Post by downtoearth on Sept 19, 2018 9:53:56 GMT -5
Not done yet, but the irony in what this one physician who studies obesity is crazy.
Not all physicians set out to denigrate their fat patients, of course; some of them do damage because of subtler, more unconscious biases. Most doctors, for example, are fit — “If you go to an obesity conference, good luck trying to get a treadmill at 5 a.m.,” Dushay says—and have spent more than a decade of their lives in the high-stakes, high - stress bubble of medical schools.
Gah. One part of the article brings to mind an incredibly offensive gyno appointment I had a few years ago.
_While_ doing the pap smear, the ob/gyn tried to sell me on their clinic's weight loss program (meal replacement/extreme caloric deficit diet). I can't describe the combination of fury and embarrassment and other emotions that caused. That clinic is considered the best ob/gyn in the area.
Yup, I'm fat. Morbidly obese. I am slowly coming to terms with the fact that I will always be fat. This article is echoing a lot of experiences I have personally had.
I am just so mentally and emotionally exhausted from it all. It feels like a constant battle to keep the mental energy to make "healthy" choices when all of society wants to tell you what a worthless piece of shit you are for even existing. God forbid an obese person have the audacity to feel good about themselves in any way. Society must stamp that down immediately or otherwise we are glorifying obesity and all of its horrible traits.
Post by claudiajean on Sept 19, 2018 10:13:45 GMT -5
I switched doctors three times before finding one who would take me seriously. I was so tired of hearing “if you would lose some weight, I think you would feel so much better” when I went in for anything. Including a sinus infection! I snapped at one doctorand said “I have an under active thyroid, PCOS, and eat 1200 calories a day while working out 4 times a week. What else should I be doing to try to lose weight to improve my sinus infection?” He apologized but I switched soon after.
Post by jackie011 on Sept 19, 2018 10:25:05 GMT -5
So many thoughts... A few years ago we kept getting EOBs denying DH’s doctor visits. DH figured it was legit, so he just figured he’d pay and not question it. I caught wind of this and called our insurance company. I was told each time “we don’t cover obesity.” WTF?? Even though DH went in for a sinus infection, the fact that the doctor discussed weight, and must have coded it as such, caused the whole appointment to be denied. Sooooo frustrating! DH has several weight related health issues and we’re all well aware that he is overweight, but he’s also a human being with other legitimate concerns.
Being fat is exhausting. I think about it all the time. Every social media post featuring an overweight person, regardless of what it is, is full of fat-shaming comments like just looking at the overweight person is ruining the commenter's life. Why is this okay?!
This was heartbreaking to read. This part stood out to me:
The most effective health interventions aren't actually health interventions—they are policies that ease the hardship of poverty and free up time for movement and play and parenting. Developing countries with higher wages for women have lower obesity rates, and lives are transformed when healthy food is made cheaper. A pilot program in Massachusetts that gave food stamp recipients an extra 30 cents for every $1 they spent on healthy food increased fruit and vegetable consumption by 26 percent. Policies like this are unlikely to affect our weight. They are almost certain, however, to significantly improve our health.
Why is this concept so difficult for policy makers and our government to understand?
I switched doctors because I had gone in to see my (thin) doctor a couple of times about sleeping poorly. I get crappy quality sleep basically daily, and I'm often tired, which makes it harder to work out and eat properly when you don't even want to get up from your chair, plus getting up early is tough when you didn't sleep well. Anyway, she basically told me to lose weight and exercise more. When I went back for a follow up and told her I had been doing well with working out 3 days a week, she told me to do 5.
Well, fine. But there was really no "that's fantastic, you are doing a great job" sort of thing. Just basically a "well that's not enough so do more". That's not the only reason I switched, but it really bugged me. My bloodwork is and has been fine. I realize this is a minimal comment compared to what many get, but it's so frustrating anyway. I have been fortunate to be generally healthy so I haven't had to push much, but hearing stories of how people with serious health issues are brushed off all the time just makes me so angry.
