Asshole of the Day

That would be Dr. Carl J. Lavie, medical director of cardiac rehabilitation and prevention at the Ochsner Medical Center in New Orleans. Regarding the so-called “Obesity Paradox” (one of them anyway)—that obesity is correlated with an increased risk of heart disease, yet fat people seem to recover from cardiac issues better than thin people—Lavie says:

It’s well-known that obesity leads to heart disease, and that’s a big part of the paradox. These people wouldn’t have developed heart disease in the first place if they weren’t obese. A thin person is getting it [heart disease] for a different reason, so he or she is getting a worse form of the disease, getting the disease despite being thin.

OK, seriously. “These people wouldn’t have developed heart disease in the first place if they weren’t obese”—immediately before you talk about thin people getting heart disease? And thin people get “a worse form of the disease” because… you think it’s unfair that they got it at all? Fuck the what? 

Here’s what else this DIRECTOR OF CARDIAC RESEARCH AND PREVENTION AT AN ACTUAL HOSPITAL has to tell us about obesity and heart disease.

Obesity in the United States is a major problem. It is increasing in skyrocketing proportions.

Evidently, he missed the good news from the CDC. A year and a half ago.

Also,

There are several possible explanations for the paradox, Lavie said.

One is that obese people visit physicians earlier than others because they develop symptoms, such as fatigue and breathing problems. Heart disease is more treatable if identified early.

Evidently, he also missed the studies showing that fat people do not seek medical treatment as quickly as thin people, because they are so terrified of being mistreated by fatphobic doctors.

Let me help you out, Dr. Lavie.

Two studies in the journal Obesity Research in 2003 found that many physicians harbor negative attitudes toward fat people: A University of Pennsylvania study of 620 primary care physicians found that more than half reported viewing obese patients as “awkward,” “unattractive,” “ugly” and “noncompliant”; a Yale study reported that health professionals strongly associated being overweight with being “lazy” and “stupid.”

Such negative views, some experts charge, may be helping to drive patients away: These experts point to a 2000 study of 11,425 women, which found heavy women less likely to obtain cancer screenings such as Pap smears and mammograms even though they’re at higher risk of dying from cervical cancer and breast cancer. Newer research has produced similar findings: A 2006 study of 498 women, published in the International Journal of Obesity, found that obese women delayed cancer screenings more than other women. Negative attitudes of health-care providers and disrespectful treatment were among the reasons cited for postponing care.

Negative attitudes? Such as?

[Lavie] wanted not only to remind doctors of the paradox, but also to warn them and the general public that it offers no excuse for being fat, he said.

That is the whole thing in a goddamned nutshell. The director of cardiac research and prevention at an actual hospital—like entirely too many of his colleagues—believes fat people are looking for excuses to stay fat, as opposed to looking for compassionate, realistic, trustworthy medical care. I can only guess he assumes we’re having such a grand old time being fat—what with all the donuts and relaxing, the totally never suffering any discrimination or humiliation because of the size of our bodies, the being blissfully ignorant of/willfully blind to the daily screaming headlines about how we’re gonna drop dead any minute—that we’re simply not motivated to go out and get permanently thin, which is totally possible. (Second link is a PDF.) He believes we might just be in the doctor’s office all the time, following up on minor symptoms that could portend larger problems, instead of putting off treatment until we’re so sick we can’t stand it. Instead of dying alone because our doctors told us not to come back still fat. He believes obesity is “skyrocketing,” when the last NHANES results told us there’s been no change overall since 2003-2004, no change for women since 1999. And he believes that fat people who have heart disease have it because they are fat, while thin people who have heart disease have it despite being thin. No possibility of a common cause. Fatties are a different breed. Hell, it’s a different disease altogether in thin folks! A thin person is getting it for a different reason, so he or she is getting a worse form of the disease.

And the fact that fat seems to have some protective value in terms of surviving potentially deadly illness? Bah. You wouldn’t get the illness in the first place if you weren’t fat! I mean, unless you were one of those thin people who got a worse form of the disease, like I mentioned, but… wait, shut up. You just want an excuse to be fat!

This is the logic, y’all. This is the science. This is the director of cardiac research and prevention at an actual hospital. 

This is why fat people are afraid to go to the doctor. This is why we advise people in the book to seek out a fat-friendly health professional instead of putting themselves through the torment of being naked and vulnerable in front of a “professional” who takes one look at a fat body and sees someone ugly, lazy, stupid, and non-compliant.

This is why shit needs to change.

159 thoughts on “Asshole of the Day

  1. Fucking idiotic waste of body space. I am so fucking mad at this asshole. Like SUPER mad. This one gets me more than the typical assholes. I can’t even pretend to make sensible responses.

  2. Yeah. God knows all those trips to the doctor I take are….wait. No. I don’t even have a doctor. I need one, for my knees. We have bad knees in my family. My mother has suffered through injections in her knees so she could have some sort of cartilage there. My brother needs major knee surgery. Mom’s doc determined her problem as something not having to do with her weight. But I fear that if I go to a doctor for my knees, I won’t receive the same treatment. So they continue to crack and ache and give me trouble (even when they’re not holding my fat ass up) and I pray that they won’t just give out as I’m stepping off the bus like I fear they will.

    /rant

    I hate a medical doctor, a DIRECTOR OF RESEARCH OF A MAJOR HEALTH ISSUE, has split thin people and fat people into two separate categories: people who don’t deserve ~horrible~ illnesses and still get them, and people who do deserve ~horrible~ illnesses, get them, and must be convinced to change something about themselves so they can get the other special snowflake type of ~horrible~ illness.

  3. I agree he has drunk the Kool-Aid about TOEBOOGABOOGABOOGA, and FURTHERMORE that he’s kind of a douchebag. But when he says thin people might have a worse kind of disease, I don’t think he’s making a value judgment about how unfaaaaair it is that they have it. I think he’s actually saying there are a few different kinds of heart disease that tend to turn up in different types of patients (by clinical factors, demographics, genes, etc). I know for a fact that you can get similar-looking cancers in the same organ with different underlying biology: e.g. smoking tends to be associated with certain specific lung-cancer-causing mutations, but you also get lung cancer cases in nonsmokers, with totally different underlying mutations. And those different cancers will behave like different diseases — a nonsmoker’s lung cancer generally doesn’t progress as fast, for instance. From his language I think he means something like that. He thinks that most heart disease is caused by obesity, and that heart disease caused by obesity can be expected to behave in the usual way heart disease behaves, but that there are a few other etiologies that have nothing to do with obesity and that those may be characterized by a nastier disease with a tougher course.

    It doesn’t EXCUUUUSE him for being an ignorant douche about the biology and cultural contexts of obesity. Especially as a top-tier cardiologist, he should really know better. But it’s going around, you know? I mean, this ignorant prejudice is still a majority position and an absolutely unexamined, unquestioned one for most doctors.

  4. The advice to seek a nonjudgmental health care provider reminds me of the “kink aware professionals” list run by National Coalition for Sexual Freedom, because kinky people run into similar issues with being judged, shamed and getting bad medical care due to prejudice. (I don’t use it — being both privileged and obstreperous, I’ll assume I’m entitled to tell my physician my kinks when they could affect my treatment and my physician had better be prepared to handle it).

    So, cross-referencing the two, if one is both fat and kinky, must one pick the, what, three approriate doctors in the whole universe who will not be an asshole about either? Hey, I’ve got an idea … maybe doctors ought to view treating every patient with decency and respect as a requirement of professionalism? Ya think?

  5. Wow. I just have to say I am so glad for people like y’all, because there are days like today when I look at something like this and it’s so big and so wrong and I just say fuck it, I’m too tired and worn out to even start dealing with that shit.

  6. Aaagh. Yes, I wonder what especially horrific reason there was for my thin grandfather’s heart attack in his fifties. It angers me to think that had he had a bit of weight on him, he’d have been “asking for it” or something.

    And I’ve totally been putting up with hip/ovarian/I dunno but it’s killing me pain since before Christmas just because I’m too lazy to go back to the doctor’s. Totally. It’s nothing to do with the fact that the most I’ve been given in the way of tests in three visits is a poke in the muffintop and told “Hmm I can’t get a good enough feel” (Really? Why not have me lie down so my fat falls back instead of doing it while I’m sitting upright, then?) Nothing to do with the fact that I’m terrified of somehow getting a diagnosis and being reprimanded for being fat enough to let it happen either, no, I just don’t want to leave the house. And why would I, anyway? I’ll totally choose to live with this now I can use it as an excuse for laziness! -_-

    Wow, probably irrelevant essay. But yeah, great post, nail head hit once again.

  7. qbertina, I see what you mean, and could even see him saying “we tend to see different sorts of heart disease in fat people than we do in thin people, and fortunately the heart disease in fat people is more survivable”.

    Only, you know, he didn’t. But right now I’m too depressed to even see it if he HAD, you know?

  8. But when he says thin people might have a worse kind of disease, I don’t think he’s making a value judgment about how unfaaaaair it is that they have it. I think he’s actually saying there are a few different kinds of heart disease that tend to turn up in different types of patients

    You know, I considered that possibility. But in that case, he REALLY misspoke, and/or the reporter did him no favors. (I can relate. But still.)

    There’s a whole other section of the article that includes his speculation on why obese patients do better than thin ones — one assumes that if he truly believed one possible explanation was “thin people get a different form of the disease,” he would have mentioned it in that context. But as far as one can tell from this article, he didn’t.

    Which wouldn’t necessarily tell us anything, since we didn’t hear the interview, except that would be kind of a crucial data point to mention among possible explanations. If heart disease actually manifested differently in thin people than fat ones, then that would explain the “obesity paradox” right there: Obese people have better outcomes because they get a milder form of illness to begin with. But he doesn’t seem to be suggesting that as a possible explanation for the paradox.

    Besides which, we’re not talking about a single illness — we’re talking about lots of things that fall under the rubric of “heart disease.” He refers specifically to “high blood pressure, blocked heart arteries and peripheral arterial disease” as areas where fatties have better outcomes. Am I really supposed to believe that every one of those things comes in two distinct forms: The Fat Person one, always caused by fat, and the Thin Person one, always caused by… something else?

