Or a mentally troubled patient. Or a black patient. Or a woman.
I’ve had almost exclusively military doctors for nearly two decades, and I can tell you they aren’t trying to respect your feelings (not that they’re dicks). If your tests come back with high cholesterol, they aren’t jumping to Lipitor or some shit, they’ll refer you to a nutritionist and tell you to exercise more. They have no problems telling you that your health troubles come from that weight crushing your organs and joints.
And that’s as a person in the military, who has to maintain a certain level if fitness to keep my job.
More like as soon as they leave medical school in my experience.
Also if they’re dentists (suddenly teeth become “bones to smile with”).
I did notice my dentist’s office is decorated with various posters and such that say “smile” and none of them say “chew”
You’re going to need a root canal, not because its the best procedure for the job, but because its more expensive.
I had a dentist give me an unnecessary root canal when a filling broke and they didn’t even do it right. I’m still pretty salty about it. I’ll always get a second opinion moving forward.
Do y’all not have separate endodontists that do root canals only? That’s the norm here that dentists refer out for specialty work like oral surgery and root canals.
Sooo what are the consequences of not getting it done right? I had one done recently and I am worried.
Doctors will be the first AI replacement
no, but they might use it soon.
Probably the last one to be honest.
Last one is AI programmers
Not even close.
shoutout to my current PCP for actually listening to my symptoms and (most importantly) when they started/worsened and treating them and/or the cause while also reminding me I still need to keep working on my weight
gonna miss her when I move towns :[
it’s 100% true, I am treated as less than human because high BMI.
quality rage bait 👏👏👏
I’m not rage baiting, its a shitpost, in the community for shitposts.
You sound distressed, you should lose some weight.
What harm is the doctor doing to fat people in your opinion?
There is a fat acceptance movement that says you can’t control your wight, and also the only healthy way to eat is to eat whatever you want whenever you want, and if doctors want to weigh their patients or inform them of the health risks of being overweight or not do operations where excess fat would create complications, the only possible explanation for any of that is fatphobia.
That’s not what that is.
Its more just not going out of your way to be an asshole to fat people.
Isn’t it well-known that doctors frequently dismiss health concerns with “have you tried losing weight?”
Because in many cases, the weight is the problem.
Being obese has so many related sicknesses. From having sleeping problems to back pain to knee pain to more serious stuff like cardiac arrests - being fat brings so many health problems.
When you look at how strongly obesity correlates with everything from back- and knee pains to weakened immune response to sleep issues and cardiovascular disease…
When a severely obese person has any of the above, it’s reasonable, scientifically backed diagnosis/prescription to say “these issues will probably go away by themselves if you lose weight”. This is about treating the cause and not the symptoms: When severely obese people are heavily over-represented among those with a certain disease or problem, you can try treating the symptoms, but should expect that they return rather quickly.
Of course, there are cases where the issues come from something else, but no matter who goes to the doctor with health issues, their first response will be to try to treat the post probable cause.
This isn’t always true though, so obese people end up not receiving the care they should, because their dr couldn’t or wouldn’t see past their weight.
Weight gain can turn a small thing into a bigger thing. A outpatient procedure is more likely to turn inpatient if the patient is over 300lbs.
While I have no doubt there are doctors like that, they are the exception.
Every profession has it’s idiots…
First I’m ever hearing about it.
Denying care until an arbitrary amount of weight is lost.
Maybe there’s sound science behind it, such as the procedures not having been tested on larger patients (if that’s the case why don’t they just say), but mostly it just looks like a waiting list hack.
Risk/benefit ratio.
The benefit is X the risk is Y, but the risk increases with excess weight, at some point Y exceeds X. Once the risk exceeds the benefit, it no-longer makes sense to perform the procedure.
From the patient point of view, the likelihood of a bad outcome is above the likelihood of a good outcome. They would be worse off getting the procedure; but likely they are only considering the good outcome and wishing away any bad outcome.
From the doctors point of view, they are considering both outcomes and trying to communicate to the patient that it’s not a good option for them. There is also the opportunity cost to consider, they could be helping someone else that is more likely to have a good outcome.
This. And I suspect what they’re taking about isn’t common except in very specific cases, like transplants.
