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Thursday, August 30, 2012

166

Carter said she "doesn't consider it discriminatory"

So many questions! What if she was 6'7? What if she was 190 pounds and then got pregnant? What if she was like the amphibian lifeform from Hellboy, and her weight no longer mattered because she was constantly suspended in liquid in order to live? What if she only weighed 100 pounds, but also insisted on wearing a 101 pound puffy coat to stay warm? What if she weighed 125 pounds, but also obsessively poked people in waiting rooms with a pin?



166 Comments / Post A Comment

Oh, squiggles

If I weren't already fat, with plenty of experience being treated badly by doctors, I would be shocked by this.

Heat Signature

@Awesomely Nonfunctional I used to have a doctor who would attribute every physical ailment I had to being overweight, even though I have fibromyalgia and childhood-onset asthma. I wound up leaving her practice and writing her a letter explaining why she was such a terrible doctor.

Oh, squiggles

I understand. I have insulin resistance, and instead of treating that (which is the cause of my weight) they just told me to diet and exercise to lose weight(which I was already doing).

It really makes me curious to know if the early deaths associated with weight come from the fact that doctors don't bother to treat fat people the same as skinny people, so they miss important things.

mattewmc

ahh..I really love it:X:X@t

Scandyhoovian

What a dillhole.

area@twitter

FAT WOMEN IN YOUR WAITING ROOM BOOGA BOOGA BOOGA

Also- I can't believe she's drawing the line at 200 pounds. 200 pounds! If you're going to be a discriminatory asshole, why not really go for it? Put the line at 150, or 100! Say that anyone whose BMI strays past 25 is to get their fat ass back to Dunkin Donuts and choke to death on their mouthful of crullers! Treat only former and current Victoria's Secret models! Have your nurse try to grab handfuls of flab off anyone who walks through your door!

Christ, this makes me angry.

anachronistique

@area@twitter Aw, you beat me to my standard OBESITY EPIDEMIC BOOGA BOOGA BOOGA post!

Ophelia

@area@twitter Yeah, seriously. Also, her rationale...?? WTF? "my staff get hurt if patients are 250lbs" and then, "...it's the morbidity." Well, which is it?

And is she looking at weight only? So if this lady was actually a man (or, hey, a very tall lady) who was 6'4", and weighed 200lbs, is that too heavy? WTF.

area@twitter

@anachronistique Ahh, I'm sorry! I LOVE the BOOGA BOOGA BOOGA line and have tried to work it into my conversation whenever possible.

HeyThatsMyBike

@anachronistique Now every time I read a scare article about how the human race is going to be wiped out by obesity, I start giggling because all I can think of is your BOOGA BOOGA BOOGA!

anachronistique

@area@twitter I'm just glad someone was here to do it!

@HeyThatsMyBike MISSION ACCOMPLISHED. \o/

cuminafterall

I was wondering where to get my morning cup of rage, so thanks!

lil_bobbytables

If anything, that doctor's actions are too in line with the Hippocratic oath. She is just the best at being a doctor, and not in any way shape or form a total juicebox. Nope, you'd never catch me saying, 'Wow, what a terrible juicebox of a doctor. While she may not be doing anything illegal, I question her ethics and professionalism, and would further posit that she is, in fact, a bit of a jerk'. Nope, not something I would ever say at all.

RK Fire

@lil_bobbytables: I know, right? You can be asshole without doing anything illegal.

At the very least, now people will know who to stay away from if they want thoughtful medical consultation.

Dirty Hands

Oh dear! I'm fifteen pounds away from not getting medical treatment! (And I don't consider myself overweight, just curvy/built/wicked sexy.)

area@twitter

@Dirty Hands Hell, they'd throw me out of there so fast my fat ass would bounce off the sidewalk. But I guess I don't deserve medical care. You know, because I'm such a fatty.

Lurkasaurus

@Dirty Hands I'm 10 pounds past the point of not getting medical treatment -.- Rage.

all the bacon and eggs

I'm assuming this doctor is Ricky Gervais' character in Louie.

RK Fire

Football players! Rugby players! Field athletes! You are not welcome in that office.

fondue with cheddar

@RK Fire Tall people who are not beanpoles!

RK Fire

@jen325: Yes! There are a surprising number of people in my life who are over 6' and I know them through rugby, weightlifting, or powerlifting so this is kind of an issue dear to my heart. There are big people in the world! grrrr

Atheist Watermelon

@Didldidi sorry, caps lock not actually stuck, but my rage off- button is seemingly broken this morning

TheUnchosenOne

@jen325 Hell, I have a tall friend who IS a bit of a beanpole and he's still over 200. Not much and he's like 6'6" but still.

fondue with cheddar

@TheUnchosenOne It's amazing the difference height makes. My ex husband was about a foot taller than me. At my heaviest I weighed almost the same as him, yet I was well into the obese category and he was fairly skinny.

Hot Doom

@RK Fire I get the impression that the judgement was based not only on weight but also that the woman was not an athlete or tall person. Something tells me that if a 6', 250lb rugby player in his 20s tried to get in, it probably wouldn't be a problem because they're the 'healthy' kind of heavy that insurance companies prefer. cuz they're dicks.

Ham Snadwich

@RK Fire - I'm a 200+ lb rugby player, and for 3 years running during my annual checkup the doctor tells me "You should really lose some weight. Maybe get a little more exercise".

RK Fire

@LolaLaBalc: Honestly, I'm sure that's the case, but I was just trying to highlight the silliness of arbitrarily setting her obesity metric to "200+ lb = fatties." My husband is actually 6'4" and a former lock and yeah, no one has ever been like "lololol you need to lose weight" because of the intersection of size/athletic build/gender.

@Ham Snadwich: Sounds like an opportunity to ruck your doctor. "Oh, that's fantastic! Let me just grab you and push you around the office with my shoulder."

