Health24.com | Doctors who ‘fat-shame’ patients do more harm than good

Many of us have been there: You know you might do a bit better in the healthy eating department, and the winter has taken its toll on your waistline.

You step off the scale and check your doctor’s reaction as she tallies the score in her head. “This is too much, you know. Quite frankly, a woman your age should not be in this weight range. Healthy eating and exercise for you!”

And then you walk out, ego deflated (your waistline, not so much), feeling unattractive and demotivated…

Have you ever come across a fat-shaming doctor? Doctors who “fat shame” patients do more harm than good, new research suggests.

Disrespectful treatment

“Disrespectful treatment and medical fat shaming, in an attempt to motivate people to change their behaviour, is stressful and can cause patients to delay health care-seeking or avoid interacting with providers,” Joan Chrisler, a professor of psychology at Connecticut College, said in an American Psychological Association (APA) news release.

Chrisler took part in a symposium on the topic at the APA’s annual meeting in Washington, D.C.

Negative attitudes about excess weight “might be experienced by patients as microaggressions – for example, a [healthcare] provider’s apparent reluctance to touch a fat patient, or a headshake, wince or ‘tsk’ while noting the patient’s weight in the chart,” Chrisler said.

“Microaggressions are stressful over time and can contribute to the felt experience of stigmatisation,” she said.

Biased behaviour

Bias can also affect how doctors treat overweight and obese patients. For example, some studies show frequent underdosing of overweight patients receiving antibiotics and chemotherapy.

“Recommending different treatments for patients with the same condition based on their weight is unethical and a form of malpractice,” Chrisler said. “Research has shown that doctors repeatedly advise weight loss for fat patients while recommending CAT scans, blood work or physical therapy for other, average-weight patients.”

In addition, she noted that doctors sometimes fail to take overweight or obese patients’ health complaints seriously or assume that their weight is causing their symptoms.

“Thus, they could jump to conclusions or fail to run appropriate tests, which results in misdiagnosis,” Chrisler said.

Stigmatisation a serious risk

In a review of more than 300 autopsy reports, obese patients were 1.65 times more likely than others to have significant undiagnosed medical conditions. Those conditions include endocarditis, an infection of the heart’s lining and valves; ischemic bowel disease; or lung cancers. This suggests misdiagnosis or inadequate access to health care, Chrisler said.

There’s no research showing exactly how much weight is too much, according to Chrisler. She said doctors often assume overweight patients are unhealthy, even though other factors – such as genetics, diet, stress and poverty – also play a role.

According to Maureen McHugh, a psychologist who also took part in the symposium, evidence shows that fat shaming is not an effective way to reduce obesity or improve health.

“Rather, stigmatisation of obese individuals poses serious risks to their psychological health,” McHugh said. “Research demonstrates that weight stigma leads to psychological stress, which can lead to poor physical and psychological health outcomes for obese people.

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Health24.com | 5 foods that can trigger an asthma attack

No one really knows exactly what causes asthma. What we do however know is that asthma is a chronic inflammatory disease of the airways. Symptoms can vary from person to person, but one thing is constant: when airways come into contact with an asthma trigger, the airways become inflamed, narrow and fill with mucus.

According to statistics from the Western Cape Government, there was a significant rise in adult asthma in South Africa over the past 25 years.

If you are suffering from asthma, it is important to know that although your symptoms can be easily controlled, an attack may be deadly.

Common asthma triggers include colds and flu, cigarette smoke, exercise and allergies (allergy-induced asthma).

Allergy related triggers

“Allergy asthma” is triggered by allergens that cause the bronchial tubes to treat inhaled particles as “obstructions”, resulting in wheezing, coughing and difficulty breathing.

When you come into contact with an allergen, your body responds by producing histamine, as a result of an overreaction of your immune system. It’s ultimately histamine that’s responsible for your symptoms. 

Here are some of the most common foods that can trigger asthma symptoms:

1. Milk

Milk is an essential source of calcium, and the link between milk and asthma has often been disputed by researchers. But there are a small number of asthma sufferers who will actually benefit by cutting milk and dairy products out of their diet. People who are already predisposed to dairy allergy from a young age can suffer from wheezing, coughing and breathlessness. If you find that your symptoms are indeed triggered by dairy, find an alternative source of vitamin D and calcium.

milk jug and glass

 2. Eggs

Egg allergies are more common in children and outgrown in most cases. Symptoms are more often triggered by raw, undercooked or medium eggs than fully cooked eggs. According to the American College of Allergy, Asthma and Immunology (ACAAI), people who are prone to egg allergies should also check food labels and medications that may contain eggs.

3. Additives and preservatives

Sulphates and tartrazine are the most common additives that can trigger allergies. These are often added to give food a longer shelf life. Look out for food labels containing these, or steer clear of processed meats, canned, packaged food, sauces, fruit juices and fizzy drinks.

food cans

4. Wheat

Wheat allergy is usually caused by albumin and globulin amino acids in wheat. When these amino acids enter the body through the digestive system or the lungs, the immune system reacts by making so-called immunoglobulin E antibodies. These antibodies then cause the actual symptoms associated with asthma, such as wheezing and coughing.

wheat

5.Soya

After milk, soya allergy is the second most common allergy in the Western World, according to a Health24 article. Soya is found in processed foods like pre-packaged soups and fermented foods, such as soya sauce.

soya beans

If you suspect that any of these foods trigger your asthma symptoms, you can experiment by eliminating them or consult your doctor to do an allergy test. 

All images supplied by iStock.

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Health24.com | Many rural rape victims still use ‘gentleman’s agreement’

For Thuthuzela Care Centres operating in rural areas such as Lusikisiki in the Eastern Cape, rape cases that go unreported and are discussed only by traditional councils remain the biggest challenge for the centres.

Thuthuzela Care Centres were established as one-stop facilities that have been introduced as a critical part of South Africa’s anti-rape campaign strategy, aiming to reduce secondary trauma for the victim, to improve conviction rates and to reduce the cycle time for finalising cases. 

‘A gentleman’s agreement’

According to Eastern Cape Thuthuzela Care Centres provincial manager Mkhuseli Jokani there are numerous challenges in rural areas.  Although they have ongoing campaigns through which they engage with the Department of Health and the Department of Education, people in rural areas remain unaware of the services available to them and are still not coming forward to report their cases and access help.

“In some instances families resort to a gentleman’s agreement, which is basically a discussion of rape cases at home rather than in court, generally resulting in the withdrawal of charges. The most critical part is people in rural areas believe in following their customs and traditions, and so some cases of rape end up being discussed in traditional councils by traditional leaders without the intervention of the relevant government departments,” Jokani said.

Let the law take its course

Meanwhile Contralesa (Congress of Traditional Leaders) provincial chairman Chief Mwelo Nonkonyana says they are surprised by this, as leaders are supposed to work with government and towards the protection of women and children.

“I urge those traditional leaders who discuss crime cases in their traditional councils to assist victims to report their cases and allow the law to take its course against the perpetrators of crime,” Nonkonyana said.

This follows Eastern Cape Health MEC, Phumza Dyantyi’s recent visits to hospitals and clinics in the eastern part of the Eastern Cape. This came after a series of complaints by rural communities about conditions at hospitals in the region. During these visits the Thuthuzela Care Centre was one of the areas identified as requiring urgent attention. – Health-e News.

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