Funny question you might say, because it would seem quite natural to contact your general practitioner. First of all because he is certainly the one who knows the best of our medical history, then because he is the strategic axis put in place by the Health Insurance, the one who knows where to refer if it exceeds his skills.
Yet this is often where the difficulties begin. In fact, when dealing with an obese or massively obese patient, the general practitioner is relatively helpless. Let’s forget the “grossophobic” doctors who hate fat people to be interested in the majority of them who are really keen to offer their patients a care path worthy of the name. What are the means at his disposal?
The system of government
In first intention, the general practitioner will undoubtedly prescribe a mode. He will not call it diet, but food re-balancing. The vocabulary changes, but the concept does not. For the patient, it will be a question of eating differently, or of learning to eat differently. Problem, obese patients already very often have dozens of diets to their credit which have only reinforced the fact that it will be difficult for them to lose weight with this technique.
Put in difficulty, the doctor will therefore seek other solutions.
Obesity surgery
Today, in second intention, the general practitioner will direct towards the techniques of obesity surgery. Sleeve gastrectomy, by pass, he may even have an opinion on the matter.
It is therefore most of the time to the surgeon that the obese patient will be directed. Theoretically, he will therefore enter a long course largely bordered by high health authorities and will have, if the surgeon is a priori in agreement to operate, do a battery of examinations and meet certain specialists: pulmonologist, cardiologist, psychologist. , etc.
At the end of this course, the intervention will be performed, or not. But what about patients who refuse to go through obesity surgery? What about those for whom it is not possible? What about general practitioners a little lost in the face of the intricacies of this surgical treatment?
Obesity referral centers?
For all of these patients, the trap is closed and the general practitioner finds himself somewhat helpless. Of course, he can offer a visit to a treatment center, but places are limited and it is not always possible for patients to go there.
The ideal for this doctor and his patients who are sometimes in a deleterious medical wandering, would probably be the creation of obesity referral centers.
A place in which it would be possible to initiate multidisciplinary care, in conjunction with the referring doctor. A place where the difficulties could be tackled on a case-by-case basis, with a personalized care path, but why not also a place of training for all health professionals who are on the front line when dealing with obese patients and who are often relatively poor.
These centers are sorely lacking today. While waiting for their implementation throughout the country, it is important for obese patients not to give up and not to isolate themselves.
Obesity is a chronic disease that does not only affect the heart, kidneys, etc. It weakens the joints and can be the cause of severe disability when osteoarthritis of the knees, ankles or hips worsens.
Do not hesitate to insist on obtaining care in the hospital, for example, and to get closer to patient associations in order to exchange both personally and medically and share addresses.
Obesity is a disease like any other and the associative fabric therefore plays a crucial role in supporting patients who can speak freely about their difficulties and sometimes find resources they had not thought of.
Because, in the end, the worst thing for an obese patient would be to give up and think that no treatment is possible. Obesity being a chronic disease, the pounds would then continue to accumulate.