Mingus_Thurber

@Ham Snadwich Are we going to the same doctor?

Hot Doom

@RK Fire Yeah, I gotcher drift. It is totally arbitrary. I wouldn't be surprised if they made that number up on the spot with the woman and then said 'quick! write it down! make it policy!' before the news van showed up.

permanentbitchface

@Ham Snadwich Ugh! It's amazing that people are still doing this height vs weight= foolproof number of healthiness! It's fucking 2012 people! BMI is not always right! Geez!

fondue with cheddar

@permanentbitchface Seriously. The healthy range on the BMI chart for my height seems pretty accurate for me so I find it helpful. But it's definitely not realistic for everyone! Muscle mass, bone structure, and fat distribution skew the numbers for a lot of people.

permanentbitchface

@jen325 As a short lady it's pretty frustrating! At 5'4" you're at your healthiest at 115-120? No way dude! I weighed that much in high school when I was depressed and not eating. At my most I think I dipped into the overweight category, and I think I was at my healthiest! I was running every day and skiing a lot and eating vegetarian/vegan most days of the week, and I was overweight somehow?

MmeLibrarian

@permanentbitchface At 5'3" and 145, I am convinced that the BMI doesn't want to admit that I have an awesome rack and it doesn't.

fondue with cheddar

@permanentbitchface Waaaaait a minute...have they changed the BMI chart? I'm 5' and I specifically remember that, when my weight dipped down to 127, it was the upper end of the healthy range. It took skipping meals to get there (not on purpose), but that's not the fault of the chart, it's that I have a really hard time losing weight.

WaityKatie

@jen325 I think pretty much everything is the fault of that chart, actually.

permanentbitchface

@jen325 No you're probably right, I think I have it in my head that 120 was the lower point of healthy weight for my height, or I was closer to 5'3" at some point.

fondue with cheddar

@MmeLibrarian Boobs make a huge difference. These puppies are heavy!

Okay, I just calculated mine and it says I'm nearly obese, which seems accurate because I'm at the point where it's having an impact on my health and comfort level. It says I should be 95-128 pounds. I was 103 when I graduated high school, and I was thin but not skinny. The upper range of that is probably best for me, but I've also got big boobs so that's probably why.

fondue with cheddar

@WaityKatie For some people, yes. It just happens to be fairly accurate for me. I've got a pretty good sense of what is a healthy weight for me, and the chart is pretty on. It's just not that way for a lot of people (you included, apparently).

WaityKatie

@jen325 But if it's not accurate for everyone (which I agree, it is not), what is the purpose of using it? We're not gaining any knowledge from using it. I think its existence, or at least the way it is used, is utterly pernicious and only serves to produce increasing amounts of false information about weight and health.

PistolPackinMama

@RK Fire I bet if she had a leg amputated she'd go under the weight restriction.

fondue with cheddar

@WaityKatie I might be wrong, but my understanding is that it's pretty accurate for sedentary people, who just happen to be those for whom it would be most helpful. If any sedentary people out there feel the chart is not accurate for them, I would be interested to know.

ELECTROMAGNETIC CHAOS

@WaityKatie: It's accurate enough, and for enough people; that is to say, it's good enough to use as a general arbiter. One can then take that and go much more into detail (caliper measurements, water displacement, dietician analysis, etc.) to obtain pertinent information about oneself. So it's not the law, but a good place to start regarding metrics like this.

Ham Snadwich

@Mingus_Thurber - Is he a fussy, moustachioed Syrian who wears support hose?

WaityKatie

@ELECTROMAGNETIC CHAOS I so disagree. Why is it helpful to start off from a standpoint of "Ok, the BMI says you're a fatty; now let's see if you really are."? The way it is used seems to be to be just a way for naturally thin people to feel good about themselves; nothing more, nothing less.

PistolPackinMama

@WaityKatie Let's not forget also that it allows Science(TM) to endorse Arbitrary Health Indicators That Allow People to Deny You Services While Thin People Feel Good About Themselves. It's a mutli-faceted tool!

@M_T *snerk* My dentist is a foxy Syrian. I don't know what kind of hose he wears. But when he refills a filling, HE REFILLS A FILLING.

Also, I am pretty fucking sure I could, with training, help lift people who weigh 200+ pounds. On account of how I can leg press... 200+ pounds and am getting close to body squatting it.

Guess how many pounds I need to gain to be ineligible for care at this location?

Mingus_Thurber

@Ham Snadwich No. Mine is a pudgy Filipino who, upon discovering that I needed blood pressure meds, said "Now you are a real American, like me! Real Americans need blood pressure medication!"

During my next visit, he took two personal calls on his cell phone. He is no longer my doctor.

fondue with cheddar

@ELECTROMAGNETIC CHAOS Maybe it's best to use it as a supplement to other tools rather than the end-all-be-all measure of healthy weight.

It's like college admissions: a mediocre SAT score doesn't mean you're stupid, and colleges know that. If your grades and entrance essay are good and you're involved in extracurricular activities, they will probably consider you for admission. SAT is just one of the many factors they consider, and none of those factors, if taken by themselves, give an accurate picture of the quality of the applicant.

Ham Snadwich

@permanentbitchface - To be fair, he's wasn't wrong. I dropped about 15 lbs (mostly through writing down what I ate) and I really do feel better. Gained some speed, less hip and knee soreness after games.

It was more the "try to get more exercise" bit that amused me. I mean, I can *try*, but outside of the 6-8 hours a week that I'm either practicing or playing rugby, I don't have a lot of free time.

Jinxie

@Mingus_Thurber Your former doctor sounds remarkably like Dr. Nick from The Simpsons.

ELECTROMAGNETIC CHAOS

@WaityKatie: What Jen says just above is more to my statement; it's a starting point, using a simple system of a couple containers. You then take it further, if you wish; it's not a black/white distinction.

