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Old 02-05-2012, 06:45 AM   #1 (permalink)
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Default Fat prejudice in Health Care

I'm a health professional and have had a few bad run-ins with doctors who seem to think that being overweight means you are also stupid. I've looked into this and discovered there are many, many people who have had doctors ignore their actual problems in lieu of telling them to lose weight. While acknowledging that there is a place for weight loss, I'm appalled at the implication that an overweight person must lose weight before other problems are taken seriously.
Happily, top public health programs have begun to study fat prejudice and how it interferes with care. If anyone feels like sharing experiences, I'd love to hear them, as well as any insights you have as to how it affected your own behavior and health.
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Old 02-05-2012, 08:23 AM   #2 (permalink)
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Unfortunately the doctors are probably right in many cases. Being overweight can have many affects on a persons overall health. Often times weightloss can turn around so many problems such as depression, stress, issues with many vital organs including the heart, bad cholesterol, blood sugar, aches & pains, sexual problems, etc, etc.

There's a reason why the obese cost the health industry more than people of a normal BMI. Same reason why a persons build is factored into life insurance premiums. A heavier person is more likely to have health issues that could affect their life span than that same person with a healthy BMI.

I DON'T think that doctors put enough emphasis on weight control. Being overweight has become "the norm" and is real epidemic in our society. People are living longer because of the advancement in medicine, not because they are taking better care of themselves. There is a drug to help many issues because it's easier to take a pill than it is to take responsibility for our weight.

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Old 02-05-2012, 10:35 AM   #3 (permalink)
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Default Wow.

So obese people don't have a right to have their medical issues addressed the way other people do? So it's appropriate to be demeaning toward people and reduce them to one aspect of their being? How exactly do those behaviors improve anyone's health?

I'm not sure on what you are basing the statements about health care costs but there is some disagreement on the matter. There are many assumptions made based on correlation rather than causality. The following book was pretty eye-opening for me:

Bringing up weight loss is an entirely different matter. Are you familiar with change theory? A person who wants to change, will. A person who is not ready, won't. A physician can provide education if needed and open the discussion but cannot make someone lose weight (which as I'm sure you know has a poor long term success rate and can lead to dangerous yo-yo fluctuations).

By the way, how much physician behavior do you witness? Because I was appalled by some of things I heard out of my attendings during medical school.

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Old 02-05-2012, 01:53 PM   #4 (permalink)
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I completely agree that there is discrimination based on weight, although I don't believe it's epicenter lies in the medical field, as it's abundantly practiced across the board. I was treated like a stupid person for years, while admittedly I did not have a firm intelligent grasp on how to control my weight, in almost every other aspect of my life I was either in complete control or ahead of the game. Somehow or another for society at large it is inconceivable that a short fat white girl with a cheerful disposition can also be very intelligent and resourceful beyond the norm. As a result I have been underestimated for the majority of my life.

I also agree with Mike, doctors do not stress weight loss enough. My own doctor has never once in 18 years mentioned it to me and it has been a factor the entire time. I did ask her about it and she basically said that she doesn't tell all her obese patients that they are obese because if she did, she wouldn't have any patients left. In essence it's bad for business. That might be changing, as the hospital system she works within is preparing some sort of "Healthy Lifestyle" program. I will say that although my doctor hasn't seemed to be prejudiced toward me for my weight, she has run all sorts of tests on me for conditions related to obesity, that I probably could have avoided with a lower weight.
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Old 02-05-2012, 03:53 PM   #5 (permalink)
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We don't have to agree, but don't put words in my mouth.

I can quickly see that you have a reading and comprehension problem, which is pathetic for someone that went to medical school. You obviously have an issue with reading or you would have known not to post a link spamming this website. That alone can & does usually result in being banned. Comprehension is not your strong point either... or you are trying to twist what I'm saying? Where did I say ANY of the following?
Quote:
Originally Posted by neurogrrl View Post
So obese people don't have a right to have their medical issues addressed the way other people do? So it's appropriate to be demeaning toward people and reduce them to one aspect of their being? How exactly do those behaviors improve anyone's health?
I didn't.

When it comes to health care costs...
Quote:
Originally Posted by neurogrrl View Post

I'm not sure on what you are basing the statements about health care costs but there is some disagreement on the matter. There are many assumptions made based on correlation rather than causality. The following book was pretty eye-opening for me:
I don't care what you've read in some book. Take a group of 200 people (100 of normal BMI and 100 of obese BMI). Run a battery of test on them all. Comprehensive blood work, EKG, stress test, BP, lung capacity test, etc. and the numbers will show that the obese group is in poorer health... WHICH DIRECTLY AFFECTS HEALTH CARE COSTS!

