The reputation of doctors

Today I learned a lot about a TV doctor in Ireland who calls herself an “ob*sity and weight loss” expert. Her name is Dr Eva Orsmond and you probably won’t have heard of her unless you live in Ireland, in which case you probably have quite a visceral reaction to the sound of her name. Let’s just say her reputation proceeds her.

I don’t recommend it, but if you google her you will find that she owns several weight loss clinics and was on a TV program that shamed fat people into losing weight. Her “no-nonsense” style is just a fancy way of saying that she is a bully and a nasty piece of work. It’s how she has gotten rich, and I am old enough to know that this is the way of the world and there is nothing we can do to change it.

However, this doctor needs to be held to account. Because whether you like her or not, her advice flies in the face of experts. She is causing a lot of harm and is bringing the profession into disrepute. Speaking of…

The GMC and I

Some of you will be aware that I received a total of 5 complaints forwarded on to me by the GMC last week. They wrote to let me know that they had received these complaints about my social media account and instead of closing the cases without further incident (which is what happens to the vast majority of complaints from the public about social media accounts), the complaints against me were taken further.

An assistant registrar had triaged the complaints and decided to raise an enquiry. They concluded that it did not meet the threshold for investigation but they did chose to share it with me, NHS England, and my Responsible Officer (who is in charge of whether I am able to revalidate and continue to practice medicine).

A copy of the email

This is a copy of the email that was sent to me (I received five in total, one after the other).

As with all complaints we receive, it has been considered by an Assistant Registrar as part our triage process. Please be assured that we are not investigating this matter and this complaint has no bearing on your fitness to practise record.

We have reviewed the examples provided and while we are mindful that doctors are entitled to have their own views and to express them, we are also aware that public comments made by doctors have the capacity to influence and affect others and cause offense.

The comments are within the public domain and it is arguable that comments such as these could risk bringing the profession into disrepute. Although we do not consider that the threshold is met for investigation, we are however forwarding the complaint to you and your Responsible Officer for your reflection and for your appraisal process. We ask that you consider what implications this complaint might have for your practise when you are discussing this with your appraiser.

I have explained to the complainant that we will not be investigating this matter and they are aware that we have handled the complaint in this way with you.

We will share the complaint with your responsible officer for them to consider in the wider context of your practice and revalidation.

Email from the GMC to myself on 6th May 2021

Why I refuse to take this lying down

Here’s the thing. If I had been a thin woman who was promoting weight loss like Dr Eva Orsmond, would the GMC have treated our cases similarly? If said doctor had received a complaint outlining the potential damage that their weight stigma was causing, would the GMC have closed the case or would they have written to the doctor in question and demand that they discuss it with their Responsible officer?

What about if I had been a man that was promoting health at every size? Would they have taken the complaints as seriously then?

Let’s face it, I am a fat doctor who is standing up for her rights and the rights of fellow fat folk who are sick and tired of being mistreated and marginalized by the medical community. Of course I am going to make some enemies. Some of them, such as Dr Nikki Stamp, are going to be petty and vindictive enough to complain about me to the GMC in the hope that they can destroy my career and shut me up.

Fortunately, or unfortunately depending on which side of the argument you find yourself on, that isn’t going to work.

The reputation of Doctors

We have reviewed the examples provided and while we are mindful that doctors are entitled to have their own views and to express them, we are also aware that public comments made by doctors have the capacity to influence and affect others and cause offense.

So the GMC acknowledges that we have the right to our own views and are allowed to express them. That’s good news. For a second there I was worried that my profession was getting in the way of my right to free speech. But I agree that doctors have the capacity to influence and affect others. I also agree that what we say has the potential to cause offence.

Take Dr Aseem Malhotra. In April 2020, he was interviewed by a number of national newspapers and media outlets about the so-called link between ob*sity and COVID. He made wild and outrageous claims that were not based on any robust evidence, which helped to set the narrative that fat folk were far more likely to die of COVID.

I imagine he is patting himself on the back for being right, even though the evidence did not support him at the time. Of course, some would argue that his campaign caused millions of people to feel shamed and stigmatized, and we all know that weight stigma leads to avoidance of the medical profession. We also know that avoidance leads to delayed treatment, and it turns out that during the last worldwide pandemic (Swine Flu) delayed treatment played a vital role. In fact, a meta-analysis demonstrated that once you adjusted for delayed antivirals, the increased risk of death from H1N1 in ob*se folks disappeared.

Conflicts of interest

So one could argue that Dr Aseem Malhotra may have been partly responsible for COVID positive fat folk avoiding the healthcare profession, thereby delaying medical assessment and leading to poorer outcomes. But surely we can’t blame Dr Malhotra can we? I mean, I’m sure he didn’t mean to stigmatise people. He was just putting out a public service announcement and was doing his best to educate people using the only evidence available to him at the time.

So what if he released a book a few months later called “The 21-Day immunity plan” which made the Sunday Times Bestseller list? One clearly has nothing to do with the other. And the fact that he has made his fortune selling the Pioppi diet clearly does not disqualify him from sharing his medical opinions, even though there is a clear conflict of interest. Right?

Nothing to see her folks.

Respect and influence

Public comments made by doctors have the capacity to influence and affect others. But apparently the GMC only cares about this when the public comments go against the status quo.

Let’s take a look at Dr Eva for a moment, shall we. She once went on national television and shouted at a woman for crying. If it weren’t for the fact that she is a doctor, there is no way people would tolerate that kind of behavior. She is mean. She is a bully. And she also doesn’t know what she is talking about.

