Writes Kate Manne in "Doctors have fatphobia, too — which does serious harm to patients" (WaPo).
February 1, 2024
"Many nurses admit: They feel repulsed by our bodies and do not want to touch us. Doctors are..."
"... more likely to view us as a waste of their time and have less desire to help us. We are hence, unsurprisingly, far more likely to die with serious health conditions that have gone undiagnosed. We are people who live in larger bodies. And the discrimination we face is incredibly harmful....I have come to believe that we need to work on changing not our bodies but the world that unjustly down-ranks us.... The truth is, fat people aren’t failing. It’s the system that is failing fat patients."
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107 comments:
You make choices and you live with them.
This does sound like a business opportunity though. A Medical Clinic that tolerates all choices that its clientele makes, even the very unhealthy choices.
Anything except take responsibility for our own health.
Well they’re gross. Make at least an effort to not be gross.
Yes, we definitely need another non-discrimination law and another protected class. If nothing else, at least attorneys get paid.
The truth is, the system isn't failing failing fat patients. It's fat patients who have failed themselves. You are responsible for your personal health choices, and short of conditions like undiagnosed hypothyroidism, fat patients are flubbering it.
"The system"....I don't know about that; sounds like buck-passing to me.
I don't know where this patient is getting care but the doctors and nurses Boston has been churning out the last few years couldn't be more woke. Bonus for you WaPo reader's- there's no straight white guys. The bigger worry is probably groping.
Isn't it part of the job description that nurses are repulsed by no one? They aren't touching Ryan Gosling all day long, after all.
Most of their job is wrangling bodies, and a large one is more difficult and dangerous. What if someone wobbles in the shower? Even a smaller person is a lot of dead weight if they slip. Maybe their trepidation is about safety.
I have come to believe that we need to work on changing not our bodies but the world
Get out of bed. Make your bed. If you must protest, push away from the desk and plan a series of 5k walks.
We are .. far more likely to die with serious health conditions that have gone undiagnosed.
BULL! you are morbidly obese* they diagnosed you when you walked through the door.
They KNOW the treatment too (so do YOU!) the treatment is weight loss.
They feel repulsed because they are disgusted with having to "treat" a patient that REFUSES treatment
morbidly obese* in August, 2022 gilbar weighed 374.5 lbs; he KNOWS about being morbidly obese
ps. just stepped off the scale: 265.9 lbs.. (-106.6lbs) Still obese, but continuing treatment
pps. my doctor (who i saw 3 weeks ago) LOVES seeing me.. i'm pretty sure i make her day
Tufts hired a black lady to run things and manage it into the ground. It's kind of a ghost town now. Lucky there's anybody there...
Flubberimg! Perfect!
Huh. It’s no longer “fat people” or “obese people”, it’s “people that live in larger bodies”. It’s like they’ve become hermit crabs who can change their home as they grow.
rockpile said it best...
You let the knife and fork, dig your grave
What does Elmo have to say?
As a retired physician, I would argue her point. I couldn't see the article due to the pay wall, but does she present any objective data to support her claim?
"...The truth is, fat people aren’t failing. It’s the system that is failing fat patients.""
The system could probably do better, which is true of all systems, but the person most responsible for a fat person being fat, is the fat person.
Upvote for gilbar for the Rockpile reference...from 40 years ago!
I guess the trans thing isn’t working out so well with the Left so they need a new victim class.
Every doctor’s office should display a full body X-ray of a person living in a larger body. Once you see the bone to muscle/fat ratio, you won’t be able to deny the structural and physiological risk of all that extra body you carry.
“Here's a silly jingle,
You can sing it night or noon
Here's the words, that's all you need
'Cause I just sang the tune:
Oh, I don't want her, you can have her
She's too fat for me
She's too fat for me
She's too fat for me
I don't want her, you can have her,
She's too fat for me
She's too fat
She's too fat
She's too fat for me!”
You need to push yourself away from the table earlier. For yourself. Not for others.
Tags: The Nile ain't just a river in Egypt; Biology is a top-quality real science
Let the morbidly obese doctors and nurses serve morbidly obese patients. Oh, I forgot, morbid obesity involves an elevated risk of heart failure, joint failure, immobility, deaths with surgeries, and shorter lifespans. So, maybe there are no obese doctors left alive to service people with this morbid condition? Maybe those doctors went on disability and share hospital rooms with the obese patients seeking care?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881295/
https://www.asahq.org/madeforthismoment/preparing-for-surgery/risks/obesity/
Too Fat Freddie and Large Marge gotta go!
Yeah, it is pretty disgusting. My mom was a fat lady. Toward the end of her life, she had to wrangled by orderlies with a lifting crane. I wouldn’t have wanted their job for nuthin
- Krumhorn
Down and Outer on the street: “Say buddy… can you help me out with a sandwich?”
The Late Louie Anderson: “Sure. Where is it?”
Obese people don’t live long.
They are probably the only people environmental zealots truly love.
I say probably because fat people do overtax the environment, while they are around.