NEXT TIME YOU TRY TO CALL SOMEONE OUT, READ WHAT THEY ARE SAYING AND TAKE IT FOR FACE VALUE. ADDING TO SOMEONES STORY TO MAKE YOURS MORE INTERESTING IS B.S.!

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Old 02-05-2012, 04:10 PM   #6 (permalink)
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Well, it's not just BS it's poor debate skills. Whether or not it's intentional is always a matter of debate.

But in this case it's definitely insulting. Which is interesting because the OP is claiming being insulted by the healthcare industry.
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Old 02-06-2012, 02:11 AM   #7 (permalink)
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Quote:
Originally Posted by 01gt4.6 View Post
We don't have to agree, but don't put words in my mouth.

I can quickly see that you have a reading and comprehension problem, which is pathetic for someone that went to medical school. You obviously have an issue with reading or you would have known not to post a link spamming this website. That alone can & does usually result in being banned. Comprehension is not your strong point either... or you are trying to twist what I'm saying? Where did I say ANY of the following?
I didn't.

When it comes to health care costs...

I don't care what you've read in some book. Take a group of 200 people (100 of normal BMI and 100 of obese BMI). Run a battery of test on them all. Comprehensive blood work, EKG, stress test, BP, lung capacity test, etc. and the numbers will show that the obese group is in poorer health... WHICH DIRECTLY AFFECTS HEALTH CARE COSTS!

NEXT TIME YOU TRY TO CALL SOMEONE OUT, READ WHAT THEY ARE SAYING AND TAKE IT FOR FACE VALUE. ADDING TO SOMEONES STORY TO MAKE YOURS MORE INTERESTING IS B.S.!
"Unfortunately the doctors are probably right in many cases."

That is a direct quote in reply to my talking about doctors being prejudiced, demeaning and condescending. I was not talking about bringing up weight, although people here seem to think that's what I meant. Nice ad hominem, though. And I'm wondering how including a reference is "spamming." It's interesting how multiple people keep hitting the idea that doctors don't do enough to encourage patients to lose weight. That is a completely separate issue from treating people as lesser beings due to their condition. Your own reading comprehension doesn't strike me as all that impressive.


"I don't care what you've read in some book. Take a group of 200 people (100 of normal BMI and 100 of obese BMI). Run a battery of test on them all. Comprehensive blood work, EKG, stress test, BP, lung capacity test, etc. and the numbers will show that the obese group is in poorer health... WHICH DIRECTLY AFFECTS HEALTH CARE COSTS!"

First of all, on what do you base this? Second, what 200 people? Would you be including the obese people that have avoided routine health care for years because they were so turned off by the way they were treated? Finally, why do you think that an entire group having higher health care costs justifies giving them worse health care? Wouldn't it be more logical to try to *improve* the health care of such a group? There are definite risks associated with obesity, but there are also many confounds in the figures including delays in care whether from lack of access or having poorer care offered.

To provide an analogy, imagine a smoker who wants to start an exercise program and experiences knee pain. Do you think it would be appropriate to deny care for the knee until the person stops smoking?

To the person who talks about fat prejudice elsewhere: yes, but that's not what I was addressing.
I seem to have really touched a nerve here, which doesn't surprise me. I would have provided more references to back up what I've said, but apparently this forum doesn't allow that. As I'm not interested in participating in a forum where people's preconceptions hold more weight than scientific evidence and shouting/ad hominems are acceptable behavior, this most likely not the forum for me, which is a shame since I've had great success with the fitday logs for years. And yes, I *did* read the rules. If posting references is spamming, again this is not the place for me. I wish you all the best of luck.
P.S. Here's a final "spam" so you can ban me with no regrets:
Study on physicians’ (dis)respect of fat patients
BRIEF REPORT
Physician Respect for Patients with Obesity
Mary Margaret Huizinga, MD, MPH1,3, Lisa A. Cooper, MD, MPH1,2,3, Sara N. Bleich, PhD2,
Jeanne M. Clark, MD, MPH1,3,4, and Mary Catherine Beach, MD, MPH1,3
1Division of General InternalMedicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore,MD, USA; 2Department of
Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 3Welch Center for Prevention,
Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA; 4Department of Epidemiology, Johns Hopkins
Bloomberg School of Public Health, Baltimore, MD, USA.
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Old 02-06-2012, 03:09 AM   #8 (permalink)
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Quote:
Originally Posted by neurogrrl View Post
"Unfortunately the doctors are probably right in many cases."

That is a direct quote in reply to my talking about doctors being prejudiced, demeaning and condescending. I was not talking about bringing up weight, although people here seem to think that's what I meant. Nice ad hominem, though.
What I said was...
Quote:
Originally Posted by 01gt4.6 View Post
Unfortunatelythe doctors are probably right in many cases.
I didn't say fortunately or definitely and I didn't say all the time. Why did you twist my words?

