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.
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.
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.