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

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

#151

Post by jakebasile » Mon, Sep 26, 2016, 5:13 PM UTC

hasenj wrote: post #64

CalRobert wrote: post #44

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 wave away so many reasons a person could be big and put them all into the "they are asking for it" box with a nice big bow. From your comments elsewhere you claim to have been big and since lost the weight. That's great for you. I wish you'd stop making yourself feel better by being vile towards others who haven't been able to make that change.

> No one wants to be around people who don't take care of themselves and ooze of negativity and desperation.

No one wants to be around hateful people like you.

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

#152

Post by jessaustin » Mon, Sep 26, 2016, 5:13 PM UTC

fjjrxcbdhx wrote: post #2

Coming from a family of medical doctors, medicine stands to gain a lot in terms of quality of service by increasingly automating doctors out of the loop. These people (my family members and relatives included) typically go into the profession for money and social status instead of helping patients, to the point where it borders on being exploitative.

I also have health care professionals in my family, and I've heard the phrase "shit through a pipe" used to refer to patients on multiple occasions. Doctors want to help, but primarily because helping is part of their job. If some aspect of a patient's situation makes the job harder, doctors respond just like anyone else does. They don't inherently care more about their customers than e.g. the wait staff at a restaurant.

ISTM that many of the complaints of fat people echo those of elderly people. The medical community has somewhat responded to those by creating the specialization of geriatric medicine. End-of-life care, especially for elderly patients in pain, still sucks, but they're trying to do better. When fat people have better politics, perhaps they'll be able to pressure the doctors into providing less egregiously poor care for them as well.

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

#153

Post by hasenj » Mon, Sep 26, 2016, 5:14 PM UTC

speeder wrote: post #146

hasenj wrote: post #138

Earlier quoted context omitted.

There's hardly any calories in your nails. You can supplement with specific vitamins and minerals for your nails and skin. You can supplement with protein and perform basic exercises to protect muscles (pushups, beginner level). Protecting hair is not a good excuse to not lose weight.

Are proteins calorieless? Right now my diet is already protein heavy. There is a way to force all my protein eaten to do protein job without a single bit of it being turned into calories for other purposes? EDIT: my questions were rethorical. I know proteins have calories, that is my whole point. even with a diet where I get only the macronutrients I need, my calorie intake is too high. Right now my lifestyle consist…

Combine it with healthy fats and healthy carbs.

Muscle loss is unavoidable. But you can't use it as an excuse to not lose weight. You just try to minimize it by having a balanced diet and performing some basic exercises.

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

#154

Post by dragonwriter » Mon, Sep 26, 2016, 5:15 PM UTC

JackFr wrote: post #57

dclowd9901 wrote: post #26

Earlier quoted context omitted.

But therein lies the problem: being overweight is so _unbelievably_ unhealthy that most problems would be resolved simply by losing the weight. And conversely, I don't think any doctor out there is refusing to treat a sinus infection because a patient is overweight.

As reported in the article, a patient who over the course of a week became unable to walk at all without shortness of breath. Her doctor told her to lose weight. The cause of the shortness of breath was blood clots on the lungs. And in my personal experience, my mother experienced precisely what you don't think ever happens. A sinus infection went untreated for weeks after repeated doctor visits. It is not that the d…

> As reported in the article, a patient who over the course of a week became unable to walk at all without shortness of breath. Her doctor told her to lose weight. The cause of the shortness of breath was blood clots on the lungs.

What some docs seem not to have learned is to ask the first question you learn to consider in tech support (and medicine is, in a sense, tech support for the human body) -- "what's changed?".

Unless the patient had a sudden and rapid change of weight that corresponds to the symptoms occurring, even if it is something whose onset was brought on by weight over time (or just made more likely by weight), its probably not the weight itself directly causing the symptoms, and if you don't properly diagnose the cause, you have no idea if losing weight is an appropriate remedy, irrelevant to the symptoms at hand, or something likely to cause changes in the body which exacerbate those symptoms.

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

#155

Post by jakebasile » Mon, Sep 26, 2016, 5:17 PM UTC

hasenj wrote: post #147

AstralStorm wrote: post #106

Earlier quoted context omitted.

Another person who thinks obesity is caused by solely overindulgence. Maybe next you would claim that people with movement disorders (e.g. in wheelchairs) are overweight because of overindulgence. Or maybe you will shift the blame to lack of exercise, not considering they would need multiple times more. Our maybe you will start designing diets for everyone that are trivial to adhere to and make millions as a life coa…

I used to be obese. I know what causes obesity. It basically does boil down to over indulgence. If you're in denial about that, I can see why you would be. It's no different than religious people denying science to protect their egos. However, your sensitivity does not warrant that others should indulge your delusions and fantasies.