WaityKatie

@ELECTROMAGNETIC CHAOS Well, but how does this system address people who weigh within the "normal" range, yet have all the same health problems associated with lack of exercise and poor diet? It seems BMI is just as useful a tool as just looking at someone and saying "you look fat" or "you don't." Which is to say, not very useful.

Jawnita

@WaityKatie The thing is, BMI was never intended to be a measure of individual humans, just populations. Here's a good article to link people to: http://www.maa.org/devlin/devlin_05_09.html

Ham Snadwich

@Jinxie - Did he go to Hollywood Upstairs Medical College too?

mlle.gateau

@Jawnita Thank you for pointing this out, I was about to, and yes, they did actually change the BMI chart some years ago so that us upper-range-normal folks were suddenly fatties overnight. BMI, it is not a real indicator of your health as an individual.

ELECTROMAGNETIC CHAOS

@WaityKatie: That system doesn't; the health problems they are experiencing would fall into other systems and would invite a visit to the doctor or specialist.

Correlation is not causation, so a thin person could be unhealthy and a fat person perfectly healthy.

But I think we need to get real real here for a second and have some objectivity. There are medically proven issues that come along with increased amounts of bodyfat. Not everyone has them. Some do. Enough do that to get checked out is a very prescient thing to do.

Mingus_Thurber

@Jinxie Not for the first time, I wish I watched The Simpsons.

WaityKatie

@mlle.gateau Yeah, I remember reading that, and also reading that the rationale for doing it was basically that they didn't want us Borderline Fats to get too comfortable and let ourselves go. How amazingly scientific and objective.

Plant Fire

@jen325 HI, sedentary person here! I feel the chart has always been fairly accurate for me starting around high school and through all the weights highs and lows I've had since then. But I'm truly sedentary, I mean, I can't drive so I do walk and bike to most places I go but when I bike its sort of a relaxed cruising along going no more than 15 minutes away and walking is pretty much the same (and usually leads to me going into a metro or subway where I sit). But I don't exercise or have much muscle and I think that's a huge part of why it's accurate for me. All of the people I know who've had issues with the chart were people that exercised, and usually people that exercised a lot.

ETA there were a couple times im my life where I did exercise and it was still accurate but I think that's mostly because the type of exercise I did was usually along the lines of yoga or occasionally dance rather than stuff that would build a lot of muscle.

Craftastrophies

@ELECTROMAGNETIC CHAOS IF your doctor will treat you...

A lot of them are also correlation - from years of dieting that affect your heart, for instance. Or you've put on weight because of having diabetes. I mean, your essential point of there being related health issues is not incorrect, it's just, I think, not very relevant.

The BMI is a statistical tool. It's very useful if you're an insurance company trying to limit your risks by not insuring anyone with correlations - like how depressed people are more sedentary and therefore often more overweight. Or how people in the 'healthy weight' range have lower recovery rates from surgery or serious illness. Oh wait, not that last one. It's useful when considering large amounts of numbers, but like all statistics it doesn't have much to say about the individual. Using it to measure one person's health is as rational as using comic sans for a legal report - that's not what it's FOR. Or maybe as rational as planning your day around what your horoscope says - there's enough general truth in there that some people will have amazing results, but there's a lot of margin for error there.

Also, they did change the charts, in... '98 I think? A whoooole lot of people became overweight overnight. Because it's an arbitrary measurement, and that's how that works.

fondue with cheddar

@Sea Ermine That's kinda what I figured. Thanks for your input. I'm the same way in that when I've exercised it's been stuff like walking (sometimes as much as 3 or 4 miles but still...just walking) and leisurely bike-riding, which like you said doesn't build much muscle.

MoonBat

So the staff in this Primary Care Center has had three injuries from caring from patients who weigh over 250 pounds? WHY, exactly, is the staff manhandling the patients??? I thought that physically moving patients was something done in a hospital or long-term care facility.
Now that this story is out, and hopefully gets widely spread, I hope that the doctor doesn't find the sudden outflux of patients to less juiceboxy doctors to be "discriminatory".

thatgirl

@MoonBat I was going to say, this is a primary care facility, which implies that most patients have command of their mobility.

Unless they're saying their medical furniture can't handle it, which is bullshit because those tables have to stand up to a lot of weight, legally. I could probably look up the ratings if I cared right now, but I'm fairly certain it's well over 200 pounds.

And are there no male patients at this facility? Are they required to be under 200 pounds as well?

area@twitter

@MoonBat I was wondering precisely the same thing! What are you doing in an outpatient setting that requires you to be hauling around your patients? People coming in should be fairly mobile.

The Attic Wife

@area@twitter I had to re-read that section twice before I understood it, I thought she was saying that the patients over 250 lbs were injuring THEMSELVES and they were a liability to the practice because...I don't know, they'd sue or something? This makes even less sense. In the first place, why are so many people moving patients? Do they have a policy where everyone is lifted onto the scale? Is the scale broken and nurses have to approximate weight by how hard it is to pick someone up?

fondue with cheddar

@area@twitter Maybe they don't have a stepstool so they have to lift patients onto the exam table? "Here you go, Mrs. Johnson...upsy-daisy...OW MY BACK YOU FAT FATTY!"

Lily Rowan

@area@twitter Well, unless they are all old and/or disabled. When I was getting primary care in a clinic that mostly saw old and disabled people, my doctor commented once that I was her only patient of the day who could get myself up on the table myself.

I am NOT saying that doctor was right or OK.

teaandcakeordeath

@MoonBat
I was very confused about this. What treatment is this for? Dont people go to doctors for consultations as opposed to what appears to be physical therapy?

