I can’t blame doctors for letting obesity color their opinion. Look around your doctor’s waiting room. Everyone is fat. Imagine the suffering and illness they see daily due to fat. How can those observations not color their general attitude?
Look around your doctor’s waiting room. Everyone is fat.
Lots of people are old and age correlates with weight gain. But the volleyball player who blew out her ACL isn’t fat. Neither is the chemo patient who is back for a final round.
How can those observations not color their general attitude?
Doctor: “Feels like everyone I see is either sick or injured”
I’m not sure your second point works, or maybe I just don’t understand it. It’s not like the doctor is making judgements that people are fat outside a hospital- they’re doing their job. You’ve got a car and it’s starter goes out every year, last time being a year ago. Your car wont start. Whats the first assumption?
It’s not ableist or bias to assume that the most common issue is the most likely issue. They see a ton of people whos problems are irrefutably due to their weight. It’s not the doctors job to make judgement calls on whether that person is wholly responsible for their situation, it’s their job to doagnose the problem and help take steps to fix it. The problem being their weight, the steps include: burn down capitalism and replace it with a system that doesnt incentivise companies to use the cheapest least healthy ingredients, or tell the patient unless they lose weight they’re going to die. One of these is completely pointless to tell the patient, the other gives them an unfair opportunity to potentially save themselves.
Medical care for obesity is currently in most cases like telling someone with a broken starter that they need to run their car more instead of replacing the starter.
If eating too much compared to energy usage is unhealthy then there’s already something wrong with the patient that’s causing them to eat too much or expend too little energy. Telling them to lose weight might be the only thing within a provider’s abilities to do, but it’s equivalent to telling someone with a broken starter to leave the engine running.
It is abelist and biased to pass judgement on ones patients for having symptoms of physical, mental, social, or environmental ailments. When a symptom is already socially stigmatized a provider has a responsibility to care for the social impacts of that stigmatization as well, at the bare minimum in one’s own dealings with the patient.
Your first two paragraphs i agree with 100%. Your final paragraph i feel is accurate but id want to really mull over that before I really form an opinion. Obv in an ideal world it’s pretty easy to assign blame, but our legal and cultural issues are so fucked that topics like that really have to be analyzed in depth under the lens of how that would actually effect reality.
analyzed in depth under the lens of how that would actually effect reality
You are implying you imagine some moral hazard where their provider minimizes the risk of the conditions the patient has, and as a result the patient stops seeking treatment. What you’re talking about in reality is shame. “Should a patient feel shame talking to their provider”?, and the answer to that is resoundingly “no”. Shame is a powerful demotivator, it’s function is to stop a person from doing something that threatens their relationships with others or the society they depend on. Trying to motivate someone with shame is counter-productive. All shame in a patient care setting can do is demotivate the patient from seeking care.
Nah, the moral hazard is from the doctors side. What can a doctor get away with without risking them losing their job or putting themselves in a dangerous position.
Sorry, “moral hazard” is a term-of-art (something that doesn’t mean what it says on its face but is used in some particular way in some fields or professions). In this case by “moral hazard” I meant the idea that if you reduce the harm of some course of action there’s a chance that people will engage in it more because it’s less harmful now. It usually is applied to risky-yet-beneficial behaviours like injury from sports or from outdoor pursuits. It’s ridiculous in that context (I don’t think we should make things worse just so they don’t get better) and doubly or triply ridiculous when the risky behaviour isn’t beneficial or also isn’t effectively voluntary.
Ah yeah, that wasnt what I was trying to imply. I think honestly the main reason that I didnt agree fully was because you were using a lot of terminology in ways that i wasnt sure i understood, and id like to familiarize myself with more of the topic before i formed a distinct opinion of the less clear aspects of issue. Obviously i want everyone to get the help they need though, and I don’t think we were ever seriously in disagreement about that. I appreciate the clarification btw, im not familiar with that usage.
They see a ton of people whos problems are irrefutably due to their weight.
