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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

#181

Post by forgottenpass »

ivraatiems wrote: post #173
forgottenpass wrote: post #160

Earlier quoted context omitted.

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 i…

I'm not sure you understand what sympathy and empathy in this context are, or what the difference between them is. Sympathy is effectively just compassion. False "sympathy" like pity isn't what I'm asking for. Sympathy isn't a bad thing; treating someone with sympathy but not also with respect is a bad thing. Empathy is about putting yourself in somebody else's shoes. It's about asking yourself "how would I feel if I…

treating someone with sympathy but not also with respect is a bad thing.

OK, I think we're on the same page. I have no reason to respect that about them and don't.

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

#182

Post by ivraatiems »

forgottenpass wrote: post #181
ivraatiems wrote: post #173

Earlier quoted context omitted.

I'm not sure you understand what sympathy and empathy in this context are, or what the difference between them is. Sympathy is effectively just compassion. False "sympathy" like pity isn't what I'm asking for. Sympathy isn't a bad thing; treating someone with sympathy but not also with respect is a bad thing. Empathy is about putting yourself in somebody else's shoes. It's about asking yourself "how would I feel if I…

treating someone with sympathy but not also with respect is a bad thing. OK, I think we're on the same page. I have no reason to respect that about them and don't.

That means you haven't put in the time to develop a sense of empathy for them.

How can you claim to treat all people with basic civility, while at the same time admitting to disrespecting (and thus judging) something about a specific group of people on a mass level without trying to understand it?

I think you need to reevaluate how you treat this issue and the people who are affected by it.

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

#183

Post by CalRobert »

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…

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

To be fair, nobody wants to be around people who reek of judgment and pass off simple answers to complex problems like they're brilliant insights.

Anyway, you kind of proved my point, so thanks. Regardless, I should mention that I am the same person, with (I imagine) largely the same character, as I was before. I think my own issues had a lot to do with 1) the diet which Americans are encouraged to have, and 2) our built environment.

For the first, US culture has so drastically lost sight of what a proper portion is that many people genuinely don't know what a healthy portion is. When I was in my early 20's I had always been fed way too much, and my college meal plan was all you can eat and based on number of meals per week (encouraging someone to think they should take as much as possible). Coupled with that, the exercise people recommended was EXACTLY the wrong exercise for a heavy, self-loathing person. Running is AWFUL. Getting acquainted with the elliptical does help a lot (though exercise, while wonderful for general health, is of limited benefit for weight loss).

For the second, we have built our cities so that you get pretty much no exercise whatsoever in the course of a normal day. The walk from the parking lot to the store, the office, and home is what most people get.

Anyway, what worked for me was aggressively counting every single calorie I ate, living in a place where I could have a 7 mile round trip bike commute (with a brutal climb on the way home), and making meals that could still be big and filling but low calorie - mostly gigantic mountains of vegetables prepared without oil.

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

#184

Post by MOARDONGZPLZ »

speeder wrote: 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…

That's really interesting. How was your body able to continue to acquire the calories to gain more fat and eventually become obese with such strict controls on diet. Does the body a mechanism for drawing calories from the atmosphere?

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

#185

Post by CalRobert »

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.

In light of your past experience overcoming your indulgence, you may wish to take some time to recognize that a community of informed, helpful people (basically HN) is pointing out that you're indulging in arrogance and self righteousness, and you might consider applying the same self control that you used to overcome obesity to your other character flaws.

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

#186

Post by CalRobert »

jakebasile wrote: post #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 commen…

The Venn diagram of HN and liberal overlaps a lot, but more than that it also tends to skew towards the "young, hyper-confident (perhaps arrogant) male who thinks they can fix every problem and basically knows better than everyone else" set. I've known plenty of liberals who are aware that being an asshole isn't magically OK because you're being an asshole to fat people. I am one.

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

#187

Post by forgottenpass »

ivraatiems wrote: post #182
forgottenpass wrote: post #181

Earlier quoted context omitted.

treating someone with sympathy but not also with respect is a bad thing. OK, I think we're on the same page. I have no reason to respect that about them and don't.

That means you haven't put in the time to develop a sense of empathy for them. How can you claim to treat all people with basic civility, while at the same time admitting to disrespecting (and thus judging) something about a specific group of people on a mass level without trying to understand it? I think you need to reevaluate how you treat this issue and the people who are affected by it.

How can you claim to treat all people with basic civility

Civility, manners and etiquette are to show people you respect them when it isn’t obvious that you respect them – like when you don’t respect them.

And just because I don't respect them w/r/t their weight, doesn't mean I can't respect them at all.

without trying to understand it?

You assume that understanding would imply respect.

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

#188

Post by __jal »

wyager wrote: post #158
__jal wrote: post #39

Earlier quoted context omitted.

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…

Bluntly, this discussion makes it pretty clear that asking skinny technical people about medical obesity is pretty close to asking Donald Trump about how to solve crime: get more violent. If it doesn't work, you weren't violent enough. If it does, get more violent, because it is clearly working.

Change a few words and you're there. The ignorant certainty the arrogant dismissiveness that comes with it are breathtaking. It is genuinely sad.

> You clearly aren't familiar with how medicine actually works.

Physician, heal thyself.

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

#189

Post by DanBC »

wyager wrote: post #158
__jal wrote: post #39

Earlier quoted context omitted.

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…

> we also make alcoholics stop drinking before giving them organ transplants, and smokers have to quit before receiving a lung transplant.

That's done by providing alcohol treatment and smoking cessation, not telling them to just stop.

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

#190

Post by imagist »

dragonwriter wrote: post #135
whamlastxmas wrote: post #104

Earlier quoted context omitted.

The whole point of the majority of the conversation here is that there isn't systemic discrimination happening. People like to feel victimized and are claiming discrimination when it's overwhelmingly not the case, and dishonest articles like this do a huge disservice to the real, legitimate discrimination that does happen.

> The whole point of the majority of the conversation here is that there isn't systemic discrimination happening. Yes, the article links to research showing systematic discrimination here, and many people here are dismissing the possibility without addressing the research, acknowledging it is even referenced, or doing anything more than stating their firm belief that discrimination is not occurring. > People like to…

The study did not show systematic discrimination. It showed that obese patients presenting with hip and knee problems were systematically denied surgery in favor of weight loss as a treatment. There is a strong case to be made that weight loss is the proper treatment for those patients, given that weight loss is a much less risky treatment, and has positive side effects beyond treating the condition at hand.

For me to believe that recommending weight loss is discriminatory, you would have to show that weight loss isn't an effective treatment for obese patients presenting with hip and knee problems.

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