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

nytimes.com

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

#161

Post by hasenj »

jtuente wrote: post #95
hasenj wrote: 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…

> 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.

Which further proves how common this character flaw is.

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

#162

Post by scarface74 »

imagist wrote: post #33
lsy wrote: post #20

Earlier quoted context omitted.

This seems like an unfair characterization of the article. Denial of care, or dangerously mismeasured care, is not acceptable simply based on BMI (a non-scientific measure invented in the early 1800s). If you look at the statistics on weight loss success rates, asking a 500lbs person to lose 200+lbs before you're willing to treat their disease with actual evidence-based medicine—looking at symptoms, pathology, etc—is…

> Denial of care, or dangerously mismeasured care, is not acceptable simply based on BMI (a non-scientific measure invented in the early 1800s). How did you conclude that BMI is non-scientific? Did you know that Centigrade was invented in the early 1800s, and the first realization of the metric system was in 1799? BMI definitely isn't accurate for people with high lean body mass, but the patients in this article aren…

When I was in the best shape of my adult life, I weighed 175, with 10% body fat (measured with calipers) and a size 30 waist. I wasn't overly into lifting weights but did a lot of cardio. My BMI was 30 - obese.

5 years later. I do about 3 hours of cardio a week, I weigh 185 and my waist is about 32. My BMI is 31.8. No doctor has ever looked at me and said I need to lose weight.

BMI is completely bunk in my case.

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

#163

Post by hasenj »

jakebasile wrote: post #148
hasenj wrote: post #112

Earlier quoted context omitted.

Why is it the doctor's obligation to provide her with a scale for her size? Why can't she buy one herself?

Because she is paying the doctor for medical care, either directly or indirectly through insurance. Because the doctor has taken some form of oath to do no harm, and to take every measure necessary to treat a patient, and to have empathy and sympathy for the sick. Because she is a human being who deserves medical care.

Did she pay the doctor for an extra extra extra large scale?

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

#164

Post by jakebasile »

hasenj wrote: post #163
jakebasile wrote: post #148

Earlier quoted context omitted.

Because she is paying the doctor for medical care, either directly or indirectly through insurance. Because the doctor has taken some form of oath to do no harm, and to take every measure necessary to treat a patient, and to have empathy and sympathy for the sick. Because she is a human being who deserves medical care.

Did she pay the doctor for an extra extra extra large scale?

What the fuck does that have to do with receiving medical care? A heart patient pays for medical care and gets the use of an EKG. An obese patient deserves the same level of care.

I guess the oath to heal the sick doesn't matter if that person happens to be big. They don't really deserve to live anyways, they're just weak, right?

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

#165

Post by jakebasile »

hasenj wrote: post #159
jakebasile wrote: post #155

Earlier quoted context omitted.

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.

"The thing is, no one can help people through bipolar disorder. Only you can help you do it. Unless you make a decision to endure suicidal ideation everyday, it will not happen."

I'm not asking for special treatment, I'm asking to be treated like a human being who deserves dignity and life.

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

#166

Post by jlarocco »

jakebasile wrote: post #55
jlarocco wrote: post #17

Earlier quoted context omitted.

And when those people go to the doctor with complaints related to not taking care of themselves, the doctors tell them they need to stop drinking, smoking, or whatever. Why would obesity be any different?

Telling them to correct the initial cause is wholly different than not treating the symptoms or not mitigating damage because "they don't deserve it" or "they can't even take care of themselves".

I'm not sure it has anything to do with the patient "deserving it" or not. Nobody wants to put effort into something when somebody else is actively working against it.

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

#167

Post by halostatue »

imagist wrote: post #33
lsy wrote: post #20

Earlier quoted context omitted.

This seems like an unfair characterization of the article. Denial of care, or dangerously mismeasured care, is not acceptable simply based on BMI (a non-scientific measure invented in the early 1800s). If you look at the statistics on weight loss success rates, asking a 500lbs person to lose 200+lbs before you're willing to treat their disease with actual evidence-based medicine—looking at symptoms, pathology, etc—is…

> Denial of care, or dangerously mismeasured care, is not acceptable simply based on BMI (a non-scientific measure invented in the early 1800s). How did you conclude that BMI is non-scientific? Did you know that Centigrade was invented in the early 1800s, and the first realization of the metric system was in 1799? BMI definitely isn't accurate for people with high lean body mass, but the patients in this article aren…

Most of the people that I know who have needed hip or knee surgery are thinner people. One’s occupation and/or recreation activities are far more likely to have an impact on whether you need knee surgery than one’s mass (one gentleman I know who had to have both knees replaced was at most 65 kilo and about 165cm—140lb and 5'5"—but had played tennis all his life and had a job which required using his knees often).

I know, anecdotes are not data, but there is essentially no data that supports the claims made about BMI, and there are known measurements that are more effective than this grossly ineffective ratio that is loved pretty much only by insurance underwriters.

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

#168

Post by jakebasile »

whamlastxmas wrote: post #124
jakebasile wrote: post #111

Earlier quoted context omitted.

Yes, the majority has investigated the majority and found the majority not guilty of discrimination. Please tell me more about how you know that big people aren't discriminated against.

I would if it wasn't the equivalent of talking to a child with hands over their ears yelling "LALALALALLALA"

You got me, I'm just ignoring your mountains of evidence.

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

#169

Post by vonmoltke »

lsy wrote: post #105
asynchronous13 wrote: post #74

Earlier quoted context omitted.

"But there should not be blanket refusals to operate on fat people" I don't know anyone who would disagree with this sentiment. And the article doesn't present any evidence that there are blanket refusals. Sure, the article presents a few anecdotes, but that's not enough to show that blanket refusals are happening on a larger scale. > You can inform people of the increased risks and possible outcomes and let them mak…

From the article: "A recent survey of more than 700 hip and knee surgeons confirmed Dr. Yates’s impressions. Sixty-two percent said they used body mass index scores as cutoffs for requiring weight loss before offering surgery." It sounds to me like "cutoffs" and "requiring" would indicate a blanket refusal, and 62% seems like a fairly large scale to me. What evidence are you looking for? Other common conditions can a…

Some aren't. Patients with severe hypertension, for instance, are often categorically denied non-critical surgeries as well.

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

#170

Post by imagist »

scarface74 wrote: post #162
imagist wrote: post #33

Earlier quoted context omitted.

> Denial of care, or dangerously mismeasured care, is not acceptable simply based on BMI (a non-scientific measure invented in the early 1800s). How did you conclude that BMI is non-scientific? Did you know that Centigrade was invented in the early 1800s, and the first realization of the metric system was in 1799? BMI definitely isn't accurate for people with high lean body mass, but the patients in this article aren…

When I was in the best shape of my adult life, I weighed 175, with 10% body fat (measured with calipers) and a size 30 waist. I wasn't overly into lifting weights but did a lot of cardio. My BMI was 30 - obese. 5 years later. I do about 3 hours of cardio a week, I weigh 185 and my waist is about 32. My BMI is 31.8. No doctor has ever looked at me and said I need to lose weight. BMI is completely bunk in my case.

1. It's true that BMI doesn't provide a complete picture of a healthy fat percentage, but weight and waist measurements provide even less information, so I'm not sure why you would present that information as if it contributed to your point.

2. Caliper fat measurement is pretty accurate if done correctly, but it's also hard to do correctly.

3. In your own words, no doctor has ever looked at you and said you need to lose weight. This seems to indicate that while BMI isn't always an indicator of health, doctors are capable of identifying the exceptions.

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