Why We Hate Fat Patients

Why We Hate Fat Patients
Carl Streed Jr, Medical Student, 10:14AM Oct 6, 2012

"This one's a porker."-Surgery Attending

The patient had just been anaesthetised when the attending, a senior gentleman, pinched the patient's stomach and commented about her weight. It was my first time in the OR, many months ago, and I recall being shocked by what I'd just witnessed and heard. Paralyzed to act in that way all too common for medical students, bottom of the totem pole and all, I remained silent.

Recently, during a surgical oncology case, the patient was sitting on the bed preparing to be anaesthetised and said, "I'm sorry I let myself get this way;" she was referring to her 35+ BMI (reminding me of What's Eating Gilbert Grape--"I wasn't always this way'). Sadly, the patient's apology fell on deaf ears as the residents' sighed about how much subcutaneous fat they had to go through to reach the ovarian mass.

"...almost two in three adults are overweight or obese, and diseases caused by obesity cost Americans $145 billion last year...?"

There are plenty of studies out that connect obesity with disease (eg diabetes mellitus type II, cardiovascular disease, colon cancer, et cetera), and we all know the number of adults and children who are considered overweight or obese continues to grow. Yet, the way we talk to patients, or about patients, does not seem to be motivated by statistics and prospective studies. Medical professionals, which I now count myself among, talk about their overwieght and obese patients from a place of disgust.

"How could they let themselves get that way?" or

"They're eating themselves to death!" or

"I'm sorry about your weight."

Do I want people to be healthy? Yes. Do I think being obese is a danger to one's health? Yes. Do I think degrading patients, demonizing their bodies, and finding them morally reprehensible for having a BMI over 25 will help them? Emphatically no.

There are a million different kinds of fat people in the world because FAT PEOPLE ARE PEOPLE. And kids are people. And if your solution to this "problem" is telling already vulnerable fat kids that they're an epidemic that's ruining the world, then **** you. Try harder.

We have to try harder and stop hating our patients.

-----------------------------------

This post only scratches the surface of this issue. The "obesity epidemic" is multifaceted, and to think there is one solution is naive.

Disclaimer: I reached a BMI of 32 in my youth before plummeting to below 25. I experienced and continue to experience the psychological slings & arrows of peers and the medical profession for my weight.

Overeating is an addiction.

Overeating is an addiction.

I think that there are a lot of people who eat when they are depressed, and the food gives temporary relief, but then the weight gain leads to further depression.

Exercise is the answer. It gives the lift that is needed so badly, but unlike food, it doesn't lead to further depression. It alleviates it.

wishandaprayer

wishandaprayer wrote:

Overeating is an addiction.

I think that there are a lot of people who eat when they are depressed, and the food gives temporary relief, but then the weight gain leads to further depression.

Exercise is the answer. It gives the lift that is needed so badly, but unlike food, it doesn't lead to further depression. It alleviates it.

It doesn't give everybody a lift. I worked out two-three times a week for six months. I never once...not one single time felt anything like a lift. All I ever got was sore and tired.

Katherine wrote: It doesn't

Katherine wrote:

It doesn't give everybody a lift. I worked out two-three times a week for six months. I never once...not one single time felt anything like a lift. All I ever got was sore and tired.

Were you depressed?

wishandaprayer

wishandaprayer wrote:
Katherine wrote:

It doesn't give everybody a lift. I worked out two-three times a week for six months. I never once...not one single time felt anything like a lift. All I ever got was sore and tired.

Were you depressed?

.

What makes you happy?

What makes you happy?

Science says we fatties

Science says we fatties are missing a chemical called leptin that is excreted when the body says we have had enough . So we keep on going till our trousers burst.

Sugar is an addiction .

wishandaprayer wrote: What

wishandaprayer wrote:

What makes you happy?

Puppies, kittens, and prozac. Smiling

Katherine

Katherine wrote:
wishandaprayer wrote:

What makes you happy?

