Fat Acceptance: Callous Helpfulness

[Content Note: Medical Issues, Surgery, Fat Hatred, Dieting]

Ana's Note: This is a Fat Acceptance 202 post, not a 101 post. If you need a 101 course on Fat Acceptance, please refer to Kate Harding's excellent archive; there are about 10 linked posts in that archive and they are all awesome and admirably cover most FA 101. 

Please also note that this post is going up the week I'm in hospital. That means moderation will be done on a smartphone whilst I am under heavy medication. Comments which are not FA-friendly will be removed without notice, warning, or apology.

I went to a new dermatologist today to have a mole removed.

I have lots of moles removed. Little brown ones that lie flat against my skin sometimes puff up and I get worried. Or they rub against my clothing and bleed, and that worries me too. For the longest time, I went to my general practitioner doctor to have them removed, even though I can't stand him because he has a habit of poking at painful places and saying with a grin, "This hurts? Right here? This is the hurting place? It hurts? Are you sure?" *poke* *poke* *poke* I keep meaning to get a new GP -- I've had "get new doctor (HAES)" on my to-do list for two years now, but mostly I just don't go to the doctor. I spend a lot of time with specialist.

I decided to go to this new dermatologist because my GP started charging me twice for mole removal: once to come in so he could look at the mole, and then a second time to come in for removal. I couldn't afford that on our insurance plan, so I found this dermatologist who would do everything in one sitting. And I picked a woman doctor because I'm at the point in my life where I just don't want to be naked-in-a-paper-gown with any more strange men than necessary, and maybe I'd hit jackpot and get someone a little more compassionate than my GP.

And this dermatologist was nice. Got me in and out real fast, cut the mole off like nobody's business.

But she was thin and I am fat, and one of the first things she said to me -- without any discussion whatsoever about my health or my family history -- was "I can tell by looking at you that you have a genetic risk for diabetes. So you might want to think about lifestyle changes."

I could hear the clock on the wall.


Really? You know, that's very interesting, given that no one even remotely related to me has diabetes.


It's interesting that you can tell that just by looking at me. Did they teach you that in dermatology school? I ask because my parents -- both of them quite thin -- have not been told of this genetic risk that apparently runs through our bodies, and I'm distressed that they're not receiving adequate treatment from their current doctors.


Lady, my "lifestyle" is complicated. Do you really want to hear all about it, or do you just want to cut this mole off and be done with me?

She was trying to help, I'm sure. Hippocratic oath! Serve and protect! Heal all the harms! I'm sure she genuinely believes in the DEATHFATS, and wants to save and educate as many people as she can. I'm sure she optimistically believes that everyone can Do Better! and that if they're not already, it's just a question of educating them to Do Better!

I'm sure she'd be shocked to find out that I already know quite a lot about diabetes because she's not the first person to diagnose my genetics from a quick once-over. I'm sure she'd be sorry to hear that I have a non-obvious physical disability, that I'm under the strictest orders from my specialist to walk as little as possible, and to never run or jump under any circumstances.

I'm sure she'd be surprised to learn that I have an expensive recumbent bike -- expensive because a mesh-chair that conforms to my painfully hunched back is considered a luxury in the exercise bike world -- and that I do in fact use it regularly in order to keep my muscles active, yet with no effect on my weight. I'm sure she'd be disbelieving to hear that the last time I went on a calorie restricted diet, my basic body functions essentially starting shutting down over the course of a very long year: I was cold no matter how many heaters were pointed at me or sweaters were wrapped around me; I was sleepy to the point of almost narcolepsy, regularly falling asleep at my desk despite my best efforts to stay awake.

I'm sure that if I really wanted to tell her all this, she'd probably sit down and politely listen. Maybe she'd even learn something, but if my experience is any indication, she'd be more likely to file me under "Strange Special Snowflake Butterfly Patient". And then she'd forget it, and I'd have to explain it all, all over again, the next time. My entire life with doctors is repeating myself, over and over, as I explain my physical disabilities, my infertility, my medical history that I'd really rather not have to relive once or twice or thrice a month to complete strangers who won't even do me the courtesy of remembering what I tell them.

And this is why I still have my GP as my GP and haven't crossed that "get new doctor (HAES)" line off the to-do list. Because I can't just call up a doctor's office and say "Is she accepting new patients, and also is she going to bring up my weight because I don't want that." I can't say that because I'm pretty sure that the nice person on the other hand is going to say "no" because the nice person on the other end is going to believe that the doctor won't.