If there’s a compatible kidney doner available, and it’s a choice between an obese and a non-obese adult, they’re going to give it to the person more likely to survive and make longer use of the donation, and all other things being equal that’s the non-obese person. OP will categorize this as “denying care,” but it’s really a question of saving the person who isn’t likely to die anyway from comorbidities.
People love to claim that doctors don’t take fat patients seriously and complain when they tell them to loose weight.
In the Fediverse there are also some Nutjobs who will claim that being morbidly obese isn’t unhealthy and that those doctors just don’t have a clue if they think it is unhealthy
#loose
Fat people can lose weight. Loose people… are more fun I presume.
Look, the doctor just said I needed exercise, but didn’t say it had to be boring.
What part of the Hippocratic Oath does this refer to? If anything, the Oath specifies “us[ing] those dietary regimens which will benefit my patients according to my greatest ability and judgment”.
I’m consistently 20-30 kilo above what was considered ideal weight for my height. It took 10 different visits to 10 different doctors to find my life-altering disease that was caused by basically a slow acting infection. 9 of them attributed my very real and severe symptoms to “well, what do you want from me, you’re a fatty fat fat and until you fix this you will be bad and miserable and actually deserve it, and did I mentioned you’re fat?”. All of them were as smug as you are right now, all of them presumably thought that they’re helping.
Now that that shit is fixed, I’m still the same weight, but weirdly enough, no symptoms and I am feeling good. Almost like my body type has nothing to do with anything.
And that’s what the meme is referring to.This is a joke, in a community for jokes.
I heard Dr Mike saying the other day how we a doctor, prescription drugs suck. End of the day, they have serious risks vs benefit. But the one thing known to give you the benefit of drugs without the risk is lowering your weight. Like across the board it improves so many things. I don’t envy doctors who know what the answer is but are told they’re assholes for trying to help
Obesity is a disease, so it should be treated as such. It’s not more of a personal failure then getting lung cancer from smoking.
Yet tobacco companies are shamed and taxed, while the sellers of addictive junk foods and sugary waters are thrivingcand marketing for children.
And at the end, people are dying, and taxpayers are paying the cost for capitalist greed.
Nobody blames the patient for getting lung cancer, they blame the patient for smoking for years knowing the risks.
Same thing with obesity related heart issues. You aren’t being blamed for the heart issues, you are being blamed for eating yourself into obesity.
There’s a saying: “it’s not your fault, but you are the only person who can solve it”.
Only you can reduce your calories, only you can stop smoking and only you can quit alcohol. That’s shitty that you have to, and in an ideal world it wouldn’t be like this, but it is.
Got a lot to say but I’ll keep it brief-ish. Corporations love unhealthy people. They will artificially celebrate this and reinforce unhealthy lifestyles. This extends beyond weight.
Once entrapped, escape is hard. Some are passive and depressed. Some are dismissive and defensive. No matter which cycle you are in, it’s unhealthy.
I think smoking is bad like I think being overweight is bad. If a doctor says alcohol is killing you, it probably is. I don’t think hatred is deserved, but don’t expect any validation for those choices.
I’m just sitting here waiting for the point of what you said. 60 people upvoted, but you didn’t say anything.
The phrase of the day (which you should Google of you downvote this) is pseudo-profound bullshit.
I think their point is that doctors don’t want their patients to become entrapped by obesity into lifelong poor health, which also traps them as sources of revenue for corporations that profit from sickness and fat: pharma, companies that sell fad diet and/or exercise plans, etc. So if your doctor tells you to lose weight, it’s probably coming from a good place, regardless of what else might be going on with your health.
(And just in anticipation of some replies I might get: yes, it’s absolutely a real and shitty thing when doctors only see the fat and assume it’s the cause of all the patient’s problems. You deserve better healthcare than that. But also recognize that while the fat might not be the cause of a given problem, it might be exacerbating that problem.)
You count just say you disagree and explain why it upset you.
You are ignorant of the genetic factors at play here and I think you need to realize that your rhetoric is identical to victim blaming eugenics ideology. You sound like RFK Jr. and I’m guessing you would want me dead if you could have things that way. It’s honestly despicable and I don’t know how people like you sleep at night.
Used to see the odd “genetics” fat person and they’d just be built a bit bigger. Now I’m seeing fucking waddling planetoids and that’s not genetics man. Part of that blame belongs to individuals but part of it belongs to the food lobbyists and their quest to add sugar and corn syrup to everything.