Over the weekend she has been all over the Irish media telling parents to weight their children regularly to help them shed the lockdown weight. I’ve talked about this before, and the evidence here is clear. Weighing children causes a great deal of anxiety and shame. Shaming children, talking about weight, and putting them on a diet have all been shown to have the exact opposite effect that Dr Eva is claiming it will have.

All of these behaviors have been linked to poorer mental health, disordered eating, and long term weight gain. We need to sop weighing children. She claims that “children should be weighed and measured in schools to help tackle the rise in child ob*sity”. She cites the successful National Childhood Measurement Program in the UK as an example of what she believes they should be doing. Interestingly, the Women and Equalities Committee disagreed and have recommended that the program be scrapped.

Bringing the profession into disrepute

The comments are within the public domain and it is arguable that comments such as these could risk bringing the profession into disrepute.” Those were the GMC’s findings following their inquiry into my conduct. Whilst they agreed that it did not meet the threshold for investigation, they were concerned about the potential “misinformation” that I was spreading. Take the complaint I received by Dr Nikki Stamp, for example. She is an Australian cardiothoracic surgeon who is registered with the GMC herself.

Let’s get a few things straight. Everything I post is based on evidence. I make sure to quote my sources regularly and I would be happy to defend any of the so-called misinformation that I am spreading. I most definitely did not accuse her of being fatphobic, transphocbic or racist, and the images that she supplied to the GMC make that very clear. it is also very important to distinguish between bullying and holding colleagues to account (in the same way she held me to account by blocking me and reporting me to the GMC).

Knowing your limitations

But most importantly, Dr Nikki Stamp does not know the difference between and SGL2 inhibitor and a GLP1 agonist (sometimes called GLP1 analogues or incretin mimetics). As far as I am aware, SGL2 inhibitors are not licensed nor indicated as a weight loss treatment. Not at the time of publishing this article (that may change though as they often cause weight loss as a side effect). I believe she was talking about Semaglutide, the new miracle weight loss drug that I have spoken about.

Look, it’s not her fault that she doesn’t know the difference between these two medications. She is a surgeon not a physician, and she has likely never commenced a patient on either. I, on the other hand, prescribe them to patients routinely (for diabetes not weight loss!) I know the indications and side effects and I have experience with them, which makes me more qualified to talk about them than someone who can’t tell the difference between the two.

The crux of it all

So let’s take a look at all her accusations, shall we? I am advocating for evidence-based medicine. In my last 360 degree feedback I scored 98% for teamwork. Nikki Stamp is not my colleague, but if you want to know what kind of a doctor I am you need to speak to the people that actually work with me before you accuse me of violating good medical practice.

Reporting a colleague to the GMC is a serious step and should be reserved for doctors who have serious concerns about someone’s fitness to practice. Not a couple of instagram stories that you take umbrage with. As for the public’s trust in the profession. Well that’s where it gets really interesting. Doctors like Nikki make an awful lot of money through advertising and sponsorship. She isn’t always above board when it comes to the rules about advertising on social media. Some would argue that people lose trust in the profession when they see doctors compromising their ethics so that they can earn a fast buck.

Others would argue that advocating for a community that experience the same kind of discrimination as those who are experiencing gender and race based discrimination is doing the exact opposite of what I have been accused of. Some would say that I am working hard to gain back the public’s trust. A trust that no longer exists thanks to the toxic levels of weight stigma that exist within the medical profession.

And I can’t help ask myself one simple question. If I looked like Nikki Stamp and Nikki Stamp looked like me, would the outcome have been the same?

6 thoughts on “The reputation of doctors”

  1. Absolutely brilliant blog post. Thanks so much for sharing this with us. I felt really empowered by reading your response to the complaints. When you stand you for yourself it’s like you stand up for us all.

  2. Annette Hackett

    Oh Natasha, I just feel for you so much. I’m a fat GP in Australia, and will apologise on behalf of all Australians for the behaviour of Dr Stamp (who, even worse, graduated from my old medical school). It’s much easier for those who are singing from the accepted hymn sheet. Those who step outside the previously accepted norms will always struggle, but eventually the truth will get out there – slavery is no longer seen as acceptable (although still happening), and women vote and work. One day HAES will be accepted as normal and fatphobia will be legislated against. That doesn’t mean the struggle will end. You are at the beginning of this movement, and are vocal about it, and therefore are seen as an easy target. I would be very happy to have you as my GP.

  3. Thank you. This post has helped to Validate the feelings I have about Dr. Eva. I have seen her shame and shout at many people in larger bodies who genuinely were doing their best and following incredibly strict routines. She degraded them and treated them so poorly on live TV and my mid-sized teenage self thought she was right. I saw her shout at people who looked like me and at the time I “knew” my body was a problem. I was the failure if I didn’t lose weight because she was a doctor who convinced me it was a lack of effort, nothing more. She was a part of the diet culture that lead me to wasting 15 years dieting, only to end up in a larger body anyway!! And now she wants to weigh kids… it’s horrific. Thank you for all you do.

  4. Katherine Bowett

    There is a clear and obvious double standard here, I’m very happy your highlighting the issues. Please continue to call out the BS !

  5. Fantastic blog post as always. I would be very interested to see if Dr Eva receives any complaints regarding her ‘work’ and if so, if the GMC bother to raise those complaints. I would consider the message she is putting out far more dangerous, misinformed and harmful to the profession!

  6. Thank you for keeping fighting and not letting these bullies chase you away. It takes a lot of energy and determination to keep fighting against a system that doesn’t read its own research and evidence base properly.

Leave a Comment

Your email address will not be published. Required fields are marked *