The dermatologist didn't walk in today and say, "Hello, I notice you are fat." She tried to bring to my attention a concern she had about me.

But she based this concern 100% entirely on the fact that I am visibly fat.

My mother -- who has been slender all her life -- has never once been cautioned about diabetes. My father was Fat Like Me a year ago; in one year's time he's lost over 40 pounds, and has been praised by doctors and family members alike for his deep devotion to Health. And now he's also the first in our family to be diagnosed with cancer, the first symptom all the cancer doctors ask him is "have you lost a lot of weight?", and he's under doctor's orders to gain as much weight as he can in the few weeks between now and chemotherapy because his life may literally depend on him not starving to death in the process. However, if my thin father walked into this dermatologist's office today, I'm sure she'd proclaim him the picture of good health. Why not? He certainly looks like it.

Except that you can't tell health by looking. No one has ever correctly deduced on meeting me that I have constant debilitating pain, that I carry a hunched back and a full-body scar underneath my clothes, or that most physical movement is both painful and incredibly dangerous to my health. And yet a dozen or more doctors in my life have felt the need to tell me that I'm "genetically" at risk for a disease that doesn't run in my family, based largely on the indicator that I look pretty darn fat. Not that there's anything wrong with that! But you should know that you're an unhealthy fatty who needs to make "lifestyle changes"! Do they bother to ask what my lifestyle currently is? Of course not! We all know that fatties don't exercise or eat anything other than baby donuts! Otherwise, they wouldn't be fat. Q.E.D.

By the time this post goes up, I'll be in the hospital recovering from yet another surgery to correct a spinal problem that manifested when I was a skinny child and the spitting image of my slender mother. At the same time, my father will be in the middle of a seven-week long, daily radiation and chemotherapy treatment to cure a cancer that doctors told him for a year he couldn't possibly have because he looks so very healthy. Tragically, terrifyingly, ironically, distressingly, I have a better chance of surviving my hospitalization than he, simply because I started out fatter.

Frustratingly, we have both experienced extensive misdiagnosis that has added risk to our lives: him, because he just looked so dang healthy and because extensive and unprecedented weight loss in a single year is Healthy! and totally not an indicator of something Very Wrong until suddenly it is; me, because I just looked so dang unhealthy and because Laziness! and DEATHFATS cause all things, including back pain, until suddenly they don't and there actually is something Very Wrong and the fat was just another symptom.

And the worst part, of course, is that I can't say all this when I'm in the paper gown and the nice dermatologist lady is smiling sweetly at me and the clock on the wall is ticking. I have a life, I have a job, I have deadlines I need to go out into the big wide world and meet. I have a limited number of spoons each day, and I can't bear to spend the last few combating the person who just unknowingly took a whole handful of spoons from me with her callously "helpful" remark.

It's a battle I'd spend the rest of my life trying to fight and never able to win.

And yet it's a battle that keeps being lobbed at me, over and over and over again.


buttercup said...

I am right there with you. I am in fact diabetic, and fat, and I cannot exercise much due to a bad accident/six subsequent surgeries/ metal in my leg , and I've been over this with my doctor but when we were discussing my increasingly horrible peripheral neuropathy on Tuesday, she actually said 'well, you could try losing some weight". Even though she went on to admit there is "no treatment for obesity" and even though diabetics who lose substantial weight are no longer diabetic, it 1)doesn't cure the neuropathy and 2) is temporary because when 95% of them regain, the diabetes comes back, and badder than ever. There are not enough desks for my head.

Yamikuronue said...

I've been thinking of doing a kickstarter for a website that aims to match up doctors and patients based on shared beliefs. For example, if you're strongly pro-life and want an OB-GYN that wouldn't ever dream of bringing up the A-word no matter how complicated the pregnancy gets, or if you're (like myself) a larger person recovering from eating disorders and want someone who won't hassle or trigger you about that, you'd just put in the relevant belief and bam, list of doctors in your area. The reason I haven't done so yet is that I don't think I have the resources to make it happen as far as connections and marketing :(

Anonymus said...

People suck, Ana. Hope they're treating you well in hospital.

EdinburghEye said...

My great-grandfather, my grandmother, and my mother all developed Type 2 Diabetes, so I am by this time accustomed to the idea that quite probably I will too. Eventually. (My great-grandfather died before his daughter was 10: my grandmother died in her eighties, diagnosed with diabetes in her sixties: my mother is 77 and developed diabetes last year, and was diagnosed very promptly thanks to the NHS. But even before my mother became diabetic, I was aware that this hazard potentially lay in my genes - as it does for my sister and brother of cousrse.