Incentivise people to grow their own vegetables (or source them locally from those who already are) and disincentivise the purchase of processed and sweetened food. Have our agencies promote healthy recipes using weight rather than volume measurements and show people how to use scales to properly weigh ingredients and help make it as easy as possible to count calories.
Buddy, you’re over stating the importance of genetics. Time and time again it shows that getting bigger is more nurture than nature. Papers and research retounely come out saying its a two-sides of the same coin issue, but then fail to support their nature/genetics claims, which are often refuted. Slender families get children who end up obese because of lifestyle, and their children become obese. That’s not genetics. The grandchildren end up obese because obese parents place their lifestyle and diets onto their children.
Claiming something is victim blaming is insanely disrespectful to the people who actually get blamed for things out of their control. Your weight is in your control for the vast, VAST majority of people.
People with disabilities who can’t get an opportunity to do something about it? Sure. Can that disability come from genetics, sure. But that’s a small minority of people who are overweight.
it shows
[citation needed]
Read the sources here and you see that monogenetic, epigenetic and polygenetic obesity is only partly of influence on actually becoming obese, and that with a proper healthy environment (which not everyone has access too, I understand) obesity doesn’t need to develop.
https://obesitymedicine.org/blog/obesity-and-genetics/
Meanwhile, where are the sources supporting the initial statement?
This is a recent problem. Do we think those purported fat genes just evolved in society over the past eightyish years, and spread so widely that, per the 2017-2018 NHANES data, 73% of American adults are overweight (30.7%) or obese (42.4%)? On a population level it’s clear this cannot be genetic. There’s been a cultural shift that has caused this problem, often thought to be related to processed food, less time to cook, and for some underserved communities, food deserts.
Look at how dramatically obesity has risen since the '80s:
It’s an overly simplistic view of the very complex set of issues. Even if we isolate the weight, which we shouldn’t do, even if we assume we should all strive to be of some set weight, which we shouldn’t do even harder, there is no one definitive factor that contributes to that. Reducting it all to “just eat better bro” is, in a lot of cases, akin to saying to a person with depression “just stop being sad”.
There is no “weight gene”, but it doesn’t mean there is no underlying physical issues that a person can’t overcome with just a sheer force of will.
And that’s not even going into the poverty cycle issue, which means that for some people better dietary choices simply unavailable.
Notice, I don’t know the percentage of people with it, but neither do you. But the problem is, weather a person can do something about their weight or not, putting all the, pardon the pun, weight of their bodyshape on them is almost never helpful, and almost always harmful.Yeah, but an unforgivable number of people simply don’t understand calories, or nutrition, or the benefits of excersise. Like, I know several overweight people, who are profoundly upset at being overweight, but refute the idea that managing calorie intake would help, _genuinely _ believe that all food is equal, and don’t believe excersise would help improve their health.
Hear me out. You’re villainizing me because what I said struck a nerve. You don’t actually believe I want you dead. You’re just upset that I pointed out a deep flaw. Maybe it’s an insecurity, or cognitive dissonance, or whatever. I’m very familiar with this type of response. Whatever it is, realize that someone likely depends on you and that an unhealthy lifestyle is not good for them. I’m encouraging you to do better, if not for yourself, the people in your life you care for. I recognize my ignorance. I’m not a therapist. I’m just stating something I’ve personally observed.
And you sound like a moron. OP didn’t say anything and you said even less.
I am down 50+ pounds, and have another 20 to go. This is new to me, but I absolutely agree with everything you said.
The meme isn’t about that, I’ve read stories of some doctors refusing to perform surguries to overweight people, but other doctors doing the surgery anyway.
The same way a lot of women get told stuff is just from their period by doctors…
I’m guessing that’s under the US health system, where doctors are incentivised to only perform surgeries with a low risk of complications
What countries medical system encourages risky surgeries? As far as I’m aware “reducing risk” is most of the game in medicine
For a lot of doctors, the incentive to not do risky procedures is the fact that you have to live with the guilt of your patient’s death, even if you did everything perfectly. Or, you do everything perfectly, but they still have a poor outcome because they weren’t healthy enough to go through the procedure and the recovery, and you get sued for millions of dollars because you didn’t spend 4 hours going through the informed consent with the patient to ensure that every single possible complication was adequately discussed.
