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Wisconsin's "obesity map"

I am a patient of University of Wisconsin Health, and for the most part, I've gotten outstanding care from the UW Health providers.

This notice popped up on my Facebook page last week:


Health researchers have compiled a searchable map of obesity in America’s Dairyland by ZIP code, and the picture is alarming. 

Wisconsin is the first state with an obesity map based on electronic health-record data, meaning it reports how much people weigh at their doctors’ offices, rather than self-reported weights. 

Dr. Vincent Cryns, a UW Health endocrinologist and leader of the Wisconsin Obesity Prevention Initiative (OPI) will unveil and explain the searchable map during a Facebook Live interview on June 5 at 11 am CDT. 

This is the edited version of the intro -- edited, I'd like to think, because of me. The original intro said, "It isn't a pretty picture" instead of "The picture is alarming." 

I wrote a fairly wordy comment about the upcoming live Facebook presentation, which I hope to watch if I'm not up to my eyeballs in work (a distinct possibility...I've got a lot of big stories due this week).
The Readers' Digest version of my comment:1. The original line "It isn't a pretty picture" reinforces the stereotype that's all too familiar to people who are obese -- carrying extra weight is mainly about being unattractive, not health.2. Health care providers' approach to obesity is, too often, faulty in the following ways:
B. As a result of that assumption, providers (primarily doctors and nurses) often don't listen to their overweight patients' descriptions of their symptoms, and miss diagnoses of problems that are, in fact, not connected in any way with the patients' weight.
C. Based (I think) on the assumption that "overweight" is the worst, most unhealthy thing a patient can be, many providers push invasive weight-loss surgeries -- procedures that are outrageously expensive to many of their patients, and which have risks and side effects that might be more debilitating than carrying a few (or a lot of) extra pounds.
3. Since this "obesity map" is based on weights compiled at doctors' offices, then for sure the map under-reports the incidence of obesity in Wisconsin. Many overweight or obese patients avoid going to the doctor until their symptoms become debilitating, because they hear the doctor's talk about their weight as the same fat-shaming they experience every day. For every patient who steps on a clinic scale and shows a BMI of 30 or more, there are dozens like her who won't go near their doctors for fear of experiencing shame at weigh-in time.
In my comment, I also offered to share what my physical therapy team did RIGHT with me. I don't recall either of the Dans mentioning words like "obesity," "overweight," "BMI" or anything related to my girth, even though my osteoarthritis was probably at least partly a result of my carrying too many pounds. Instead, they treated me as a whole human being, and showed me what it's possible for my body to do -- giving me a taste of what fitness feels like, before I actually began pursuing it. Respect, dignity and addressing patients as intelligent human beings all go a long, long way toward promoting health. 

A. Many of them take one look at a patient's bulky body, or a number on a scale, and conclude that whatever ails the patient is directly tied to obesity, and the cure is to lose weight by any means necessary.



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