  9. If you can’t treat your patients without prejudice, Dr. Lavie, you have no business being a doctor. It’s that simple. You’d think at the very least he would, you know, research these trends he’s spouting off about and claiming to be an expert about. I’m so, so tired of all this.

  10. The good news is that as medical director, he’s likely only seeing patients when he leaves the rarified air of his office and walking through the halls to a meeting with other white coats and medical vendor reps.

  11. So I didn’t THINK I could be more furious about anything after someone, who I already hate because they are having their dog’s vocal chords cut, stood up in our company wide meeting and recommended locking down the internet and taking away admin privileges from everyone.

    But apparently, I CAN.

    Do you think douchebag doctors experience a different kind of “repeatedly punched in the face” than non douchebag doctors? These doctors wouldn’t have gotten repeatedly punched in the face if they weren’t such a FUCKING DOUCHEBAGS in the first place.

  12. I had to go back to the doctor recently for the pain in my leg. My regular doctor was unavailable. He has been treating me for years and understands that my pain is from the inflammation in my veins so he never questions my requests for more pain meds but this doctor totally disregarded my history of clotting/inflammation/chronic pain and went straight to giving me the third degree about my lifestyle and how if I lost weight, I wouldn’t be in so much pain. Which really pissed me off. I cannot exercise at the intensity it would require to get this fat off me because I’m in pain! Do you see the problem here? Secondly, the pain has nothing to do with the fat. The pain is because I have repeatedly had blood clots in the same leg and my veins have just given up. But please make me sit through a lecture about how how my fat is the reason for all my problems and humiliate me. Cause that makes it all better.

    Speaking of fatphobic doctors and all…*ahem*

  13. It’s well-known that obesity leads to heart disease, and that’s a big part of the paradox. These people wouldn’t have developed heart disease in the first place if they weren’t obese. A thin person is getting it [heart disease] for a different reason, so he or she is getting a worse form of the disease, getting the disease despite being thin.

    If one of my first-year undergraduates wrote something like this, I’d… well, I wouldn’t give them a bad grade because I try to take grades out of it as much as possible; and, honestly, I’d probably not even write *that* snotty of a comment in the margins, because I guess I think first-year college students, who haven’t declared majors yet, deserve some grace that trained “experts” don’t.

    But still. This is so circular. It’s like, I have this unfounded assumption that fatness is responsible for heart disease. So *instead* of defending my falsifiaible assumption, I’ll just take it as axiomatic. FATNESS CAUSES HEART DISEASE! And then I’ll do this transparently weaselly maneuver to address the obvious counterfactual: that thin people develop heart disease too and can have a harder time recovering from it. Shit. Um… um… it’s because they must have SUPER EXTRA BAD HEART DISEASE! Heart disease SO VIRULENT that it even penetrated the fortress of VIRTUE and THINNESS and HEALTH! Can you even IMAGINE?

  14. And since I already ranted about my own asshole doctor here, I hasten to add a very big thank you to all of you because there was a time when the doctors gave me that lecture that I’d nod my head in agreement and spend the next 6 months starving myself. Now I recognize that it’s just their phobia. So no diet temptations as a result. Thank you for that.

  15. Wow…that was some exercise in (as the Steely Dan album puts it) Pretzel Logic. By that, I mean the Good Doctor’s Pronouncements. Kate has, as usual, sliced, diced, and Vegomaticked the silliness of his arguments into delicious bites of STOOPID.

  16. @car

    yes what you said! I have no fight left in me today, and this just makes me wanna scream, bitch, throw things, and then cry, and cry alot. Since I tend to get pounced on and yelled at for the first three, I will probably just settle for the latter.

  17. Muffinbean: That sucks. I know it sucks because I went through the same thing for more than a year, being told by multiple doctors that my mysterious pelvic pain was actually BACK pain that had to be caused by my FAT. After I eventually flipped out in a doctor’s waiting room I was finally given exploratory surgery and a diagnosis of one of the worst cases of endometriosis the doctor had ever seen. Though fat sure doesn’t cause endometriosis, fat prejudice clearly delayed my treatment, allowed scarring to continue, and effectively halved my fertility. Look at my statistics and you could say that my damaged fertility is correlated with obesity. Damn straight — it was CAUSED by fat prejudice.

    But enough about me: I’m no doctor, but your pain sounds like pain I’ve had since my surgery that is definitely caused by my endometriosis. If you can take heart that you DO deserve good treatment maybe you can find a better OB/GYN.

    Living400lbs: “we tend to see different sorts of heart disease in fat people than we do in thin people, and fortunately the heart disease in fat people is more survivable”. I’m afraid that you’re giving this guy the benefit of the doubt by assuming that he’d like to see us survive. I’m not so sure.

    Sorry, folks, it’s kind of a bitter day in my world. Thanks for being there.

  18. [Lavie] wanted not only to remind doctors of the paradox, but also to warn them and the general public that it offers no excuse for being fat, he said.

    And being a medical director offers no excuse for being an asshole, but I bet he really, really hopes it does.

  19. It slices, it dices, it makes julienne fries!!!

    I have chronic lower back pain, and if I hear one more time that it’s cuz of my wait, I will VOMIT. Gee, and that’s with knowing the fact that my back pain developed when I was thin and obsessively exercising because of my eating disorder. Hmmmmmmm.

    Another thing is that since I’ve been going to my eating disorder therapist, who has told me OMG stop dieting, my back pain has IMPROVED!!!! Hmmmmmmmmmmmmm.

  20. So, if I decided to lose weight because I’m worried about getting heart disease but I still get heart disease, it would be a WORSE kind of heart disease than the kind I would have gotten if I’d just stayed fat?

    I think instead of trying to lose weight I’ll just go to New Orleans and put a cocnut crab on this guy’s office chair. I think that will do wonders for my health.

  21. Man, that was cathartic…
    Kate you write in this way that takes all the anger I feel about the stupidity of fat phobic annoying people and you just smash their shoddy arguments to bits. It’s totally like you are the superhero that has the power of writing a kick ass blog that destroys villains with your killer words!

    As for the aggravating doctor – I feel like when I go to doctor’s offices now I need to go armed with copies of all the research that proves their ill-informed arguments WRONG.

    GAHHHHHHHHHHH ill-informed arguments. WHY!?! When there is a way to be informed…I think I mentioned this before but who is really lazy here…the fat people — or — the doctors who NEVER READ THE DATA. jebus.

  22. Today I posted on Facebook that OBESITY RATES NOT ACTUALLY GOING UP, EVERYBODY CALM DOWN a friend of mine actually accused me of just saying that as an excuse to not eat well or “stay physically fit.” Ugh. I don’t want to deal with crap today.

  23. So, if I decided to lose weight because I’m worried about getting heart disease but I still get heart disease, it would be a WORSE kind of heart disease than the kind I would have gotten if I’d just stayed fat?

    That’s what I was thinking. I’d rather take the less-fatal fat-person heart disease, thanks.

  24. That should read “coconut” crab. But if there are “cocnut” crabs, I’ll get one of those too. :)

  25. You know, since when does a doctor need to “excuse,” or withhold excuse, for ANY DAMNED ASPECT OF A PATIENT’S LIFE. Dude, you’re neither my deity nor my pastor nor my spouse so kindly STFU.

    And, good doctor, if you would incur some risk of a malpractice suit based on some screwball treatment I demand — if I say I want my heart disease treated by having Crest Whitening Gel applied intravenously — then feel free to say, “I’m sorry, I can’t be your care provider,” mmmkay? Because you are NOT in the excuse business, you’re in the health business, and your moral pronouncements are unwelcome and besides the point.

  26. cock-nut crabs??

    Okay, I just have to add that I’m so fucking tired of people saying that I’m lazy because I’m fat. Oh yes, that’s why I have a PhD. It’s because I’m so damn lazy that I just sit around eating baby fucking donuts.

  27. I’m not sure where else to post this so sorry if this isn’t the appropriate place.

    Just bought Lessons from the Fat-O-Sphere at Borders in San Diego. Very excited to read it.

    What sucks though is that they had the book in the “weight loss/diets” section. Lame and completely irrelevant and opposite to the book’s point.

    I hated even being in the section…bad vibes…BAD VIBES!!!

  28. Ayzie, that person sounds like a “friend,” not a friend. Or better yet, an asshole.

    This guy makes me so mad I want to find his contact information so I can send a satisfying but otherwise probably ineffective nasty letter. Some people make my doctorate look bad. (YES I SAID *MY* DOCTORATE WOOOOHOOOOOOOO ahem.)

    shyvixen, that is a perfect idea.

  29. So let me see if I’ve got this straight. This so called specialist says that fat people wouldn’t get heart disease if we weren’t fat, yet the heart disease we do get isn’t as bad as the heat disease that thin people get and we have a better chance of survival than thin people do (which we know from actual honest to goodness scientific studies!) AND this same doctor thinks that we should all shed the fat so we can get the worse kind of heart disease and have less chance of survival???? What the F????? Sure, let me run right out and do that…..DUH!!!

  30. Because you know it’s so much more serious (and tragic) when illness befalls thin people.

    Fat people bring it on themselves, anyway.

    /deadpan

  31. Dude, you’re neither my deity nor my pastor nor my spouse so kindly STFU.

    Oh heavens, did I just write that? I think Mary Daly just put a hex on me. Sorry, y’all, my internalized sexism and religious shame was showing.

  32. So, wait… fat people get heart disease because they’re fat, and thin people get it for another reason, because thin people don’t get heart disease, but shouldn’t get it at all and therefore it’s more serious.

    I think my brain is leaking out my ear. It is trying to make sense of this “scientific” argument, and failing miserably. ;.;

    … it’s probably because I am fat, and therefore stupid.

    (that was sarcasm, btw)

  33. So, not only is the thin-person heart disease worse, but there’s fewer symptoms beforehand (otherwise they would have gone to see the doctor like those fat folks.)

