Why do we care what the Surgeon General weighs?

As soon as President Obama announced Dr. Regina Benjamin as his pick for surgeon general last July she came under fire for—can you believe it?—her weight!

Dr Benjamin’s figure has received more scrutiny and bashing from bloggers and commentators than her exemplary qualifications and achievements.

Last Monday, on Dr. Benjamin’s swearing-in date, she gave an interview to Good Morning America, in which she honestly responded to the comments about her figure. “Most women want to be attractive,” she said. “You don’t want to see negative things, people calling you names. So it was very hurtful.” Such straightforwardness and openness is refreshing.

I have two things I have to say about this:

First: Where are our manners?

Aren’t we the nation of political correctness? I don’t support euphemisms and practices that empty language of all meaning, but there’s something to be said for good manners: Language is the expression of thought, and suppressing language that might offend people not only spares these people’s feelings, but hinders the social acceptance of what’s ultimately bad manners.

It seems obesity is one of the final frontiers of out-in-the-open social marginalization and stigmatization--obesity bias is still socially acceptable and regularly expressed without any shame.

Strange that in a nation in which the majority of the population is overweight—and one in three adults is obese—where talking about a person’s color, ethnic background or religion can get you into major trouble, criticizing body fat is considered just fine.

And second: What does weight have to do with being a good surgeon general?

Our celebrity-obsessed culture confuses us into thinking that one’s appearance and personal story are major qualifications for any job.

Nothing can be further from the truth, certainly in most professional roles, and especially in science- based disciplines.

The Surgeon General is the leading spokesperson on matters of public health in the federal government. Quoting from the Office of the Surgeon General’s website, “The Surgeon General serves as America's chief health educator by providing Americans the best scientific information available on how to improve their health and reduce the risk of illness and injury.”

The key words here are “best scientific information.” The Surgeon General is a physician. She practices a discipline in which evidence and scientific inquiry are the main tools. A doctor’s personal opinion about most subjects hardly matters. When you consult a doctor what you’re supposed to get is what medicine knows about your condition, and hopefully, a treatment plan that has been proven to work. Doctors aren’t supposed to draw from their anecdotal personal experience or gut feeling when they’re on the job; they should be looking at evidence, referencing clinical studies and applying the gathered experience of many other trained professionals.

That’s why a male physician can be an excellent obstetrician, a pediatrician needn’t be a parent, and psychiatrists don’t need first-hand experience with overcoming mental illness. You follow a doctor’s advice (and the guidance of any other expert) because he knows his stuff and has sound clinical judgment, not because he’s a role model.

The Surgeon General is the country’s head doctor, not a health celebrity. She’s a professional, dispensing advice based on evidence, science and the consensus of peers in order to promote our national health.

Criticism that Dr. Benjamin might have a credibility problem when talking about obesity and can’t lead a national discussion on the subject is as absurd as insisting that a male physician couldn’t guide the delivery of a baby.

A weight-loss guru, touting a miracle diet that’s a quick cure-all for obesity, has a credibility problem if he’s overweight. (Actually, he’d have a credibility problem even if he’s skinny, because we should all know better and question whether such a fix could actually work.)

Prevention and public health are at the top of Dr. Benjamin’s to-do list and obesity is the number one public health issue facing America right now. Regardless of the Surgeon General’s personal experience with weight, her office would be looking at the same studies referenced by physicians and nutrition experts all around the world.

The data shows that obesity is multifactorial, isn’t easy to solve, isn’t a failure of personal will-power, and that telling people to lose weight—whether this comes from a thin or a fat person—is hardly an effective enough solution to this complex problem.

One of the most important roles of the Surgeon General is to influence public policies. In the case of obesity and the very sorry state of our country’s eating habits, a major effort is needed in order to change our obesogenic environment so that one won’t need such enormous self-control in order to be fit and thin.

I have no idea why we’re looking so hard for role models, and why we seem to expect no less than perfection from public figures.

Competency, wisdom and honesty from real people seem like plenty to me; and we’re fortunate that there’s so much more to admire in our new Surgeon General.

Most people can’t name many—or any—previous Surgeons General, have no idea what they did, and certainly don’t know their size. I hope Dr. Benjamin attracts more public attention than her recent predecessors did, and when she speaks it's the message--not the messenger--we should be paying most attention to.

I’m looking forward to a heated discussion on this topic.

Dr. Ayala

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