I’ve worked in emergency medicine and I’ve had patients die in my care that we had absolutely no way of saving. The screams of their families still haunt me and I will carry those cries of anguish and loss to my grave. I would not perform a procedure that was not 1000000% necessary if the risks are too high because I have enough blood on my hands already, and I haven’t even finished medical school.
Similarly - if you are trans and on HRT, every problem is due to your hormones.
I’m a medical student and I have some direct experience with this. Sometimes, the difference between the surgeon who will do the procedure versus the surgeon that won’t do the procedure is the availability of specialized facilities and equipment that they have access to. An elective surgery (i.e. not an emergency surgery) can go from routine to very high risk depending on the amount of adipose tissue the patient has.
And it’s not just a matter of the fat tissue overlying the surgical site. Morbidly obese patients are much more likely to have things like sleep apnea which can make anesthesia more risky and might require more specialized equipment than a particular surgeon/hospital/anesthesiologist might have access to. The “morbid” part of “morbid obesity” also refers to the fact that people above a certain threshold of weight are much more likely to have other health conditions like heart disease that make anesthesia more risky.
Would a surgeon unable to do it refer the patient to one who is capable?
Sometimes. It depends why the first surgeon would be unable to do the procedure. If the problem is that the patient might not wake up from anesthesia because of problems with heart disease, lung problems, or other metabolic issues, then it doesn’t really matter what the surgeon has to say about actually doing the procedure because the anesthesiologist is the one saying “no”. If it’s an issue of too much adipose, sometimes it would mean that the surgery would take longer than it’s safe for the patient to be under anesthesia.
Another possibility is that the first surgeon operates at a facility that doesn’t have access to more advanced technologies or other medical specialists in the event that something goes wrong. And there are some surgeons that are just more willing to accept the risk of a bad outcome, and I would argue that that’s rarely in the patient’s best interest. There are alternative options that the surgeon should discuss with the patient as part of the informed consent process, and sometimes, the alternatives to surgery are just safer than the risk of the surgery itself, even if they aren’t as effective or are a long term treatment (ongoing) as opposed to a definitive treatment (cure). If the patient has a high risk of serious complications, up to and including death, then attempting the curative procedure might be more risk than it’s worth compared to a long term medication that mitigates the disease.
You’ll see this with pregnant patients too. For elective procedures that have safer alternatives or temporizing measures (a holdover treatment until surgery is safe), those are generally preferred to putting a pregnant patient under anesthesia because of all the cardiovascular, immunologic, and other physiologic changes that happen during pregnancy alongside potential risks to the fetus.
This is what I came to say but wasn’t smart enough to put into words. There’s a lot more factors than just being overweight of why a surgery can’t be performed. For a while an issue at my hospital was we were one of the few in the area that could do MRIs on larger patients. So bigger hospitals would transfer these patients to us just for an MRI because their MRI machine was too small or couldn’t handle the weight.
There’s a reason you have to get a pre-op physical exam for any non-emergent surgery. Figuring out if you’ll wake up from the anesthesia at all is part of the calculus that determines whether the benefits of the procedure outweigh the risks.
When talking about obese insividuals, the fat very easily gets in the way of surgery. Compared to a healthy patient the risk of complications during surgery is much greater and really not worth chancing it (most if the time)
The reason for that is that surgeons are rated based on their success percentages meaning they’ll recommend against risky surgeries.
The upside of this is that surgeons aren’t operating willy-nilly on people and will make a proper risk assessment. The downside is that overweight people have an inherently higher risk of complications from surgery, so some surgeons will pass.
It’s not because they think these people don’t need it, it’s because they think it’s too risky. They’re usually not wrong about that, you just need to find a surgeon willing to take the risk or, if possible, reduce the risk by losing weight.
There’s also no point to surgeries if the people aren’t committed and are just going to eat even more and put the weight back on. It’s like consolidating debt to make one payment easier but keeping all the credit cards and building up the debt again. It just makes you worse off
That’s why where I am from you usually need a clearance from a psychiatrist that there are no psychological issues in eating habits that would render that surgery useless, before the surgeon is allowed to do it
That depends on the surgery. Gastric bypass notoriously has weight requirements, but a gallbladder removal can still kill you if you’re too fat, and there definitely is a point to doing that even if the patient isn’t going to change their diet.