    *cough* I wonder if this form of heart disease is what my brothers referred to as “silent but deadly”?

    So, get thin so you can die suddenly and with more certainty! Whoooo!

  34. I’m so sick of horrible doctors. I had one doctor come in for five minutes(or around that), accuse me of being too lazy to lose weight, didn’t believe me that my depression affected my ability to regularly take my medication, and said, “If i prescribe you some prozac, will you take all of your pills?” and put me on a placebo dosage. I stopped going to him after that.

    (I found a psychiatrist who evaluated what my problem REALLY was and gave me the right medication to be able to handle it. Yay!)

    Another doctor told me, after I came in with a sprained ankle but without having had my blood-tests done before my visit, that I should really get my blood-tests done before our NEXT visit, “So as not to waste either of our time again”. I haven’t been back, either.

    The assumption that obese people are putting a tax on the healthcare system is completely and utterly unfounded. Either a fat person is afraid to go to their doctor in the first place, or has been to a doctor and was too ashamed to go back, or tries to see a doctor for a medical problem, and is dismissed as having “no real problem, you’re just fat”. Where do doctors like THIS asshat see these imaginary fat people coming in to pester doctors with “minor conditions”?

    Minor conditions that are almost always a symptom of a serious underlying condition that most doctors would jump at testing “average-sized” people for.

    I wish I’d been exposed to FA before when I went to the doctor years ago about a horrible, asthmatic wheezing in my lungs (perfectly audible to the naked ear), and the nurse checking my breathing gave me an exasperated, “I can’t hear the wheezing through all the fat!”. I’d have gone off on her so bad.

    …Sorry for ranting. v.v But I’ve had so many bad medical experiences that reading about douchehound doctors peels my skin raw.

  35. So let me see if I’ve got this straight. This so called specialist says that fat people wouldn’t get heart disease if we weren’t fat, yet the heart disease we do get isn’t as bad as the heat disease that thin people get and we have a better chance of survival than thin people do (which we know from actual honest to goodness scientific studies!) AND this same doctor thinks that we should all shed the fat so we can get the worse kind of heart disease and have less chance of survival???? What the F????? Sure, let me run right out and do that…..DUH!!!

    I think the argument that he’s trying to make is that obesity causes heart disease in many people, while at the same time there is still a small population of thin people who are going to get heart disease regardless of their weight. If that’s what he’s saying, it isn’t as if being thin causes you to get a worse form of HD.

    **I don’t buy this arguement, I’m just attempting to clarify**

    It reminds me of the hospital paradox (and example of Simpson’s paradox) they always use as an example in into stat classes. Hospitals that are ranked better for cardiac care often have lower patient survival rates for heart attacks. The idea is that if your heart attack is just mild, you don’t go to the bigger, more intense hospital because it isn’t necessary. In essence, the lower your survival rate is off the bat, the more likely you are to go to the better hospital, which drives down the overall survival rate for the better hospital.

  36. Sorry for double posting, but I realized that there should be a satire blog, “Dr. Douchehound”. I couldn’t do it myself, I have zero medical jargon at my disposal, but I think it would be funny. XD

  37. What if we were to transpose Dr. LaVie’s logic onto some other risk factor? He surely knows, for instance, that men are more likely than women to have heart attacks, but women are more likely than men to die from them.

    If Dr. LaVie really believes his own line of reasoning, then surely he should be setting an example for all of us by getting sex reassignment surgery. There is, after all, no excuse for him to remain male.

  38. “But please make me sit through a lecture about how how my fat is the reason for all my problems and humiliate me. Cause that makes it all better.”

    This kind of thing does make me want to punch things. I’m sorry you had to experience that, April.

  39. Every time I step foot into a doctor’s office–which has been occurring rather often lately, as I found I have an ENT, a gynecologist, have taken 2 trips to the hospital in the last 3 months, a gastroenterlogist, and my psychiatrist along with my normal doctor–they can’t help but be shocked when the listen to my hear beat, see my blood-work, or check my blood pressure. I am a model of good health other than being overweight. I exercise regularly, my blood pressure is absolutely perfect, my blood sugar is normal, and the only thing any doctor can complain about (other than my weight, of course) is my cholesterol being a point or two higher than average for someone my age, which can be explained by the history on both sides of my family having bad cholesterol.

    I rue going to certain doctors, though. One of my regulars is always on about how I should try to lose weight and I need to eat less and blah blah blah. It doesn’t help when they act like I can do more when I have a hectic schedule and am looking for a job to add onto it. I gained 20 lbs. over the winter and the only thing I want to do is get back down to my old size, but even then, it wasn’t good enough!

    I can’t wait until the problems my mother and my aunts and uncles and father all have trickle down to me some point in the future and I get to feel completely horrible about myself when all I wanted was a little help.

  40. Okay, let me get this straight…fat people get heart disease because they’re fat, but thin people get heart disease because for completely different reason. And when thin people do get heart disease, it’s more serious because they shouldn’t get it in the first place because they’re not fat?

    I bet this doctor’s fingers are bleeding from scraping the bottom of the barrel tyring to find a reason to keep believing that fat=death.

    Thank God for people like you, Kate.

  41. I was gonna bang my head against the desk repeatedly, but then I figured I could try and find this doctor and bang HIS head against the desk repeatedly. SO much more satisfying!

  42. And on the other end of the scale, I’m far too thin to have diabetes OR endometriosis, so would I please be a good woman and shut up and stop bothering the nice doctor? *patpat*

    Sometimes, I wonder if you don’t get these statements from doctors who have given up. They don’t care any more, they don’t want to deal with the problem, they’ve thrown everything into a career they now hate, and so rather than help you, they’ll just say it’s your fault and get rid of you so they don’t have to deal with it.

  43. Am I really supposed to believe that every one of those things comes in two distinct forms: The Fat Person one, always caused by fat, and the Thin Person one, always caused by… something else?

    Not to defend the doctor’s insensitive remarks, but “heart disease” is a broad enough term that something like this would certainly be possible. Obesity could be one risk factor for heart disease (that could be outweighed, positively or negatively), and a different genetic predisposition could be another and more severe risk. You wouldn’t get “always”, but you might get “statistically significant.”

    More damning to my eyes is why the doctor doesn’t consider that recovery from a heart attack requires extra physical resources (though he considers this for breast cancer). My uncle, a healthy non-smoking yoga enthusiast on the slender side of average, lost fifteen pounds following his heart attack and felt weak for months afterwards. He’s fine now, but had he been underweight, he likely would have had a harder time to recover. My other uncle who has all manner of health issues often feels drained because he no longer can keep on enough weight to have any reserves to fight off illness.

    In other words, the paradox doesn’t strike me as all that paradoxical, especially given how little we know about the relationship between obesity and heart disease.

  44. @BeccaBoo, I only recently (like, within the last year) started going to see doctors. I spent a fifth of my life actively avoiding them (and I’m pretty sure I had a broken ankle during that time). FA blogs like this one got me to start taking care of myself, isn’t that funny since according to the reviews at Powell’s, FA is all about letting yourself get sick… BUT I DIGRESS.

    So, I’ve been to the doctor twice in the last year, once for a physical and once two weeks ago for a severe pain. Now, a month or so ago, worried because I’ve got hypertension on both sides of the family, I bought a home blood pressure monitor and supersize cuff to take my BP twice a day. And for the three weeks before I got hurt, my BP was consistently high. So my first thought after I got off the phone with the scheduler was, “Oh, hell, now I have to listen to the Fatgirl With Hypertension lecture from the doctors.” I get myself all hyped up and pumped up and ready to yell back if the shame game starts, and I even roleplay walking out and asking for a refund of my copay.

    So I roll out of bed, scream in pain, and fall into my desk chair. I take my blood pressure with the little machine, 143/101. That’s pretty much classic hypertension. “Great”, I think to myself. I limp myself in to the doctor’s office, and am called back to do the pre-visit stuff. I get on the scale, and I’m at 308 lbs. And mentally I throw my arms in the air and yell, “FATGIRL! WOOOHOOO!” In we go to the exam room, and the CNA busts out the big cuff.

    A minute later, she’s ripping it off my arm and announcing, “106/68.”

    I think she took the look of shock on my face for confusion, because she clarified, “That’s really good.”

    Moral of the story? I AM AWESOME AND SO IS EVERYONE HERE. Also? My little home blood pressure machine is a liar and I don’t trust it any more!

  45. … no excuse for being fat ….

    I’m often told that, after some 20-odd years of unusually aggressive and poorly controlled rheumatoid arthritis, I do have an excuse. I am, nonetheless, still told by some doctors that I should diet, even by those who freely acknowledge that the effort would almost certainly be futile.

    I’ve come to the conclusion that what’s primarily at issue is authoritarian control and patient compliance — and that, at bottom, so long as we’re passive and compliant doctors like this do not care if our health improves or not.

  46. Wow, I have to say that at this point I’m less worried about encountering hate-harboring doctors than I am about encountering doctors who defy all logic and proven fact in order to cling to their own superstitions. Can such a doctor really be counted on to skillfully and professionally take care of anyone, much less a fat person? It’s medical professionals like this, who conveniently forget any study that goes against their beliefs, that make treatment riskier for everyone. I have to wonder how many thin people with heart disease don’t get diagnosed until too late not because they don’t notice symptoms, but because their doctors believe that heart disease only happens to fat people, despite piles of evidence to the contrary.

  47. Wow, gillian, Anna Wintour should change her name to Ann Suxxour, because she is clearly what I can only kindly describe as bereft of win.

  48. It looks like this is the article on which the news story is based. Unfortunately, I can’t access the full text without paying for it, even when I go in through my university’s electronic journal databases. I wonder if journalists got free copies or if it’s another case of Science by Press Release?

    Also, the abstract has Dr. Lavie’s e-mail address on it. Maybe we should invite him over here to explain his research.

