Some will say ‘You are a neurosurgeon, stay in your lane, what do you know about obesity’.

Well you have a point- I am a doctor who treats brain and spine conditions.

My attitude is simple: the person sitting in front of me is not a spine or a brain.

We can’t separate a human being into small boxes that are convenient for us.

A person is an entire system. That’s why in faculties of health we are taught a basic degree which is all encompassing.

That makes me a generalist first before I am a specialist.

Where I trained- I was taught to take a full history.

In that history I take a social history- find out where you work, how much you smoke, how many children you have, how life is going- that’s your context of your disease.

Context also determines outcomes to treatment.

Enough about my credentials.

The conversation around obesity is sensitive because of the feelings it invokes.

Let’s be honest- obesity has been used as an insult.

From my own experience struggling with weight comes with feelings of inadequacy- and nobody likes that feeling.

I have a friend that I have succesfully avoided because- the first thing as I sit on the table at a coffee shop is ‘Yhooo chomi what’s going on!’.

I have had some difficulty shedding off baby weight and this last one has been the most difficult because I have a context.

The friend is avoided and I worked silently on my weight away from eyes and opinions that are unsolicited and hurtful.

So I raised the topic because I know the issue is complex.

I have been very happy to see dieticians and other thinkers commenting.

Because really how do you expect a person to deal with obesity when they wake up at 4 to get to work- get back home at 7pm after three taxis. Have not even square meter to make own food.

Also how do you expect me to lose weight if I eat for comfort because of past/ongoing trauma

You insist I lose weight but have not actually considered that I could have a medical reason for my weight gain and difficulty losing it.

I have one patient- I will never forget.

Had serious difficulties in life- losses of loved ones. Obese and was eating for comfort.

They hated the conversation but came to me needing surgery.

I had to address the elephant in the room- obesity has implications for my treatment at times.

Problem is we couldn’t wait- they were fast deteriorating and would have had no chance at weight loss if didn’t intervene.

So intervened and indeed we had the problems we anticipated.

We worked hard, addressed the medical issues contributing to obesity aggressively.

Dealt with the social issues making them eat for comfort.

Not long ago- I was sent a picture of the patient crossing their legs.

The message read: ‘Because of weight I could not cross my legs but Doc look at me now!’

Happy patient=happy doctor!

We must read the room and make no assumptions about culture, sex or whatever.

When trying to address a problem you must be genuinely prepared to learn and change your mind.

Patriachal approaches to care are out of the window! Thing of the past u- ‘Doctor said...’