I am in awe of your complete lack of empathy for other humans, and your ability to be so completely self righteous while dismissing their struggles.

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

#156

Post by hasenj » Mon, Sep 26, 2016, 5:17 PM UTC

dragonwriter wrote: post #130

jtuente wrote: post #127

Earlier quoted context omitted.

None of them cause weight gain, which is explicitly was the original comment was about, not disease treatment.

> None of them cause weight gain All three of them do cause weight gain, actually; that is, any medical treatment of them will list something like "weight gain or increased difficulty losing weight" as a symptom.

Weight gain cannot occur without consuming excess calories. Your body cannot defy physics. Your body cannot create energy out of thin air.

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

#157

Post by [deleted] » Mon, Sep 26, 2016, 5:18 PM UTC

speeder wrote: post #146

hasenj wrote: post #138

Earlier quoted context omitted.

There's hardly any calories in your nails. You can supplement with specific vitamins and minerals for your nails and skin. You can supplement with protein and perform basic exercises to protect muscles (pushups, beginner level). Protecting hair is not a good excuse to not lose weight.

Are proteins calorieless? Right now my diet is already protein heavy. There is a way to force all my protein eaten to do protein job without a single bit of it being turned into calories for other purposes? EDIT: my questions were rethorical. I know proteins have calories, that is my whole point. even with a diet where I get only the macronutrients I need, my calorie intake is too high. Right now my lifestyle consist…

[deleted]

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

#158

Post by wyager » Mon, Sep 26, 2016, 5:19 PM UTC

__jal wrote: post #39

wyager wrote: post #7

To be a bit blunt, the doctors are probably thinking "if you won't take care of your body, why should I?" If someone is so massively overweight that they need to use equipment intended for large animals or industrial scrap, they are putting themselves in an extremely precarious health situation.

So they don't prescribe statins, and just tell people to change their diets, yes? Hold back on insulin until those nasty diabetics stop gulping soda, even the thin ones? They tell people who do physical work to suck up the back pain, because they should have taken care of their body? Your needlessly weird comments about equipment betray your bias, as does your implicit belief that everyone who has a weight issue can…

On the less straw-man extreme, we also make alcoholics stop drinking before giving them organ transplants, and smokers have to quit before receiving a lung transplant. Medical care is a finite resource, especially in countries where it's publicly funded. We prioritize people who don't destroy their bodies because it's more likely that we'll diagnose them correctly and that a treatment will be successful. The article talks about people who have e.g. joint pain, which is almost certainly caused by their continuous obesity, rather than something like diabetes, which won't go away if they lose weight.

> Your needlessly weird comments about equipment betray your bias

What are you talking about? Did you even read the article? That's where I got those examples from.

> your implicit belief that everyone who has a weight issue can do something about it

You caught me; I believe in conservation of energy.

> this line of thinking runs looks pretty awful when applied to other medical conditions.

You clearly aren't familiar with how medicine actually works. Prioritization and triage are unfortunate facts of life.

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

#159

Post by hasenj » Mon, Sep 26, 2016, 5:22 PM UTC

jakebasile wrote: post #155

hasenj wrote: post #147

Earlier quoted context omitted.

I used to be obese. I know what causes obesity. It basically does boil down to over indulgence. If you're in denial about that, I can see why you would be. It's no different than religious people denying science to protect their egos. However, your sensitivity does not warrant that others should indulge your delusions and fantasies.

I am in awe of your complete lack of empathy for other humans, and your ability to be so completely self righteous while dismissing their struggles.

I'm only dismissing the fat logic that's being despersed everywhere here.

Losing weight is hard but that does not entitle obese people to special treatment.

The thing is, no one can help you lose weight. Only you can help you do it. Unless you make a decision to endure hunger everyday, it will not happen.

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

#160

Post by forgottenpass » Mon, Sep 26, 2016, 5:23 PM UTC

ivraatiems wrote: post #98

forgottenpass wrote: post #87

Earlier quoted context omitted.

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…

The people we need to have sympathy/empathy for, though, are the people who haven't gotten there yet.

Why though? Isn't sympathy towards people who "haven't gotten there yet" really fucking patronizing?

I'm not on this "empathy" bandwagon that has gotten popular in the last few years. It's really good at being unemphatic towards people the group has already decided not to like, so the whole thing reads as a sham.

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.

They're adults. I'll treat them with the civility I treat everyone. Beyond that? Fuck 'em.