Doctor says patients are in a weight-loss 'wilderness'

"Most overweight patients know they should lose weight. I don't believe for a minute that they are weak or gluttonous or afflicted with a defect in character."

— Physician William Bestermann Jr.

Despite the growing obesity epidemic, some physicians find it difficult to talk to heavy patients about their weight — and even harder to help them lose weight.

A patient's weight is often the elephant in the examining room. Both patient and doctor know it's a problem, but often neither party wants to talk about it, says internist William Bestermann Jr., 62, medical director of a cardiovascular treatment program for the Holston Medical Group in Kingsport, Tenn.

But "if doctors are serious about keeping patients from having heart attacks and strokes, they have to have this conversation, and they have to help their patients lose weight," he says.

Bestermann is helping develop recommendations for physicians on how to guide and treat overweight patients on a committee for the STOP Obesity Alliance, a coalition of professional groups, businesses, unions, insurers and health care providers whose goal is to figure out how to best attack obesity.

"He has been a phenomenal advocate to convince patients and physicians that they are a team attacking this problem together," says Christine Ferguson, director of the alliance.

Debra Horne, 52, of Dungannon, Va., says Bestermann "gave me my life back" by addressing her weight.

In July 2007, she went to see him for the first time. "I'll never forget that day," she says. "Dr. Bestermann walked into the examining room and sat down and introduced himself. He said, 'I see you have a lot of medical problems,' but he never mentioned my weight."

At the time, Horne, who is 5-foot-9, weighed 298 pounds and had type 2 diabetes, high blood pressure, high cholesterol and high triglycerides. She had suffered from depression. She had had foot and back surgeries and was getting around on a motorized scooter. When she got down on the floor to play with her grandchildren, she couldn't get back up on her own.

Bestermann asked Horne to read The South Beach Diet. "He said: 'I'm not asking you to go on a diet or lose weight. I just want you to get the knowledge that is in there,'" she says.

The next time she went to see him, he had results of her blood work. He told her, "Debra, you are a walking time bomb, but I'm here to help you, and we're going to work on this together."