Obesity is a global epidemic, and its prevalence is increasing in every part of the world. While we have new medications and complex surgical techniques that promote weight loss, the awareness of healthy eating habits and dietary education are still the most important factors in helping control body weight.
Unfortunately, nutrition knowledge appears confined largely to books and exams; as the doctors barely engage in nutrition counseling with patients. In teaching hospitals, where residents work closely with patients, it is important that the residents develop a comprehensive knowledge of nutrition science and apply that knowledge to clinical practice. But they are under the misconception that nutrition counseling is not their role, it is rather the function of dieticians. Inadequate knowledge of nutrition or not feeling competent enough to address nutritional concerns is also commonly seen among health care providers.
However, this brings up an interesting point: Are physicians themselves (including residents) healthy enough to provide this counseling? Are they, in fact, the models of healthy living their patients believe them to be? It is a well-known fact that physicians’ attitudes and personal habits may have a significant impact on their practice of nutrition and lifestyle counseling. If the physicians are consuming a high-calorie diet, eating fast food, avoiding home cooked meals due to busy schedules (while having time to go out and eat) and simply unable to differentiate between real food and “food-like substances,” can they provide proper nutrition education to their patients?
As health care providers, we encounter patients almost every day who are paying the price of their poor eating habits. Acute conditions are treated in the inpatient setting, where abnormal lab values are fixed, and the patient is discharged with recommended follow-up with primary care. In the outpatient setting, the discharge notes are reviewed, medication refills provided, and referrals made. However, in most cases, other than questioning the restricted elements of a diet such as sodium or fluid intake, inquiry of the patient’s daily eating habits — availability of food, affordability of fresh produce, meal preparation at home versus consuming fast food — is largely overlooked by physicians. This is regretful because, as the literature supports, patients consider clinic physicians to be the credible source of nutrition and desire to discuss their dietary plans with their primary provider.
There is an urgent need for nutritional knowledge among young physicians-in-training and a more urgent need for physicians to promote healthy eating habits to their patients. Encouraging healthy eating choices among residents will, in turn, foster the importance of educating patients regarding lifestyle changes. Rather than going out and having pizza and drinks, residents can also have fun gathering at one place and prepare meals and enjoy doing it all together. Residency programs can have healthy meals during the noon conferences and lectures to promote healthy eating behaviors among the physicians-in-training.
Abeer Arain is an internal medicine resident.
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