Weight is a symptom not a cause. Metabolism, age, injury, psychology - these are causes.
burn down capitalism and replace it with a system that doesnt incentivise companies to use the cheapest least healthy ingredients, or tell the patient unless they lose weight they’re going to die.
Everyone dies. And big people have existed far longer than the advent of processed sugar. But asking people to adopt unhealthy eating habits in pursuit of a tiny waistline isn’t healthy.
Too often I see people conflating “Looking healthy” with “looking pretty”, absent any of the trade offs necessary to maintain appearances.
The environmental causes are availability of options we crave but are still not forced into, so individual responsibility is absolutely a thing.
I was obese and it sucked but I got down to a healthy weight, and keeping it off kind of still sucks but it doesn’t take a lot of time or money, in fact it’s generally cheaper.
Fast food is constantly highlighted as an impossibly unhealthy reality, the nicer places cost more and take too much time. Except you can choose passable choices in fast food.
If you can freely pick, there are fast food places that offer salads with maybe some grilled chicken, which can be healthy unless you opt to drown it in ranch.
But let’s say you are in a group and they pick a restaurant without an option like salad. Just asking for water instead of a big sugary drink gets you so much closer to healthy. Skip the fries, skip the mayo, get a smaller burger. All these things are cheaper and friendlier to a reasonable caloric budget.
It sucks because it means eating to feeling “ok” while skipping the most awesome foods and rarely getting to feel just utterly full, but that was just life when people had healthier weight.
Similarly on activity. It does suck that work has people sedentary, but our idle pursuits are similar. When I was a kid, TV was stuck on a schedule and video games were only so engaging, so we would get bored and want to do something. Maybe it was walk amongst some trees to see if anytime interesting was around. Maybe do something with a ball. Nowadays we can get endless engagement from streaming, video games, and Internet. So tempting to just be on the couch. We can still choose those more active things, but we don’t want to.
Note all this awesome stuff is still great in moderation. I just went full on gorging at a restaurant a week ago on pretty much whatever I wanted. The thing is this is maybe like once every 2 or 3 weeks, not daily like we really want to.
Then why are Americans so much worse at it, on average, than people in e.g. France or Japan. You can’t just say “hurt durr Americans are just irresponsible;” that’s a bullshit cop-out and you know it.
I’m trying to have a conversation about what it would take to actually solving the problem here; if you just want to feel morally superior you can go ahead and fuck off.
Oh, and by the way: even if the problem really were that Americans were more irresponsible on average compared to people from other countries, there would have to be a systemic reason why and that’s the thing that would be relevant to talk about! Your thought-terminating cliche is completely fucking worthless.
Unfortunately they were implying that that’s outside people’s control, like lead exposure or something, which is why they got the response they did. For the moment, anyway, it’s possible to eat good-ish if you educate yourself andfamiliarize yourself with your local area’s businesses. Even even there is nothing but a walmart, you can still buy veggies. If they don’t have veggies, you can buy nuts and beans. Going to McDonalds is a choice. Eating frozen dinners with family sized bags of chips for dessert is something people do because of lack of education or exhaustion, both problems with our society, but if you are the person in question then, you, personally can choose to eat healthy. It just won’t be as appealing.
For the moment, anyway, it’s possible to eat good-ish if you educate yourself andfamiliarize yourself with your local area’s businesses.
Of course it’s “possible;” anything is “possible.” What matters is, why is it apparently harder to do in the US than in other places?
Something is different on the societal level that changes the average outcomes. Disregarding that because you’re bent on blaming individuals for perceived moral failings is missing the point.
I can’t blame doctors for letting obesity color their opinion. Look around your doctor’s waiting room. Everyone is fat. Imagine the suffering and illness they see daily due to fat. How can those observations not color their general attitude?
Lots of people are old and age correlates with weight gain. But the volleyball player who blew out her ACL isn’t fat. Neither is the chemo patient who is back for a final round.