  49. “I’d just been on a trip to Minnesota, where I can only kindly describe most of the people I saw as little houses,” Wintour said. “There’s such an epidemic of obesity in the United States, and for some reason, everybody focuses on anorexia.”

    Oh my gosh. Can somebody slap her, please? Preferably a Minnesotan, but really anybody would do.

  50. think instead of trying to lose weight I’ll just go to New Orleans and put a cocnut crab on this guy’s office chair. I think that will do wonders for my health.

    While you’re down in New Orleans, grab a nutria and put it on his chair too!

    Ya know, health is like a slot machine. You’re either going to hit the jackpot and have great health, or you lose a little with a few minor problems but you’re still pretty healthy, or you’re just unlucky and get very sick. And just like slot machines, health doesn’t really care what size you are. There are unhealthy fat people and unhealthy sick people, and vice versa. Unfortunately, most doctors actually think fat people’s ailments develop because they’re fat, even if that ailment is an ear infection. They don’t take anything else into consideration, just that we’re fat and we do nothing else in life but be fat. Ay carumba.

  51. Can these people even hear themselves talk or is the hatred just clogging up their tiny little skulls?

    I read this and I got from the esteemed doctor:

    Sick fat people deserve to be sick. No one has an excuse for being fat. Thin people deserve better care than fat people because they didn’t make themselves sick.

    If you replace “fat” with almost any other descriptor, this man would immediately be known and labeled as a prejudiced, bigoted asshole. But because he is a BIG TIME HEART DOCTOR and he’s talking about FAT then it’s all in the name of HEALTH. Riiiiiight.

    God damn it. Put me down for a coconut crab attack on Dr. Buttmunch.

  52. “I’d just been on a trip to Minnesota, where I can only kindly describe most of the people I saw as little houses,” Wintour said. “There’s such an epidemic of obesity in the United States, and for some reason, everybody focuses on anorexia.”

    Hey, you know, I heard that Johnny Depp’s Willy Wonka look was based on Wintour. But what if it wasn’t just his look, but some character elements too? Like, maybe Wintour lives in some magical strange self-contained land, like Willy Wonka does… a land where people look like little houses, and where everybody focuses on anorexia.

    “Oompa loompa doompity doo. I’ve got a perfect puzzle for you….”

  53. @Coco: “Put me down for a coconut crab attack on Dr. Buttmunch.”

    That’s it, I’m going to have to write a “Dr. Buttmunch” song to the tune of Mr. Sandman.

  54. Henchminion:

    It a science by press release case before the article is published. Today’s edition of the journal (published weekly) stops at page 1924 and this article is page 1925-1932. And unlike other Elsevier pubs they don’t seem to have available articles that are accepted but not yet “published” in the print edition (since I read Icarus often for my field and we see a lot of that).

  55. Ugh.. .and it works better when I can spell my own name. Astrobababe is me. Ugh, I should go back to dissertation writing.

  56. I hate to say this, since I’m a bona fide health care professional (RN x 25 years); but there is a huge percentage of assholery present in our ranks. There are various forms of this disorder, but I’d bet we’ve all witnessed it.

    I would love to think that this doctor’s innacurate statements about obese patients with heart disease are a result of him not being aware of studies that come to different conclusions than his, but my gut tells me that he would be one of those people who think fat people lie, overuse the system, etc. I’ve met too many of the type who virtually ignore any study that contradicts any preconceived notions they already may have re: weight.

    What this reveals is that doctors and other health care professionals aren’t as interested in or knowledgable about the “science” as they’d love for you to believe. Many of them only have minimal education in statistics, etc. I’m always floored when I hear a fellow RN or physician talk about a “study” they heard about on the television news and repeat it as though it was gospel truth. WTF?

    All I can say is that this is so fucking discouraging. For years, I had an extremely supportive doctor who truly WAS aware of new developments in knowledge about weight, etc. I never once felt “less than” with her. We moved back to my home state about 3 years ago, and I only this past week had worked up the nerve to see a new ob/gyn because of my fears about how I’d be treated. Well, I sure picked the wrong asshole to see. (I posted my experience previously so I won’t go over everything again.) I work in the health care system; I know what questions to ask before I see someone; and I still wound up with an asshole who basically gave me the “no excuses for being fat” mantra.

    @Mary Sue—I never trust the little home blood pressure machines–I find them too often to be quite inaccurate. What you might want to try instead is a manual bp cuff that has the stethoscope attached so that you can actually listen to your own blood pressure. It’s pretty easy to learn how. You’ll get much better readings that way.

  57. Not to defend the doctor’s insensitive remarks, but “heart disease” is a broad enough term that something like this would certainly be possible.

    It’s precisely because it’s such a broad term that I find it hard to believe everything that falls under the umbrella “heart disease” comes in Fat Version and Thin Version. But that certainly is just a gut response.

    Obesity could be one risk factor for heart disease (that could be outweighed, positively or negatively), and a different genetic predisposition could be another and more severe risk. You wouldn’t get “always”, but you might get “statistically significant.”

    You might, but A) he’s speaking in absolutes, which is the whole problem, and B) given all the different risk factors for heart disease and how much they overlap, it would be awfully difficult to determine exactly which one caused an individual case.

    Example: I’m an obese smoker with a lot of heart disease in my family, who gets a moderate amount of exercise and eats a pretty balanced diet but does not make any special effort to avoid saturated fat. My stress levels are up and down, but sometimes pretty extreme. I have a history of weight cycling. I also have a family history of high blood pressure and Type 2 diabetes but so far (knock wood) am free of both. If I end up with some form of heart disease, can you find someone with that exact same profile — except thin instead of fat — to compare me to, to determine the difference weight makes? And then can you find at least a few hundred, preferably a few thousand, similarly matched pairs, so you could be reasonably sure you’re really on to something?

    Fact is, if you took “obese” out of that list, I’d still have a pretty damn good chance of developing heart disease; I have a shitload of risk factors for it. (On the plus side, I have almost no family history of cancer. Also, with one notable exception, everyone in my family who died of heart disease lived at least well into their eighties.) But this asshole is saying, in so many words, that if I get heart disease, it will be because I’m fat, full stop. Which is just so fucked, I don’t even know where to begin.

    Even if there were two kinds (and I fully grant the theoretical possibility there, though I’d also note that I’ve never heard of a study suggesting it), he’s not even entertaining the possibility that a fat person with many other risk factors could develop the Other Risk Factor-Related version instead of the Fat-Related Version. Or that a thin person with risk factors ALSO correlated with fat — e.g., poor diet, sedentary lifestyle — could develop the Fat-Related Version. He’s pretty much flat-out saying that the size of your body trumps all other risk factors. Come on.

  58. Fact is, if you took “obese” out of that list, I’d still have a pretty damn good chance of developing heart disease; I have a shitload of risk factors for it. (On the plus side, I have almost no family history of cancer. Also, with one notable exception, everyone in my family who died of heart disease lived at least well into their eighties.)

    This is like my heart disease risk situation, exactly. Every adult over about 40 in my family, regardless of size, has high blood pressure. My thin paternal grandmother had the most severe case and several ministrokes before her death from a stroke, but everybody has high blood pressure and ends up on medication around 40 or so. However, we also seem to have good longevity, and my paternal grandmother, who died at 83, was the least long-lived of all my grandparents.

    We also have a long history of anxiety disorders on both sides of the family. I have a long history of panic disorder, which increases a person’s chance of a future “cardiac event.” I don’t smoke and I do aerobic exercise regularly, but I don’t eat a low-fat diet and I don’t make a concerted effort to cut back on salt.

    I tend to think that when I do develop high blood pressure (which I’m pretty sure I will, given my family history and that I had pregnancy-induced hypertension, which is often a sign of future hypertension), it will likely be due to genetics and stress/anxiety than to my weight or my diet. Even if I were thin, I don’t think that would be enough to cancel out the effects of an anxiety disorder and the family history, especially since my thin relatives haven’t ended up with normal or low blood pressure.

  59. Also also also… I’ve touched on this a zillion times before and might even do a full post about it soon, but the one risk factor on that list that is conclusively both extremely dangerous and entirely within my control (force of addiction notwithstanding) is smoking.

    I can count on one hand the number of doctors who have ever even mentioned my smoking, and exactly 0 have ever berated or shamed me for it, or demanded that I quit before they would take me seriously or treat me. When they do bring it up, they inevitably say something like, “I don’t need to lecture you on smoking, do I? You already know. Let me know if you want help quitting.” Which is TOTALLY FUCKING APPROPRIATE AND FINE WITH ME.

    If a doctor ever said, “I don’t need to lecture you on obesity, do I? You already know. Let me know if you want help losing weight,” I would be 100% fine with that, too — even if under other circumstances, I would argue the premise that obesity, in and of itself, is such a big deal, not to mention that there’s a safe and proven method of permanently changing that situation. Because framing it that way shows respect for both my intelligence and my autonomy. Addressing me as though I’m ignorant and non-compliant, and I MUST take their weight loss advice seriously right now or lose the right to thorough and respectful medical care, is fucking bullshit. Continuing to smoke is about as non-compliant as it gets, but no doctor has ever acted as though I’m too stupid or lazy to take care of myself in general because of it. Being fat, on the other hand? AAAAAAHHHHHH!

  60. Dr. Sanjay Gupta did some doddering report this morning on CNN about religious belief helping people maintain their weight.

    But wasn’t it just last year that being religious meant you’d eat too much at potluck and be a fat-ass Baptist?

    These studies are like watching a bar brawl.

  61. And I solemnly swear if I ever see Anna Wintour on the street I’ll totally run up to her and tell her she should really be focused on anorexia. I will make a special effort to lurk near the Conde Nast building sometimes.

    THIS IS MY DEVOTION TO THE CAUSE.

  62. Kate, a funny flipside to that- when I’ve argued to friends that even if the evidence were stronger against obesity, doctors should respect patients’ choices about whether to get lectured or not, they’ve argued back that smokers do (and should) get lectured. And that if doctors don’t lecture their fat patients, they’re denying them adequate medical care.

    It makes me think that bodily autonomy is one of those either-you-believe-in-it-or-you-don’t things.

