The Heavy Burden: Navigating the Complexities of Treating Obesity in the ICU

Welcome back to Superdoc Insights, where we delve deep into the emotional, mental, and professional struggles we face in our journeys as doctors, and how we can grow from them.

Today’s episode comes from a recent experience I had while treating a morbidly obese patient in the ICU. Treating obesity is about more than just the primary disease the patient is suffering from. It’s the complications, the extra work required to assess and care for them, and the obstacles the excess weight itself creates.

From the ultrasound to the ventilators, to even assessing their vital signs—everything takes more effort, and the risks of complications are always higher.

But while working with this patient, I had an epiphany: The burden of obesity is a lot like the mental and emotional weight we all carry. Both are invisible barriers that make life more complicated, slow us down, and prevent us from progressing.

So today, I’m going to explore the connection between the physical complexity of treating obese patients and the emotional and mental complexity we carry within ourselves.

Obesity in the ICU: The Visible and Invisible Struggles

Obesity brings with it a host of complications. The disease itself is a major problem, but it’s the sheer physicality of managing an obese patient that poses additional challenges. Every single task becomes more laborious.

Let me give you an example:

In the ICU, the extra fat makes it hard to use the ultrasound, especially for hemodynamic monitoring. Imaging gets complicated. Procedures like central line insertions, tracheostomies, and even surgeries become more complex. You find yourself constantly double-checking, repositioning, and rethinking your next steps.

This is why, for every morbidly obese patient I get in the ICU, I feel a need to mentally prepare. You know, right off the bat, that everything about the case will take more time and attention. There’s no cutting corners. The stakes are higher.

But here’s the thing:

These physical complications feel like they mirror something else—something deeper. Just like the excess weight makes it difficult to treat the physical body, our emotional and mental blocks create invisible barriers that make our personal growth difficult.

Unseen Burdens: Beyond the Physical Weight

When I treat an obese patient in the ICU, I often think beyond just their physical condition. Yes, we have to deal with the immediate medical challenges—difficult intubations, complications with procedures, and higher risks during recovery. But something always strikes me when I work with these patients:

Obesity is often a symptom of something much deeper. It’s not always just about food or lifestyle. Somewhere along the way, these patients might have felt stuck—mentally, emotionally—caught in a cycle they couldn’t escape. And how many of us are carrying that same metaphorical weight in our own lives?

“Just like obesity, mental and emotional weight builds up slowly. It clouds our thinking, blocks us from seeing solutions, and keeps us in a cycle of self-doubt and procrastination. But how many of us have the courage to dig deep, to uncover the root cause of our stagnation and truly treat it?”

It’s a tough process, both for patients and for ourselves. But if we can identify the underlying issues, whether it’s fear, unresolved emotions, or a lack of direction, we can begin to shed those layers and move toward growth and freedom.

The Invisible Weight We Carry: Mental and Emotional Barriers

Now let’s shift gears for a moment and go deep about the mental and emotional weight that we all carry.

Have you ever felt like something was holding you back, even when everything around you seemed fine? It’s like carrying a heavy emotional load, but unlike physical weight, it’s not immediately obvious. It’s that invisible cloud that hovers over you—doubt, fear, procrastination, or stress—making everything more difficult than it needs to be.

I call this state mental obesity—that extra weight you carry around in your mind, which clouds your thinking, drains your energy, and makes even the smallest task feel like a mountain to climb.

And just like with physical obesity, the longer you carry this mental weight, the more it begins to affect your ability to take action, think clearly, and move forward with your goals.

“Carrying your emotional baggage around is like carrying a suitcase filled with bricks. Letting it go doesn’t make you weak—it just makes you lighter.”

Let me lighten the mood with this thought:

It’s like that moment when you’ve just settled down for the night and you hear, “One last patient in the ICU.” You know it’s never just one patient. Similarly, you think you’ve dealt with your emotional baggage, but it’s like saying goodbye to a clingy friend who doesn’t actually leave the party!

Post-Victory Slump: The Emotional Stasis

I want to talk about something I call the post-victory slump. I’m sure you’ve experienced this. Recently I went through this and saw myself spiraling away from my higher goals and saw myself booted down by my baggages I was carrying. Let me explain:

You work hard toward a big goal—whether it’s a project, exam, or milestone in life—and once you achieve it, you celebrate. You bask in the glory of your success. But then, something happens. You get comfortable. You stay in the celebration mode a little too long. It’s like you’ve wrapped yourself in a cozy blanket, and you just don’t want to leave it.

Here’s where it gets dangerous:

If you don’t set your eyes on the next goal, you can fall into what I call a mental dormancy—a place where you avoid growth, avoid challenges, and let your inner resistance dictate your actions.

Much like an obese patient facing complications, you start to feel overwhelmed by everything you have to do. It all feels like too much work, and you start to retreat into a cycle of procrastination and self-doubt.

Funny how life works, right?

Like that patient who says, “I promise I won’t eat sugar anymore,” while holding a candy bar in hand. You know it’s going to be a tough recovery ahead!

Finding the Way Forward: Aligning with Purpose

Here’s the solution:

When I’ve found myself in these slumps, I’ve realized that the only way to shed this weight is to align myself with a higher purpose.

I stopped setting goals that were just about the next exam or the next achievement. Instead, I began to work for something bigger—something that aligned with my purpose as a doctor, as a teacher, and as a person trying to add value to the lives of others.

This shift in mindset made all the difference.

When your goals are tied to your higher purpose, it’s easier to keep moving forward, even when the weight feels heavy. You stop letting the mental blocks hold you back, and instead, you work for something greater than yourself.

The Parallels Between Obesity and Emotional Weight

I realized that just as obesity is often a symptom of something deeper, the emotional weight we carry often stems from unresolved issues or fears. For patients, obesity can be a result of past trauma, stress, or unhealthy coping mechanisms. For us, emotional baggage comes from similar sources—stress, self-doubt, unresolved conflicts.

“What if the extra weight you’re carrying is a symptom of something deeper? And how many of us have the courage to dig deep and treat the root cause?”

This introspection is crucial because, without it, we’re simply treating symptoms, not the cause. If we can learn to dig deeper and address the real issues at play, we can begin to shed those invisible layers and move forward with clarity and purpose.

So, here’s what I want you to think about:

• What’s weighing you down?

• What’s your metaphorical obesity a symptom of?

• And most importantly, how can you align your actions with a higher purpose to push through that weight ?

So, that’s what I leave you with today.

Just like treating an obese patient requires extra effort, treating your mental and emotional blocks takes intentional work. But once you start shedding that weight, you’ll find yourself moving forward with clarity, purpose, and energy.

Stay balanced, stay healthy.

Dr.Krishna Bharath, MD.