Doctor: “Feels like everyone I see is either sick or injured”
Nurse: “Try spending less time in the ER”
I’m not sure your second point works, or maybe I just don’t understand it. It’s not like the doctor is making judgements that people are fat outside a hospital- they’re doing their job. You’ve got a car and it’s starter goes out every year, last time being a year ago. Your car wont start. Whats the first assumption?
It’s not ableist or bias to assume that the most common issue is the most likely issue. They see a ton of people whos problems are irrefutably due to their weight. It’s not the doctors job to make judgement calls on whether that person is wholly responsible for their situation, it’s their job to doagnose the problem and help take steps to fix it. The problem being their weight, the steps include: burn down capitalism and replace it with a system that doesnt incentivise companies to use the cheapest least healthy ingredients, or tell the patient unless they lose weight they’re going to die. One of these is completely pointless to tell the patient, the other gives them an unfair opportunity to potentially save themselves.
Medical care for obesity is currently in most cases like telling someone with a broken starter that they need to run their car more instead of replacing the starter.
If eating too much compared to energy usage is unhealthy then there’s already something wrong with the patient that’s causing them to eat too much or expend too little energy. Telling them to lose weight might be the only thing within a provider’s abilities to do, but it’s equivalent to telling someone with a broken starter to leave the engine running.
It is abelist and biased to pass judgement on ones patients for having symptoms of physical, mental, social, or environmental ailments. When a symptom is already socially stigmatized a provider has a responsibility to care for the social impacts of that stigmatization as well, at the bare minimum in one’s own dealings with the patient.
Your first two paragraphs i agree with 100%. Your final paragraph i feel is accurate but id want to really mull over that before I really form an opinion. Obv in an ideal world it’s pretty easy to assign blame, but our legal and cultural issues are so fucked that topics like that really have to be analyzed in depth under the lens of how that would actually effect reality.
You are implying you imagine some moral hazard where their provider minimizes the risk of the conditions the patient has, and as a result the patient stops seeking treatment. What you’re talking about in reality is shame. “Should a patient feel shame talking to their provider”?, and the answer to that is resoundingly “no”. Shame is a powerful demotivator, it’s function is to stop a person from doing something that threatens their relationships with others or the society they depend on. Trying to motivate someone with shame is counter-productive. All shame in a patient care setting can do is demotivate the patient from seeking care.
Nah, the moral hazard is from the doctors side. What can a doctor get away with without risking them losing their job or putting themselves in a dangerous position.
Sorry, “moral hazard” is a term-of-art (something that doesn’t mean what it says on its face but is used in some particular way in some fields or professions). In this case by “moral hazard” I meant the idea that if you reduce the harm of some course of action there’s a chance that people will engage in it more because it’s less harmful now. It usually is applied to risky-yet-beneficial behaviours like injury from sports or from outdoor pursuits. It’s ridiculous in that context (I don’t think we should make things worse just so they don’t get better) and doubly or triply ridiculous when the risky behaviour isn’t beneficial or also isn’t effectively voluntary.
Ah yeah, that wasnt what I was trying to imply. I think honestly the main reason that I didnt agree fully was because you were using a lot of terminology in ways that i wasnt sure i understood, and id like to familiarize myself with more of the topic before i formed a distinct opinion of the less clear aspects of issue. Obviously i want everyone to get the help they need though, and I don’t think we were ever seriously in disagreement about that. I appreciate the clarification btw, im not familiar with that usage.
Weight is a symptom not a cause. Metabolism, age, injury, psychology - these are causes.
Everyone dies. And big people have existed far longer than the advent of processed sugar. But asking people to adopt unhealthy eating habits in pursuit of a tiny waistline isn’t healthy.
Too often I see people conflating “Looking healthy” with “looking pretty”, absent any of the trade offs necessary to maintain appearances.
Weight can cause plenty of issues, it’s both a symptom and a cause.
Exactly, which points squarely at an environmental cause, not at individual sloth/gluttony or some shit like that.