I am hyperaware of my blood sugar. (My mother, brother, sister, and myself are all prone to fits of extreme bad temper/self-pity if we let blood sugar get too low: so I think is my older nephew, though my sister is a lot less fraught about mealtimes than our mother used to be.) I avoid the hidden sugar and fat of processed food by eating by preference mostly from-scratch meals. I bake my own bread. I love chocolate, and carefully ration myself to small quantities. I eat sweet treats in small quantities, and things like dried fruit rather than cake. I exercise regularly.

And I'm probably, someday, going to develop Type 2 Diabetes no matter what, because we do seem to have that genetic tendency quite bloody strong. So I read about it, try to keep aware of possible warning signs, and let my optician and my doctor know that this is in my genetic heritage - when I do develop diabetes, I'd like it to be as late as possible in life and to find out as soon as possible and manage it as well as possible.

Oh and I'm fat. Which means that I get uninformed people asking me if I worry about diabetes without even knowing about my mother, grandmother, and great-grandfather.

There is a long answer, which is more-or-less the above, which I give when people appear to be motivated by genuine concern.

And there is a short answer, which I give to people who seem to be just thinking "She's fat, she's diabetic". ("No.")

And then there's the practice nurse, who helpfully told me that I should be eating a low-sugar high-fibre diet and exercising a lot, after she measured my waistline, checked my weight, and took some blood for testing. (As I'd rather thought, the tests came back Not Diabetic, low cholesterol.) She was also visibly startled to discover that she couldn't give me the speech about high blood pressure, because that isn't a health problem I have.

Don't get me started on the time I got lectured patronisingly on how being fat had caused my back problem when it turned out to be caused by my workstation being set up wrong, and went away as soon as the computer was moved three inches to the right. (Yes, I was still fat.)

SherryH said...

Oh, ugh! Isn't paying attention and reading the patient's history something medical professionals are supposed to be trained to do? And yet, so many of them take a quick glance and make assumptions about us that can range from just flat-out wrong to hurtful, even harmful. Those ones are so locked in to their fat = bad health paradigm that they can't see outside the narrow lines they've drawn. (There are good ones out there, just not always easy to find.)

I'm so sorry that happened to you.

Gelliebean said...

"I can tell by looking at you that you have green hair," yes.

"I can tell by looking at you that you are overweight," well, yes - [i]but[/i] really what's the point of saying that?

"I can tell by looking at you that molecules (too small to see) stored inside cells (too small to see) mean you have a problem (that can't be seen)," - er... no.

Unless the gene that causes diabetes is also a gene that causes moles to appear in a pattern/shape/color that distinguishes them from moles caused by any other factor... er... no. Because I would expect a dermatologist to recognize and explain when something appearing on the skin is a possible symptom of deeper root cause, and then to recommend a course of action and consult your PCP on it.

In Texas, there's no requirement that a physician with a self-declared specialty be specifically trained in that field (yeah, I know) but far and away, the majority of specialists completed their residency or fellowship in their chosen field and not in general practice. They also tend to do most of their CMEs in that same specialty when possible, so there's no knowing how long it's been since any one specialist touched information on general practice - could have been yesterday, could have been 12 years ago. I definitely think it was out of line for the dermatologist to be addressing any topic that was not either directly related to the immediate reason for the visit, or directly related to her specialty.

All of that to say I'm sorry, that really sucks. The situation sucks, the attitude sucks, the idea that we carry our 'inferiority' in plain sight and anyone/everyone feels entitled to comment on it really sucks. The idea that a statement like that could come as a surprise to anyone - "oh, gee? Really? I hadn't noticed my own body today" - sucks. The fact that weight becomes a short-hand way to determine someone's worth as a human being really sucks. Intelligence - yeah, if we were smarter we wouldn't let ourselves be fat. Work ethic - if we weren't lazy, we'd put in the effort and not be fat. Neither of those (obviously) really has anything to do with the way I look, but people like short-cuts and templates for thinking and categorizing their responses to different stimuli. I know I'm preaching to the choir here.....

Lonespark said...

Heal all the harms!

Before I finish reading the post, I must say that I now want Hyperbole and a Half to make some kind of med-school t-shirt with that on it.

Lonespark said...