Look. Shitty doctors exist, but when 1/3 of the US is overweight, there are underlying issues that need addressing. I only hear horror stories when an addict, alcoholic, or overweight individual in my life is feeling insecure or defensive about a prognosis. Too many people deflect and it’s enabling a much larger issues. Our basic instincts are being exploited.
I have some horror stories about being a normal weight woman seeking medical care. What’s that about then?
Different issues have different causes.
I don’t know, the medical community ignoring fat people’s health concerns (beyond obesity) and ignoring women’s health concerns, seem to be the same issue and I posit they are the same cause too (hubris, arrogance, and just simply not living up to their oath)
America’s obesity epidemic is a function of our car culture. This is the only country on God’s green Earth that feels putting in sidewalks is a moral failure.
Obesity is a food issue, our reliance on cars and increasingly sedentary lifestyle may exacerbate the issue but it’s not the cause
You can’t really know it. I suspect it’s a combination of the two. If you drive everywhere and sit around the rest of the time, you can’t be healthy no matter your diet.
It’s obvious that this is not the most important underlying cause, as other countries which are less auto oriented are also quite fat.
Obesity is a product of excess caloric intake NOT sedentary lifestyle.
Lack of cardiovascular and kinesthetic health is a product of a sedentary lifestyle.
It is once again, incredibly simplistic view of a very complicated issue, so simplistic it stops being accurate.
Look. Shitty doctors exist …
Yes. They’re in the meme.
I know, I’m not arguing for obesity, that would be stupid.
Well someone’s gonna have to
Surely no coincidence that being obese is a gateway to hyperconsumerism anyway. Sugary, fatty, processed snack foods are way more profitable than healthy meals.
Walking around town is free, can’t have that. Sit at this computer chair, watch advertisements and play video games instead.
Heart disease at 26? That’ll be $2k/month until you die.
Get depressed, buy the meds, never leave your couch, don’t fight back, you’re the evolution of humanity and - most of all - you are beautiful.
Or lgbtq
I can’t blame doctors for letting obesity color their opinion. Look around your doctor’s waiting room. Everyone is fat. Imagine the suffering and illness they see daily due to fat. How can those observations not color their general attitude?
Everyone is fat
Exactly, which points squarely at an environmental cause, not at individual sloth/gluttony or some shit like that.
The conclusion you’re saying doctors arrive at—which I don’t doubt you’re correct about—is actually completely fucking backwards.
which points squarely at an environmental cause
No, it points to people eating processed food and other shit. Guess what, you can still be healthy if you eat healthy.
That’s the cause I think they were referring to.
Yeah but your doctor cant prescribe you burning down capitalism, they can prescribe you lower your caloric intake.
Yeah but your doctor cant prescribe you burning down capitalism
Unless…
“Actually officer I have a prescription”
That’s the trick!
They believe everyone is gluttonous and slothful because they’re misanthropic.
Look around your doctor’s waiting room. Everyone is fat.
Lots of people are old and age correlates with weight gain. But the volleyball player who blew out her ACL isn’t fat. Neither is the chem patient who is back for a final round.
How can those observations not color their general attitude?
Doctor: “Feels like everyone I see is either sick or injured”
Nurse: “Try spending less time in the ER”
I’m not sure your second point works, or maybe I just don’t understand it. It’s not like the doctor is making judgements that people are fat outside a hospital- they’re doing their job. You’ve got a car and it’s starter goes out every year, last time being a year ago. Your car wont start. Whats the first assumption?
It’s not ableist or bias to assume that the most common issue is the most likely issue. They see a ton of people whos problems are irrefutably due to their weight. It’s not the doctors job to make judgement calls on whether that person is wholly responsible for their situation, it’s their job to doagnose the problem and help take steps to fix it. The problem being their weight, the steps include: burn down capitalism and replace it with a system that doesnt incentivise companies to use the cheapest least healthy ingredients, or tell the patient unless they lose weight they’re going to die. One of these is completely pointless to tell the patient, the other gives them an unfair opportunity to potentially save themselves.
Medical care for obesity is currently in most cases like telling someone with a broken starter that they need to run their car more instead of replacing the starter.
