Dateline 2024 – a client enters the GP cubicle.
“X” (gender or marital status is no longer recorded in medical information) “Back before 2018 you used to tell me it would be healthy for me to lose weight. I didn’t listen but have done a dark web search (Google no longer allows searches on weight) and found that my BMI is in the obesity range. I want to do something about being obese.”
The ashen faced government health worker (formerly called GP), glances at the CCTV camera which records every consultation. “Let’s do a skin check today. I suggest that you rebook an appointment for another time when we can talk about how your scales appear to be malfunctioning. Since they don’t show an inclusive weight we can have them repaired for you.” Covering the mouth and whispering “Please, for our safety do not repeat to anyone what you have told me.”
Sound far-fetched? Today it is. But hard won individual freedom can be easily chipped away at by the state. In a 35-page edict on how doctors should assess weight, The NSW Health department tells doctors and other health practitioners to avoid words like obese, morbidly obese obesity, underweight or overweight. Terms like above or below a healthy weight are advised.
Maybe for their next advisory they will tell doctors not to use the word cancer but rather talk about “a cute extra growth” in your lung or breast.
For the record, I don’t use the term obesity that much but find that patients do. However, doctors need to use language, which works for them and those who choose to consult them. Thus, an on high directive by bureaucrats is to be strongly opposed for three key reasons.
First, doctors are not, and must never be, an arm of the state. The reputation of the medical profession was highest when it was seen as independent. People could trust their doctor to deal with them as an individual and not just allocate them to some “best practice algorithm”, a one size fits all approach ignoring individual circumstances. Sadly, the profession has allowed itself to increasingly be an agent of the state rather than of the individual. History shows that medical collaboration with government does not always end well.
Second, unless we admit there is a problem we cannot deal with it. The BMI (of which I am no fan) defines cut off levels for overweight and obese. There are calls for obesity to be classed as a disease. Nobody is going to attempt to reduce weight unless they perceive there is a problem. Nobody will accept chemotherapy unless they understand that they have cancer!
Paternalism in medicine was supposed to have ended yet the push is now to infantilise people as being incapable of dealing with reality unless it is “sugar coated”.
Lastly, like most government attempts at “solving crises” this directive is what Chris Kenny described in The Weekend Australian (Jan 6) as gesture politics. It is not about helping people, it is about virtue signalling. He writes; “Don’t like obesity and want to make a sanctimonious gesture? Trumpeting a sugar tax is for you. Oppose litter but are worried people don’t know you always put your rubbish in a bin? Join the campaign to outlaw helium-filled balloons for kids. Or devise a return-and-earn scheme for drink containers. No policy is worth backing unless it gives you a platform to signal your virtue”.
Want everyone to know you care about obesity? Publicly support PC language and call for a sugar tax. Meanwhile let’s ignore that another arm of government has banned a doctor from talking to patients about nutrition because he told them to cut down on sugar.
The reality is that the increased rates of obesity in the Western world coincided with the introduction of low fat dietary guidelines and the food pyramid promoting more grain consumption. Food sales show people have followed this advice.
Government public health advice has been a big part of the problem. Rather than admit the evidence proves them wrong they call on doctors to pretend the problem can be fixed by not referring to it.
Doctors and patients need to communicate in ways that work for them not follow some PC government language guide. Empty gestures will never improve the health of people. It is sad that due to, understandable, fear of complaints and a gaggle of government “discrimination” agencies many doctors will fall into line. The more the medical profession cedes its independence the more it loses what makes it a profession.
This article first appeared on Medical Observer.
Medical Doctor, author, speaker, media presenter and health industry consultant, Dr Joe Kosterich wants you to be healthy and get the most out of life.
Joe writes for numerous medical and mainstream publications, is clinical editor at Medical Forum Magazine, and is also a regular on radio and television.
Joe is Medical Advisor to Medicinal Cannabis Company Little Green Pharma, Chairman of Australian Tobacco Harm Reduction Association and sits on the board of Arthritis and Osteoporosis WA. He is often called to give opinions in medico legal cases.