A friend of mine moved to a new city and obtained a new primary care doctor, along with a new hairdresser and gym. She writes, "I was somewhat appalled at the size of the receptionist and nurse in the doctor's office. The doctor was a little pudgy, but the two others verged on morbidly obese. It was like going into a hair salon and seeing all the hairdressers with split ends and gray roots, or going to the gym to see the personal trainers sitting in the gym smoking and watching television."
Her observations were not unique. I have been making weekly visits to a local VA hospital because of a research collaboration and noticed that many of the employees, both administrative and clinical, are also overweight or obese. The unhealthy weight of health care workers is now well documented in a research study published in 2014 in the American Journal of Preventive Medicine (vol 46: 237-248). The lead author, Sara Luckhaupt, analyzed data from the 2010 National Health Interview Survey and found that 35 percent of health care workers, both in medical offices as well as clinics and hospitals, are obese. The study was very careful to eliminate factors such as gender, race, smoking, and age as contributing to their excess weight.
Long hours, stress, limited access to healthy food, excessive commuting time, and sedentary jobs push us toward eating the wrong foods and/or eating too much and avoiding exercise. But all these factors operate across most work situations. And in some respects, health care workers who can stop working when their shifts are over are better off than the corporate worker, who is expected to be on call and meet work obligations 24/7.
Yet my friend wondered why the people working in her new doctor's office were so overweight. Was it because there was a large container of Hersey's Kisses on the counter where the patients check in and, in the small room where coffee was available for the staff and patients, a basket of highly caloric cookies stood next to the coffee machine?
"I feel as if I am receiving a dual message," she told me. "I don't need a medical degree to know that excess weight may affect my blood pressure and make me vulnerable to diabetes since I have a family history of that disease. So why the candy and the cookies? You wouldn't expect a dentist to offer sticky sweet snacks to the patients unless business was poor. It was hard for me to resist eating the chocolate. It must be much harder for the office staff who stare at the container all day."
Obviously my friend wasn't going to cancel her appointment with her new physician because the person checking her in was overweight. As she told me, "I take full responsibility for my weight and I don't need to be in a medical office with a skinny staff to motivate me to eat healthy foods." But then she went on to wonder if someone who is struggling with her weight would decide that it is all right to be obese if surrounded by hospital and medical office employees who are also obese.
Seeing hospitals and medical offices filled with very overweight employees gives the impression that this profession is not taking care of its own. It is hard to understand how health care workers can see evidence of the medical consequences of obesity, and yet fail to maintain a healthy weight themselves.
Imagine going into the orthodontist's office and seeing the dentists and office staff with pathologically bad teeth alignment. Or being examined by an optometrist who can't read the figures on the machine because she needs glasses. What if the hospital staff never got flu shots and consequently they all come to work with fevers, bone aches and coughs?
No one in the health care profession has the right to impose weight standards on anyone else in the profession anymore than a dentist has the right to insist that the staff use dental floss. But given the multitude of health problems associated with obesity, it should not be necessary for the health care worker to become a patient, before his or her obesity is addressed.
It begs the question, this contradiction of obesity in the health care industry... Could changing the work environment help reduce the high incidence of obesity among health care workers? Do current work schedules contribute to overeating, stress, and too few healthy food choices, especially for evening and overnight shift workers? Should exercise facilities be made available on the premises, or at least a room for yoga, Pilates and relaxation techniques? Should employees who are morbidly obese be offered weight-loss strategies, including bariatric surgery?
Ironically, the health care profession is in the best position to implement a healthier work environment among its employees, because it is the health professionals who are telling the rest of us how to eat, exercise, decrease stress, and live more balanced lives. If they take care of their own by making it easier for them to maintain a healthy lifestyle, the health profession will be an example for the rest of us. But if they are not interested or fail, then the take-away message for the patient is, "Do what I say, not what I do."