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February 05, 2008

An Apple A Day Shouldn't Keep Your Doctor Away

85282_42766926I went to see a new doctor last week and it got me thinking about a post I wrote a couple years ago about women, body image and health care.

It's true - getting naked in front of someone who doesn't know a thing about you sucks. Yeah, your doctor may have seen it all before, but does that really matter when it's your naked body sitting there? Your aches and pains, your bumps and scars and all the history that goes along with it. It is not the most pleasant way one can spend a sunny Friday afternoon - that much I do know.

We’ve known for quite some time from our own experience speaking with women over the last 35 years, that missing regularly scheduled doctor visits and yearly Mammogram and Pap smear appointments can be a residual effect of being over weight.

Here’s an excerpt, from an article that I posted a couple years ago - I thought it was worth posting again:

Obese Women Less Likely To Be Screened For Cancer
By Amy Norton - Tue May 8, 2007

NEW YORK (Reuters Health) - Women who are extremely obese are less likely than thinner women to undergo screening for breast and cervical cancer, according to a new study. Using data from a national health survey, researchers found that severely obese women were about half as likely as normal-weight women to be up-to-date with their mammograms and Pap tests.

"We are currently conducting focus groups with women and interviews with physicians to determine what can be done to help improve cancer screening among severely obese women," said lead study author Dr. Jeanne M. Ferrante, of the University of Medicine and Dentistry of New Jersey in Newark. - SOURCE: American Journal of Preventive Medicine, June 2007.

It's not clear why severely obese women are less likely to be compliant with these guidelines. But the study found no evidence that their doctors were lax in recommending the screening tests. It will be important to figure out why, since obesity has been linked to higher risks of breast and cervical cancers, the study authors point out.

Here are just a few of the reasons we’ve heard over the years, which might help to identify why women who are considered ‘severely obese’ find it intimidating to visit their doctors, in general:

1. No one relishes the idea of being scolded for being fat. It is likely they will be told they are unhealthy, if not on death’s door.

2. Feeling humiliated. Many medical tests are not conducive to very obese women. Mammograms and/or PAP smears are not fun for anyone – imagine if your test was not set up for someone with your body type and was made much more challenging.

3. Women who have not followed the advice of their physicians (getting annual testing, etc), may be suffering tremendous guilt (piled on to the guilt of being fat in the first place), compounded with fear about their health.

4. It’s never fun to be naked in front of strangers, but if you have serious issues with body image (you don’t have to be severely obese to fall into this category), the prospect of exposing yourself in a gynecologist’s office can be intimidating, even frightening.

5. Getting weighed. Any women who struggle with their weight – particularly those who are significantly over fat do not know how much they weigh and do not want to know.

6. Denial and fear.

7. Many women have negative experiences at their doctor’s office.

I’m sure there are many other reasons why women find it hard to follow up with very important screenings each year. Let’s hope physicians can work to discover what they can do to make their offices more welcoming and the experience as comfortable and safe as possible, because these check ups are vital for every woman.

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Posted by Cindy on February 5, 2008 | Permalink


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