Yamikuronue, that sounds like a great idea. It would be hindered by the general continuing (but hopefully slightly improving) state of health coverage in the US, but it would be awesome. I'm glad I can search for doctors with the right linguistic knowledge, but things like this are at least as important. People who are made uncomfortable by their doctors won't go there unless it's the least evil. Maybe you could make it so patients could kind of interview potential docs in a chat or something?

depizan said...

Even when it doesn't lead to dangerous misdiagnoses (or failure to diagnose), it's disturbing how much of a factor the DEATHFATS play in medical care. I am thin. My mother is fat. These differences lead doctors to make different assumptions about the exact same things.

Once in a while, when I was younger and prone to fainting when needles were involved, my blood pressure in the doctor's office would be high. The nurse would assume it was stress and test again at the end of the visit (when the possibility of needles was no longer hanging over my head), and low and behold, it was normal. The first time my mom's blood pressure was a little high, she had an instant diagnosis of high blood pressure and prescription for pills for it.

Once a blood test came back a little off on the blood sugar for me. The doctor shrugged it off as an anomaly. (Which it was.) Once a blood test came back a little off on the blood sugar for her. The doctor instantly diagnosed Type Two Diabetes.

Funny thing is, my mom was able to cure both of the conditions she may (or may not) have had with very minor dietary changes. Convincing the medical community to stop pointing pills at her was much harder. Even though her blood pressure and blood sugar were completely normal. Because DEATHFATS.

It's bad science, bad medicine, dangerous, and just plain annoying.

Rosieknight said...

*hugs* I'm sorry you had to deal with that, Ana. The whole DEATHFAT thing is both highly annoying and unhelpful. The dermatologist was there to remove the mole, not make prejudiced assumptions about you and your health based on your appearance.

I hope your recovery goes smoothly.

Makabit said...

I can't be the only person who picks my healthcare professionals after carefully scanning their photos and picking the chubbiest ones.

Yes, this is irrational. There are undoubtedly many thin healthcare professionals out there who are not obsessed with DEATHFATS (a divine word, BTW). And undoubtedly many fat healthcare professionals are equally capable of being insensitive and nutso.

But I am cautious.

Re: diabetes, this is my thing: My mom is diabetic, and my dad is diabetic, and at least two grandparents were diabetic, and I pretty much have a target on my fanny that says "Diabetes Cometh". If this happens, OK, I will cope with it.

But I know that if I am about as fat as now when and if it happens, that will be WHY, according to some doctor I will encounter. And I also know that if my current weight loss project continues, and I get back to down to my target weight, what I weighed in college, a nice healthy weight, and I get diabetes, it will STILL be because I'm fat--because even at target weight I will be 'overweight'.

There are many worse things in the world, and some of them have even happened to me, but sometimes I just get pissed off. I imagine this scene, vividly, where I get told I'm diabetic, and they explain that my weight is WAY too high, and NOW maybe I'll 'lose the weight', and I tell them I weigh X huge amount less than I did in my early thirties, and they blink for a second and say 'that's nice, so you know you can lose the rest of the weight...' and then I attack them with the scale.

Thank you for indulging this whine about a health problem I don't even have at the moment.

Makabit said...

Don't get me started on the time I got lectured patronisingly on how being fat had caused my back problem when it turned out to be caused by my workstation being set up wrong, and went away as soon as the computer was moved three inches to the right. (Yes, I was still fat.)

I once had a physician tell me that being fat had caused me to have an allergic reaction to a tetanus shot. I decided I was done talking to her, so I never learned how that worked. Luckily, my arm did not fall off.

depizan said...

because even at target weight I will be 'overweight'.

And they just keep edging "overweight" downward, too. I figure it's only a matter of time before I'm "overweight," too. Not because I've gained weight, but because acceptable has dropped into WTFAREYOUKIDDINGME levels.

I have on more than one occasion wanted to thwap a healthcare provider for telling me what a great job I must be doing at managing my weight. It's called genetics. And, frankly, the idea that everyone must "manage" their weight - as if it's some sort of dangerous animal - is frickin' creepy.

Penprp said...

I got diagnosed at Type 2 Diabetic early this year. Or very, very late last year, really. *I come home from Christmas with a truckload of cookies and half a pie, and there's a message on my machine saying "You're diabetic!" ... Except with appropriate patient privacy precautions, you know what I mean.*

Dr. Dixon: Yes, I see that you lost fifty pounds in the last few years. Unfortunately, your genetics caught up to you. It happens. (My grandmother was diabetic.)

