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Are there chairs without arm rests? Are the seats strong enough? Are the aisles wide enough? Overweight people are used to humiliation, but do we have to humiliate them in a doctor’s office too?Īsk patients with obesity what terms they would feel comfortable to discuss their weight. We all should look more carefully at our waiting room offices. But no one asked her, “Were you sexually assaulted as a child?” It was the doctor’s responsibility to draw it out. Gay had attentive parents who were concerned about her weight, took her to physicians, and spared no expense to help her. These have value, but if a patient comes in with a BMI of 50, consider and delicately approach the subject of sexual assault in childhood. It’s easy to get wrapped up in theoretical questions about weight contributions from genetics, epigenetics, medications, psychology, environment, and culture. Here are some of the lessons I learned:Ĭonsider rape or sexual assault as a significant contributing factor in obesity. You can even read this critically from the perspective of an “evidence-based medicine only” physician-scientist.īut I read it from the perspective of a person who has intermittently struggled with my own weight and who also happens to be a doctor, to gain a little insight into my own biases and issues. You can read this book as a writer’s journey, an account of sexual assault, or a straightforward memoir of a bisexual, black, obese feminist. No matter who you are and how you identify yourself, you will learn something about humanity. Gay, we would do well to study her book as if it was one of our textbooks. To understand what it means to be “fat person” or a “fat woman,” according to Ms.
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You now have a good understanding of the basic neurobiology of obesity and will ace your Obesity Medicine Boards, but you’ll have no insight into the human dimension of what it means to be significantly overweight. Start with Volumes 1 (695 pages) and 2 (496 pages) of Bray’s Handbook of Obesity, follow it with the last two years of the journal Obesity or Nature’s International Journal of Obesity, then review the latest approved medications and new surgical procedures. I used to believe that if a physician wanted to get a solid grounding in Obesity Medicine, they had to read. So what does this mean to me as a physician?
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DR. ROXANE GAY ROSEANNE DRIVER
Gay’s book Hunger, A Memoir of (my) Body, I agree that her rape was the principal driver of her obesity. I am acutely aware of both the need to listen to a patient’s account of any disease process and the need for caution in accepting a patient’s self-assessment.Īfter reading Ms. She eventually reached 577 pounds.Īs a physician who is Board-Certified in Obesity Medicine and has seen over 100,000 urgent care patients, I understand the multifactorial etiology of obesity - the confluence of genetics, epigenetics, behavior, and environment. She cites her rape, and her reaction to her rape, as the reason for her subsequent weight gain. Gay kept this secret throughout her teenage and young adult years. Then, he helped hold her down by the wrists and spat in her face as his friends followed suit, one by one.įeeling humiliated and ashamed, Ms. He bragged to these friends, and then he pushed her to the ground and raped her as they pinned her down. Her then-boyfriend took her on a bicycle ride to an isolated cabin in the woods, where they met some of his friends. When New York Times best-selling author Roxane Gay was twelve years old, she was gang-raped. Op-Med is a collection of original articles contributed by Doximity members.