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

nytimes.com

191–200 of 239 posts

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

#191
post #70

Earlier quoted context omitted.

> They aren't here to look pleasing to you So? GP is not here to indulge them either. To each his own. They can choose to indulge on food, it's their freedom, and he can choose to ignore them, it's his freedom.

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…

https://www.youtube.com/watch?v=bEchNTesu88

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

#192

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.

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 think that big people are discriminated against. I've experienced this in the workplace firsthand, where people were not hired for positions where their weight had no bearing on their ability to perform the job.

However, obesity does have real health implications, and as such, weight loss is an effective treatment for obese people presenting with a wide variety of health problems. Recommending weight loss when weight loss is a low-risk, effective way to treat the patient's condition isn't discrimination, it's just proper medical practice.

The actual study cited in the article which is being cited as showing systemic discrimination: "The group concluded that heavy patients should first be counseled to lose weight because a lower weight reduces stress on the joints and can alleviate pain without surgery." There were, of course, exceptions to the rule mentioned.

So yes, I do think that fat people are discriminated against, but I do not think that recommending weight loss as treatment to obese patients is an example of discrimination.

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

#193
> Be civil. Don't say things you wouldn't say in a face-to-face conversation. Avoid gratuitous negativity.

Much of the discussion in this thread does not meet this standard of discourse that we ask for on Hacker News. It's all too easy to respond reflexively (and thus with less likelihood of reaching this bar) when commenting on controversial issues, and while that might be OK elsewhere, it isn't here.

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

#194
post #188
post #158

Earlier quoted context omitted.

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…

Nice response. Instead of addressing anything I said, just make tenuous political metaphors and baseless claims of ignorance.

> It is genuinely sad.

It's ironic that you're using Trump as an example of bad argumentation, given that your styles are quite similar. "You're so sad. You're a slob. You're a mess." Etc. etc.

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

#195
post #189
post #158

Earlier quoted context omitted.

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.

I agree, society currently has unfortunate views towards food addiction.

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

#196

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.

Me too. I realize that I also painted with a broad brush there. I was admittedly getting pissed off.

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

#197

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 think that big people are discriminated against. I've experienced this in the workplace firsthand, where people were not hired for positions where their weight had no bearing on their ability to perform the job. However, obesity does have real health implications, and as such, weight loss is an effective treatment for obese people presenting with a wide variety of health problems. Recommending weight loss when weig…

I agree that recommending weight loss is not discrimination in and of itself. I think that refusing to explore other treatment options in tandem is wrong, and I think that the comments in here blaming big people for being big as if it's a moral failing are discriminatory and ignorant.

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

#198

Earlier quoted context omitted.

> 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 t…

Quite true

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

#199

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…

>Empathy is not a "fad," empathy is a basic human societal construct and a fundamental psychological building block.

I agree. But would you not also agree that "empathy" has become quite the buzzword recently? I have a hard time separating "empathy" from "Empathy."

And the people peddling "Empathy" seem to think if everyone was empathetic, we'd all come to the same set of conclusions. A very narrow set. I want off this train because I haven't found the right way to retool my lack of respect into the "Empathtic" vocabulary for strong disagreement. I think it involves uses the words "problematic" and "pernicious" quite a lot, but I don't care to find out.

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

#200
post #175

Earlier quoted context omitted.

"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.

Then ask the doctor to help you lose weight, instead of complaining that the doctor shouldn't advice you to lose weight. If a cure for bipolar disorder exist but a bipolar patient refused to take it because it hurts their self image, what do you presume the doctor should do?

Find another way to help the patient.
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