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First, Do No Harm: Rethink the Way We Talk About Nutrition- Part 1

Dolapo Babalola, MD, reviews our words' impact on weight and nutrition, both on ourselves and on our community.

July 12, 2022

I recall the day I took the Hippocratic Oath as if it was just yesterday.

It was a beautiful day filled with so much delight in the air.

Surrounded by my loved ones, I could feel and smell my aspiring dreams and goals in every breath I took.

I am finally a medical doctor; after so many years of vigorous training, I can now care for patients, help them heal, and problem solve alongside them.

Confidently, I stood as I committed myself to “First, Do No Harm.”

Further research into the origin of the oath highlights the three other commitments: respecting patient confidentiality, respecting teachers, and upholding the profession’s integrity.

Today’s focus will be on the commitment to “First, Do No Harm.”

 

It was either due to the excitement or the euphoria of becoming a doctor that I didn’t realize that the Hippocratic oath I took to “First, Do No Harm” did not only apply to my patients.

First and foremost, this oath refers to me as the physician.

 

It was either due to the excitement or the euphoria of becoming a doctor that I didn't realize that the Hippocratic oath I took to 'First, Do No Harm' did not only apply to my patients. Click To Tweet

 

No matter how hard you try, pouring out of an empty cup is impossible. My body, mind, and spirit matter need to function at their optimal and not the bare minimum.

My sense of realization only came when my health and well-being began to decline due to a diet consisting of 70% processed carbohydrates and 30% vegetables, resulting in hypertension and inflammatory joints.

 

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I demeaned myself by using unpleasant language because I was disappointed in myself.

I didn’t think of the oath.

First, Do No Harm applied to me. I am a physician, so I should know better. It is all my fault.

My food choices were to blame for my health conditions. I am powerless to practice self-restraint from unhealthy foods that caused me to crave more calorie-dense foods instead of nutritious foods, which all led to my weight gain, poor gut health, hormonal imbalance, and inflammation.

Unfortunately, willpower couldn’t deliver me, but how could it be with the food industry’s constant display of addictive foods which were highly advertised, made easily accessible, affordable, and age-targeted to a specific demographic? I had caused so much self-harm through negative remarks and actions that I needed an urgent solution.

 

“If you know better, you will do better”

Those were the words of the late John Lewis that haunted me to pursue additional training and better understand the world of nutrition through Lifestyle and Obesity Medicine. The light bulb came on during this journey of discovery, and I had a better understanding of why I felt out of control with my food choices, and I needed to extend the same grace to my patients and community.

The concept of “stop eating, and you would lose weight,” “exercise more, and you would lose weight,” “or calorie in and calorie out” no longer suffices; instead, it makes individuals downcast and perplexed. It is even worse now with the numerous diets, eating patterns, and meal plans. Evidence-based medicine has demonstrated how complicated obesity is, such that it is considered a chronic disease by the American Medical Association in 2013. It is defined as a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.”

 

The concept of 'stop eating, and you would lose weight,' 'exercise more, and you would lose weight,' 'or calorie in and calorie out' no longer suffices; instead, it makes individuals downcast and perplexed. Click To Tweet

 

We must be mindful about our words to ourselves, family, and community members if we want to fight this disease together and appropriately.

First, Do No Harm were also the words of Dr. Carolynn Francavilla, a Family and Obesity Medicine Specialist who was a guest on my Living At Your Finest Podcast Show, Episode 43, where we spoke about Managing the Complexities of Obesity.

If you don’t know the patient’s unique situation, don’t body shame them or assume your sarcastic comments would help them stop eating because these actions would only do more harm than good.

 

If you don't know the patient's unique situation, don't body shame them or assume your sarcastic comments would help them stop eating because these actions would only do more harm than good. Click To Tweet

 

A few of my patients come to mind buttressing my point of how discouraging words about weight and nutrition have made matters worse.

A middle-aged woman who was 300 pounds with severe knee pain due to osteoarthritis sought medical attention from an orthopedic surgeon.

He wasn’t kind with his words.

He called her “fat” and assumed that all she ate was McDonald’s and fast foods.

 

A middle-aged woman who was 300 pounds with severe knee pain due to osteoarthritis sought medical attention from an orthopedic surgeon. He wasn't kind with his words. He called her 'fat' and assumed that all she ate was McDonald's and… Click To Tweet

 

My patient was crying about how frustrated she felt and even ashamed.

She mentioned her specialist told her there was no surgery until she lost 100 pounds.

But that wasn’t the kicker.

He stepped out of the examining room with no solutions or referrals.

Unfortunately, by the time my patient returned to me, she had gained ten more pounds from being depressed about her weight and had no sense of direction.

First, Do No Harm!

 

Another scenario was a younger patient that struggled with hormonal irregularity and lesions on her body.

She sought medical care from a gynecologist who told her all her problems would go away if she just lost weight.

Per the patient, there were no further questions to dive into other causes, and regrettably, there was no sense of next steps or direction, leaving the patient confused.

She shared her experience with me when I met her for the first time because she was looking for answers.

First, Do No Harm!

 

There were no further questions to dive into other causes, and regrettably, there was no sense of next steps or direction, leaving the patient confused. Click To Tweet

 

 

Let’s rethink the way we talk about nutrition by, above all, being person-centered.

Seek permission first to discuss weight and nutrition in any scenario, clinic, home, or work.

Once approval is given, inquire about what the person has done to aid with weight loss and applaud them for their actions.

Note that just because the desired results were not achieved doesn’t minimize the efforts.

The next step is to make a need assessment and act accordingly.

If you cannot provide adequate evidence-based nutrition guidelines, please point the individual in the right direction but do not make a problem a more significant problem with unsolicited and ill advice.

This approach applies when you are talking to yourself, a family member, or a community member.

We have learned in my home the repercussions of negative remarks around weight and nutrition, and now we do our best to practice weight-friendly words such as excess weight instead of the fat problem or excess weight. We ask questions about nutrition to understand and not judge.

 

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Together, let’s First, Do No Harm, by stopping the weight bias and stigma around weight and nutrition.

These weight struggles are real, and the best we can do for ourselves and others is to approach them in a sensitive and supportive manner.

Dolapo Babalola, MD, FAAFP, DiploABLM/ABOM

Dolapo Babalola, MD, FAAFP, DipABLM, DipABOM

To provide an evidence-based and holistic approach to achieving optimal health and wellness through an accessible, affordable, and appropriate Direct Primary Care Model for my patients/clients, their families, and their communities.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. For more information, or to submit your own opinion, please see our submission guidelines or email opmed@doximity.com. Do you have a compelling personal story you’d like to see published on SoMeDocs? Find out what we’re looking for here and submit your writing, or send us a pitch.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. Do you have a compelling personal story you’d like to see published on SoMeDocs? Submit your own article now here.

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