Maybe it's the embarrassment of being too heavy. Or maybe they don't want to hear yet another warning to "go on a diet."
Whatever the reason, overweight women delay such crucial clinical tests as breast and gynaecological exams and Pap smears, according to a recent study on body weight and health care. And the delay may be putting their health further at risk.
Advertisement
The exception seems to be mammograms, according to the survey in the Archives of Family Medicine.
Why the difference? A mammogram is less embarrassing and can be booked directly without a physician's intercession.
"The number one reason is that it doesn't really involve disrobing. And a physician doesn't do it - just a technician," says Kevin R Fontaine, a research psychologist at the University of Maryland who specialises in obesity.
The cost of a doctor's appointment may deter some women, but often "women delay screening because they feel uncomfortable with physicians. They withdraw from all medical care because they don't want the embarrassment," Fontaine says.
"The physician says, first thing, 'You need to lose weight,' as if all a person's health problems are related to weight. Many physicians have negative stereotypes of obesity, like obese people are lazy or could just stop eating," Fontaine says.
He suggests women stop worrying about what the doctor will say about body fat and get the screening they need to avoid diseases like cancer.
"The take-home message is that overweight people are definitely put at a greater risk for some cancers and are even more at risk if they delay the screening tests," Fontaine says.
Empathy is what's needed If a patient is obese, it's better to have a nurse meet her first and ask her if she's comfortable with being examined, says Dr Jeffrey Deitz, a psychiatrist in New York, who treats a number of obese patients.
"Somebody should be able to spend a few minutes with an obese patient," Deitz adds, to encourage her to undergo an examination. "'Go into the examining room and take off your clothes,' has a non-empathetic ring that always gives doctors a bad name."
Fontaine's research team surveyed almost 7 000 women over the age of 18 to examine the relationship between body mass index (BMI) - the ratio between height and weight - and the use of medical care services. Like the national average, about one-third of the people surveyed were considered obese.
The survey found that obese women (a BMI of 30 or more) were more likely to delay the screening exams than non-overweight women (with a BMI of 25).
The chances of obese women getting breast exams were 26 percent less than non-obese women; having a Pap smear, 29 percent less; and getting a gynaecological check-up, 39 percent less.
Body mass index is one of the most accurate ways to determine when extra pounds translate into health risks. BMI is a measure that takes into account a person's weight and height to gauge total body fat in adults.
Someone with a BMI of 26 to 27 is about 20 percent overweight, which is generally believed to carry moderate health risks. A BMI of 30 and higher is considered obese. The higher the BMI, according to Fontaine, the greater risk of developing additional health problems.
Maybe it's the embarrassment of being too heavy. Or maybe they don't want to hear yet another warning to "go on a diet."
Bookmark with:
What are social bookmarks?