Manne in a minute:
Like women, fat people are hated, killed, and abused under the boot of men, their powerful patriarchy, and their unwitting allies. Let's pull it all down and see what happens, since it will have to be better than this. Just keep chipping away.
Our intellectual prowess and moral superiority will make a better world than the one we inhabit. Perfection is possible.
This is kind of material Norm would have revealed in.
Did I tell you all lately how much I miss Norm?
Oh gee, but ain't it grand to have a girl
So big and fat that when you go to hug her
You don't know where you're at
You have to take a piece of chalk in your hand
And hug a ways and chalk a mark
To see where you began
One day when I was a-huggin' and a-chalkin'
And a-beggin her to be my bride
When I met another man with some chalk in his hand
Comin' around the other side, over the mountain
And over the Great Divide
Huggin' and Chalkin' - Hoagy Carmichael - 1946 - back then, when you heard 'Trigger', you thought of a palamino.
10+ to @Gilbar. Keep chopping wood, brother. You'll get there.
How much better do you feel?
I think what bugs me most about the article is its objectifying of all the people involved. The person defines themselves by their weight and the only agency they have is demanding others care for them anyway. You also have the agency to do something about your weight. The Doctors and Nurses trained and took oaths to take care of patients, but they are not required to just touch you because you demand they do.
Also, it is not fatphobia. It is the disgust in demanding they care for you while you demand not to listen to their medical advice and care for yourself. They are not there to waste time treating a person, who isn't interested in following the proper treatment. Doctors and Nurses are also taught triage, and they'll prioritize their time with patients by treating the people they can save first. If you won't take treatment, they can't save you, and they will prioritize you appropriately. Your Rx is to eat less, move often, Elmo!
+1 to gilbar. I had similar issues. My best results came when I was the most receptive to doing what my Doctors (didn't really need Nurses and I married to one) told me to do. My previous post may seem glib, but if a person won't take those steps, all of them, particularly the first and last one, then they won't get better.
Frankie Yankovic is still the King:
Frank Yankovic & Friends - Too Fat Polka
50% of humans are genetically predisposed to obesity in an environment of high calorie dense satiable foods, specifically the combo of fat sugar and salt.
It has nothing to do with willpower contrary to the abrahamic desert dwelling fetish of controlling people with guilt and shame.
I don't think there's a Giant food conspiracy behind it or a giant medical conspiracy behind it. It's just the way modern Life unfolded and obesity coupled with metabolic disorder mental illness and the various other diseases like cardiovascular dementia cancer autoimmune etc.
In any event one of interesting findings is that lack of muscle may be a bigger problem than too much fat.
The gag reflex is something that people can't control either, so it's no surprise that doctors and nurses are repulsed by the morbidly obese.
Here's a pro tip. Always be positive and enthusiastic whenever you're dealing with medical people the better you make them feel the better care you will get. That is especially important if you're getting surgery and you have a hospital stay afterwards.
Attitude is everything.
Well, they're right. Staff will tell you obesity is the no. 1 problem driving all of America's health care woes.
Besides the usual metabolic syndrome diseases, they're hard to move, hard to catheterize, their skin breaks down and smells, can't wipe themselves, and on top of that they act whiny and entitled, perhaps as a defense mechanism.
What's not to like...
It's like feeling too wide to fit through even the "intersectionality" intersection.
The fat portion is ridiculous. But doctors don’t touch anyone very often anymore. It has all been replaced by tests.’
Yeah right. It's the doctors' fault.
Hmmm, maybe it's because of the yeast infections lurking in the folds of your rolls or how a man's penis disappears. Could that be unpleasant to deal with? Possibly.
does she present any objective data to support her claim?
That's a fair question. Does Manne list names, sample size, personal history, citations, or is this the routine projection, impeachment of diversity (i.e. color, class blocs) that we expect from JournoListic, academic, Democratic, et al sources.
My sympathies go to paramedics who have to lift the obese down multiple flights of stairs.
Now do albinophobia on bumpers, in yards, in retail, on parade.
Any other "burdens", of phobic conceptoon, WaPo?
https://www.sciencealert.com/obelisks-entirely-new-class-of-life-has-been-found-in-the-human-digestive-system
“We are people who live in larger bodies” is destined for the next edition of Bartlett’s.
I will make an observation, call it bigotry if you will.
On the 400#+ people that say the nurses and doctors are disgusted by them, did you take a shower right before going to your appointment?
Did you take a shower today?
Did you take a shower this week?
Personally, I would not enjoy performing a physical examination on a morbidly obese person that has not had a shower in over a week.
Likewise, I would not enjoy the exam on a scrawny homeless junkie that has not had a shower in a week.
Perhaps it is not their weight that is the problem?
I've never seen a picture of Joe Biden sniffing a fat kid's hair.
Draw your own conclusions.
I go to a urologist and am shocked at the horribly fat people in the waiting room. I thought about going to medical school rather than law school, but this is one of the reasons I decided against.
