Could an overweight physician convince you to lose weight?

Robert I. Field, Ph.D., J.D., M.P.H.

Who could be a better guide for helping people to lose weight than their physicians? No one sees the dangers of excess weight more clearly, and no one is better positioned to spread the word.

But what if the physician giving the advice could stand to lose a few pounds, himself? Does that dilute the message?

According to a 2004 study, 44 percent of all physicians in the United States are either overweight or obese. That means almost half of the most effective spokespeople for the benefits of slimming down have ignored their own profession’s recommendations.

Some of the reason may be the enticements they constantly face to overeat. A study just published in the Journal of the American Medical Association tried to estimate the number of free meals that are offered to physicians on a regular basis. It found an abundance of them.

The study reported that more than 40,000 continuing medical education events for physicians were held in the United States in 2010, a large number of which offered free meals. Many of the 9,000 residency training programs for new physicians arrange at least one free lunch conference a week. Many medical students regularly attend free weekly pizza club discussions. And research projects often provide free meals at regular meetings of team members.

What do attendees eat at these events? The study’s authors found that the typical meal contains 1,280 calories, about double what is needed. Between a turkey sandwich, bag of chips, cookie and sugary drink, there is a lot of fat and salt and no vegetables. (And we can only guess what attendees consume when the menu includes pizza.)

Another recent study looked at offerings at hospital cafeterias where many physicians grab a lot of their meals. It found excessive calorie counts for most of them. And another examined the food served as medical society meetings and discovered that menus rarely follow nutritional guidelines.

What does this mean for the function of physicians as role models? According to another recent research report, physicians who are overweight are less likely to diagnose obesity in their patients or to offer counseling for it. They usually identify the condition only when a patient’s weight is higher than their own.

Once upon a time, many physicians smoked. They did so in hospitals and often in front of patients. As the anti-smoking movement gained steam, that behavior stopped. Hospitals no longer permit smoking inside their walls, and today, patients rarely see their caregivers lighting up.

Perhaps it’s time to take the same approach to unhealthy eating. Hospitals, medical schools, continuing education providers, and medical societies could start by serving the same meals to physicians that physicians would like their patients to eat. It may not slim down the entire profession, but it would help to eliminate the conflicting message that physicians and patients currently receive.

If there’s going to be such a thing as a free lunch, at least it should be healthy.

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