Puppies, kittens, and prozac. Smiling

Dig further and maybe you'll find your key to happiness. Smiling

Personally, the feeling that I get AFTER I finish exercising, is a wonderful feeling, and there are times when I enjoy it too (elliptical with good country music), but it's that bloody mountain that I have to climb to get there.

I really feel for children with weight problems as I was one of them. There weren't too many of us back in my day, and that made it more emotionally difficult. But, I found consolation in food.

And my mother always said that if they were talking about me, they were talking about their betters. And, then, no doubt, she would give me a little treat to make me feel better - like any good mother would. Eye-wink

I believe that if I had been taken out of my environment where food was used for love and entertainment, and given adequate amounts of good food to keep my blood glucose levels steady, and given plenty of options for FUN activites, then my weight problem would have disappeared as a child.

It did pretty well disappear when I was a teenager, because I took myself out of my environment, making new friends, ice skating, walking/hiking, swimming, dancing, etc.

Today, I have to be careful not to sit at my computer too long and buy the popchips in little bags, rather than the big bags. I am, once again, too scared to get on the scale.

I just hope that I don't need surgery.

So everyone's like you eh??

So everyone's like you eh?? Addictions are, clinically speaking a way to comfort oneself. Anything can be an addiction including all those endorphin's from exercising. Yes exercise is helpful; yes many folks are depressed; yes our kids get lousy food choices these days, both at home and in school. AND all addictions are a form of self-comforting. Learn ways to get your patients to acknowledge this and they may be able to make healthier choices...knowledge is power. Patients need to feel empowered to begin to make healthier food choices and life-style changes.

I never really thought of an

I never really thought of an addiction that way before; I thought that it could be caused from trying to take your mind off of something painful; physically or emotionally.

But that really does simplify it.

And for me it highlights the necessity of making a list of things to do which bring you happiness, and substituting that activity in order to comfort yourself, and hopefully make your addiction go into remission.

Perhaps it could even make your fat and/or your depression go into remission.

You've got nothing to lose and everything to gain, including taking your life back.

I think, rather than focusing

I think, rather than focusing on size, we need to focus on whether patients are practicing healthy habits. We all know the tiny person that can live off Cheetos and beer and not gain any weight. We still have a long way to go to truly understand how nutrition works and how best to feed our bodies. I have a BMI over 30something and I don't really care, because my blood work always comes back great. Just because there is a correlation between obesity and diseases doesn't mean there is causation. That's like saying "sometimes people who get on elevators DIE." Well. Yes. So do people who don't get on elevators. There's something else at work here. Studies have shown repeatedly that 95% of people that deliberately lose weight gain it back, that weight-cycling is worse for the body than simply being healthy and fat, and that one of the bigger causes of these diseases is stress. I would think that the rampant societal stigma of fatness is pretty stressful.

So, keep on keepin on, Good Doctor. Thanks for not hating the fatties. You seem to be one of those doctors that when presented with a "cure" that only works 5% of the time thinks it's a crappy cure. That's pretty awesome! Smiling

Some people are not heavy or

Some people are not heavy or obese because they are addicted to food. Sometimes a person can become obese due to physical limitations. It can creep up on you and before you realize it you have gained too much weight. Personally, I was not obese until my back was hurt in a car accident. That very quickly curtailed my physical activities and I gained weight. I don't like it and I can tell you "no one grows up thinking I want to be an obese adult". I am not depressed now, but I take anti-depressants. My physical activity is very limited due to constant pain. I am fighting for all I am worth to lose my excess weight. Exercise is still a challenge for me. It's a viscous circle. I need back surgery, but I cannot have the back surgery until I lose my weight. Cortisone shots are helping with the pain. Exercise is still very painful for me due to my back. I have tried other avenues to break the circle. I have had a vertical sleeve gastrectomy and still lost nothing. Another doctor has helped me and I now take phentermine and have lost 55 pounds in 4 months.

Please do not judge people too harshly until you have walked a mile in their shoes.

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