It is sad, and I imagine there is plenty of truth to the notion that health conditions may be overlooked in very obese people. They have my sincere sympathy. Very few people choose to be fat. Having said all of that, I think a little moral opprobrium may still be in order. Deciding what to eat is a pretty basic part of being an adult human, and it DOES determine how much a person weighs despite all the hoopla about carbs etc.
Eat less food. Be more active. The solution to obesity is extremely simple, even though for many people it is also unbearably difficult. I have my own weaknesses, thankfully this is not one of them, so staying fit and lean is very easy for me. I do know that it is not the same for many other people who would dearly love to be slim and healthy.
Ok, look. There are people whose off button for food works better than others. There are people whose metabolisms are naturally faster than others'. For a lot of people, losing weight is not a cakewalk, if you'll pardon the inappropriate phrase, and saying, "Just put down the fork" is like telling me, "Just brush the grass" with golf; I would if I could. It isn't fair, but it is true.
My mother-in-law is naturally very thin and always has been, except for a brief period in her 60s where she actually hit probably the 80th percentile of the healthy weight range for her height and age was distraught about how "fat" she was. As soon as she and her husband couldn't afford to go on a bunch of cruises, the "extra" weight dropped off and has never returned.
She has never had to work at losing weight. She cooks with heavy cream and pasta and potatoes all the time, she serves bread and dessert with every dinner, and she barely tops 100 lb. at 5'2". She herself eats very little most of the time - like 1 to 1 1/2 meals a day unless she's on a cruise, when she eats every dessert on offer, like 3 per dinner - but it's because she literally doesn't feel hungry, not because she's working at controlling her intake.
And I am not like that. I'm almost always hungry. If I don't eat at least two meals a day plus two big mugs of coffee in lieu of breakfast (this is my version of intermittent fasting), I get hangry. I cook from scratch to avoid processed foods; we eat very low carb except for vegetables, plus moderate "good" fats; I pay careful attention to portions; I only make desserts on holidays; we don't keep unhealthful snacks in the house. I work very hard at maintaining a healthy weight, always have had to (post-high school, anyway) and I'm sure always will have to.
Fortunately for me, I do have a food off button, though it's not very sensitive; I have a good friend, however, who basically doesn't. She works much harder than I do at trying to eat healthfully, both in terms of portions and in terms of what she eats.
And I have two friends who've had bariatric surgery, changed their eating habits as was necessary post-surgery, were thin for a year or two, and are now overweight again.
For me and even more so for my friends, weight maintenance and weight loss require a sustained, lifelong effort - it's not like "I have to lose 5 pounds to fit into the dress" or "Bikini season is coming up, so I'd better drop a few pounds." And that's just the way it is. Not fair, but true.
And fat people do indeed have worse health outcomes, but it seems pretty dang clear that it's primarily because they're fat and being fat puts a lot of extra stress on every bodily system, not because nurses don't like to touch them or doctors don't see the point of treating them. Gilbar's comment above is salient: doctors can make a general diagnosis when a fat person walks through the door. (Might they therefore miss an underlying condition? Maybe - but it seems unlikely to me that they'd be wrong in saying, "Step 1 is lose 50 pounds," since being at a healthy weight makes almost everything easier and better.)
"It’s the system that is failing fat patients."
No. Changing the world will not bring you better health outcomes. You're fat ad you're destroying your health. You need to learn better habits.
"... we need to work on changing not our bodies but the world ..."
Says it all.
Then again, the fat positivity movement won't last long. One of the few who publicly say what's really happening.
My wife is a ED/ER & our daughter a CRNA. I’ve never heard either of them mention this issue.
Kate:
Isn't it part of the job description that nurses are repulsed by no one?
No. Just that they care for them; physically care, not emotionally care.
@gilbar - Impressive. Good on you.
Has she heard of Jardiance? You know, the little pill with a great big story to tell.
I lost 50 pounds over a year and a half. Have kept from regaining it for 4 years.
By today’s standards I wasn’t obese, just chubby. But, I was losing my ability to walk any considerable distance. The excess weight screwed up my posture, and 40 years hunched over a computer deformed my tail bone. All the nerves to your legs and feet go through this bone. After walking about a quarter a mile, my feet would go numb and become useless.
My doctor originally diagnosed me with peripheral neuropathy, but an MRI revealed the deformation of my tail bone, pinching the nerves. My doctor is obese, a common problem among healthcare workers.
How did I lose the weight? Keto, calorie counting, bicycle riding and yoga. I only eat two meals a day, so I’m also doing intermittent fasting. Done eating for the day by 2 p.m. I reduced my daily caloric intake from, probably, 3,500 to 2,200. I underwent physical therapy. Fortunately, I’ve been doing yoga for 35 years, so I had a foundation for an exercise regimen.
The hunger issue went away after a couple of years. I can afford to eat 4,000 calories at holiday feasts and birthdays, and I know how to take the weight gain back off. I don’t feel as if I’m sacrificing anything. I’m retired. I couldn’t have accomplished this if I were still working full time.
