I was thrilled to read that Dr. Regina Benjamin is President Obama’s nominee to be the next Surgeon General of the United States of America. Her background in family medicine and her work on behalf of her community and the poor make her an amazing candidate to be the public face of the nation’s health care initiatives.
Unfortunately, not everyone shares that opinion. Soon after the nomination, critics began to claim that, despite her resume and achievements, Dr. Benjamin may be "too fat" to be Surgeon General.
People are actually speculating on the dress size of the Surgeon General nominee and debating whether it is large enough to disqualify her for the position. I’m more than aware that size matters more than health to too many people. But this is different. People assume that a full-figured person must rack up medical conditions with every pound. The media also sends a lot of mixed messages about the connection between health and weight. On one hand there are news stories fretting over women starving themselves to fit into skinny jeans. On the other hand there are features promoting ways to slim down fast. And somehow there’s yet another hand out there raising the alarm that America is in the midst of a costly obesity epidemic.
It is into that storm that the charges that Dr. Benjamin is too fat to be Surgeon General are thrown. Critics charge that Dr. Benjamin sends the wrong message to Americans because she’s not visually thin and thus visually healthy. I contend that that charge sends the wrong message to Americans – thin does not equal healthy any more that a deep tan makes a person "look healthy" or a full figure means a person is unhealthy.
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The National Health and Nutrition Examination Survey recently released data that shows that more than half of people labeled overweight are metabolically healthy. The study goes on to point out that examination of metabolic health — blood pressure, cholesterol, sugar levels — are better predictors for future health problems that a person’s weight alone. I am not saying that a person’s weight cannot play a role in high blood pressure, cholesterol or unhealthy sugar levels. What this study says is that there is not an absolute connection and that we all need to start talking health instead of weight alone.
As a full-figured woman of color I was also disturbed but not surprised that some critics of Dr. Benjamin’s weight come from the medical community. Even before research was released connecting the quality of medical care with a person’s weight and race, I knew from personal experience that some doctors make judgments based on their patient’s appearance and then provide medical care based on those flawed judgments. In my case, the flawed care came when I was about 40 pounds lighter and my then primary care doctor assumed that I was the picture of health. I wasn’t…and it took a change in physicians to finally get down to the business of addressing my health concerns. Now that I am 40 pounds heavier I’m alarmed to learn that a recent study found that 40 percent of doctors surveyed reported having a negative reaction to heavy people. Will my weight put me at risk of receiving inadequate care? Is the reward for not looking a certain way substandard medical care?
Another issue raised by the critique of Dr. Benjamin’s weight is whether a person’s health and weight should weigh into their qualification for a job. Do doctors and nurses have to present a physically fit appearance, if the appearance of being fit is all there is? One doctor quoted on ABCNews.com mentioned that she lost weight to set a good example for her patients. But what if a doctor looks fit but is actually unhealthy? To some, health seems to matter less than the appearance of health and that just doesn’t seem like a healthy outlook to me.
Health care reform needs to include more than expanded coverage and access. It needs to include respect and understanding, dedication and empathy. Given the new data challenging previously held beliefs about the connection between weight and health, we might want to revise our definition of what healthy is and how it looks to align with reality. And given Dr. Benjamin’s impressive qualifications we might want to revise our opinion of her as a nominee and hold off on making health care assumptions based on her weight.