  63. I’m starting to think Anna Wintour is just trying to solve the housing crisis. After all, there are apparently millions of Minnesotans walking around who are the size of small houses. I’m sure many of them are unemployed. We can simply hire them, hollow them out, and turn them into housing.

  64. I’m just wondering…do any of you say anything to these doctors when they are idiots? I mean you shouldn’t have to but I wonder how they’d respond. And it can’t hurt. People’s wrong assumptions need to be questioned, especially doctors’ since they are taking care of patients all day. Doctors were raised in the same fatphobic society we were all raised in. I’d think they should know better because they’re doctors but I don’t know what they teach in med school.

  65. I wish a “little house” would sit on Anna Wintour. And not anywhere she’d find pleasurable, either. I’d pay real money to watch that happen.

    The director of cardiac research and prevention at an actual hospital—like entirely too many of his colleagues—believes fat people are looking for excuses to stay fat, as opposed to looking for compassionate, realistic, trustworthy medical care.

    NO NO NO, Kate, we’re not looking for excuses to stay fat, we’re looking for excuses to keep eating. And eating. And eatingandeatingandeatingandeating. Because that’s all we care about. We don’t care about being treated like lepers as long as we get our bathtubs full of fries! Because fries are like heroin and cocaine combined in their ability to make us zone out and forget all about how much people hate us. I know that if I have a choice between ordering fries and actually being successful, there’s no contest! And of course I’m presented with that very choice every single day of my life and still pick the fries. THEY’RE THAT GOOD.

    (I have no doubt people who never allow themselves fries even though they love them actually do think this way. No, really, they’re just potatoes.)

    Continuing to smoke is about as non-compliant as it gets, but no doctor has ever acted as though I’m too stupid or lazy to take care of myself in general because of it.

    I can tell you that older people do routinely get smoking cessation lectures from their doctors, though, judging from both my mother’s experience (she quit a decade ago) and from the thousands of medical records I’ve had my hands in over the years. So don’t be shocked if they start giving you shit for it after you turn 40. But you’re right to notice that you’re never too young for your doctor to start in on you about your weight. You don’t even have to be old enough to form sentences.

  66. As a scientist, I am so deeply disappointed and insulted by these jerks who are spouting nonsense and claiming to be scientifically backed.

    I work in diabetes research, and I’m fat. I’m also studying epidemiology, and when discussion in journal club veers towards fatty-blaming, I make a point to remind them that it’s VISCERAL fat, around the organs, that’s the big bad evil culprit for all these so-called obesity related diseases, and that external appearance of fatness is NO INDICATOR of visceral fat distribution. It is entirely possible, and even common in some ethnic types, to be on the underweight end of the BMI scale, and still have dangerous amounts of visceral fat, and develop type II diabetes – but these people don’t get tested for diabetes, because they’re skinny.

    Fortunately for me, the group accepts this bit of science, you know, the real science.

  67. “DAMN MY ATHEISM-INDUCED OBESITY!!!
    *shakes fist at self*”

    Damn! I just realized that my biggest weight gain began JUST AFTER I ACCEPTED AND ADMITTED I WAS AN ATHEIST!!!!!!!!!

    It’s universal proof; PROOF, I tell you!

  68. Did your atheisim induce my obesity, too? Because I’m on the Board of Directors of my church… DAMN YOU ATHEISTS WITH YOUR CONTAGIOUS OBESITY!

  69. See, this is why I’ve been putting off finding a new OB/GYN. The current one is a classic patronizing douchebag who had me literally in tears lecturing about my fat and how I would never find a lover if I didn’t lose the FAT. (Seriously!) All this after I had told her that I was very nervous about getting a pelvic exam because it always hurt like hell when my previous doctor did them. I was a total weepy mess for the rest of that day… and since this was pre-FA for me, I completely believed that I deserved it and I was a horrible, bad, ugly monster of shambling blubber who totally did not deserve the self-confidence I had gone into that office with.

    Arrrrgh. I’m tempted to just call my GP and ask her to prescribe the Pill for me. She’s always super-busy and I rarely see her for more than fifteen minutes at a time, but at least she doesn’t lecture me about my weight.

  70. Ah, the good old “no excuse” statement. The good old NO LICENSE, I remember these.

    You may not have heart disease now, but that’s certainly NO LICENSE for thinking you’re a human being worthy of respect from your medical professional.

    Oh yeah, and fat people aren’t a single population, there are plenty of fat and thin people who “put off” seeing a doctor because medical care is completely unaffordable. We get blamed for “waiting until it’s too late” when we aren’t given any friggin economic alternatives. But to acknowledge that might shed light on the fact that there’s a “health care crisis”.

  71. Electrogirl, I know it’s not always the case and some nurses are just as fatphobic as some doctors, but personally I’ve had really good luck with nurse practitioners, who I’ve used for my gynecological care since college. In general I’ve found them to be far more willing to treat me like an actual human being, rather than an appointment to check off, much more likely to talk to me about things rather than jump to conclusions (if my blood pressure is elevated, I’ll get asked if I’m nervous or if I’ve been stressed, rather than lectured or handed a prescription), and more likely to act as if they are a partner in my health care, rather than the boss of it. I haven’t had any fat-shaming lectures from them, and they’ve generally treated my weight as irrelevant to my health. I am usually at the lower end of the obese range or the higher end of the overweight range, so it’s possible that if I were heavier they’d be more fat-shaming, but personally I find going to nurse practitioners to be a much more pleasant experience than going to doctors, and you can usually find an NP who does ob/gyn care relatively easily.

    Also, if you know any fat women in your area who are happy with their medical care, asking them who they see might be a good idea. I have some fat friends who have gotten good obstetric care around me, and I definitely plan on using their recommendations if I become pregnant again while we’re living here, just so I’m not unpleasantly surprised by fat-phobia in my care.

  72. People who behave like wicked witches* are understandably afraid of houses, as sometimes they do fall on them, you know, like, after a twister. Just sayin’.

    I think that cardiologists are among the most fat-phobic doctors. Does anyone know why? Is it because they are thin**?
    Cardiac rehab almost always advocates massive “lifestyle change” and then people who are “noncompliant” are seen as lost causes, because OMG they have had a heart attack, and they STILL WON’T CHANGE. There is so much class and cultural stuff here, but I don’t begrudge anyone who makes massive changes after a heart attack because that is a very scary thing. The last thing a person needs to hear who has gone through it is that it’s their own fault.

    I can understand doctors and nurses wishing they could prevent suffering, but they are completely clueless on the suffering they inflict with their words. Do they “hurt because they love***?”

    *No offense meant to any wiccan readers.
    **No offense meant to any thin readers.
    ***No offense meant to any readers who love.

  73. Kate:
    ‘Besides which, we’re not talking about a single illness — we’re talking about lots of things that fall under the rubric of “heart disease.” He refers specifically to “high blood pressure, blocked heart arteries and peripheral arterial disease” as areas where fatties have better outcomes. Am I really supposed to believe that every one of those things comes in two distinct forms . . . ‘

    Yes they do come in 2 distinct forms . . . my arteries are clogged with baby donut residue where as a thin person’s arteries are clogged with fat free salad dressing!

  74. I started getting fat at Baptist potlucks, and then kept getting fat after becoming an atheist! DAMN YOU ALL!!!
    *shakes both fists, almost drops baby-flavored donut*

  75. And this is why, just as feminism is healthy for men, too, fat acceptance is important for people who are not fat.

    If fat people’s major illnesses and medical problems are all because of fat (right, yeah, whatever), then skinny people must all be pictures of perfect health — because all health issues are caused by fat!

    What utter bullshit. And to think, I count on my doctor to be a scientist.

  76. It’s doctors like him that make me dread when the time comes for me to go to an OB/GYN. That whole experience is going to be nerve wracking enough, I don’t need a whole heaping load of fat shame with it.

    Come to think of it, I’m kind of dreading finding a new doctor so I can get a refill on my anti-depressant.

    Grr.

  77. I don’t know where to start so I’ll just tell a little story about one of my friend’s brothers who had a heart attack.

    He was 36, had a ‘perfect’ BMI and went to the gym four times a week. He could not have looked healthier on paper or had a worse heart attack than he had – the only reason he survived was because he fortunately had it in front of a doctor in the car park of a hospital. At 36 he was the youngest (non-drug damaged) adult heart attack patient that the hospital had seen. It turns out that he had a genetic condition that usually kills young men in their prime – often when they are running around a football field.

    His sister, my friend, who is carrying a few extra kilos immediately had herself tested for this genetic disorder plus her general cardio health. It turns out she is in perfect health and fortunately doesn’t have the condition.

    Sometimes these things are just a matter of genetic luck.

    But get this, my friend was still told to lose weight “especially given that there is a history of heart problems in your family”. Umm you mean due to a genetic condition that it turns out she doesn’t have???

    Smashes head on the desk.

  78. I couldn’t read the Wintour article, because their site was down, but I saw the quotation in other people’s comments. I’m from Minnesota, and people are, as a group, heavier there then they are here in Arizona, where I live now. I noticed it myself, because I’m generally the largest person in any room these days, whereas back up nort’, I wasn’t always. I don’t know what the cause is, but were I to speculate, I would guess it has a lot to do with ethnicity and weather. Not only is it winter 10 damn months of the year, and people can’t get out of the house, but–hey!–it’s winter 10 damn months of the year, and it’s freakin’ cold. You need padding to withstand that. Rural vs. city culture probably plays into it, too. In any case, Wintour can shut up.

    I went to one of those Walgreen’s quick clinics for a strep test last winter, and of course the PA there weighed me and proceeded to give me a diet and exercise plan, plus the obligatory lecture. I ignored her, but I didn’t shut her down, and I wish I had. The next presumptuous jerk will not be so lucky. No, I won’t get on your damn scale, and no, I won’t have my BP taken unless you fetch the big cuff on out here. Uppity patients unite!

  79. @Shyvixen, the coconut crabs made me giggle – I had forgotten about those things!