Call sports illustrated. They can put you on the cover of the swimsuit edition.
Oh, never mind…
Too bad Randy Newman didn't create a sequel to "Short People".
Has she heard of Jardiance? You know, the little pill with a great big story to tell.
What would really sell that medication is bringing that commercial's lead actress back to tell her story after 6 months, assuming she is using the product.
There are people who truly have medical conditions that cause their obesity. Low metabolism. Or whatever. Everyone else just needs to shut their pie hole, and lose a few pounds.
Doctors look at a fattie and think they don't care about their health, why should I? They probably have the same reaction to alcoholics, drug users, etc.
Gilbar: Keep up the good work, brother. I hope you are lifting weights. Sarcopenia can accelerate during massive weight loss unless you do resistance training. You don't want to go from being morbidly obese to skinny fat. Normal BMI south Asians and east Asians actually suffer from higher rates of diabetes than obese Americans. You need muscle to store blood sugar.
While I'm a believer in a no white carb fish and grass beef focused high fiber Mediterranean diet, you might consider doing carnivore as a weight loss tool so you can keep building muscle as you burn the rest of the fat off.
Planet fitness is only $10/month. No excuses not to lift weights.
And I’ll bet the nurses who act this way are fat themselves. Well, at least some of them.
This is called “irony.”
Howard said: "Here's a pro tip. Always be positive and enthusiastic whenever you're dealing with medical people the better you make them feel the better care you will get. That is especially important if you're getting surgery and you have a hospital stay afterwards."
This is very true in my experience.
I unexpectedly spent 16 days in the hospital in September/October. I tried my best to be ebullient and positive with the hospital staff I encountered - the RNs, aides, food service, cleaning crew. I know for a fact they appreciated it, and they bent over backwards to make my stay as pleasant as they could. After I got out, I brought a card and a box of nice chocolates to the nurse's station as a sincere gesture of thanks.
Don't bother being nice with the doctors. They're blinkered; they only see you as a bundle of test results and a host for billing. Sorry, but they were the most unpleasant, uncaring people I encountered throughout.
"I have come to believe that we need to work on changing not our bodies but the world that unjustly down-ranks us.... The truth is, fat people aren’t failing. It’s the system that is failing fat patients."
This is a perfect example demonstrating James Lindsay's explanation of a key feature of the Woke/Social Justice/Critical Theory etc. etc. that is dominating our society now. He says that they view all of society and every human interaction as consisting of systems of oppression. And they literally mean EVERYTHING is a system in which all individuals participate. Therefore, the system must be disrupted, dismantled, and destroyed. All of it.
An example he uses is a hypothetical where two people are walking down the street and one accidentally bumps into the other, causing her to stumble and fall into the street and then get hit by a car. The SJW would allow no individual responsibility for this result. It's not an "accident." Instead, systems created the condition to where the sidewalk isn't constructed to prevent such accidents; the road system is wrong; the construction of the vehicles is wrong; the very use of cars is wrong.
Here, the above quote demonstrates this mindset. People are fat entirely because a system made them that way---and therefore, only a complete dismantlement of the entire medical system will suffice.
This "Fat Phobia" thing is probably the most destructive myth in health care right now. Some of it comes from black women who say it is racist to point out their obesity. Type II diabetes is out of control because this nonsense is taken seriously.
This "Fat Phobia" thing is probably the most destructive myth in health care right now. Some of it comes from black women who say it is racist to point out their obesity. Type II diabetes is out of control because this nonsense is taken seriously.
Jamie said...
I'm almost always hungry. If I don't eat at least two meals a day plus two big mugs of coffee in lieu of breakfast (this is my version of intermittent fasting), I get hangry.
back in August, 2022; when they told me i was diabetic, they had me go to a dietitian.
I Knew that she'd HATE what i was eating (frozen pizza for supper and pancakes for breakfast),
but was Glad that i'd be able to tell her that i Never ate lunch.. Just breakfast and dinner.
She WAS horrified; but MOSTLY about my only eating twice a day (REMEMBER, i went to her for diabetes).
She didn't have a problem with the processed food per se, just the amounts.
She made me count carbs ("only" 75 grams per meal, Which people here will tell you is a LOT), that's it.
So..
3 or 4 pancakes (1/2 cup of flour, 1/2 tbsp of sugar, less than 2 tbsp on syrup) + sausages
.....(and coffee with splenda and milk) for breakfast.. 75 grams for breakfast
these frozen meals called "healthy choice steamers" with a cookie equals 75 grams for lunch
HALF of a frozen Jacks Pizza with a cookie (and diet pepsi) equals 75 grams for dinner
OH! AND i'm supposed to (allowed to) have THREE snacks (30 grams) 2 hours after each meal
That is a LOT a food (less than i was eating though.. KEY THING.. i eat every 2 or 3 hours.
Between the snacks AND the metformin, i'm not hungry.
The key is NO sugar drinks and Not allowing myself to go over 75 grams.. AND the metformin.
