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Why Do Obese Patients Get Worse Care? Many Doctors Don't See Past the Fat

nytimes.com

91–100 of 239 posts

Re: Why Do Obese Patients Get Worse Care? Many Doctors Don't See Past the Fat

#91

Obesity is deeply repulsive on two levels. People who get to these extreme levels of obesity are basically suicidal. Aside from the obvious revolting physical appearance, there's an underlying message of "might as well die". Their chosen method of suicide is death by uninhibited indulgence in food.

> People who get to these extreme levels of obesity are basically suicidal.

Sometimes they might be, but this is far from universally true.

Re: Why Do Obese Patients Get Worse Care? Many Doctors Don't See Past the Fat

#92
post #46

I didn't read the article yet, since I opened the comments first... and was shocked by them. I have a thyroid problem, the first symptons started to show up when I was 13 or 14, including my hair starting to get white. I didn't knew, it was a thyroid problem, my mom, for some reason (that back then offended me, I told her I didn't wanted to go to a "fat people doctor") took me to a endocrinologist, suspecting somethi…

Whatever condition you had didn't cause you to gain weight. You can't defy physics. If you control your caloric intake, your body /will/ lose fat. Your story is anecdotal so I'll response with an anecdote as well: I've seen more than one person with a "thyroid condition" who were in good shape.

Re: Why Do Obese Patients Get Worse Care? Many Doctors Don't See Past the Fat

#93
post #64

My experience, having been both a very obese person (100 lbs overweight) an an almost normal-weight person (10ish pounds overweight) is that obese people get worse _everything_. I expected to have an easier time talking to the opposite sex when I lost weight, and this ended up being true. I had no idea how much better talking to everyone else would be. In customer-business interactions, job interviews, and really eve…

Having been obese in the past as well, I can confirm some of your experience. However, to be honest, I don't see it as a form of negative prejudice. It's a completely reasonable prejudice. You can only become obese due to some very critical character flaw. For example: inability to delay gratification, lusting over immediate pleasures, inability to make plans and stick to them, inability to read social cues telling y…

> You can only become obese due to some very critical character flaw.

Maybe in some alternate universe. In this universe, you can get obese by, among other things:

- untreated hypothyroidism (even low grade)

- certain autoimmune diseases including type 1 diabetes

- inborn errors of metabolism

- having parents consistently overfeed you at youth

None of the above is a character flaw.

Re: Why Do Obese Patients Get Worse Care? Many Doctors Don't See Past the Fat

#94
post #45
post #37

Earlier quoted context omitted.

Surgery isn't riskless. This source shows knee surgery has serious complications in 2% of cases. That's for all patients. But it states the risk of knee fracture is higher for overweight patients. http://www.zimmer.com/patients-caregivers/article/knee/knee-... Here's a source specific to overweight patients. Obesity is often comorbid with conditions that make it harder to heal and increase the risk of infection, such…

From the article: "But there should not be blanket refusals to operate on fat people, the committee wrote. Those with a body mass index over 40 — like a 5-foot-5-inch woman weighing 250 pounds or a 6-foot man weighing 300 — and who cannot lose weight should be informed that their risks are greater, but they should not be categorically dismissed, the group concluded." It's really simple. You can inform people of the i…

Article doesn't mention who pays for the increased cost to serve the morbidly obese. Replacing all the MRIs, Xray machines etc would be very expensive. Also added malpractice insurance as morbidly obese have more complications especially when it comes to anesthesiology as dosing is extremely hard to to get correct.

Re: Why Do Obese Patients Get Worse Care? Many Doctors Don't See Past the Fat

#95
post #64

My experience, having been both a very obese person (100 lbs overweight) an an almost normal-weight person (10ish pounds overweight) is that obese people get worse _everything_. I expected to have an easier time talking to the opposite sex when I lost weight, and this ended up being true. I had no idea how much better talking to everyone else would be. In customer-business interactions, job interviews, and really eve…

Having been obese in the past as well, I can confirm some of your experience. However, to be honest, I don't see it as a form of negative prejudice. It's a completely reasonable prejudice. You can only become obese due to some very critical character flaw. For example: inability to delay gratification, lusting over immediate pleasures, inability to make plans and stick to them, inability to read social cues telling y…

> inability to read social cues telling you to stop gaining weight

This one is going the way of the dodo of late, especially for females. Articles like this one are a symptom of the normalization of obesity.

Re: Why Do Obese Patients Get Worse Care? Many Doctors Don't See Past the Fat

#96
Irrespective of the article, the comments in here are appalling. Ask yourself if it's truly acceptable to paint big people with such a broad brush. HN commenters are generally liberal, and liberals (I am one as well, this is not an insult) will fall over themselves to decry real or perceived discrimination against women, minorities, or disabled people - unless that disability happens to be obesity. Would these comments be acceptable if the subject was some other class of people receiving inadequate care?