Post by claudiajean on Sept 19, 2018 10:43:12 GMT -5
Personally, I find it to be a cycle like so many other things. I’ll avoid going to the doctor because I hate being weighed and feel judged (even when the doctor hasn’t said or done anything to make me feel judged) and then my chronic conditions get worse, etc. We really need to change the way obese patients are treated at every level.
Post by lurkydoodle on Sept 19, 2018 10:51:01 GMT -5
I really thought I was doing great with my own personal body positivity, and then I read the part in this article that talked about going to birthday parties with your kids and not eating because of being worried that people are judging you/what you eat. Yep, totally did that this past Saturday. Sigh.
This was heartbreaking to read. This part stood out to me:
The most effective health interventions aren't actually health interventions—they are policies that ease the hardship of poverty and free up time for movement and play and parenting. Developing countries with higher wages for women have lower obesity rates, and lives are transformed when healthy food is made cheaper. A pilot program in Massachusetts that gave food stamp recipients an extra 30 cents for every $1 they spent on healthy food increased fruit and vegetable consumption by 26 percent. Policies like this are unlikely to affect our weight. They are almost certain, however, to significantly improve our health.
Why is this concept so difficult for policy makers and our government to understand?
They understand it — they just don’t want to pay for it. Because bootstraps.
I am just so mentally and emotionally exhausted from it all.
This bolded is what I get the most so far (still reading since I'm busy at work today). I honestly think that the mental work of trying to be okay in your own skin while you constantly get medical professionals and society telling you that your body is "wrong" - consciously or subconsciously is making this WAY worse. Your sentiment is powerful and repeated in the article:
“Your conscious mind is busy the whole day with how many calories is in everything, what you can eat and who’s watching,” she says. After a few intrusive comments over the years—should you be eating that?—she has learned to be careful, to perform the role of the impeccable fat person.
Post by downtoearth on Sept 19, 2018 11:43:38 GMT -5
Not only does the stress of worry and anxiety about social situations, medical stress, and dieting cause cortisol to release making your body unable to process normally...
And, in a cruel twist, one effect of weight bias is that it actually makes you eat more. The stress hormone cortisol—the one evolution designed to kick in when you’re being chased by a tiger or, it turns out, rejected for your looks—increases appetite, reduces the will to exercise and even improves the taste of food.
...but being in white spaces does the same (and causes medical conditions to occur or worsen) for people who aren't white:
The effects of weight bias get worse when they’re layered on top of other types of discrimination. A 2012 study found that African-American women are more likely to become depressed after internalizing weight stigma than white women. Hispanic and black teenagers also have significantly higher rates of bulimia. And, in a remarkable finding, rich people of color have higher rates of cardiovascular disease than poor people of color—the opposite of what happens with white people. One explanation is that navigating increasingly white spaces, and increasingly higher stakes, exerts stress on racial minorities that, over time, makes them more susceptible to heart problems.
Personally, I find it to be a cycle like so many other things. I’ll avoid going to the doctor because I hate being weighed and feel judged (even when the doctor hasn’t said or done anything to make me feel judged) and then my chronic conditions get worse, etc. We really need to change the way obese patients are treated at every level.
Post by Jalapeñomel on Sept 19, 2018 12:01:33 GMT -5
The pressure around being fat insurmountable. My heart goes out to those who are dismissed and/or treated like second class citizens by their doctors (and society).
I do take pause at articles saying that the medical community has the ability to fix medical issues but choose not to. This is a slippery slope with conspiracy folks regarding medical conditions/diagnoses/vaccines etc. maybe I misread it so I will go back and reread.
The pressure around being fat insurmountable. My heart goes out to those who are dismissed and/or treated like second class citizens by their doctors (and society).
I do take pause at articles saying that the medical community has the ability to fix medical issues but choose not to. This is a slippery slope with conspiracy folks regarding medical conditions/diagnoses/vaccines etc. maybe I misread it so I will go back and reread.
