwent is nothing compared to the stigma of being morbidly obese in our society and the grave ill-health that will affect your daughter very soon. [b]The situation has gone too far for you and your DD to do this alone. Get professional help, enlist the ped, who will recommend an experienced nutritionist, a psychologist, etc. [/b]

Good luck.[/quote]

Really dip shit. You act like the situation has gotten worse. [/quote]

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