About last march (60 lbs down after), the weight loss started to slow, and i started walking
(4 times a week for an hour (2+ miles) a walk), and the weight continued to recede.
Soon, the 2+ miles became 4 miles, and the walks got Much hillier, but as you see;
i'm Not starving myself, or wearing myself out exercising.
Is the main thing the metformin? Probably. they say that it reduces hunger pangs, and decreases your body's ability to process the food you eat (am i bulimic? Probably so)
Still, it beats insulin!
As of last month (Jan) my A1C was 5.1, and my fasting blood sugar was 91
As of 2 minutes ago, my blood pressure was 116/61 with a pulse of 71
What happened to Howard today? He's making sense.
Ask the average person if they could help you move some heavy objects, such as a 100lb TV or something. They would say oh, no, too heavy. But the obese person carries the extra 100lb everywhere, all day.
When you get old and you are still fit, life is not so bad. I can still hop up a curb or hustle my way out of the path of a car in a parking lot. Cut my own grass. If you are not even old yet and can't climb stairs...that is pitiful. No excuse.
I have a longtime friend who is a well-respected surgeon, and she described the medical challenges of dealing with fatties --
a) They usually have multiple comorbidities which greatly complicate general care, pre- and post-surgery.
b) Abdominal surgery is a horror, with 6, 12, or more inches of blubber outside what abdominal muscles there are. Trying to keep it all from sloshing into the opening is a real challenge.
c) Inside, everything is surrounded by even more visceral fat, enveloping the organs.
She's not "grossed out" by it, because she's preoccupied by the technical challenges of trying to work around and through all that fat, just to get to the object of the surgery in the first place
Perhaps the doctors know what obesity can do to a person and get disheartened by patients who refuse their advice?
Yeah, OK, babe...do a pelvic exam on a 300-pounder - of which I have done many - and then get back to me on this subject. "Many" is the key word there - we do them anyway, don't we.
Fat is only one of countless kinds of gross that doctors encounter. We take care of all of them, even if we do grit our teeth and hold our breath now and then. This writer is one giant fecal impaction.
Hawaiians and many Polynesians have evolved/bred into having super efficient metabolisms. They very easily gain weight, and these days show up as massive football players and sumo wrestlers. This is clearly a genetic trait, where they'll never be like slender Ethiopian marathon runners, but it's not made any better by their cultural tradition of heavy carb diets. The Pacific tropical diet of poi (taro root), rice, bread, and sweet fruits was likely essential for surviving long ocean voyages and living on small islands, but it does their health no good.
Equal outcomes by race? Obviously impossible. Eating lots of protein and avoiding simple carbs? Easy mitigation strategy.
Fat people are hardly the most repulsive thing that health workers are subjected to. Projectile vomit. Impacted feces. Infected wounds. A health worker's lot is not a happy one. The human body, with the exception of a few Playboy models, is pretty icky......By and large, people are more critical of nicotine addicts than over eaters. I guess meth addicts occupy the low rung on the totem pole, but their deterioration is total and comprehensive. It's very hard to have an upbeat, positive attitude when dealing with a drug addict......I can see how people get fat. There's so much temptation, and it's everywhere. And not only that, cheap food tastes better than expensive food. It's not a wonder that there's so many fat people. It's a wonder that everyone isn't fat.
Fat people are hardly the most repulsive thing that health workers are subjected to. Projectile vomit. Impacted feces. Infected wounds. A health worker's lot is not a happy one. The human body, with the exception of a few Playboy models, is pretty icky......By and large, people are more critical of nicotine addicts than over eaters. I guess meth addicts occupy the low rung on the totem pole, but their deterioration is total and comprehensive. It's very hard to have an upbeat, positive attitude when dealing with a drug addict......I can see how people get fat. There's so much temptation, and it's everywhere. And not only that, cheap food tastes better than expensive food. It's not a wonder that there's so many fat people. It's a wonder that everyone isn't fat.
Howard is right about the weight training. Losing that much weight inevitably means losing a huge amount of muscle. Skip the machines and use barbells if possible. Squats and deadlifts are the most important lifts.
@gilbar - many congrats on the success of your health journey!
We had an electrician come by the house a year after COVID hit. He told us he had lost a lot of weight recently - can’t remember how much rn - and changed his diet, stopped smoking, etc, all because of COVID. He was just 29 yrs old at the time. He had come face-to-face with the harsh COVID reality that the people most at risk of dying from it or other RSVs were people like him, so he was incentivized to change his ways dramatically. Very impressed by him.
You are fat because you choose to be fat. Stop with the victimization canard. We are all so over it.
“a) They usually have multiple comorbidities which greatly complicate general care, pre- and post-surgery.
“b) Abdominal surgery is a horror, with 6, 12, or more inches of blubber outside what abdominal muscles there are. Trying to keep it all from sloshing into the opening is a real challenge.
“c) Inside, everything is surrounded by even more visceral fat, enveloping the organs.
