Reviving the thread, a reader sighs, “I should have set a timer for how long it would take a physician to tell me my weight will kill me”:
My original letter prompted this predictable response:
As a physician I am dismayed by one of your readers’ quotes: “I am healthy despite my weight.” That’s the equivalent of saying I’m healthy despite my heart disease or I’m healthy despite my colon cancer.
It is that global belief, which is quickly being undermined by research, that puts doctors outside the reality of the lives of their patients. Recent studies have shown that in the absence of heart disease, diabetes, high blood pressure or other chronic illnesses that can correlate with obesity, but do not always, obesity itself may not be the risk it is assumed to be. The blunt instrument of weight, or the specious BMI, as an absolute indicator of health does not square with the actual experience of many people. The prescription to lose weight – a “losing” proposition in the long run for most people – does not recognize the reality that doing as prescribed – eating healthily and exercising regularly – doesn’t always result in weight loss, but it may result in health.
Another is more blunt:
By insisting on continually recommending weight loss to their fat patients instead of emphasizing healthy habits for all, doctors like your reader do real harm.
In fact, studies have shown that many health professionals have a bias against fat people, finding them disgusting, lazy, noncompliant, etc. Largely because of this bias and its effects, fat people are less likely to go to the doctor. And when they do go, they get substandard care, with symptoms of serious health problems often ignored and attributed to fat rather than the underlying condition.
I’m not saying doctors shouldn’t talk about good nutrition and exercise and other health habits with their fat patients. They should talk about all these things with all their patients, all the time. But as anyone who has ever been to a doctor like your reader knows, most of the time conversations about health habits are ignored in favor of pointless and harmful scolding about weight loss.
Recent Dish on doctors’ bias against fat patients here. Another reader brings mental health into the equation:
The physician who e-mailed you is surely saying what is decreasingly popular to say out loud: obesity is a health risk. But the implication in that e-mail that the numbers on the scale are of paramount importance overlooks the mental health aspect of living and dying by the scale.
I have lost about 70 pounds, from a high of almost 250 to a low in the 170s. I am lucky that I never hit the point of stretch marks or damaged skin, so I saw the changes in the mirror and gained the promised confidence, but for a long time, I frequently weighed myself. When I lost weight, of course it felt good, but at some point, the urge to step on the scale at every opportunity became overwhelming. If my weight was up, I would enter a cycle of self-hatred, sometimes culminating in the use of laxatives (which I have never told anyone – I may have an undiagnosed eating disorder). All this over five pounds or less. For perspective, a person’s weight can fluctuate by 10 pounds over the course of a day.
This happened over and over and over again until I put my scale away so deep in my closet that I have forgotten where it is. I may have lost it in a move by now. I am so much happier, even if I’m not hovering around my all-time lowest weight.
The Dish 