I dont in anyway want to excuse discrimination but is it a possible explanation that this was caused by a fear of being sued? If so it would mean that the legal system has had a really depressing effect on healthcare. ie a nullifying effect if doctors are too afraid to treat patients for fear of legal repercussions.

teaandcakeordeath

@teaandcakeordeath
Eurgh writing that comment made it sound like I was saying this doctor had a valid reason - I disagree with the doctor! I do not agree with the doctor! This is a bad doctor!

The Attic Wife

@teaandcakeordeath Hey, don't beat yourself up about it, being afraid of a lawsuit was my first thought too. And if there was more to the story, ie the doctor refused to perform some kind of potentially dangerous procedure because the patient's weight and overall level of health meant that it was too risky to attempt, I could understand. But she just seems to have a 'fatties don't get check-ups' policy, which is such crap. And a 200 pound limit? Completely arbitrary.

teaandcakeordeath

@The Attic Wife
Completely agree. I try to understand the thought process when I hear stuff like this but this was just ridiculous, especially with the 'explanation' offered. The world is not how it should be.

datalass

@Lily Rowan That could be a factor. I had a similar experience once. When getting a CAT scan (which just involved stepping up and lying down on a slightly elevated table), the technician commented that she was worn out because she was helping people on and off the table all day.

Like you said, this totally doesn't excuse the doctor, but some people do need a fair amount of physical assistance in these situations.

permanentbitchface

@jen325 Yeah this is pretty ridiculous! Say the doctor weighs 150 or something, and tries to lift anybody, of any weight. Anybody is going to have a hard time lifting a person of 100+ pounds.
This shit doesn't make any sense!

PistolPackinMama

@jen325 How are they not being trained in how to lift stuff? I mean, it's not like the rest of the world doesn't have training for this sort of mass-lifting-management.

Xanthophyllippa

@The Attic Wife Yeah - I found myself wanting to know more about what actually happened in that appointment. This just seems so outlandish to me that I can't help think there has to be more to the doctor's side than "no fat people." Like, did something else go wrong in the appointment? Why was she so fixated on the patient's feet - was this a new patient the doctor didn't know well and thus she thought she saw a warning sign, or a longtime patient whose condition changed suddenly and who didn't like that the doctor picked up on it? Am I being too lenient on the doctor?

astrangerinthealps

Funny, I've mostly quit going to the doctor since my weight went over 200, because I got tired of having this conversation:

"Doctor, I've got this rash/insomnia/headache."
"Well, you're fat. How about losing some weight."
"Working on it."
"Okay, see you in twenty pounds!"
"..."

I wouldn't mind except that doctors have been totally clueless when it comes to actually advising me on how to take the weight off; I've had to figure it out myself through Internet research, word of mouth, and a lot of trial and error (at the moment I'm down a few pounds, thanks, but who knows what tomorrow brings?). I don't think it's the doctors' fault, it's just that medical science these days is mostly either clueless or helpless when it comes to helping actual fat people lose actual pounds and keep them off, without an unacceptably high risk of exploding blood vessels, moving on to harder drugs, or equally undesirable side effects.

fondue with cheddar

@Fflora Ugh. Suggest a patient lose weight is understandable because it's part of their job (though pretty much everyone who's overweight knows they should lose weight). But geez, being overweight is not the cause of every health problem.

And really, if the patient doesn't lose weight maybe the doctor could say, "It seems like you're having trouble losing weight. If you would like my help I would be happy to discuss what you've been doing and what you're having a problem with. Maybe together we can come up with a diet and fitness plan that works for you."

area@twitter

@Fflora This right here. Yes, my doctor is probably right in suggesting that I lose some weight to lower my blood pressure. However, there's no reliable, successful intervention that she can prescribe that will lower my weight, and certainly not one that my insurance company will cover. So while I'm doing my best on my own to be healthy, in the meantime would you mind, you know, treating my hypertension now? Like every single guideline says you should?

The Attic Wife

@Fflora I love my current primary care physician, he's never told me to lose weight, probably because he treats me like an intelligent person who knows that weight loss wouldn't be a bad thing, but that it won't happen if you try to harass someone into it. So there are doctors out there who aren't completely insensitive assholes.

Beatrix Kiddo

@The Attic Wife I almost feel like this doctor's rule is a blessing in disguise, so the woman can avoid wasting time seeing her and find a doctor who'll take her seriously as a patient rather than guilting her about her weight.

Ophelia

@area@twitter Yes - I've always been athletic, but a few years ago was NOT getting enough exercise or eating right because I was spending too much time eating out of vending machines at the office. I got lucky and had a really helpful doctor who basically had this exchange with me with I started going to her office:

Her: "So, you weigh about 195. Is this a typical weight for you?"
Me: "No, I've gained 30 pounds in the last year, but I'm kind of at a loss as to what to do. This hasn't happened to me before."
Her: "OK, no problem. Here's what I'd recommend (gives sensible feedback about exercise per week, and paying attention to what I eat while in the office instead of mindlessly snacking)"

6 months later when I came back having not lost a ton of weight, but having lowered my blood pressure and upped muscle tone, she congratulated me, said it looked like I was doing things right, let her know if I had questions, etc.

THAT was a helpful consultation. I was pretty bummed when I moved out of state and had to switch doctors.

fondue with cheddar

@Ophelia YES THAT IS HOW A DOCTOR DOES THEIR JOB. I'm so sorry you had to move away from her, because she sounds fantastic.

Biketastrophy

I hope UMass happens to not renew her lease since it seems she's an independent dr in the Umass building. I've actually been in this building before, and live up the street. I should stroll in and see if I get treatment, I'm >200 lbs 6'0 and just ran a 5k last week so its a decent amount of muscle since I exercise enough.

I'm over her weight limit though, so I should be refused as well cause she's just discriminating based on weight and not on fat RIGHT?

xine

@Biketastrophy Hey there, fellow Worcester pinner!