    Also, that comic… did anyone else notice that the p-value given right at the start is 0.56, which means there is absolutely NO statistically significant correlation between A and B at all? In fact with a p-value like that you would conclude that there is no correlation between A and B. LOL

    Now I wonder if that was a sneaky chuckle the author put in there on purpose…

    Plus… that doctor guy, he is full of FAIL. I don’t have anything else coherent to say on the matter.

  80. I’m from Minnesota, and people are, as a group, heavier there then they are here in Arizona, where I live now.

    True, but only just. According to the CDC as of 2007, 25.6 percent of Minnesotans are obese, whereas a mere… 25.4 percent of Arizonans are. ;)

    I’m not trying to show you up, and it’s entirely possible that there are more visibly fat Minnesotans in the “overweight” category, which this doesn’t take into account. It may also be that the town you live in now has a much higher number of thin people than the one you lived in in MN. But I’m always skeptical when people mention that they’ve observed a certain state or country is fatter than another, because the chances that you’ve personally observed a sample that’s random and large enough to generalize about are pretty slim. And I happened to have run across those stats earlier today, so I knew where to look. :)

    Thing is, if I hadn’t seen those stats earlier, I never would have bothered to look it up and probably would have accepted the premise that Arizonans are, on average, significantly thinner than Minnesotans. I’m married to a fat Minnesotan and fond of many others, whereas all but one of the people I know from AZ are thin. Furthermore, my image of AZ is that it’s a place where people are outdoorsy and run around half-dressed all the time, whereas my image of MN is that it’s a place where people bundle up inside and eat hearty food to survive the 10-month winter. So, between stereotypes and a very tiny, very NOT random sample of people I know, I could easily have bought that premise.

    And that’s a problem. That’s THE problem with stuff like this. When you go with your gut response to stereotypes and anecdata instead of bothering to look up the numbers, you can get stuff really, really wrong. And I know I’m guilty of that sometimes — nobody loves anecdotes more than me. But I’m also not a fucking doctor.

    (Again, Kristie, I hope that doesn’t sound like I’m chiding you or putting you on the spot. It just seemed like a perfect illustration of the pitfall of assuming that what you personally observe, and the conclusions you draw from that, necessarily reflect a larger truth about the general population. And that’s a lesson the likes of Dr. Lavie could really stand to learn.)

  81. Not at all, Kate. I knew I was opening myself for that potential critique. :o) I was just sharing my observations because that very impression (albeit in less rude terms) had occurred to me when I lived there and visit there still. Those are my people, but even within my own family, there are huge variations, and probably only 2 of the 13 of us in my generation could be considered overweight (my cousin) or obese (me). And I see that you have similar impressions. However, neither of us would pass off an impression as definitive and infallible fact, because that would be ludicrous. Would that Dr. Lavie held himself to a similar standard!

  82. I’ve lived in Phoenix. Plenty of fatasses there, believe you me.

    Keep in mind that in Phoenix, half the year it’s too hot to go outside for anything. Nobody’s going to be that “outdoorsy” when it’s 118 degrees out; in fact, almost nobody will even be walking fast. In Sedona and Flagstaff it doesn’t get nearly that scorching, but I remember when I lived in Phoenix, during “hot season” (April through October), any errands I was going to do had to be done before 8:00 a.m. or after 6:00 p.m. Maybe even after 8:00 p.m. if it was a particularly noxious heat wave. Even waiting for the bus required a wide-brimmed straw hat, a squirter fan and a stash of Gatorade. Man, was it hot.

  83. randomquorum- This is a very geeky correction, sorry (I’ve been TAing psych classes too long!), but you can’t say that p=.56 –> no correlation. It could be that there’s a strong correlation, but your study had awful statistical power and so you couldn’t see it. (Like if you were studying gender and height and your entire sample was a male and a female who happened to be almost the same height.)

  84. EmilyMorgan – yes, that’s true.

    I think what I meant to say was that you can’t say that your study shows any statistically significant correlation. Does that make sense? In a uni assignment I would probably write something like “the p-value of 0.56 indicates that the correlation between A and B is not statistically significant at a 5% significance level” or some such wordy thing.

    Damn but statistics requires you to be so damn fussy with your wording LOL.

  85. Okay, it’s not heart disease, but I’m compelled to throw this in…

    My dad, in his mid-70s, a big guy for much of his adult life but active and healthy, had a bad outdoor fall that could just as easily have happened to someone half his age. He shattered his shoulder and part of his lower back. (No osteoporosis; just a damn bad fall.) To add infection to injury, he contracted MRSA in the hospital. He almost died on 3 separate occasions we know of during this time.

    He lost I think about 80 pounds in the process. Had he not had that extra weight to burn, I suppose he’d have blown out like a candle. It took well over a year, but he’s doing fine now, living independently, all that good stuff. All of this gave me a new perspective from which to view my own extra padding. It may BE padding, in the best sense of the word.

    I wonder if this worse-heart-disease-in-thin-people claptrap could possibly have anything to do with our FAT helping us to recover from illnesses, accidents, etc. Fat is ::drumroll:: stored energy and it’s usually hard to eat when you’re ill. Hey, if I ever get cancer, I HOPE I’m fat going into it.

    But an MD toeing the party line has probably lost the ability to see anything in other than black & white, and everybody knows that fat = bad. I do hope someone will send him a link to this post (along with a prepaid lifetime membership in the American Wankers’ Association).

  86. Oh thank you, thank you, Kate, for this. Thank you for picking this apart. I’ve felt like hiding under the covers today because of a veritable avalance of anti-fat sentiment, so it’s great to hear someone speak out against this – and especially against the supposed “making excuses to stay fat”. As if we’re doing something morally reprehensible but want to keep doing it anyway because it’s easy, or fun – I’m trying to come up with a good comparison but my brain’s foggy, it’s early here…

  87. This makes me sad.

    I went to the doctor a couple of weeks ago, because I’d been having terrible headaches, fatigue and allergies. The first thing he asked was how much I weighed, then told me I needed to lose 20 kilos, and what was I doing to achieve that? He didn’t even bother to examine me for anything that could be causing all my problems or give me any pain relief for the headaches, which were getting so bad I was missing out on work and social events. I came home miserable and upset, but couldn’t tell anyone because I knew they’d just say “He’s got a pointt”

  88. Thanks so much Dr. Lavie for my excuse.

    All these years I strained every pore trying to find one, my quest is now over, thanks to you.

    Pass the cake, nimrod.

  89. Woohoo! Finally, an excuse to be fat! I was just about to start exercising 6 hours a day and eating 1000 calories so that I could lose 10 and gain 20 back, but now I’ve got an excuse to continue my “unhealthy” lifestyle! Yay!

  90. Obviously he’s like alot of people.. if you’re fat, not only do you deserve to be punished and ostracized for it, you should die a horrible death too.
    To say that thin people get a worse version of heart disease because they’re thin and still get it is almost too sad and pathetic to comment on. I sure wouldn’t want him for my doctor.
    So basically, I guess we deserve whatever we get for being overweight, and HOW DARE WE live in spite of being fat !! So there !!

  91. But you guys, NO ONE in Arizona eats at Chilis, and in Minnesota EVERYONE does. just saying.

    Well, duh. I’ve never been to either place but I personally have seen a Chili’s ad that featured people with Midwestern accents. So there you go.

  92. He’s pretty much flat-out saying that the size of your body trumps all other risk factors.

    I really don’t read him as saying that, but I don’t have a lot of interest in defending the guy.

    As far as risk factors go, you’re absolutely right that one of the problems is that not only do we not know how the factors work together, but that if someone is obese and has a heart attack, it’s likely that they stop looking for further reasons why the person had a heart attack, or don’t look at it as in need of further explanation.

  93. I really don’t read him as saying that, but I don’t have a lot of interest in defending the guy.

    Fair enough. I mean, what it comes down to is, I’m really not inclined to give him the benefit of the doubt. It’s possible that he spoke poorly, and different wording might have revealed that he meant what you said upthread, or something else that made more sense. But “These people wouldn’t have developed heart disease in the first place if they weren’t obese” is not the kind of statement that makes me want to look for a more charitable interpretation. :)

  94. Wasn’t Minnesota heavily-populated with Scandinavian immigrants in the 19th century? Meaning, people from a geographical area of loooong cold seasons? With ancestors whose body types would have slowly selected for their climate? The body type for which happens to be a short, squat, heat-retaining, food-storing sort of shape? EHHH????

    Now I’m not entirely certain the above scenario carries any more weight (ba-da-bing!) than some of the other hypotheses still rattling around my head from my days as an Anthro/Arch undergrad, but I do know it’s not one of those evo-psych sort of theories. Meaning, of course, that there is actual scientific merit for it.

    Anyway.

  95. In possibly related news, I woke up this morning to someone on NPR reporting a connection between obesity and the H1N1 flu.

    I managed to get out of bed anyway, though, so go me!

  96. OTM, I’d like to report my very scientific study that I am the fattest person in my department at the hospital and I’m the only one who hasn’t gotten a cold and/or the flu in the last three months.

    It’s totally a scientific study! I observed and reported! What do you mean, I have too small of a sample size?

  97. I wish I had heard the whole store (I think). It was similar to this dingaling’s comments about heart diease – something like obese people either contracting a more severe strain of the flu, or not recovering as well or as quickly from H1N1 as “normal” weight or thin people (all per BMI chart, natch). If it’s the former, we’re back in the “fat people get a worse form of a disease because they’re FAT” territory. If it’s the latter, I wonder how much of that is due to fat people prefering to avoid doctors, and so being more likely to self-treat flu and flu-like illnesses.

    They Chicago public radio ran a story about how great a local strip club is for providing lots of jobs in this depressed economy and I decided I was going to start waking up to the classical station for awhile. For my blood pressure. Which is high because I’m so fat.

  98. @ ASarah – I am now happily awaiting singing along to your “Dr. Buttmunch (To The Tune of Mr. Sandman)” ditty. Please post full lyrics soon!

