this post was submitted on 11 May 2025
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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?
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.
No, it points to people eating processed food and other shit. Guess what, you can still be healthy if you eat healthy.
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.
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.