Friday, December 4, 2009

Dr. Oz big fat questionable diagnosis

As I was wrapping 24 little advent gifts for our traditional German advent wall-hanging, I was forced to settle for Dr. Oz's medical show. (Again, why a cardiac surgeon is giving general medical advice is beyond me. See an old rant...) A gentleman stood up and asked if his hot flashes and night sweats were normal. With no further questioning, Dr. Oz basically told the man that he had a hormonal imbalance, akin to menopause and he could reduce his circulating estrogen by losing his belly fat. This gentleman was "average" to below average build, don't know if he was fit or had other health factors, but the first thing that jumped to my mind was not that he needed to lose a fairly insignificant amount of belly fat.
Since I've been learning about eating and wellness, I have become much more sensitive to instances of weight bias, which can manifest as a willingness to assign weight as the cause of a condition without any kind of indication it is a factor, and with potential danger in ignoring other possible factors– such as night sweats being a symptom of lymphoma and other serious illness.
Chances are he does not have lymphoma, but was any purpose served by blowing this off as an unlikely hormone imbalance? Will some guy at home who is a little heavy ignore night sweats now as simply another by-product of being big?
FYI, here is an excerpt of possible things that can cause night sweats...
Night sweats are a common outpatient complaint, yet literature on the subject is scarce. Tuberculosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practice. While these diseases remain important diagnostic considerations in patients with night sweats, other diagnoses to consider include human immunodeficiency virus, gastroesophageal reflux disease, obstructive sleep apnea, hyperthyroidism, hypoglycemia, and several less common diseases. Antihypertensives, antipyretics, other medications, and drugs of abuse such as alcohol and heroin may cause night sweats. Serious causes of night sweats can be excluded with a thorough history, physical examination, and directed laboratory and radiographic studies. If a history and physical do not reveal a possible diagnosis, physicians should consider a purified protein derivative, complete blood count, human immunodeficiency virus test, thyroid-stimulating hormone test, erythrocyte sedimentation rate evaluation, chest radiograph, and possibly chest and abdominal computed tomographic scans and bone marrow biopsy. (Am Fam Physician 2003;67:1019-24. Copyright© 2003 American Academy of Family Physicians.)

Just thought it was interesting. Another example of weight bias: a woman sprains her ankle, her BMI is 26 ("overweight" range.) Though she is an athlete with high muscle mass and her BMI is not indicative of any increased health risks, her physician says she probably sprained her ankle because she is "overweight." (Playing ultimate frisbee on wet grass had nothing to do with it...)
What are your thoughts and experiences?

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