I think, like most things, a few people have the knowledge to fix these issues, but they don’t have the power to do anything about it, and those who can do something about it don’t have the information.
Doctors are in a great position to inform change on this issue, but they don’t get the education they need to help patients. And those who haven’t struggled with weight might only tell patients to “diet and exercise” because that’s the limit of their understanding of the subject of obesity.
Our lawmakers don’t give a shit about fat people, so they aren’t going to dump any money into research, and most of them have been paid off by the corn/wheat/whatever lobby anyway.
Non-fat people want to put individual responsibility on fat people, not on society, because they see obesity as a moral failing and something that can’t possibly be anyone else’s fault except for the fat person.
This whole article made me really angry and sad. I’m still processing it all. It definitely hit the nail on the head of a lot of the emotions I have surrounding my weight. But I still don’t see this problem going away.
Post by oregonpachey on Sept 19, 2018 12:41:16 GMT -5
This article makes me feel worse than I already do. I am dealing with my OB who I have had for damn near 20 years. He wants me to lose 50 pounds before he will do my tubal. Gee thanks.
I am tired. Tired of being fat but also tired of being treated like crap for being fat.
The pressure around being fat insurmountable. My heart goes out to those who are dismissed and/or treated like second class citizens by their doctors (and society).
I do take pause at articles saying that the medical community has the ability to fix medical issues but choose not to. This is a slippery slope with conspiracy folks regarding medical conditions/diagnoses/vaccines etc. maybe I misread it so I will go back and reread.
I agree with your point about the medical community. I do think most doctors are well meaning and wouldn't choose not to help people if they were able to. It's not exactly the same thing as saying "we know how to fix obesity and we're choosing not to". I think nobody really knows exactly how to fix the obesity issue - if it was as simple as having a cure, I would hope it would be shared (like the scurvy example).
I think what they are doing, instead, is blaming obesity for a lot of things that aren't obesity related. And ignoring all the other surrounding circumstances that contribute to medical issues (excluding AND including obesity). They are looking at patients and saying "you're fat, go on a diet and then we can talk about what else is going on". When there is a lot of evidence to the contrary - that maybe it's not just being fat that is an issue and maybe they should not focus on that.
Post by minionkevin on Sept 19, 2018 13:04:44 GMT -5
This article... it hit hard and I’m still processing it. But one thing that still puzzles me is our reliance on BMI as a one-size-fits-all metric. I have a mid-20s something coworker. Super thin, to me. Male, a hair under 6’ tall, 190-195lb depending on the day, says he wears size medium shirts and 30x32 pants. Recently went to the doctor for a minor issue and got the “overweight” talk bc his BMI is literally 25.something. He is among the thinnest people I know. He weighs less than I do. Yes I know vanity sizing even for men is a thing so maybe he’s more of a 32” waist IRL, but he is in amazing shape, and was actually trying to GAIN weight before this. Now he’s concerned, which is hilarious that he came to me bc I have been overweight since I was, like, 10, but it really confused me. If this actually healthy person - works out religiously, eats healthy food (mostly), doesn’t consume alcohol - is considered overweight, what chance does an actually overweight/obese person have?
This statistic is just so depressing: Chances of a woman classified as obese achieving a normal weight: .008%
I've lost 90 lbs over the last 15 months, and am a normal healthy weight for the first time in forever. However, I know the rest of my life will be a struggle to keep it off. This article confirms what my doctor has told me. My body will be fighting me forever, in an effort to regain the weight. Why does this have to be so hard?!?!?!
Not done yet, but the irony in what this one physician who studies obesity is crazy.
Not all physicians set out to denigrate their fat patients, of course; some of them do damage because of subtler, more unconscious biases. Most doctors, for example, are fit — “If you go to an obesity conference, good luck trying to get a treadmill at 5 a.m.,” Dushay says—and have spent more than a decade of their lives in the high-stakes, high - stress bubble of medical schools.
