When Weight Bias in Healthcare Leads to Missed Diagnoses—And How We Can Do Better with Dr. Lindsay Ogle

Walking into a doctor’s office should feel like a step toward better health—but for many, it’s filled with anxiety, judgment, and shame. The fear of being lectured about weight or having concerns dismissed keeps too many people from getting the preventive care they need. And the consequences can be devastating.

Dr. Lindsay Ogle, a board-certified family medicine and obesity medicine physician, shares the story of a patient who avoided check-ups for years, only to later be diagnosed with a serious, advanced-stage cancer—something that could have been caught earlier with routine screenings. It’s a heartbreaking but all-too-common reality.

In this episode, we dive into how weight bias affects patient care, why even well-meaning providers may unintentionally contribute to the problem, and what small but powerful changes can make a real difference. Whether you’re a healthcare provider or someone who’s ever felt hesitant to book an appointment, this conversation is one you won’t want to miss.

References

Connect with Dr. Lindsay Ogle:

Website: https://missourimetabolichealth.com/

Instagram: https://www.instagram.com/dr.lindsayogle/

YouTube: https://www.youtube.com/channel/UCMV0X6U0JLZgRMiNwGtmpeg

Facebook: https://www.facebook.com/lindsay.ogle.90/

TikTok: https://www.tiktok.com/@dr..lindsay.ogle?_t=8prC4VUQZ5i&_r=1 

Audio Stamps
01:35 - Today’s guest, Dr. Lindsay Ogle, shares her background in family and obesity medicine, how she developed an interest in weight management, and her experience treating patients in primary care.

03:08 - Dr. Ogle shares a patient case of delayed cervical cancer diagnosis and discusses the impact of missed screenings and medical bias.

06:17 - Dr. Ogle explains how obesity increases cancer risk and why routine screenings are essential, even when weight management feels like the priority.

08:22 - Dr. Ogle outlines the key preventive health screenings for men and women, emphasizing the importance of routine blood pressure checks, lab work, cancer screenings, and vaccinations by age group.

12:03 - Dr. Ogle discusses how medical providers can create a more supportive and nonjudgmental environment for patients in larger bodies.