If eating too much compared to energy usage is unhealthy then there’s already something wrong with the patient that’s causing them to eat too much or expend too little energy. Telling them to lose weight might be the only thing within a provider’s abilities to do, but it’s equivalent to telling someone with a broken starter to leave the engine running.
It is abelist and biased to pass judgement on ones patients for having symptoms of physical, mental, social, or environmental ailments. When a symptom is already socially stigmatized a provider has a responsibility to care for the social impacts of that stigmatization as well, at the bare minimum in one’s own dealings with the patient.
Your first two paragraphs i agree with 100%. Your final paragraph i feel is accurate but id want to really mull over that before I really form an opinion. Obv in an ideal world it’s pretty easy to assign blame, but our legal and cultural issues are so fucked that topics like that really have to be analyzed in depth under the lens of how that would actually effect reality.
analyzed in depth under the lens of how that would actually effect reality
You are implying you imagine some moral hazard where their provider minimizes the risk of the conditions the patient has, and as a result the patient stops seeking treatment. What you’re talking about in reality is shame. “Should a patient feel shame talking to their provider”?, and the answer to that is resoundingly “no”. Shame is a powerful demotivator, it’s function is to stop a person from doing something that threatens their relationships with others or the society they depend on. Trying to motivate someone with shame is counter-productive. All shame in a patient care setting can do is demotivate the patient from seeking care.
Nah, the moral hazard is from the doctors side. What can a doctor get away with without risking them losing their job or putting themselves in a dangerous position.
Sorry, “moral hazard” is a term-of-art (something that doesn’t mean what it says on its face but is used in some particular way in some fields or professions). In this case by “moral hazard” I meant the idea that if you reduce the harm of some course of action there’s a chance that people will engage in it more because it’s less harmful now. It usually is applied to risky-yet-beneficial behaviours like injury from sports or from outdoor pursuits. It’s ridiculous in that context (I don’t think we should make things worse just so they don’t get better) and doubly or triply ridiculous when the risky behaviour isn’t beneficial or also isn’t effectively voluntary.
They see a ton of people whos problems are irrefutably due to their weight.
Weight is a symptom not a cause. Metabolism, age, injury, psychology - these are causes.
burn down capitalism and replace it with a system that doesnt incentivise companies to use the cheapest least healthy ingredients, or tell the patient unless they lose weight they’re going to die.
Everyone dies. And big people have existed far longer than the advent of processed sugar. But asking people to adopt unhealthy eating habits in pursuit of a tiny waistline isn’t healthy.
Too often I see people conflating “Looking healthy” with “looking pretty”, absent any of the trade offs necessary to maintain appearances.
Weight can cause plenty of issues, it’s both a symptom and a cause.
The patient is a women, in poverty, disabled, mentally ill…
Medical culture is unbelievably bigoted.
And all of that would be made worse if she was fat as well. Being fat is unhealthy. I was a medically obese child. 250lbs at 12. Losing 80lbs is one of the greatest changes I’ve ever made in my life, if not the best, for my daily quality of life.
Being fat is unhealthy
It’s funny, because the metrics we use to declare an individual “fat” loops in quite a few professional athletes.
Being a professional athlete is terrible for long term health, but for different reasons. Sometimes there’s overlap like joint health though.
It’s terrible primarily because of risk of concussion and other injuries.
Also, because being - for instance - basketball height is hard on your body as you get older.
But telling LeBron James that he’s overweight and he’s going to die if he doesn’t lose weight does nothing of benefit. He’s not going to get any shorter and he’s not going to retire just so he can give up a professional’s career requirements.
bmi doesn’t apply to outliers like athletes and heavy weightlifers per design. it never did and was never supposed to
its for the regular joe, where its pretty good at telling you that you’re a fat fuck
The BMI number that is calculated just from weight and height is really just a number that tells us we need to go look at some other numbers. The other numbers are things like body fat percentage, cholesterol levels, blood pressure, blood sugar, etc. It is entirely possible for someone to have a “normal” BMI and still be very fat and unhealthy, and those people are pretty easy to identify visually, just as someone with a “high” BMI who is a powerlifter or something is very easy to visually identify.
If you’re referring to BMI yes, but doctors tend to use body fat percentage, at least where I live.