I wish I could clone this man. He's mentioned my weight all of one other time in the past ten years that I've been seeing him, and that was when he commented that weight loss sometimes helped get rid of acid reflux. But I know I'm very lucky.

Silver Adept said...

I think the health service that matches doctors with patients would be a great thing, and I know a friend who would love to see it include mental health care, so that you can go to a doctor that you can actually talk to about being poly or kinky and not get the same reaction as DEATHFATS in the body.

What dooms such a system, though, its that the perfect doctor its out of you're insurance network, and is thus unaffordable. Maybe it should start in countries with social insurance, so as to remove that problem.

cjmr said...

I haven't gotten that line from a non-GP doctor yet, but at my last physical "New Doc" looked at my PERFECT bloodwork (cholesterol the lowest I've had it in 20 years and lipids at the proper balance, fasting blood sugar low, that test that somehow shows historic blood sugar right on target, only thing low was Vit D as usual) and told me that I really had to lose weight. When I told her that I'd been walking 1.5 miles a day all winter without seeing any weight loss results but wasn't now because of pollen season, she was horrified that I'd let a little thing like that stop me. Because "You'll never get results that way". Ummm, my record says 'asthma' and 'spring pollen allergies', I'm supposed to hide inside with AC/air purifiers for two months...

"New Doc" became "ex-Doc" and I'm still in the search for "New Doc 2.0" out here.

Selcaby said...

The time I lost a lot of weight rather fast, without trying, and got lots of compliments on how healthy I looked et cetera, it turned out to be because I had type 1 diabetes.

The person who made the best observation about my health was my hairdresser. For a couple of years after my diagnosis, she kept telling me she could tell exactly how much of my hair had grown since I went on insulin because it was so much healthier than the older hair.

The other day I heard two coworkers telling one another how their wives' medical problems are all being explained away by their doctors as symptoms of pregnancy. I told them diabetes is another condition doctors blame everything on. The fact that my ankles swell up in hot weather is because of diabetes, apparently, although I've never heard a good reason why. It's a bloody nuisance because it makes my ankles look awful just when it's too hot for trousers, and it stops my sandals fitting me comfortably just when I most want to wear them.

Evan said...

Someone could still start it up here in the US, though. Some people might be lucky enough to find an acceptable doctor in-network, and some others might be lucky enough to be able to pay for occasional visits out-of-network. It wouldn't be anywhere near perfect, but it might still be nice to be able to find out the stuff.

Mary Kaye said...

Please feel very free to reject this idea as still putting too much burden on you, but for what it's worth:

You could print up a business card that says, "My medical situation is complex and is being managed by specialists. Unless you are fully conversant with the details, do not offer unsolicited medical advice." On the first offense you hand them the card and ask for it to be permanently affixed to your records. On subsequent offenses you say, in as threatening a way as you can reasonably manage, "I gave you a card explaining that you're not to do that."

You could optionally ask an authority figure to put their imprimatur on it: "recommendation, John Hopkins Clinic of such-and-such" carries some clout.

If this plan sounds good except you can't afford the business cards, let me know and I will drop the money in your tip jar. No one should have to deal with this shit.

April Marie Gilbert said...

my good thoughts go out to you and your father for things to work out well.
I am unfortunately one of those people who always has to watch their diet because I have a history of diabetes in my family. Though since I'm relatively thin no one looks at me and thinks that. Doctors look at me funny when I tell them that I have a history of it in my family and that just about every woman in my family down to my mum has had it. Same with the fact that we have every type of cancer running through our family mostly through the women though the men have had a few too. As such when I tell my gynaecologist that I NEED to have a pap smear every year she usually looks at me like "yeah. uh huh. you're full of it" It's so frustrating having people judge you on how you look and determine what medical diagnosis they determine off that and NOT off your actual medical history. Hell, according to the doctors, I've been overweight since middle school when I was a stick figure with a shit ton of muscle in my legs from sports/walking/running/biking/rollerblading. So I tend to dismiss doctors on things that they don't actually test me for or judge off my medical history.
My theory on other people's weight is as long as they are healthy for THEM, I don't care. Now if they don't have a medical reason for being obscenely obese and they are unhealthy for themselves(which you really don't know unless you talk to them and that makes for awkward conversation starters)then I start having a problem with it. Or conversely if they are unhealthy and underweight I have a problem too. Unfortunately I know some people like that and I'm working with them in conjunction with their therapists to try and help them see that their mental image of themselves is unhealthy and that they look good but it is a long process. I listen to them and try to help all I can. In the end I can't control whether they eat or not and if they do if they throw it up afterwards. I can just encourage them to think better of themselves and support them. My best friend was quite a bit overweight and slightly unhealthy and she decided to eat better and exercise and I told her that I'd be there for her and that we'd go on hikes every now and then when she had time between work and school. And as such I have been there for her.
I tend to not believe society's definition of beautiful anyway.

kiseklieia said...