Quotes
“Years ago, when I went into the my primary care panel, there

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Transcript

0:33

Welcome back to another episode of the podcast today. We have another really exciting interview. So I have Dr. Lindsay Ogle, and I'm going to let her introduce herself in a second. But as I always say on the podcast, I never have anyone on where it's just a random physician or, you know, things like that. So I have actually been seeing your content online, but then we connected and something that I thought was really powerful is, she brought up a patient experience where this patient had not had regular preventive care and had a really serious cancer and she said, Hey, I don't think you've actually done a preventive health episode and why I was so happy that you brought that up despite us being at like episode a hundred, this is such an important topic because this is actually something that probably like you, I go over with every patient in my metabolic health clinic. Many of them have not had mammograms or PAPs. They. delay care because there's so much shame associated with it or they get so much discrimination when they go to the physician. So I'm so glad that you brought this up. I'm so glad that we're going to have this conversation today. Can you start out just telling everybody who you are and how you help people? And then I know I'm gonna have a lot of great questions for you. Yeah, absolutely. Well, thank you so much for agreeing to have me on. I love your podcast that I've learned so much. And I know that in this month of January, you were wanting to kind of go back to the basics. So I think this is a perfect time for us to talk about the preventative health screenings. My name is Dr. Lindsay Ogle. I am a board certified family medicine and obesity medicine physician and I went into family medicine because I wanted to work in the outpatient setting, develop relationships with my patients, and help them achieve and maintain their health to live longer and happier lives. And I was fortunate enough that, during my residency program, we had a lot of elective opportunities and I worked with an obesity medicine physician and a bariatric surgeon and I worked at an eating disorder, center and I really kind of fell in love with this patient population and then immediately kind of dove into the obesity medicine training and then sat for those boards as soon as I could. My first job out of residency was in a primary care clinic, as an employed physician. And when they have new physicians, they advertise, we're available at accepting new patients and we can list our interest in the things that we help with. And one of the first things that I listed was obesity and weight management. So I had a lot of patients come to establish care with me for primary care. And then for help with their weight management. And this patient that I brought to your attention and wanted to talk about, she did just that. So she was establishing with me as a new patient. I believe she was in her early forties and Over the course of a couple of months, we really determined that the best treatment for her for her weight management would be to, pursue, bariatric and metabolic surgery. And luckily we were in an area where that was accessible. So she went forth and did that. And unfortunately, after the surgery had a complication, which was really not. Related to the bariatric surgery, but just a complication from having a surgery in general. And that was, she had a blood clot after the surgery. And then she was started on treatment with, a blood thinner and then unfortunately developed another clot after that. And then, so they switched the type of medicine that she was on, switched her blood thinner, and then developed another clot on top of that, which is. Extremely abnormal. And so the decision was made to bring her into the hospital to look into why this was happening. And unfortunately, she was found to have a cancer diagnosis. And it was a diagnosis of cervical cancer, which any cancer diagnosis, of course, is upsetting and something that, nobody wants to hear. But, Diagnosis of cervical cancer. It can be or it was upsetting to me because, you know, as, as you know that we have very clear screening guidelines for certain cancers that are common, like cervical cancer that once when those are followed, these are ideally caught early and are managed, pretty quickly. And so it, having this patient be diagnosed with cervical cancer kind of having a delayed diagnosis really made me take a pause and reevaluate I guess the approach to, to these, to these patients and think about, why did this happen? Why was this diagnosis delayed? And unfortunately, I experienced this a lot also years ago when I went into the my primary care panel, there were a lot of cancers that I was diagnosing initially and I thought this is not normal right because I'd come off of three years of residency clinic and I was thinking, why am I diagnosing things right and left and partly I was wondering is it. That there was some weight bias involved, right? Like if you have a doctor that is just not doing some of the things. And by the way, I say this cause we have a lot of clinicians that are listening. I don't think that clinicians realize this is happening. They just are preoccupied with other things. They're forgetting certain things. But we do see disproportionately that if someone struggles with overweight or obesity, that, that this is. affecting them. And so I'm so glad that you brought this up. And it's so unfortunate. I hope that by us talking about this today, that maybe one patient out there will hear this and say, have I got those screens? And know how to advocate for themselves is something I'm really a fan of is that patients know what to ask for, because then even if on the other side, they forgot, you at least know what to speak up for. So it's actually a really good segue because, I know you're seeing patients that are high risk for conditions. Like we just said, cervical