Biketastrophy

@xine *Highfive*

Dirty Hands

@Biketastrophy Worcester Worcester Worcester Worcester!!! (Not there now but have been!)

TheUnchosenOne

I'm curious as to what definition of "discriminatory" she's using because by mine that is exactly what she's doing.

Maybe this is why fat people often have worse health. Because doctors refuse to treat them. Because even when doctors DO allow all the gross fatty fat fatties into their office they just say "Hey, lose some weight and whatever you have will clear right up." Maybe it's because fat people get so tired of getting shamed whenever they go to the doctor that they just kind of stop going.

But hey, what do I know. I'm just a guy who's 215 pounds who hasn't been to a doctor in 6 years.

I have a friend who is overweight (well more than one but this is just an example). I don't know how much she weighs but I'd guess she's just under the "obese" category of BMI (which is bullshit but that's another discussion entirely). This summer she ran at least one half-marathon and several 5ks. She is easily in the best shape of anyone in our group of friends. But no, let's keep talking about how if you're not at the "right" weight you can't be healthy.

damselfish

@TheUnchosenOne Probably the legal definition, where weight is not a protected class. Not that it's right. Just "you can't sue me because I'm not discriminating by the legal standard's very low threshold."

hands_down

I need to see a doctor now because I'm about to have a rage stroke. Christ.

Xanthophyllippa

@hands_down I hope you're skinny.

staircases

Citing possible morbidity as a reason to not take a patient on is laughable. What kind of doctor refuses to see a patient because they might one day become sick???

permanentbitchface

@staircases Or possibly pregnant? That would just be too much work!

datalass

@staircases I know! I first saw my oncologist right after I'd been diagnosed with cancer. What if she had been all, "Oh, sorry, not interested because mortality/morbidity."

cmcm

In relation to that, can we talk about this article?? http://www.salon.com/2012/08/28/anti_obesity_the_new_homophobia/

Maria

@cmcm Just read it... then made the mistake of reading a few of the comments.

Plants&Rags

@cmcm Thanks for posting the Salon article. Good points. I recently discovered April Michelle Herndon, a fat studies scholar, and everything I've read of hers, e.g., is super thoughtful and smart.

cmcm

@Plants&Rags Oh hmm well I'm not gay or obese, but if I was gay I would find it incredibly offensive to compare my sexual orientation to what is essentially something that can cause health problems and shorten your life.

WaityKatie

@cmcm Do you think having a non-skinny body type automatically causes health problems and shortens life? Because it doesn't.

cmcm

@WaityKatie No, of course not. I was just thinking about this... it definitely is problematic that weight is being used as a shorthand indicator of overall health when of course (as many people have noted in these comments and elsewhere) there are plenty of examples where people are technically overweight but healthy. And being skinny does not mean you're necessarily healthy.

But science has shown that being extremely obese DOES imapct your health and I think it's probably rare that people who are morbidly obese follow generally recommended dietary/exercise guidelines. I absoultely am not saying there aren't plenty of other reasons that people are overweight, and I would never say "oh, but all you need to do is X and you'll be skinny!" But I guess my point is that gay people are born gay and I have a hard time feeling comfortable saying that obese people are born to be obese.

Plants&Rags

@cmcm Sorry to misunderstand and be misunderstood. I've recently become convinced that there isn't solid evidence that obesity causes disease or early death. The studies available show correlation, not causation. I understood the Salon article author to be comparing the medical establishment's response to sexuality and obesity, not sexuality and obesity themselves. But maybe I was wrong. And maybe you know of more information I should read. I'm open to learning more on this.

WaityKatie

@cmcm I guess I don't really have a problem saying that fat people are born to be fat, though, because they are. People come in all different shapes and sizes. I agree that morbid obesity often seems to lead to health problems, and many, perhaps even most, people who are currently morbidly obese could reduce their weight to a point where they are merely "fat." They're never going to be thin though, most likely. I have a big problem with the idea that we can all just "diet and exercise" and drop 50 or more pounds, permanently, and be thin, hooray, which is what mainstream culture thinks. I have never found that to be true in my own life, and I diet and exercise the hell out of myself. Guess what, I'm still a size 12.

Maria

@WaityKatie And I think the articles point was more, regardless of the how or why, the discrimination still exists in the medical community and in society at large. And that is a problem.

WaityKatie

@Maria Exactly. How does shaming and judging someone do anything to improve their health? Even if gay people could "choose" not to be gay, by being celibate forever or having parts of their brains removed or whatever insano shit right wingers want them to do, WHY would that be a good bandwagon for doctors and society at large to jump on? Likewise, if fat people could stop being fat through starvation, having surgery, etc., why is that a thing that society should pressure them to do?

anachronistique

@cmcm Terrible headline for a decent article, I think. The "old homophobia" is still alive and well, after all. And compare-and-contrast of oppressions never works. But:

"Telling fat people they ought to be thin is about as helpful as telling gay people they should be straight."

Is nicely put.

Plants&Rags

@WaityKatie Right. Shaming and judging are unethical for health professionals (and a jerk thing for anyone to do), and are also ineffective. Society, many doctors included, is way too focused on people's weights and not on actual health issues, which can be addressed in ways that may or may not lead to weight loss.

Mira

@cmcm I'm gay, and I did find that article incredibly offensive.

PistolPackinMama

@cmcm Yeah, I think making the comparison is unwise, but not for the reason you're putting out there. For one thing, the jury is still out on how much your fat will contribute to killing you. And for another, homophobia is still alive and well so, it's not a case of the old/new anyway.

But they are different kinds of discrimination, and setting up the parallel isn't really doing much to actually help anyone understand why both of them are actually going on and why they are really bad news.

I expect one shared issue might be that queer people, like fat people, depending on the circumstances are denied decent health care/ can't get access to it because of their status. Another is I expect there are cases where you are blamed for your health problems because of your status. And saying "the discrimination is socially acceptable and an affront to human rights and the right to dignity"... is also true.