This is why I couldn’t keep seeing a nutritionist back in my 20s. I have an abnormally low resting metabolic rate and really struggled with how to adapt to it. It was like talking to someone from a completely different planet. It’s a specialty filled with people obsessed with food in a completely academic way. We weren’t going to get each other.
(I fully expect someone to come in here and stan for nutritionists lol.)
Parts of the article hit hard. I can't recall my weight ever being discussed in a medical setting but I do know I was always concerned it would come up when I was in the obese range. The being mentally exhausted part really got to me because when I started on this weight loss journey I would have mini break downs about how this had to be my life forever and a few years in, I was correct. It is my life and it's not easy to maintain at all.
“Your conscious mind is busy the whole day with how many calories is in everything, what you can eat and who’s watching,”
^^^ that right there is my daily life and when I let myself drift away too much I'm up in weight and it's not gradual gain. My body feels like it holds onto everything it can. It's a mental drain and daily struggle. There are days when it's no big deal for me to follow a nutrition plan or workout but then the parties happen, the weekend gatherings, food at work, etc and then I have to start trying to figure out how to tackle that with workouts and food.
Post by claudiajean on Sept 19, 2018 13:32:34 GMT -5
I also have never had a doctor accuse me of lying about any other issue the way they do about diet and exercise.
My endocrinologist doesn’t ask me if I’m taking my meds and then say “are you sure you’re really taking them?” When I fell my gyno when my most recent period is, she’s never said “are you sure you aren’t forgetting to write one down?” Yet I’ve had multiple doctors look at my food/exercise journals and imply I’m leaving things out. Because if what I’m telling them is accurate, there might be a medical reason for my weight and not “lazy and gluttonous” like they wish to assume.
This statistic is just so depressing: Chances of a woman classified as obese achieving a normal weight: .008%
I've lost 90 lbs over the last 15 months, and am a normal healthy weight for the first time in forever. However, I know the rest of my life will be a struggle to keep it off. This article confirms what my doctor has told me. My body will be fighting me forever, in an effort to regain the weight. Why does this have to be so hard?!?!?!
And we know how hard weight loss is to maintain, so....what's the answer to that?
I found this article frustrating, because it really doesn't give any answers.
This article... it hit hard and I’m still processing it. But one thing that still puzzles me is our reliance on BMI as a one-size-fits-all metric. I have a mid-20s something coworker. Super thin, to me. Male, a hair under 6’ tall, 190-195lb depending on the day, says he wears size medium shirts and 30x32 pants. Recently went to the doctor for a minor issue and got the “overweight” talk bc his BMI is literally 25.something. He is among the thinnest people I know. He weighs less than I do. Yes I know vanity sizing even for men is a thing so maybe he’s more of a 32” waist IRL, but he is in amazing shape, and was actually trying to GAIN weight before this. Now he’s concerned, which is hilarious that he came to me bc I have been overweight since I was, like, 10, but it really confused me. If this actually healthy person - works out religiously, eats healthy food (mostly), doesn’t consume alcohol - is considered overweight, what chance does an actually overweight/obese person have?
BMI is pure crap. I won’t see doctors that even mention it because it’s so outdated and not helpful. There is a study where adults that were in the overweight category of BMI lived the longest. So what’s the point of it if people in the “normal” category aren’t living the longest. Overall health isn’t factored into BMI at all. thescienceexplorer.com/brain-and-body/overweight-people-actually-tend-live-longer-normal-weight-individuals
I also have never had a doctor accuse me of lying about any other issue the way they do about diet and exercise.
My endocrinologist doesn’t ask me if I’m taking my meds and then say “are you sure you’re really taking them?” When I fell my gyno when my most recent period is, she’s never said “are you sure you aren’t forgetting to write one down?” Yet I’ve had multiple doctors look at my food/exercise journals and imply I’m leaving things out. Because if what I’m telling them is accurate, there might be a medical reason for my weight and not “lazy and gluttonous” like they wish to assume.
Next time a doctor says this to me I'm asking about meds. This is so so true.