cancer, breast cancer, colon cancer, things like that. How do you approach the conversation about routine screening? So things like mammograms with your patients. And are there any specific considerations that you keep in mind when you have that conversation. Yeah, absolutely. So many people may not even be aware that obesity is linked to a higher risk of certain cancers. And so that is something to, for us just to, take a moment and, and highlight. So, and then another thing that I see with patients is oftentimes, The excess weight is something that They they can see and other people can see and hidden and in cancers, especially early on They're not something that we we necessarily see right away, which is why we need to screen for them so oftentimes, we or patients or even providers have that focus where they're wanting to treat the weight and and really what we're needing to do is to take a pause and make sure that we have that baseline health established and diagnose underlying conditions and manage those if they're there and then make sure we have the appropriate screening. So, again, just emphasizing that you have It is you've established with a primary care doctor that you trust and that they are doing On your wellness visit and making sure that that's a priority And it's not as exciting or as fun as managing these conditions that you know, you have a priority a priority and, and, addressing, but it's very important of having that, that baseline primary care, preventative screenings, established first. I think people don't understand the power of getting some routine lab work, getting the blood pressure checked. And I know that there are a lot of barriers because especially the area that I served in with primary care was an understaffed area and. Not enough doctors to go around. So, I know this can be easier said than done, we are totally acknowledging that, but I think it's worth, it's worth getting this done. Now, something that I know when people listen to this podcast, they always want to know, okay, what do I go do? So I'm gonna, I'm gonna always ask you here that is a good one. What are the top preventive, would you say like health screenings or tests or exams that men and women that they really need to stay on top of? For sure. One of the first things is having your blood pressure checks. And ideally, this is happening at every office visit, but high blood pressure leads to so many complications. And so that is something that you want to be screened, ideally, at least once a year. So that's one for sure. Lab work, some common lab work that we would want to screen for would be a diabetes screen. Fasting cholesterol panel, kidney and liver function, maybe a blood cell count screening for things like anemia. And this is something definitely by age 40, you want to have done. And then periodically after that, but for some people, you may want to be screened earlier if you have certain risk factors. And then. Of course, in primary care, we're always thinking about prevention. So vaccines, you're wanting to make sure you're up to date on your vaccines. And then depression screenings is also something that we do in primary care. So checking in on mental health, substance use disorders, those sorts of things. And then cancer screenings, like we started this conversation. So for both men and women, colon cancer screening now starts at age 45. So that is something that you want to get started at 45 now, lung cancer screening. So history, if you have a history of smoking, you want to start at 50 for lung cancer screening. For women cervical cancer screening, current those guidelines are changing a little bit. Right now I still have, my patients start at 21, but it's looking like it may be able to be pushed back to 25. So definitely by 25, you want to start your cervical cancer screening. Breast cancer screening, those previously varied a little bit, but now most societies are saying 40 is a good age to start, with breast cancer screening and then prostate cancer screening. This one has changed a lot over the years and still varies on which medical society you're looking at, but. I start the conversation with my male patients around age 45 for prostate cancer screening. And then there's a couple of other things like bone density scans. Those start for women around 65, sometimes earlier in certain risk factors. And then men who have smoked, we do an abdominal aortic aneurysm screening at age 65. So those are the, the main, preventative screenings that I like to have my patients have. I, you know, when you're saying this, I'm always thinking through, it's like, okay, some things happen when you're young, but then it's like 45, 50, 60, you know, it's like, there's a certain year it might be yearly for the mammogram, but it's like, once you get into the cadence of these things, it's not as overwhelming as it sounds. Like, I just want to tell everybody listening, If you're not in the swing of things, you think, how am I ever going to do all these things? But it doesn't happen all at once. So that's the good news, right? Yes, absolutely. So, so this was a really good list. And again, we're going to make sure everybody, when you're listing, we always have in the show notes, a really nice, just everything listed out. We'll make sure to link to all the recommendations on this. So if you need a little cheat sheet on that, and we have a handout for, you know, lab work that would be great to ask for. So that might be a nice resource if you kind of just want to look through there and think like, am I fitting in this? Or, or if you haven't had it and you think you need it, maybe asking your doctor, why, like, do I need this? Maybe not coming accusatory, but just saying, do I need this? You can see what the answer might be. And this brings up another thing. So I think that, I think, you know, You know, we have a mix of who listens on here, right? So it's both what I say patients, but people that are receiving, health care, and then people that are delivering that health care. And I think that