That's true of a lot of categegories, though, so again... unclear here.

Punk-assBookJockey

@cmcm It's kind of funny that you say that, because 50 years ago doctors thought of the "gay lifestyle" (at least for men) as "essentially something that can cause health problems and shorten your life."

Craftastrophies

@PistolPackinMama I really hate the "fat is the last taboo!" because uh, we still have plenty of taboos. And plenty of discriminations. What, we're only allowed to have one discrimination at a time? What about the fat, black, gay people? Are they not allowed to exist, or are we only allowed to care about one aspect of them? I see the benefits of the comparison, in this context, but I also think it's dangerous.

Personally I feel strongly that doctors should treat everyone. They should treat smokers with lung cancer and drug addicts with health problems from that and pregnant people who have complications from their pregnancy, and cancer patients with cancer from living next to a factory, and anyone who has any illness or problem, regardless of the perceived self-infliction. Sure, you should talk to the alcoholic - politely and respectfully - about getting some help to make healthy choices. But shouldn't you treat them anyways? It's like telling a depressed person that they're being too pessimistic and to come back when they're feeling happier.

PistolPackinMama

@Craftastrophies Yah- it's not like there is a zero sum game for suffering going on here. Unfortunately, it's a renewable and abundantly available resource.

Maybe the problem is that there is a limited amount of compassion in the world.

God. What a bummer of a thought.

sarah girl

This reminds me of a time when I went to a new gynecologist, and WHILE I WAS ON THE TABLE she said "Oh, thank you for taking care of yourself and staying skinny." She then described in great detail the large woman she'd done surgery on earlier that day, how difficult it had been, etc etc.

It was extremely upsetting, and you can bet your ass I never went back there.

Beatrix Kiddo

@Sarah H. EW. Why on EARTH would she say that? Just to make clear that not only does she judge her patients, but she gossips about them to other patients?

Mingus_Thurber

@Sarah H. Oh, man. That's horrible. Come see my gynecologist! Not only is she the gentlest doctor I've ever had, but she looked at my back and legs and biceps during my first visit and said, "Your weight is good, your blood pressure is good, you look quite fit."

The heavens opened up and the angels fucking SANG.

sarah girl

@Mingus_Thurber That sounds much better! I'm at a different practice now and am totally satisfied; I don't have one dedicated gyno, but they're all very professional and nice and don't say a GODDAMN THING about weight, mine or anyone else's.

dontannoyme

@Sarah H. God that is shocking. And also marks you out as someone I like. Many's the person who would have been secretly thrilled by that and probably saved that anecdote as part of their "I'm not part of the fat tribe and anyone who is is just stupid" narrative

fondue with cheddar

If lifting people is truly part of the job, MAYBE SHE SHOULD HIRE STRONGER EMPLOYEES.

Plants&Rags

@jen325 Or some of the equipment that is available for moving patients of various sizes. See a fun Flash slideshow!

fondue with cheddar

@Plants&Rags I want one of those hammocks! It actually looks kind of comfy. I don't know why the dude looks so bored.

Jinxie

@jen325 And how much lifting are they doing, really? I mean...really? When I go to the doctor I have to hoist my own ass up onto the table.

Jinxie

@jen325 Also, apparently I'm stalking you around the 'pin today. Unintentional, but kind of awesome!

fondue with cheddar

@Jinxie Let's walk together! *holds hand*

Craftastrophies

@jen325 I'm currently editing a whole unit on proper manual lifting techniques in the health industry. There are quite comprehensive rules.

The only conclusion I can come to is that either she and her staff are poorly trained and unprofessional, or that they were injured by backing away slowly in horror from the disgusting fatties, and slipped on a banana skin.

fondue with cheddar

@Craftastrophies Judging by their handling of this patient, I'm going to assume it's the latter. Instead of refusing patients they should just stop eating bananas at work. ATTENTION ALL EMPLOYEES: PLEASE LEAVE ALL POTASSIUM AT THE DOOR.

Hello Kidney

@Plants&Rags I can attest that those lift devices are SUPER FUN to play with. My class all lifted one another with them in lab, and it was definitely a high point of that semester.

DickensianCat

Where can I get me one of those 101 pound puffy coats? I'm planning on being immobile all winter but still want to enjoy the occasional snowfall, so this sounds perfect!

MoonBat

@DickensianCat And can we still poke people in waiting rooms with pins? It's not an either/or, is it?

DickensianCat

@MoonBat oh, there will be poking a-plenty!

Heat Signature

At my very skinniest I weighed 214 lbs., at which point I stopped losing weight because my body was telling me that this where I needed to be. Oh, and also the medical community is filled with assholes.

Xanthophyllippa

@Heat Signature Yep. I've only been under 150 twice in the last decade, and once was because of severe depression and the other was the summer I over-trained for sprint triathlons and was doing things like biking 10 miles, running 4, and biking the 10 miles back home -- five times a week. My body just wants to be at 150. It's happy here, even if the BMI thinks I'm 0.7 away from being morbidly obese.

Mingus_Thurber

What I don't get is this: I lift people all day, every day, as part of my job. You can hurt yourself as easily--if not more easily--moving somebody who's 125 lbs and mobility-impaired as you can moving somebody who's 250 and trying to cooperate.

Is this doctor going to kick out all the folks she sees who've had strokes and have spastic hemiparesis as a result? How 'bout the people who have broken a leg or sprained an ankle? How about patients with vertigo? Or syncopal episodes? I mean, holy crap, it's not just weight that makes you a danger to other peoples' backs. Falling over unexpectedly can do a number on somebody, too.