The conclusion you’re saying doctors arrive at—which I don’t doubt you’re correct about—is actually completely fucking backwards.
The environmental causes are availability of options we crave but are still not forced into, so individual responsibility is absolutely a thing.
I was obese and it sucked but I got down to a healthy weight, and keeping it off kind of still sucks but it doesn’t take a lot of time or money, in fact it’s generally cheaper.
Fast food is constantly highlighted as an impossibly unhealthy reality, the nicer places cost more and take too much time. Except you can choose passable choices in fast food.
If you can freely pick, there are fast food places that offer salads with maybe some grilled chicken, which can be healthy unless you opt to drown it in ranch.
But let’s say you are in a group and they pick a restaurant without an option like salad. Just asking for water instead of a big sugary drink gets you so much closer to healthy. Skip the fries, skip the mayo, get a smaller burger. All these things are cheaper and friendlier to a reasonable caloric budget.
It sucks because it means eating to feeling “ok” while skipping the most awesome foods and rarely getting to feel just utterly full, but that was just life when people had healthier weight.
Similarly on activity. It does suck that work has people sedentary, but our idle pursuits are similar. When I was a kid, TV was stuck on a schedule and video games were only so engaging, so we would get bored and want to do something. Maybe it was walk amongst some trees to see if anytime interesting was around. Maybe do something with a ball. Nowadays we can get endless engagement from streaming, video games, and Internet. So tempting to just be on the couch. We can still choose those more active things, but we don’t want to.
Note all this awesome stuff is still great in moderation. I just went full on gorging at a restaurant a week ago on pretty much whatever I wanted. The thing is this is maybe like once every 2 or 3 weeks, not daily like we really want to.
No, it points to people eating processed food and other shit. Guess what, you can still be healthy if you eat healthy.
So then the question becomes, why is processed food and other shit so pervasive in the average American diet? That’s what an environmental factor is.
Refusing to think about the problem in terms of systems because you’ve got a hard-on for blaming individuals is absolutely missing the point.
You are 100% correct that we as a society have a problem with this
That’s why the individual has to take extra care to eat right and excersise. Their doctor needs to emphasize this as much as possible.
VCan we fix out society? I don’t know, I sure hope so. But in the meantime people are responsible for their own health.
Eating health is a responsibility of an individual.
Trying to blame the omnious evil system instead of the responsibility of each individual is absolutely missing the point.
Then why are Americans so much worse at it, on average, than people in e.g. France or Japan. You can’t just say “hurt durr Americans are just irresponsible;” that’s a bullshit cop-out and you know it.
I’m trying to have a conversation about what it would take to actually solving the problem here; if you just want to feel morally superior you can go ahead and fuck off.
Oh, and by the way: even if the problem really were that Americans were more irresponsible on average compared to people from other countries, there would have to be a systemic reason why and that’s the thing that would be relevant to talk about! Your thought-terminating cliche is completely fucking worthless.
That’s the cause I think they were referring to.
Unfortunately they were implying that that’s outside people’s control, like lead exposure or something, which is why they got the response they did. For the moment, anyway, it’s possible to eat good-ish if you educate yourself andfamiliarize yourself with your local area’s businesses. Even even there is nothing but a walmart, you can still buy veggies. If they don’t have veggies, you can buy nuts and beans. Going to McDonalds is a choice. Eating frozen dinners with family sized bags of chips for dessert is something people do because of lack of education or exhaustion, both problems with our society, but if you are the person in question then, you, personally can choose to eat healthy. It just won’t be as appealing.
Of course it’s “possible;” anything is “possible.” What matters is, why is it apparently harder to do in the US than in other places?
Something is different on the societal level that changes the average outcomes. Disregarding that because you’re bent on blaming individuals for perceived moral failings is missing the point.
Yeah but your doctor cant prescribe you burning down capitalism, they can prescribe you lower your caloric intake.
Unless…
“Actually officer I have a prescription”
That’s the trick!
They believe everyone is gluttonous and slothful because they’re misanthropic.