something that I know I've experienced this, there's so much shame sometimes going to the doctor when you have excess weight, you worry about being judged. You worry about the exam needing to be different. There's just so many worries that potentially that patient compared to someone else. And so I wonder if You could give any tips and tricks. This is really for the for the medical providers that are listening how we can really have a nonjudgmental supportive environment just because I think that that is so important. I think many of us. We don't even realize that the way in which we're delivering care. is doing that. And so I'm wondering if you have any tips and tricks for that. Yeah. I love this question. And of course there is, you know, reality and then an ideal situation. And most of us are working as employed physicians. So we do not have full control over our patient's environment and experience. But I do think if we acknowledge where we're at and then try to take the steps towards that ideal situation, then we're doing the best that we can for our patients and improving their experience. Some of the, like, more ideal situation, would be, like a scale in an enclosed space in a room, although any doctor's office that I've been to or worked at does not have that. So again, that's an ideal situation, but reminding me of the clinic that I was at. I kid you not. The scale was in a direct walkway for like five directions. And I just, they're thinking, who wants to get on this? And they were all like, well, I'm going to take my jacket off. I'm going to take my shoes off. And I'm thinking, yeah, because your number is being like splayed to the world. Like this is horrible. Yeah, absolutely. And that's the first thing that happens when you go in for your appointment. So. That experience really will kind of set the tone for your appointment. So I do think that that's important to, optimize and have it discreet if possible. And then other things such as having, you know, the, we talked about blood pressure being an important screening, measure, at your preventative health visits, and so making sure that you have all the, the sizes of blood pressure cuffs in each and every room, so it doesn't have to be, a whole display with walking out of the room and getting a different sized cuff, not as something that is a simple change that can really make a big difference, In certain things such as, staff training and using, patient first language and not, sharing the, the weight or certain numbers out, out loud, those sorts of things. And so those are the steps that we can head in that direction of an ideal, environment. But the things that we have control over day to day is how we approach our patients and, I really try to approach all my patients with compassion and respect and curiosity. And so for patients who may kind of present as, you know, either never like the word non compliant, but maybe they're kind of pushing off, certain testing. Like they always are saying, next time I'll do my pap smear or something like that. Just take the time and Ask maybe why in a very non non judgmental open question. And really take the time to listen to why they may be putting that off because you may be surprised of what you hear. They could have had a traumatic experience in a medical office with a similar procedure in the past. Or a history of, of trauma, or they're worried, like you mentioned that it could be different for them, with that experience. And so just hearing your patient out and then meeting them where they are and filling in the gaps of those worries can really make a big difference and allow the patients to get that care that they need. Yeah. These are such good points. I really like how you're, how you mentioned, you know, some of the things, I mean, we can't move a scale if we're in a big clinic. I, I, at least I didn't feel I had agency to do that. But I like how you're approaching the patient. I know for me, I think the thing that changed the most when I learned more, what I was doing with weight management was just saying, can we talk about this? Cause I feel like there, I know that's, it was not the main topic that we talked about, but it's asking consent more for things. Cause I feel like a lot of the time I know as physicians, we have an agenda. So there's the patient agenda and ours. And we just want to get through it and we want to make sure that they're getting all this stuff done, but. If their fear is something that's blocking all this other stuff if we're not asking them, we have no idea, so that's so incredibly helpful. So tell everybody how they can find you. I know you have a clinic as well, which is so exciting. People are writing me all the time from different states, and I'm like trying to make the list of who's great everywhere. So, tell us a little bit about how people can find you and, about your clinic. Yeah, thank you. So I have a telehealth clinic based in Missouri. It's called Missouri Metabolic Health and that's the the website Missouri Metabolic Health dot com. So pretty easy to find and you will have links to all of my social media. I also have a YouTube channel where I have new videos every Monday. I'm on Instagram and TikTok under my name, Dr. Lindsay Ogle, but you can find the links on that website, Missouri Metabolic Health. dot com. There's also a page where you can contact me and send me a message directly. If you have any questions or if you live in Missouri and would like to be my patient, you can schedule right from the website. Thank you so much for coming on today. I hope that everyone is inspired to look at their preventive health and really realize the, the huge impacts that this have. I mean, honestly, potentially this is life saving for someone to hear this and think, okay, I do need to get this scheduled. I know for me, I've scheduled something six months out. I'm like, I can't handle this today, but in six months we will tackle this. So, but just thank you for coming on. Yeah. Thank you so much for having me. I really appreciate it.