Part of the reason I weigh nearly 200 lbs is because I lift weights. Heavy weights. I lift them because I have to, in order to keep my back in shape for work. I'm also fifty pounds overweight, but working on that. Point being, I'm way more mobile than a lot of women twenty years my junior, and stronger than everybody in my unit except one of the men. And yet, if I gained 5 pounds, I could not see this doctor.

permanentbitchface

@Mingus_Thurber Yes, this. I was thinking the same thing. Most people can't lift someone who weighs the same as them anyway. You're a 150 lb doctor trying to lift a 130 lb person? Not gonna happen!
The last time I was at Urgent Care (not really a real doctor but still) I had a dog bite on my dominant hand/wrist/arm and had a hard time getting up on the table, and I needed some help. Are they gonna kick me out cause I can't get on the table all by myself? Makes no sense!

melis

/reads headline/

NOPE

NOT TODAY

/skips away merrily/

♪ ♪ ♪ tra la la la la ♪ ♪ ♪

SarahP

@melis That was my response to the post about the Hanna Rosin book. Shall we go frolic together in a nearby field?

anachronistique

@SarahP "I will give you a topic. Rhode Island is neither a road, nor an island. Discuss."

area@twitter

@anachronistique "I'm so verklempt! Talk amongst yourselves!"

PistolPackinMama

@melis ah... I said that about the condoms (LADY OPINIONS ADDED) one.

MoxyCrimeFighter

@anachronistique I am embarrassed that I had to go look up whether Rhode Island was, in fact, not an island. Turns out - is it not! Good on ya, Coffee Talk Lady.

Xanthophyllippa

@anachronistique My undergrad advisor had a lovely Brooklyn accent and once said in class, "The Glorious Revolution was neither glorious nor a revolution." I just about lost it and the rest of the class was like....bzuh?

@PistolPackinMama Me too. NOW WITH MORE WIMMIN!

PistolPackinMama

@Faintly Macabre Who knew a cephalopod could say so much with so little in the way of vocal cords.

Kind of like Josh Is Like Germany's welp welp welp from FOT.

Xanthophyllippa

@Faintly Macabre That is simultaneously wildly entertaining and vaguely horrifying.

permanentbitchface

I can't help but wonder if the same thing would've occurred with a man. I mean, it probably would have, considering this doctor is an asshole. But I bet this shit happens to women on the regular.

hallelujah

Hey, I weighted 190 pounds & then got pregnant! :D I am so thankful for my doctor, too, who never made an issue out of it except to say "hey, you don't have to gain as much weight as other women do if you don't want to." My blood pressure is great & passed my glucose test with flying colors despite still gaining 30 pounds (whoops). I shudder to think how awful it would have been if I had to dread getting on the scale at my appointments for fear of being berated or judged.

permanentbitchface

@hallelujah This reminds me of my sister in law! She is about 7 months pregnant now and her doctor told her she couldn't gain any more weight. Like, you're done, you've crossed the threshold of fattiness. She was pretty torn up about it, understandably. She has gained probably about 30 pounds so far and that in itself has been tough for her (first pregnancy) but she's tiny! She's a really athletic lady and from what I understand if you're small to begin with, you have to gain weight and it just varies person to person.

I'm all mad about it now, cause she was so upset! You're gonna tell a hormonal 7 months pregnant woman that she's gained too much weight? Blerg.

Ophelia

@permanentbitchface A really cool thing my midwife's office does (they do well-woman care, too) is that you weigh yourself, in the bathroom, and then you self-report your weight to the midwives (I mean, if you're dramatically lying, they'd probably call you out), but they're looking at you overall - what are your indicators? Are you healthy? And it seems that they see weight as PART of that, but clearly not all of that. It's pretty refreshing.

ETA - I'm not sure what kind of guidance they give pregnant ladies, but I imagine it's similarly non-judgy. I talked to them about having kids, what they expect, all that, and they basically said the same thing - smaller people tend to need to gain more weight, taller people less (since there's more of us to start), and that while rapid, huge weight gain isn't good, they're looking at the overall picture of mom and baby, not "did you gain 30 lbs? Well, Sally only gained 15."

soul toast

@permanentbitchface Ugh, that's awful. It seems to me that you don't have that much control over your weight during pregnancy. Was she supposed to just be like, ok I'll tell the baby to stop growing.

That reminds of how rage-flaily I get when my pregnancy books tell me not to drink juice because it's "empty calories" and I don't want to *gasp* get FAT while a person is growing in me.

MmeLibrarian

@hallelujah I lost a bunch of weight when I was first pregnant because of morning sickness. My doctor encouraged me not to worry. Then, when the morning sickness let up, I gained back the weight I lost plus 15 pounds. My doctor still affirmed me, saying that I was doing an awesome job being pregnant and I should listen to my body and my head. Whatever amount of weight I gained was the right amount.

Pregnant ladies should always have cool doctors.

MmeLibrarian

@MmeLibrarian (That being said, I have had a couple of acquaintances who took pregnancy as a license to eat like absolute crap and stop exercising, which is a TERRIBLE idea when you are growing another person. I kind of think that a doctor would be within their right to step in there and say something.)

permanentbitchface

@MmeLibrarian Oh for sure! I think a lot of my sister in law's weight gain has to do with the fact that her exercise levels have gone down. Like, she is the kind of person that gets up at 4 AM to go hike 10 miles and ski all day. She's insanely active, but being pregnant has obviously cut down on those really aggressive activities. She still does a lot but it's just not nearly at the level she was before.