    @Meowser – “Bathtubs full of fries” totally has to be included in our lexicon.

  99. I’ll put three pennies in here.

    I wonder if Minnasotans may simply be big people, taller people are generally also wider (which doesn’t affect BMI necessarily); but might make someone from a different area feel that people were big, therefore fat. Bad thinking, but I could see it. I live in an area where Norwegians settled and I swear that every other woman I see could be a Valkyrie, tall, big-boned (not fat, literally big boned) and, whether fat or not, strong muscled. Seventy or seventy-two inches isn’t uncommon at all.

    Two, I vaguely remember, but cannot find, a release on sciencedaily.com from about a year ago that said that some thin people have a genetic problem depositing fat as tissue, so it floats around in their blood and clogs their arteries and they have very bad heart attacks very early in life. So really, being fat is a sign that your body is doing things right. Plus, I’ve seen stuff there that says that fat is a rich source of stem cells. I could see that having lots of stem cells could really help someone with a major disease make a better recovery. So I don’t think it’s just about calories stored, though that also makes sense, I think fat is a useful tissue, not just inert weight. Does that make sense?

    Third, Sabrina’s comment about finding Lessons in the diet section made me happy because who more needs to see alternatives than people who are dieting. Maybe someone who is on the cusp will pick it up and have an epiphany? Perhaps we should do some guerilla marketing and move it there if it isn’t already?

  100. Oh, and I was baffled by that connection people are making between obesity and H1N1. The article in my newspaper said that of the group of 30 very sick people, four were obese. That’s just about ten percent. Now I don’t recall the stats off-hand; but isn’t that about the normal percentage, certainly within it for such a small sample?

    Four were pregnant too, but we don’t see fussing that pregnancy contributes to the ‘flu. Certainly there seem to be more “obese” people than pregnant people in the population.

  101. taller people are generally also wider (which doesn’t affect BMI necessarily)

    Heh, if only this were true. It’s a very flawed measure. Proportions could stay the same, and BMI would still increase with height.

    And your comment about reasons why heart disease might manifest differently in fat and thin patients is totally reasonable, but I’m with Kate – that does not sound like what this guy was talking about, and he hasn’t earned the benefit of the doubt after saying all that other bullshit.

  102. “I’d just been on a trip to Minnesota, where I can only kindly describe most of the people I saw as little houses,” Wintour said. “

    If this is literally true, then I am forced to come to one conclusion:
    I’m going to have to hop across the border in the hope that there in the hopes of getting myself my own short Hugh Laurie. Is the American accent and drug addiction optional?

  103. Okay so all of this is complete bullshit fatphobia nonsense. Right on. Here’s my . 02 USD

    Anna Wintour is an fugly ass furhag that is in serious need of a NEW FUCKING HAIRCUT ( a cut that by the way is as OLD as the state Minnesota). Do not for the love of all things holy, pay one bit of attention to this self-hating, delusional, wretch. If Oprah listened to this harpy I have lost TOTAL respect for her. Seriously. Remember, this is a woman that thinks its perfectly okay to wear the skin of a formerly living creature that lived in filth and ended his/her life through anal electricution an/or by being skinned alive. She has zero morals.

    Normally, I don’t pull out words like fugly because women’s bodies aren’t here for inspection. But woe be to any fashionista that attempts to applaud the re-arrival of harem pants out of one side of her mouth and criticize people’s bodies out of the other. Sell crazy elsewhere.

    Should I be surprised that Dr Lavie is quoted in Forbes, the jerkoff magazine for neoliberals everywhere? No. Apologies in advance to people who enjoy Forbes but this is a popular manifestation of a particular mindset that believes the state has no responsibility for its citizens other than military defense. So of course Dr Lavie thinks its sad skinny people get heart disease! He’s being interviewed by a magazine that festishizes invisible hands and personal responsibility. These are the very people who have created a health care system where smokers ‘deserve’ lung cancer and a social safety net that is best described by ‘welfare mothers should just get a job already’.

    Latvie is an asshat that is preaching to the choir of Forbes audience. No he’s not going to read anything from the CDC because that might take time away from his personal initiative to make a shit ton of money and call anybody who thinks people have a RIGHT to healthcare ‘socialists’.

  104. Normally, I don’t pull out words like fugly because women’s bodies aren’t here for inspection

    Well, that’s true whether you like the woman in question or not. Making fun of a woman’s appearance is neither warranted nor necessary just because you find her repugnant in other ways. It’s like people insulting Rush Limbaugh for being fat, or calling Ann Coulter a “tranny.” Doesn’t matter how loathsome the individual in question is, the point is that using their physical appearance, failure to conform to someone’s idea of appropriate gender roles, etc. is insulting to people you DON’T hate.

  105. Agreed, Kate. Referring to the physical appearance of Rush or Ann would be would be an ad hominem attacks and completely irrelevant.

    But neither of those people project themselves as final arbiters of beauty and fashion as Wintour does.

    In fact, I wouldn’t use that term at all except in a case like Wintour who feels it is her duty to tell Oprah she’s too fat to be on the cover of Vogue or calls the fine people of MN big as houses. Beauty is her business.

  106. I’m glad there’s no excuse. I don’t need an excuse to be who I am, and I certainly don’t want to be excused for being who I am.

  107. “Can we nominate others for asshole of the day? Because Vogue editor Anna Wintour is my pick.”

    Oh jeeeez. Everything that she said was a bunch of crap, but did she really call every single person in Minnesota fat? Seriously? That is so ridiculous all I can do is laugh.

    SBG, from Minnesota and doesn’t look like a house. A garage, maybe. ;)

  108. This guy illustrates brilliantly the reason I avoided going to doctors for about 5 years because I didn’t want to be lectured or made to feel like a naughty child because of my fatness.

    Last September I finally got up the courage to go to the doctor and even though I had requested a fat-friendly health practitioner the experience was actually about as bad as I could have feared, right down to the woman giving me my physical clearly not believing me when she asked “Do you exercise?” and I said “Yes.” “No, but do you get your heart rate going when you exercise?” This was followed by a very condescending lecture in which this woman told me I should perhaps stop eating cakes every day, and switch to brown bread. (I told her that would be easy enough to do, considering I don’t eat cakes every day but do in fact eat brown bread.)

    Anyway I was humiliated. But then I got angry. And then I complained. Because this woman had wasted so much of my time that she had ignored the reason I had gone in for a physical in the first place. I went back, saw someone different and was correctly diagnosed (at last!)

    Somehow that experience made me take responsibility for my health. I’ve come so far that today I was at the doctor’s, and I mentioned that I’d been having some pain in one of my heels after vigorous exercise. I managed to add, “And I know I’m fat, and I know heel pain can be caused by fat, but could you please have someone LOOK at the problem and not decide it’s just because I’m fat?” I’ve come a long way, baby!

    It’s just a shame that I and any of us had to deal with this shit in the first place.

  109. I’ve been treated as a fat person by doctor when I’m not visibly fat since I’m heavy for my size. I’m 5’2″ currently about 135 pounds and wear a size 4 (American) most manufacturers are loose or comfortable. I’m not squeezing into my clothes.

    I get on the scale and then I’m called fat. They wouldn’t know I was fat if I wasn’t weighed. Besides, I’m not even over the BMI for ‘average.” Even when I was heavier, I was never in the obese area. Besides, most of my insult for being fat were before the BMI chart was changed and my weight have never been high enough to be fat on the old chart. Still, each time I went to the doctor I was given the weight lecture.

    The last time it happened, I reported the nurse for abuse. I was pregnant and told not to gain any weight because I was obese. 140 pounds is not obese. It’s barely overweight. I lost 22 pounds after my first child and he was early. I suspected to lose as much as 30 pounds if I have a normal pregnancy. Besides, I was wearing a size small ladies sweat suit to my appointment and it was big on me. I feel any doctor or nurse that calls me fat (obese) is incompetent since there is more to health than numbers on a scale.

    My younger son is now 14 and it hasn’t happened since. I’ve got weird looks when I step on a scale or a teasing comment like you don’t look like you weight… but no more diet lectures.

  110. Whoops, no Wintour didn’t call every single person in MN fat. My bad – shouldn’t have typed before all the pistons were firing properly. Heh.

    Time to slide my butt back into lurkerdom.

  111. valerie… but you didn’t just say 1) you don’t like her, and 2) on top of that, she’s a fashionista and you don’t even happen to like her clothes or hairstyle. Your phrasing was much more judgmental and vehement, and frankly had nothing to do with the topic at hand. (Since when is a person’s haircut relevant to a discussion about their positions on social issues??) And whoa on the gendered insults. I mean, god forbid a woman be a hag or a harpy.

    Also, I don’t wear fur or approve of wearing fur (and my guess is most of the people on this blog are with me on that), but that diatribe was way out of left field in a conversation about a fat-hating asshole! I pretty much agree with you, and it still got my hackles up. wow.

  112. I have been avoiding physicals, paps mammograms due to embarrassment over my size, and I have no doubt that I might have to pay a heavy price for it. The last time I got a physical, the doctor examining my breasts said, “You are definitely a big breasted woman!” WTF. Like I needed confirmation.

  113. OK, wait. There are two different forms of heart disease now? And the evidence for this is..? I love how he assumes people won’t even ask.

    Anna Wintour reminds me of a woman I briefly worked for. Briefly because she was so awful that I quit right after the day when she pulled me into the back (it was a fancy boutique), made me do a turn, and frowned while disdainfully announcing that women my size shouldn’t wear clothes that showed their shape and couldn’t I find something that would disguise it a bit more? I guess she was picturing some sort of tunic or something.

    I was an 8 at the time. Oh fashion people, why are you so wierd?

  114. Well, I’m a long-time lurker, but the bit about obesity being a risk factor for H1N1 was enough to make me jump in. That little tidbit came from this paper http://www.cdc.gov/mmwr/pdf/wk/mm58e0518.pdf

    The sample size is 30 patients who were hospitalized in California. Of these 30, 3 (10%) had obesity as a comorbid condition. One was a 7 year old with asthma, one was an 87 year old woman with “recently diagnosed breast cancer with possible abdominal metastasis, hypertension, diabetes mellitus, coronary artery disease, cerebrovascular disease, chronic renal insufficiency and obesity”, and one was a 30 year old woman with diabetes.