“She's not "grossed out" by it, because she's preoccupied by the technical challenges of trying to work around and through all that fat, just to get to the object of the surgery in the first place”
I think that Dr K has mentioned this before. My partner’s spine surgeon has repeatedly told her that she is a joy to work on, because it is so easy. Surgery, in his area of expertise is much more difficult with the obese, and a lot of their problems, that he attempts to alleviate are a direct consequence of their obesity. He won’t let anyone else touch her, but gets his assistants to do as much as they can with his (many) obese patients.
It’s not just that though. The obese often forgo personal hygiene. Talk to a gynecologist about dealing with obese women. Apparently, they often don’t properly clean themselves, and the stench can be overpowering. It’s not just women not cleaning their nether regions, of course, but also just not doing normal personal hygiene. Plus, the fat causes them to sweat more, to counter the heat buildup of that much insulation. That sweat festering in unwashed armpits. Fecal mater festering in not properly wiped and washed asses. Etc.
With that in mind, I had a morbidly obese MD as a client. His inventions tended to involve innovations that were useful in hygiene for the obese. Yes, there is a market there, but he couldn’t pay my fees, because he was disabled by his obesity from practicing medicine (he was an ER Doc, but couldn’t stand long enough or walk enough to do the job anymore). So, he wanted me to take a piece of the patents as my payment. Wouldn’t have done so if I could (bad business practice, that many solo patent practitioners fall into once or twice early in their career), but couldn’t because I was in a big law firm.
"Did you take a shower today?
Did you take a shower this week?"
I worked as a ride operator at Disneyland after I got out of high school. On the Jungle Cruise, you are (or were, anyway- don't know about today) required to help people in and out of the boat by holding everyone's elbow as they stepped on and off the dock. In summertime, nobody wears long sleeves so you're always grabbing bare skin. When it's time for your break and you go to the restroom to wash your hands, you would not believe all the filth going down the drain if you never saw it for yourself.
I don't even want to think about what doctors and nurses encounter.
@Jamie
I'm not naturally thin either but there's a difference in being a middle aged round person and being obese or morbidly obese. And it's different when young. I was this same weight in my twenties. I lost over 20 lbs through exercise alone. I am sometimes disappointed that I'm back here, but if I hadn't lost the weight, I'd probably be another 20 lbs heavier and that would be a big problem. Will I ever be at a perfect BMI? NO, but every little bit helps.
“Nothing tastes as good as thin feels.”
Yeah, dump all over the people that are actually trying to help you. Classic victim mentality. Most of the people that I know in the medical profession really try not to fat shame fat people. The same cannot be said of those that are not in the medical profession.
Maybe instead of being critical of the people that are trying to help you, you should be critical of the one person who is not trying to help you: Yourself.
Interesting inverse correlation between smoking and obesity rates.
Breezy said...
@gilbar - many congrats on the success of your health journey!
thanx for all the positive thoughts, y'all; but i'm STILL a huge lard ass (266lbs)..
So congrats on "success" is WAY premature.
It's nice to be able to fit into pants that i bought 4 years ago and never could fit into.
It's nice to be able to think, the "bad thing" about a 5 mile walk is that it takes a couple of hours
It's nice to see the progress i've made SO FAR
But, it's STILL a long way to go. I'm shooting for being under 250lbs by my birthday in June..
But; that would STILL mean, that i'd weigh Nearly 250lbs!!
i HOPE to be down to 220lbs by the end of the year (1 lb a week).. But EVEN IF; i'll STILL be overwieght.
And EVEN if i EVER got down to 185lbs; i'd Still be an old, ugly unemployed trout bum..
being realistic; It's Starting To Look Like i am NEVER going to be able to woo Lindsay Lohan.
Reality is Cruel!
I can see how people get fat. There's so much temptation, and it's everywhere
and
Nothing tastes as good as thin feels
One great challenge is that you have to eat. You can't just go cold turkey and never again cross the threshold of a bar as if you're an alcoholic who deals with strong triggers by complete avoidance; you will have to keep on facing potential triggers every day of your life.
Another great challenge is that it's not necessarily true that nothing tastes as good as thin feels - you have to be able to remember the bad parts of what fat felt like, every minute, especially when thin is feeling like no cushioning on your butt on those metal bleachers and no built-in insulation on the day when you forgot your coat and, especially if you lost weight in middle age or later, drooping skin that keeps you from wearing anything sleeveless or anything that shows your midriff even though you're thin now. Nor is it necessarily true that flavor is what drives an overweight person to eat and to keep eating. Nor is it necessarily true that everyone savors a delicious meal as much as anyone else - my mom, for example, doesn't really seem to taste food, as far as I can tell. (I've wondered if one reason my mom is thin in old age is because she never seems to have cared what she eats; it has always seemed to me that dry, overcooked, under-seasoned chicken and soggy vegetables are as good as a well-prepared meal to her. For several years of my youth she didn't allow us to use salt, because of my dad's habit of reflexively salting whatever she put in front of him before tasting it.)
In other words, I urge sympathy toward fat folks, especially if you've always been thin; they may face struggles of which you can know very little, just as you may have struggled to gain weight and that struggle may be just as incomprehensible to them.
