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Diabetes and/or Obesity: Whose Fault Is It?

Aug 28, 2018

Many people who have diabetes, especially type 2 diabetes, tell me they have no one to talk with about their diabetes. Why, with all the education and tools we have, do people who have diabetes still feel this way?

My patients who have excess weight or obesity tell me the same thing. We may not have as much clinical information on that as we do diabetes as of yet, but the patients tell me the same thing.


Whether it’s diabetes, excess weight, or obesity, there’s a lot of shame and blame associated, whether the shame and blame comes from others or the shame and blame comes from their own thoughts. Other people can usually “see” the person has the excess weight and the “food police” comes out of them. They give all kinds of advice such as, “Just eat less and move more” or “Don’t eat that, eat this.” For some that is true, but not for all. And talking with people that way doesn’t seem to help.

Some questions to ask yourself as a health care professional are, “How do I feel about people who have excess weight or obesity?” Do I judge them? How do I talk with them? How do I talk to them? Do I trust what they tell me? Do I offer help, real help? For example, when patients come in with elevated glucose levels, do I just say, “Eat less and move more?” No. We have an understanding of diabetes. Depending on the situation, the patient’s numbers, we offer help; we provide an in-depth H&P, offering help nutritionally, behaviorally and medically, which includes medications. We follow up. And we usually don’t blame them or laugh at them or tell them to use duct tape on their mouths.

The reasons people have excess weight or obesity is complicated. Could we be part of the problem?

Lesson Learned:

Please watch and listen closely to Dr. Bray’s interview. It will be well worth it to you and the people you come in contact with. It will help you avoid some disasters, such as patients not coming back to health care providers because they are ashamed. The excess weight and obesity gets worse and people don’t get the care they need for the over 200 complications related to excess weight and obesity.

Joy Pape, FNP-C, CDE
Medical Editor, DiabetesInControl.com

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