    Considering that according to the CDC, the obesity prevalence in California in 2007 was 22.6%, I don’t see how 10% of patients who also had other underlying medical conditions makes obesity a risk factor.

  115. Lillian, that’s awful, and I understand totally. Here’s a funny thing: I recently got a drivers license and proudly announced my weight. When my license came, they’d marked me down as 65 pounds lighter than I am.

    I’m either heavier than I look, or lying is so endemic they can’t believe the truth.

  116. Although I think I’m 20 pounds and one size heavier than Kate at the same height, which suggests to me I’m not all that strange.

  117. what?? I didn’t say that! I was agreeing with Kate (and disagreeing with you) that viciously criticizing the appearance of a woman with whom you disagree is problematic. Saying I disagree with you is not telling you to shut up — I never said you shouldn’t comment, period. Your comment had a lot of other stuff in it that I did not in any way disagree with, strong words or not. I mean, anger over this is pretty justified.

  118. Georgia, wow, good job finding that. I had never heard there was any association between body size and H1N1, but I was pretty skeptical. Apparently that was for good reason!

  119. There is a story why I asked the nurse practitioner when I learned that I was pregnant with my second how much weight I should gain. With my first, I didn’t show. I gained only 12 pounds; he was early and I had bad morning sickness. I didn’t want that to happen again. It gave me such problems with the doctors and lead to my first son’s early birth and possibly his subsequent brain damage.

    No morning sickness. I didn’t learn I was pregnant until my twelfth week. I forced myself to gain as much as possible with my second that turned out to be 22 pounds. I had a seven pound baby born on his due date. I’m glad that I gained as much weight as I could and I had a healthy baby and easy delivery VBAC.

  120. I should have remained a lurker and not said anything

    Valerie, for fuck’s sake, if you really do read comments here you know this is about the most self-absorbed way to respond to disagreement possible. Bashing women’s bodies is not okay here, period. You’re not being called out for commenting; you’re being called out for commenting in a way that violates the spirit of this community.

  121. From all of Valerie’s comments, it seems to me she’s kind of new at this whole thing. Which doesn’t excuse her, but I’m tempted to cut her a very small amount of slack.

    And I’m more than tempted to suggest to you, Valerie, that you take a good, hard look at your comments before you post them and ask yourself, “Is there some anger or some self-hate or some passive aggression in these words?” And if the answer is ‘Yes’, work it out, don’t be throwing it on us.

    Because in case you haven’t noticed, we throw back.

  122. SM, you made the following statement to me a week or so ago…

    …”if you find that (as in this thread) even the people who agree with the point that you’re making think you’re being a shit-stirrer, you are either in a space that is very unfriendly to your POV, or you’re doing something wrong.”

    As volcanista astutely observed, “I pretty much agree with you, and it still got my hackles up. wow.”

    I think you’re right, SM. I don’t fit in. I tend to say strongly worded things that are meant tongue in cheek and it doesn’t come across that way in this space. When the feminist from social theory gets called out on harmful language then there’s something wrong. That is my fault. It is time that I shut up. That’s not self-absorption. That’s common sense and taking someone’s advice seriously.

    I didn’t want to be accused of being insincere or whiny so I apologized outright.

  123. Valerie, I see where you’re coming from and I really appreciate the clarification. I responded negatively to your last comment because it was strongly reminiscent of the “I’ll just take my ball and go home” type of flounce that we have seen before with other commenters. I understand now what you meant, and of course you’re welcome to comment on other threads.

  124. My sister is 42 years old, has ulcerative colitis and has no large intestine anymore (which means she has a bag now), rheumatoid arthritis, early stages of COPD (she quit smoking thank goodness), grand mal seizures which are barely controlled most of the time by two different medications, suffered from bulimia, anorexia and a pain pill addiction last year (she truly needed the pills but things just went off the rails due to understandable depression and feeling like she had no control of her life anymore). The Dr’s quit giving her painpills with no notification which means she detoxed with no medical supervision(another story). We suspected the pain pill stuff but the anorexia and bulimia symptoms mimic some of her other symptoms so neither the Dr’s or us recognized what was going on. The illness list goes on believe or not….anyhoo…she went to her new Dr. recently and he said she has high cholesterol (she’s working on it) and…… needs to loose weight….that’s right, lose weight….I almost went through the phone when she told me. She took it much better then I did. I mean…sputter…sputter…that woman, my beloved sister, has almost died numerous times. She’s been brought back to life on the operating table, has needed blood transfusions, can’t drive, at least two times a year ends up staying in the hospital, can’t work and would love to, can barely get out of bed some days…cleaning house can kick her ass.. and he is giving her shit about a few lbs??? WTF people?? I’m still trying to get over it! I would love to call her Dr but since she is on medicare I’m afraid to piss him off ….argh

  125. Good god, stlwtr, that’s horrible. As though you even have that much control over how much food you’re absorbing when you’ve had a colostomy (though for what it’s worth, on the up-side, you can now say that she had UC, because at least that one’s 100% cured). And how much exercise does he expect her to get with RA?? That doctor is an ass. Correction: all those doctors sound like assholes. That kind of crap drives me crazy.

  126. Good point Volcanista! She has been cured of something :-) I called her on my way home yesterday and we talked about it again. I encouraged her to talk to her Dr. and bring her medical history more directly to his attention… let’s face it, I’m sure he hasn’t looked at it all that closely… and let him know that due to all that, her weight is not open for discussion. I reminded her that her “extra” weight has actually saved her life on more than one occasion and she does know that. Finger’s crossed he hears her.

  127. At least the driver’s licenses here don’t say your *weight* on them – that’s horrible! As if it’s something they expect to stay the same until the thing expires?

    I agree about the nurse practitioner thing, one year I made the mistake of making an appointment with the doctor for my pap instead, just because it fit the schedule, at that time I was at a perfectly normal weight even by Met Life charts, visibly Not Going To Die Of Teh Fatz, she weighs me and checks my height, then tells me I need to lose weight. Given the narrow ranges on those charts, when you weigh someone barefoot and then *subtract two inches for shoes*, instant fattie. Of course, you could always just *look* at your patient, but that would involve admitting that you have a human being in front of you. After this, I was further humiliated by being told I scheduled it a week too early – um, *your office* scheduled it for me and knew when I had my last one – for OHIP to pay for it, and I’d have to come back. Turns out she wanted to bill for an (unnecessary, as I have a regular family doctor who I see for other things) full physical, where the NP is fine with just billing for a pap. Guess who I made the next appointment with?

    Even with a female doctor, you’re screwed merely by being a woman. And ever seem to notice how heavier male doctors (just like many other men as they age – men growing a beer gut is normal, but they complain about their wives “letting themselves go”) never seem to notice that *they’re* fat?

  128. “At least the driver’s licenses here don’t say your *weight* on them – that’s horrible! As if it’s something they expect to stay the same until the thing expires?”

    In AZ, driver’s licenses are good for 35 years. I’ve been below the weight on mine and way above it now. But I won’t have to get it changed for a good long time.

  129. I have no idea if I’m above or below the weight on my license. It’s a range. I’m wt 3 whatever that means.

  130. The thin people with heat disease get it because they can’t put on weight, the fat that should be going into their fat cells is running around in their blood being triglycerides.

  131. I am a newcomer to your site, but it’s very interesting and says things that need to be said.

    Here is another article FYI, in the same vein:

    http://www.nytimes.com/2009/05/26/health/research/26child.html?ref=health

    This one preaches that food allergies in children are associated with childhood obesity.
    So, instead of stating clearly that 1) cross sectional association cannot show that ‘a’ causes ‘b’ and therefore 2) it’s equally likely that food allergies may be triggering obesity or 3) that both are triggered by some other underlying issue, the article goes on to state that clearly, childhood obesity is leading to food allergies.
    Thus crack down harder on childhood obesity.

  132. Yesterday one of my dear friends had a heart attack at work on a college campus. Co-workers summoned people from the campus health center while they awaited an ambulance. Not knowing at the time that it was a heart attack, those from the campus health center were talking about what might be wrong. With my friend sitting there in obvious pain and suffering great anxiety and fear, someone told her that she could stand to lose some weight – that that might be why she was in pain.
    I’m sure my friend found this really helpful, and I’m sure it will aid her in her recovery, right? I’m beside myself with anger and disgust, trying to decide how to handle this. Suggestions?

  133. I had a terrible experience with a cardiologist last year, right after my mom had died of sudden unexplained heart failure.

    My mom was a beautiful woman, who had a beautiful body. She exercised regularly, ate mostly healthy foods, and tried to take care of herself the best that she could. She was what would be considered a perfect weight, given that she had a small, size 4/6 frame. My mom was always much smaller than me, & I was terrified that she was going to outlive me because I am around 200lbs, and only a few inches taller than my mother.

    One night, while on vacation, my mom’s heart failed, and she died in her sleep.

    My dad, concerned for mine, my two brothers’ and my sisters’ well-being, as well as his own, signed us all up to have check-ups with a cardiologist, because we are all overweight to some degree and if my mom could die of heart failure, surely we are more likely to die of it than her. (This was his reasoning – not mine.)

    The cardiologist, upon hearing that my mom died of a heart attack, immediately began talking about how the obese are more likely to die of such a thing – and then implied that my mother had been obese, going so far as to say that if she had taken better care of her health, she wouldn’t have died in the first place.

    Seething, I told the doctor that my mother had been nowhere near overweight, and exercised four times a week, at the least. The doctor was incredibly surprised, and implied that she didn’t believe me.

    I couldn’t understand the immediate assumption that my mother had had a weight problem. Did this doctor honestly believe that only overweight people can die of heart attacks?

    Thank you for bringing this problem to light. I don’t feel so alone anymore.

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