I'm a big guy. I've been big for 2/3 of my life. It fluctuates up and down as I've tried everything in the book to lose weight. I would _love_ to lose weight. I hate being fat. It causes numerous physical problems and complicates everything I do. Most big people I know are in the same boat. It's not fun carrying the extra weight around with you, or trying to fit in airline seats (I've given up), or being uncomfortable in your own skin, or looking in the mirror every day and hating what you see. I know my weight is unhealthy. I promise you the vast, vast majority of big people are similarly aware. Do you think if we could lose the weight as you say that we would not? That we'd willingly stay this way?

Calling big people weak willed, revolting, or undeserving of medical care is unacceptable. I am not a Healthy At Every Size activist. You know nothing of why these people are big. You don't know what they've tried or why they stay this way. You don't know their struggles and what they've gone through. Please stop making value judgements on other human beings based on their physical dimensions.

Re: Why Do Obese Patients Get Worse Care? Many Doctors Don't See Past the Fat

#97
post #76

Earlier quoted context omitted.

Obesity is an actual condition. Being athletic is not a medical condition.

Obesity is a descriptor of somebody's physical state. It's not technically a disease. Your physical state is your medical condition. So, being athletic is an important piece of medical information. Athletes are at risk for some things that non-athletic people are not.

A descriptor of physical state is not mutually exclusive with condition. In fact a condition is almost always a description of a body's physical state.

Re: Why Do Obese Patients Get Worse Care? Many Doctors Don't See Past the Fat

#98

I'm disappointed by the lack of empathy in these comments. While I agree that yes, an obese person needs to lose weight, telling them that and offering no other help is like telling someone with depression "why don't you just cheer up?" It's totally unuseful advice that incorporate all sorts of gross value judgments about the person. It doesn't solve problems. I've been overweight - not obese, but close at times - al…

Don't assume that because it's easy for you to be fit and skinny, it's easy for everyone. I'm neither fit nor skinny. I am empathetic, what I am NOT is sympathetic. I have a problem, and I need to fix it. I'm working on it. But even when I'm not, I understand that my health problems are and will be primarily weight related. I actually sort of resent the comparison between "why don't you just cheer up?" and "oh, just…

> I actually sort of resent the comparison between "why don't you just cheer up?" and "oh, just lose weight." Everyone understands that weight loss is diet and exercise, even if they've never have to do it. Most people don't understand that depression isn't just an extra long bit of being bummed out, let alone the resources a person might need to overcome depression.

> I am empathetic, what I am NOT is sympathetic. I have a problem, and I need to fix it.

That's a healthy outlook for you to have. It's the one I have, too. The people we need to have sympathy/empathy for, though, are the people who haven't gotten there yet. I imagine there was a time for you where you hadn't reached the point of understanding your problem, for any of the various reasons of shame, denial, anger, blaming others, etc.

There are a lot of people in that boat. What I think commenters here don't understand isn't that weight loss is relatively straightforward, it's that straightforward things aren't always easy, and that preparing oneself to do something difficult is hard, even if that difficult thing has clear steps to take.

Given that other people have pointed out the same vagueness in my comparison to depression, maybe it wasn't the best one to make. I will think on a different one for next time. I do think that, given the above, it makes my point though.

Re: Why Do Obese Patients Get Worse Care? Many Doctors Don't See Past the Fat

#99
post #64

Earlier quoted context omitted.

Having been obese in the past as well, I can confirm some of your experience. However, to be honest, I don't see it as a form of negative prejudice. It's a completely reasonable prejudice. You can only become obese due to some very critical character flaw. For example: inability to delay gratification, lusting over immediate pleasures, inability to make plans and stick to them, inability to read social cues telling y…

> You can only become obese due to some very critical character flaw. Maybe in some alternate universe. In this universe, you can get obese by, among other things: - untreated hypothyroidism (even low grade) - certain autoimmune diseases including type 1 diabetes - inborn errors of metabolism - having parents consistently overfeed you at youth None of the above is a character flaw.

The first 3 examples you give can all be handled with self-discipline. Only the 4th must be learned.

Re: Why Do Obese Patients Get Worse Care? Many Doctors Don't See Past the Fat

#100

Earlier quoted context omitted.

Media is big on controversy and always has been. The controversy doesn't matter.

Why isn't media big on the controversy on a the pro-personal responsibility side of things? As far as I can tell it panders to fat rights groups uncritically. I think pretending this bias doesn't exist is being generous towards the real media bias that surrounds us. There's no debate here. Its clear obesity and surgical outcomes are linked. Doctors aren't "discriminating" here. Lets stop the leftist nonsense as it co…

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