If people's bodies work in such a way that they have to either go hungry or exercise themselves to exhaustion in order to keep their weight healthy (by which I mean actually healthy, i.e. including the "overweight" range, in which people are less likely to die than if they are "normal" weight), clearly something is wrong with them physically. It's not a willpower issue. There's some sort of problem with how the person's body and brain are responding to food and exercise. That's not a choice. People need to drop the "calories in = calories out" nonsense and realize that we really do not know why there is such a huge obesity epidemic and people have so much trouble losing weight, and that we need to stop blaming people for their weight and find out what is actually going on.

depizan said...

Except part of why there's an "obesity epidemic" is that they've redefined "normal." Now, that's not to say it isn't possible that there is something going on that is genuinely resulting in heavier people. There could be. That I don't know. But I do know that the "normal" range keeps getting smaller, which means that - without people's weights changing - we have more "obese" people than we did a few decades ago.

I'm not at all convinced, though, that either going hungry or exercising to exhaustion is required for most people to have a healthy for them weight. I rather suspect that the actual healthy weight range is magnitudes larger than the medical community currently wants to admit. (And some studies from other countries support this.)

Kit said...

I'm sorry you had to deal with that.

Doctors have blamed my weight for everything from TMJ to migraines. They've told me how unhealthy my weight is for my heart, while they had my blood pressure, which would be good for an eighteen-year-old (I'm 37) right in front of them.

They love to preach exercise, but when I was in training for a triathlon, I actually GAINED weight. (Did I give a crap? Hell, no!)

Eva Carlstrom said...

Moles, overweight, and infertility? Have you researched PCOS (polycystic ovarian syndrome)? That collection of symptoms matches it, and if you're not already familiar with it, it might be helpful to know about it. I have PCOS myself and found the Zone diet (controlled carbs) vastly helpful, including enabling me to get pregnant.

Sorry so many doctors are boogerheads.

Love your writing!

Ana Mardoll said...

Well, I have perfect blood pressure, very good cholesterol, normal thyroid levels, and clear skin with few incidents of acne, so I had been led to believe that PCOS probably wasn't right for me. Am I wrong about those being counter-symptoms?

Ana Mardoll said...

I don't know that I have the spoons to implement this (and deal with the follow-up questions), but I really LIKE the idea. I may just.

Thomas Daulton said...

I just about cried with relief to read this post. Longtime lurker, I think this is the first time I commented here. My medical problems are probably not even 1% as severe as yours. But I have had "thematically" similar experiences with doctors all my life.
It has driven me up the wall for years, that when I walk into my GP's exam room -- no matter if it's a new GP, or somebody I've been seeing for a decade, the first words out of their lips tend to be "Hi, you need to diet and exercise. And has anyone ever discussed with you the benefits of cutting down on salt, and reducing your intake of animal fats?" My response is typically, very calmly, "Well, as I told you three months ago, I am mostly vegetarian and have already cut out most animal fats. I cut salt out of my diet completely back in 1989. And my company has a health plan which gives me 3 hours of paid workday time at the gym every week, which I take advantage of religiously."
There is so, so, so much information out there nowadays about how the "you're fat, so diet and exercise" boilerplate medical advice is counterproductive. Even 3 years ago I was a lone voice in the wilderness pleading with all my friends to examine the holes in that model. Today you can find a wealth of information about it from people like, say, Gary Taubes. But 90% of doctors just can't bring themselves to admit that the boilerplate advice they've been handing out since the 1950s is bad advice -- and if the doctors can't admit it, then upwards of 95% of the general population can't acknowledge it either. It's a stereotype that is so very ingrained, I just don't know how we can overturn it.

Smilodon said...

If I may rant for a moment...
Why is weight a public issue rather than a private one? In a single conversation, a gentleman managed to comment that a certain girl was fat, and then ask if another girl was anorexic. Unless he's their doctor and ask him about their weight, he has no reason at all to think he's in charge of their personal health and well-being. And you cannot win - the only appropraite weight is whatever looks correct him. Without any knowledge of how they attained the weights they are, he can diagnose a physical and a mental ailment. Magic.

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