…I mean, really, what ABOUT all the mens who get ovarian cancer? Why does nobody care about THEM? So unfair.

Maybe the medical community needs to seem self-assured, or people would be rioting.. But even if you are pretending you have it all figured out, you shouldn’t believe your lies to the point that you make people pay with their lives.. or health, physical or emotional. There is so much gray area left in the diagnosis and treatment of the human body! Not to mention metabolism is still almost a complete mystery.. why can’t we just admit we aren’t sure how it works yet?

This is also personally worrying, as someone who is ‘abnormally’ light. I honestly had no idea – I am familiar with animal medicine and don’t really go to the doctor myself, I just assumed that most meds were dosed by current weight just like at the vet.

As for dosing by lean body mass.. that tends to stay pretty darn constant, from what I’ve experienced myself and heard from other people, and doctors. Despite being officially ‘underweight’, I have an average proportion of lean body mass to body fat, as do most people I know (few of them within ‘ideal’ BMI ranges) who’ve had the testing done (the only truly accurate test is a full-immersion in the multi-million dollar machine at the hospital – calipers are somewhat accurate – those vibrating scales they sell are pure snake oil).
Even if you gain a fair deal in a short time by eating more, and aren’t active, you still put on at least 1/3 of what you gain as muscle. So, as has been said before, ‘overweight’ people are not a thin frame with proportionate muscle, covered with many superflous pounds of fat – most people classed as overweight or obese, are proportioned just like ‘normal’ weight people, if we’re talking %s.

Absolutely brilliant.

Well that’s all well and good for YOU, but, I prided myself on being a good student, who studied until she got it, but I had to take organic twice, and only got a D the 2nd time around. And I took it during the summer, it was the only thing I did besides work. And since the F and the D went towards my GPA, it was destroyed. Sorry we’re all not brilliant like you… I’ll tuck my OC bitterness away now.

“Yeah, I think maybe we shouldn’t hate on doctors so much…..”

Hmm…not so much, because they get paid way more than I do because they have a hard job. Not just because they have an MD at the end of their name. I know that part has all been said and done, but, to add to it, if we’re going to say, oh their job is so hard, and the human body is so complex, then they shouldn’t be going around saying that they’ve got obesity all figured out and this epidemic would be in the bag if those lazy, undisciplined people would get it together. Again, that’s already been said, but doctors in general (not the small amount of decent, nice ones) piss me off.

And practicing medicine without basing it on sound existing science IS malpractice. Yet most med schools teach next to nothing about research and interpretation of it. The “science” classes involve identification of structure and function, a rote memorization of information, which has little to do with the complete scientific method.

RANT WARNING!

When training doctors are taught science at all. it is epidemiology, which can NEVER establish anything more than a *chance* that there might be a statistically significant correlation between one thing and another. Correlation can never establish causation at all (Did you know that over 80% of child rapists drink water?! See what I mean? Correlation never implies causation.) This is the kind of study all over the news that makes people think that eggs are a wonder food one decade and a Silent Killer the next. BTW, when the correlation is lower that 200%, it means there is no relationship between the studied factors that is better than chance.

So, “Men who ate kiwi fruit more than twice a month were 130% more likely to have their penises shrivel up and fall off.” means exactly the same thing as “Men who ate kiwi fruit more than twice a month were no more likely than other men to have their penises shrivel up and fall off.” So feel free to ignore any such “proof” that there is a magic food or diet. There isn’t. We’re omnivores who have lived on every possible type and range of foods. Actual malnutrition syndromes like beri beri or scurvy, and toxic exposures as with lead poisoning from food storage jars painted inside with lead based pigments are the exception, not the rule.

Epidemiology is a perfectly sound scientific method: it identifies out of the endless range of possibilities which correlations *might* actually have a causal relationship, and warrant a true scientific test with controlled diverse populations, double blinded so neither researchers nor participants know who gets what. And even when a cause and effect relationship is established, the direction of cause and effect is not established. To do so we must do another true test with proper methods.

There are many things we truly do not know, and it’s not malpractice to do your best to treat people with illnesses based on existing observations, even if they are technically guesses and hunches. Qualitative research is just as important as the above quantitative methods, because they can yield important “your mileage may vary” case evidence about individual differences and group differences that can’t be quantitatively captured. Quant research can only reflect populations and are biased toward the average – evidence for outliers or any other individuals can’t be adequately captured.

Studies linking BMI to cancer in populations can’t yield any information at all about an individual’s risk of getting cancer based on her BMI. Medical practice is not currently scientfiically based for the most part, even when there’s good evidence.

For example, in reproductive medicine there would be essentially no episiotomies or circumcisions performed in hospitals if medical practice were truly scientifically based. Episiotomies CAUSE vaginal/labial/anal tears 90% of the time and worsen them when cut after a tear starts, while outcomes for the babies are just as good for the the mothers without episiotomies, meaning that episiotomies aren’t “saving babies’ lives”. Circumcision has no scientifically significant health benefit at all, it’s basically just a cultural genital mutilation ritual. (Which is admittedly up to the parents, many of whom don’t regard it in this light.) Some obstetricians simply won’t believe the science on either common practice because their approach to medicine uses faith based thinking rather than scientific thinking. (Faith based thinking is wonderful in the proper context, of course!)

How, exactly, is it “mine”?

It’s not an amount I weigh.
It’s not an amount I aspire to weigh.
It’s not a number that I personally selected because I find it ideal-sounding.
In fact, it doesn’t have anything to do with me or how I see myself or what I want for myself.

So how, exactly, is it ‘MY’ ideal weight?
I think the use of that personal pronoun is designed to make the person feel like they have some stake in the whole supposed ideal-ness of the theoretical weight.

“Your ideal weight” is only a whisper away from “your target weight” or “your goal weight”, rhetorically speaking.

How can someone tell me what MY ‘ideal’ is, without me having any say in it?

What if you went to the bank and they started prattling on about “your ideal income”? Or what if we were taxed according to our “ideal income”? And only allowed to buy bras for our “ideal cup size”?

We would just tell them to Sod Off, wouldn’t we? I hope.

Well, if any medical professional ever tries talking to me about my ‘ideal weight’, I’m going to play dumb. I’m going to bat my eyes and look all confused and say “… but.. but… I don’t remember choosing an ‘ideal’!? So I think I must not have one? Maybe you have my chart mixed up with someone else’s?” I will just play so perfectly dumb that I will force them to acknowledge that it’s not MY ideal weight. It’s a coordinate on some chart. And that is all.

And then I’ll explain to them that I’ve been that weight, and in my opinion it was not ideal at all, so I moved on to bigger and better things.

“Claire embarks on a nutritional experiment – she will eat whatever she wants, whenever she wants, for six weeks. But what effect will her abandoning of self-control have on her weight, size and blood pressure? The film examines how her changing physique and body image affect her personal and professional relationships as well as her emotional well-being.”

… How is “eating when you want to” for six weeks meant to cause drastic changes in her physique and her relationships? I find this somewhat baffling. (Maybe because I’ve never really been either a binger or a crash dieter, so I can’t imagine managing to cause huge weight shifts in that time frame…)

/sarcasm

How they prescribe medication always made me wonder about weight. How could they give the same amount to me when I got sick than they do to my husband, who weighs 80 pounds more than me? And in that case, who’s the “ideal” one they’re basing it on– am I getting too much or is he getting to little– or a bit of both?

What are they going to think of next– that one size really DOESN’T fit all????

That one about square pegs is new…I’ll keep that in mind.