Quote:
And I'm wondering how including a reference is "spamming." It's interesting how multiple people keep hitting the idea that doctors don't do enough to encourage patients to lose weight. That is a completely separate issue from treating people as lesser beings due to their condition. Your own reading comprehension doesn't strike me as all that impressive.
What you included was a DIRECT link to buy a book on Amazon.com. Was it not? In case you missed the rules. Here they are for you.

1. No Advertising or self promotion
2. This forum is used to share support and is not to be used to advertise other websites or any other type of advertisements which intend to sell products or services for personal monetary gain.
3. You may link to a personal blog so you can share your weight loss story. Other links might be removed, at the discretion of the moderators. We will not support any type of affiliate link advertising & postings by individual users on our forums other than the affiliate partnerships set up by Internet Brands and Fitday.com
11. Posting links that violate the terms above may be removed at moderator's discretion. This includes links within posts, profile links, and signature links.

Does this clear it up for you? I hope so.

Quote:
First of all, on what do you base this? Second, what 200 people? Would you be including the obese people that have avoided routine health care for years because they were so turned off by the way they were treated?
A random batch of 200 people, different demographics, isn't that how most test are done?
Quote:
Finally, why do you think that an entire group having higher health care costs justifies giving them worse health care?
There you go again, putting words in my mouth. Where did I say they should get worse health care? I didn't!!!
Quote:
Wouldn't it be more logical to try to *improve* the health care of such a group?
Absolutely. I never said anything that would make you believe I felt differently.
Quote:
There are definite risks associated with obesity,
That's what I said, almost verbatim. My words were...
Quote:
Being overweight can have many affects on a persons overall health. Often times weightloss can turn around so many problems such as depression, stress, issues with many vital organs including the heart, bad cholesterol, blood sugar, aches & pains, sexual problems, etc, etc.
Is there anything that I said that you could say is untrue? Probably not, so why are you arguing with me?

Quote:
To provide an analogy, imagine a smoker who wants to start an exercise program and experiences knee pain. Do you think it would be appropriate to deny care for the knee until the person stops smoking?
No, I don't and I never insinuated that I did. If an obese patient comes in because his knees hurt, hasn't had any trauma and the X-Rays don't show anything I think the doctor SHOULD advise his patient that this could be due to the extra weight that his knees have to carry!

Quote:
I seem to have really touched a nerve here, which doesn't surprise me.
You touched a nerve because you are putting words in my mouth and twisting what I said. I speak my mind, there is no reason for you to turn it into something that it's not.

Quote:
I would have provided more references to back up what I've said, but apparently this forum doesn't allow that.
Once again, what you included was a DIRECT link to buy a book on Amazon.com.

Quote:
As I'm not interested in participating in a forum where people's preconceptions hold more weight than scientific evidence and shouting/ad hominems are acceptable behavior, this most likely not the forum for me,which is a shame since I've had great success with the fitday logs for years.
Nobody is asking you to stay, feel free to leave an anytime.

Quote:
And yes, I *did* read the rules. If posting references is spamming, again this is not the place for me.
If you read the rules before posting that link to the book being sold on Amazon and you still don't think it's spam, then I do feel you have a comprehension problem. I clearly spelled out the rules that you broke. B/C I feel that some times people have the right to voice their opinion, even when I don't agree with them, I DIDN'T ban you for it. I wanted to give you a chance to reply to my response to you and you once again are twisting my words.

Quote:
Originally Posted by neurogrrl View Post
So obese people don't have a right to have their medical issues addressed the way other people do? So it's appropriate to be demeaning toward people and reduce them to one aspect of their being? How exactly do those behaviors improve anyone's health?
Once again, I never said that. What I said was that being overweight/obese and cause a number of health issues, which we both agree on... you just want to argue me down about it.

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Old 02-06-2012, 03:35 AM   #9 (permalink)
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The twisting of one's words is trollish behavior indeed. And to do it in three separate posts is trollish X3.
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Old 02-06-2012, 03:45 AM   #10 (permalink)
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So let me clarify this, I think they everyone has the right to be treated for their illness. I firmly believe that poor health, including obesity, is a huge expense and we all pay for it one way or another.

I say it how I feel it. If you feel the need to twist what I say, then don't bother referring to me. If you want to take what I say at face value and disagree or debate, go right ahead, I don't mind.

I'll close with my favorite quote from Tony Horton.

Your poor health is ruining this country!

It's not the Democrats and it's not the Republicans, it's YOU! Your inability to move your ass and eat right is a burden on the rest of us. If you've turned things around, I thank you for your courageous effort. Just keep going. If you have not then find a way. Now! I'm tired of listening to all the whining and finger pointing from people with no discipline and bad habits. Good Health Care starts with YOU taking care of your health!
-Tony Horton
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