And again, it's not existentially fair, but it is true nevertheless, that the obese as a demographic die younger, sicker, and in more discomfort or pain than those at a healthy weight.
Why am I not surprised to read this in the Washington Post?
"Many nurses admit ...."
Name two.
You know, there are a LOT more morbidly obese people in America than there used to be. I wonder which other societies have seen the same change.
And while it is certainly the case that sufficient willpower would enable one to overcome the problem, there are very few problems of which that is not true. Arguably none. The Canadians are making great strides in the solution-by-willpower field. Soon they will have no problems left!
Well after reading all this, I guess I had better go get my daily run. I had a bad case of Covid 2 weeks ago and running still really sucks, but today is not a weightlifting day, and every day is a running day. I put on 15 pounds over Christmas /New Year, so I'm still close to 160lbs. I won't get back to being a skinny running dork by sitting on my ass.
I worked as an EMT (later medic) for 9 years, ran rescue and for 3 years did inter-facility transport. Retail Lawyer sympathized with us having to move the obese down stairs; from a transport standpoint, what goes down has to go back up...the morbidly obese patient whose doorframe(s) must be physically removed by fire crews for extraction and transport -- often involving stairs, yes, also needs the same process in reverse when going home. Our training stressed that the No. 1 cause of major injury to emergency staff was lifting and carrying. Dispatch keeps a record of known obese patients (regular consumers of emergency services) so that we can request "lifting assistance" (additional fire or ambulance personnel) to get those patients where they need to go. We had to have a dedicated bariatric ambulance with bariatric stretcher, ramp and winch to move these patients. Some of them, bedridden, required as many as 6 extra firemen using a mansack just to get them out of the bed and onto the stretcher -- it's an involved and difficult process. Also, frequently, unpleasant at best. The system DOES accommodate these people but what we can't do is make it the same for them as it is for the non=obese.
There are also a lot more people with evident mental illness. Something in the water? Maybe something in the air? The electromagnetic field? In the last century and a half, we have subjected the human body to a truly immense number of environmental exposures that it NEVER encountered before. So many that there is no way of telling which, or how many, are poisoning us. Nor, apparently, any going back.
The damn fork made me fat.
just got back from my "Standard" walk (2.25 miles, usually 65 min).
The snow was pretty low, but still made it more of a trudge; took 75 min today.
It was 48 degrees, which was nice.. trails should be clear of snow by Saturday
It's gut dysbiosis and social media algorithm, Jupiter. Look in the mirror, sweetheart.
Toxic and mutagenic microbiome feast on the overindulging of irresistible ultra processed industrial sludge sold as food at fat fuck restaurants, convenient stores and gas station mini farts.
The psycho-software is continuously uploading round the clock directly to the Brain via eye balls glued to phones shilling chilling tales of impending doom and one simple trick to melt belly fat instantly.
Anybody here ever been a smoker? Show of hands please. Yes, me, too. Remember how easy it was to quit? Me neither.
People who are "morbidly obese" get the same kind of good advice from non-obese people that smokers used to get from non-smokers -- and it helps them no more than it did us smokers.
Except there's this difference: So far as I know there was no genetic factor that made me want to smoke, but I understand that there ARE genetic factors that make some people become and stay morbidly obese. Yes, if we love them, we want them to get more healthy, but shaming them isn't the way to show that.
Anybody here ever been a smoker? Show of hands please. Yes, me, too. Remember how easy it was to quit? Me neither.
People who are "morbidly obese" get the same kind of good advice from non-obese people that smokers used to get from non-smokers -- and it helps them no more than it did us smokers.
Except there's this difference: So far as I know there was no genetic factor that made me want to smoke, but I understand that there ARE genetic factors that make some people become and stay morbidly obese. Yes, if we love them, we want them to get more healthy, but shaming them isn't the way to show that.
I've made 2 comments, both of them urging sympathy for fat people, and while I've given a nod in each to "but obesity is not healthy," I feel moved to comment explicitly on the article quoted in the post.
I have sympathy for the writer because I'm giving her the benefit of the doubt that she's one of the obese people for whom weight loss is dauntingly difficult. But I have zero sympathy for her belief that the world needs to change to accommodate her feelings. Aside from the (former? Sometimes it seems so) social requirement that everyone be treated with the respect due a fellow human being, to hell with that. Nobody gets to never have hurt feelings.
Concerning the idea that there's a significant portion of the population who are genetically predisposed to be fat... Where were these people when I was younger and most the population was not fat? There must have been a massive population-wide mutation, right?
Jamie (as I have come to expect) is the voice of reason and decency in this conversation. Being lean and fit does not mean you are a better person. Do I really need to say this? I am a skinny fucking runner guy who has never had any problem with excess weight. So what? It does not make me better than the poor bastards who struggle every day with their weight. Yeah, no. It does not. Have a bit of understanding and realize that while losing weight is simple, it is not easy for many people.
Where were these people when I was younger and most the population was not fat?