Carrie Ann

@soul toast Ugh, yes, I hate how shaming the pregnancy books and sites are. Like, this week (31 wks) the e-newsletter I get from one of those sites had a feature about dinner ideas. These things came straight from Weight Watchers, basically. "A small whole wheat pita with 2 TB hummus, with raw carrots and celery!" (No more than 400 calories in that meal.) "4 oz boneless skinless chicken breast with steamed zucchini and squash!" I mean. Those are diet meals. Let's get real. And for women like me who live their lives on diets, this is the one time where I don't have to diet. Where I can say, "I am supposed to consume 1800 calories per day PLUS 300 extra and that is what I'm going to do." If I'm on a 2,100 calorie per day plan, my dinner should easily be 600 calories minimum (and that's assuming no exercise). It just makes me mad to see the diet encouraging even in pregnancy.

entangled

@Carrie Ann I read that as two tubs of hummus (possibly because we have an insane amount of leftover hummus in our fridge right now) and it was a lot less distressing.

Heidi

@Carrie Ann I am grateful to my doctor for having had the guts to have several sensitive, constructive, conversations with me about my weight. She was not judgy or critical. She was clear. I have no weight related health problems that need to be treated, and she has never assumed a problem I brought to her was weight related. But it is her job to make sure I am healthy. And then when I got pregnant we had one quick, non-judgy, conversation about nutrition -- she suggested I did not actually need extra calories, but that I should do whatever I needed to do to feel human -- and it worked really well for us. I gained 10lbs while pregnant, meaning that now post partum I could see the terrible doctor in this article, whereas pre pregnancy I couldn't have.
You know what helped? Having a supportive doctor who wasn't an a-hole (um, also every book known to man. I mean, it's not like my doctor has ever told me anything I didn't already know, but it's different when it's an honest conversation with a person, in a face-to-face, non-judgy, open kind of way).

So, here's the thing. I don't think it's appropriate for doctors not to mention weight. They just have to do it well. And they aren't trained in that, which is terrible. Sometimes (not always, obviously!) weight IS the/an issue. And just ignoring it is not responsible or helpful. But neither is being an a-hole.

Xanthophyllippa

@soul toast Maybe you're supposed to drink beer instead? Because those calories have protein and fiber included.

Carrie Ann

@Heidi Right, weight and nutrition are important issues during pregnancy, so I understand why the books and sites cover them. But I feel like they focus on those topics in a way that reminds me of women's magazines - like Cosmo, Glamour, etc. It's treated like you should be dieting; like clearly that is what you should care about most--how much weight you've gained. Every tip is basically identical to the types of advice you would see on Weight Watchers or other diets, and most of it comes across as so condescending. "Need a snack? Try an apple or non-fat yogurt!" Oh really? Let me jot that one down!

My doctors never mentioned anything to me about my weight before or during my pregnancy, and they've only asked about my nutrition as it relates to feelings of nausea, aversions, or any numbers that appears in my blood tests. They want to be sure I'm getting the nutrients I need. That's the most important thing, and I appreciate the concern and their advice from that angle.

KatPruska

fathealth.wordpress.com

Just leaving this heartbreaking and rage-inducing internet repository of fat people's firsthand experience with discrimination in health care. Courtesy of the fabulous Kate Harding!

soul toast

Maybe this clinic offers some kind of bedtime story, sit-on-doctor's-lap service.

RoxxieRae

I am really grateful for my doctor, who looks at my weight on her chart and says "Bah, clearly there's nothing to worry about here," even though I weigh over 200 lbs.

I am 5'10" and extremely fit and yet, I have gotten the "morbidly obese" lecture many, many times from doctors. Of course, my weight is not the only instance in the medical industry where "Policy Over People" was an obvious thing... Someday I'll tell you all the story of my motorcycle accident and the abysmal treatment I received as a result...

eringthatsme@twitter

When are we going to agree that BMI is bullshit and not a measure of healthiness?

http://www.npr.org/templates/story/story.php?storyId=106268439

Tiktaalik

Until I got pregnant a few months ago, I played roller derby. This means 4-6 hours of HARD exercise per week. My pre-pregnancy BMI puts me over the line into obesity, although I am still under 200 pounds.

I would LOVE for one of my doctors to refuse to treat me because of my weight. I would hip-check them into the next exam room, then offer to see who can do cardio/squats for longer without getting tired. Bring it.

Xanthophyllippa

Can we tell more stories about horrible and good doctors' appointments now? Because I've got a horrible appointment story:

Two years ago I was having a weird, scary chest issue when I ran and I ended up having to see a pulmonologist. He couldn't find anything wrong with me, and when I asked why I was having problems, he didn't even look away from his computer screen as he said, "Well, sometimes heavy people do have trouble breathing when they exercise."

Okay, well. I'm 5' and roughly 150, which gives me a BMI of 29.3 - or 0.6 away from being morbidly obese. But I also get a ridiculous amount of exercise - like, this season alone I've logged more than 1000 miles on my road bike - and most of my weight is from muscle mass. I've done eight sprint triathlons, a half-marathon ski race, countless 5Ks, plus all the training needed to be able to do those events, yet even though I explained all this (as context for why not being able to run a half-mile without chest pain was terrifying), somehow it never occurred to him that I might not actually be A Total Fattie. And he didn't seem to care one whit that I'd never had this problem when I started running - when I was actually 25lbs. heavier than I am now. All he cared about was OMG SHE'S HEAVY.

The good parts of this story: I had to argue (cheerfully) with his PA that no, my weight was in fact entered correctly on my chart and that I did not weigh closer to 125. And then a month later I told this story to my endocrinologist (herself a very zaftig woman), and she snorted and said, "yeah, I know him. He's a dick. And you could kick his ass."

PistolPackinMama

@Xanthophyllippa I was going to say-- did the BMI chart LOOK at your calves? Because for the love of god...

Xanthophyllippa

@PistolPackinMama I KNOW, right? That was the best part of arguing with the PA - she cautiously said, "I don't see how you can be that heavy," so I showed her some leg. "Ah," she said, and then, "wow."

(Also, my fabulous GP once looked at my height and weight, looked at me, poked me in the quad, and said, "Wow. You're very dense.")

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