They were right there next to you, smoking and drinking coffee and not eating ultra-processed, hyper-palatable junk foods loaded up with salt and high-fructose corn syrup.
I have the rare experience of living in a developing nation in the Caribbean for about 20 years, working there. I saw American fast-food companies establish a presence there for the first time right around the turn of the century. Back then, people were mostly skinny on the standard Caribbean diet of fish, some pork, lots of vegetables, lentils, and rice. You'd see laborers and fishermen, with their shirts off, ripped, lean, no body fat. Now they've got McD's, Pizza Hut, KFC, Burger King, Wendy's, etc etc. Guess what: By 2010, you'd notice people getting overweight and by 2015, fat people started to become noticeably common. It's the cheap fast food doing it. And this is in a culture that, like most of South America, prizes looking sexy.
I've worked overseas from the early 90s in a lot of different developing nations. And the first thing I would notice, returning to the US (Houston) was: All the fat people. It really stands out, when you're away for long enough to get accustomed to new surroundings.
Concerning the idea that there's a significant portion of the population who are genetically predisposed to be fat... Where were these people when I was younger and most the population was not fat?
At a guess, in the past 50 or 75? years we've seen a vicious cycle take hold: postwar prosperity led to greater and better variety, abundance, processing, and distribution of foodstuffs everywhere, even in the northern Midwest (my mom said she never had strawberries in the winter, even frozen, until she was a young adult); and people who might have been predisposed to obesity but hadn't had the opportunity to become obese now had that opportunity. The newly obese people got accustomed to the larger portions and the ready availability of foods (and especially convenient, processed foods that they didn't have to take time or expend effort to prepare) everywhere. The manufacturers of the foods had zero incentive to make less of their products and almost zero incentive to make them harder to eat (I understand the first boxed cake mixes were "just add water," but the manufacturers had to de-engineer them to require the "baker" to add an egg and oil too, so she'd feel that she was actually baking*). Up, up, up go the portions and availability, down come the prices, up goes the obesity, because literally everyone whose bodily economy is such that in a hunter-gather society she'd gain weight when more food was available and would therefore out-survive her fast-metabolism neighbors, now lives in a world of constant abundance and can afford all the food she wants.
This is my guess. Add in critical theory, such that fat is now a burgeoning(!) protected class, and we're off to the motorized mobility device races.
*My mother-in-law firmly believes that adding a pudding mix to a cake mix and adding sherry instead of water along with the egg and oil creates a "homemade" cake. She's a wonderful - if both extravagant in ingredients and unimaginative in dishes - cook, but she can't bake for diddly.
I am fat. I also agree with my doctors and nurses that my fat body is grotesque. And they don't even have to see me every day, just a few times per year. Thinking that morbid obesity is anything but grotesque, a problem to be resolved, and an impediment to health is to ignore stark reality. It is grotesque. If you are fat you are in for bad health, and you should lose weight.
Oligoncella: I'm not sure I'd argue that some population group is predisposed to be fat, exactly (I certainly agree that if you look at high school and college yearbooks up to about the mid 70s or so there just aren't that many kids who were more than random variations on plump) -- but I do believe that there are a LOT of people who don't handle high volumes of starches and sugars (ie, most snacks) well, and who put on weight very quickly and lose it very slowly, if at all. The group, in fact, most prone to do very badly indeed with the government's Food Pyramid. The sixties was an explosion of fatty snack foods and sugary drinks and prosperity meant everyone, including kids, had this disastrous diet readily available. FWIW I grew up in that period and was pretty much the lone outlier in my age group -- a fat little kid, then a fat big kid, and I didn't turn it around until I went away to college and went on a scandalous version of the protein diet. I've struggled with weight all my life, and at this stage I only manage to keep some of it off by forbidding myself any candy of any kind, and shunning pastas, bread (any starches, actually) sugary stuff, etc and eating only a limited range of vegetables, meats, fish and so on. Not easy, but it's the only way that sort of works for me.
Oligonallia: Changes in environment triggers epigenetic predisposition.
"Sugar intake in the USA was fairly stable in the 1970s but then rose sharply after 1978. Per capita intake of total caloric sweeteners was 124.6 pounds in 1978, 132.7 pounds in 1988, and 154.1 pounds in 1997 [17]. This indicates an increase of 36.7 g/day (147 kcal/day) between 1978 and 1997. The increase in energy intake is sufficiently high to explain the increase in the average weight of the population [18]. One important factor that brought about the growth in sugar intake was a major drop in the price of sugar that occurred after 1980 [19]."
Welfare benefits, endless screens and TVs and gaming, and public schools that not only feed kids high carb crap but send it home with them is one significant subset of obesity. Change out all food stamps for WIC, and use the WIC diet for schools. You'll save money; people will get more nutritious food, and mom will have to get off her ass to cook something daily.
For those who can afford it, low carb is the way to go. 40 carbs a day and your fat will melt away. Every store has Miracle noodles and almost carb free tortillas. They're actually good.
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