162 points

Got a lot to say but I’ll keep it brief-ish. Corporations love unhealthy people. They will artificially celebrate this and reinforce unhealthy lifestyles. This extends beyond weight.

Once entrapped, escape is hard. Some are passive and depressed. Some are dismissive and defensive. No matter which cycle you are in, it’s unhealthy.

I think smoking is bad like I think being overweight is bad. If a doctor says alcohol is killing you, it probably is. I don’t think hatred is deserved, but don’t expect any validation for those choices.

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73 points
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Surely no coincidence that being obese is a gateway to hyperconsumerism anyway. Sugary, fatty, processed snack foods are way more profitable than healthy meals.

Walking around town is free, can’t have that. Sit at this computer chair, watch advertisements and play video games instead.

Heart disease at 26? That’ll be $2k/month until you die.

Get depressed, buy the meds, never leave your couch, don’t fight back, you’re the evolution of humanity and - most of all - you are beautiful.

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36 points

I am down 50+ pounds, and have another 20 to go. This is new to me, but I absolutely agree with everything you said.

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2 points

Congratulations, that’s really impressive!

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31 points
*

The meme isn’t about that, I’ve read stories of some doctors refusing to perform surguries to overweight people, but other doctors doing the surgery anyway.

The same way a lot of women get told stuff is just from their period by doctors.

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96 points

I’m a medical student and I have some direct experience with this. Sometimes, the difference between the surgeon who will do the procedure versus the surgeon that won’t do the procedure is the availability of specialized facilities and equipment that they have access to. An elective surgery (i.e. not an emergency surgery) can go from routine to very high risk depending on the amount of adipose tissue the patient has.

And it’s not just a matter of the fat tissue overlying the surgical site. Morbidly obese patients are much more likely to have things like sleep apnea which can make anesthesia more risky and might require more specialized equipment than a particular surgeon/hospital/anesthesiologist might have access to. The “morbid” part of “morbid obesity” also refers to the fact that people above a certain threshold of weight are much more likely to have other health conditions like heart disease that make anesthesia more risky.

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20 points

This is what I came to say but wasn’t smart enough to put into words. There’s a lot more factors than just being overweight of why a surgery can’t be performed. For a while an issue at my hospital was we were one of the few in the area that could do MRIs on larger patients. So bigger hospitals would transfer these patients to us just for an MRI because their MRI machine was too small or couldn’t handle the weight.

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5 points

Would a surgeon unable to do it refer the patient to one who is capable?

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The reason for that is that surgeons are rated based on their success percentages meaning they’ll recommend against risky surgeries.

The upside of this is that surgeons aren’t operating willy-nilly on people and will make a proper risk assessment. The downside is that overweight people have an inherently higher risk of complications from surgery, so some surgeons will pass.

It’s not because they think these people don’t need it, it’s because they think it’s too risky. They’re usually not wrong about that, you just need to find a surgeon willing to take the risk or, if possible, reduce the risk by losing weight.

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11 points

There’s also no point to surgeries if the people aren’t committed and are just going to eat even more and put the weight back on. It’s like consolidating debt to make one payment easier but keeping all the credit cards and building up the debt again. It just makes you worse off

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29 points

Look. Shitty doctors exist, but when 1/3 of the US is overweight, there are underlying issues that need addressing. I only hear horror stories when an addict, alcoholic, or overweight individual in my life is feeling insecure or defensive about a prognosis. Too many people deflect and it’s enabling a much larger issues. Our basic instincts are being exploited.

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12 points

I know, I’m not arguing for obesity, that would be stupid.

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10 points

Look. Shitty doctors exist …

Yes. They’re in the meme.

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2 points

I have some horror stories about being a normal weight woman seeking medical care. What’s that about then?

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0 points

America’s obesity epidemic is a function of our car culture. This is the only country on God’s green Earth that feels putting in sidewalks is a moral failure.

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20 points
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When talking about obese individuals, the fat very easily gets in the way of surgery. Compared to a healthy patient the risk of complications during surgery is much greater and really not worth chancing it (most if the time)

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13 points

Similarly - if you are trans and on HRT, every problem is due to your hormones.

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2 points

My mother had a doctor that refused to move forward with knee surgery because she was so depressed and refused to do therapy because it hurt her knee so much to move around.

I guess I understand, why go through the trouble of surgery if she’s just going to be a bummer couch potato afterwards and never change her ways?

But at least she’d be a bummer couch potato whose knee didn’t threaten to give out on her whenever she tried to do laundry in the basement.

If I take my car in for new brake pads, don’t refuse me service because the transmission is on its way out.

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1 point

People are more complicated than cars, and surgeons are no magicians. I think your idea of the reason of your mother’s surgeon for refusal might be a bit off:

  1. Without adequate pre- and post-op physiotherapy, a joint will likely be worse after surgery.

  2. If simple physiotherapy is already too painful, cutting into this overexcited tissue risks inducing a complex regional pain syndrome.

  3. If someone suffers from both depression and from too much pain to do physiotherapy, they need a multimodal pain therapy to prepare for surgery.

So, based on the bit of info you provided, refusing surgery was very likely the right thing to do to avoid worsening your mother’s situation. What I di hate is when doctors don’t explain themselves and just say “I can’t help you”, but do not point patients to someone who can.

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2 points

I’m guessing that’s under the US health system, where doctors are incentivised to only perform surgeries with a low risk of complications

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4 points

For a lot of doctors, the incentive to not do risky procedures is the fact that you have to live with the guilt of your patient’s death, even if you did everything perfectly. Or, you do everything perfectly, but they still have a poor outcome because they weren’t healthy enough to go through the procedure and the recovery, and you get sued for millions of dollars because you didn’t spend 4 hours going through the informed consent with the patient to ensure that every single possible complication was adequately discussed.

I’ve worked in emergency medicine and I’ve had patients die in my care that we had absolutely no way of saving. The screams of their families still haunt me and I will carry those cries of anguish and loss to my grave. I would not perform a procedure that was not 1000000% necessary if the risks are too high because I have enough blood on my hands already, and I haven’t even finished medical school.

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2 points

What countries medical system encourages risky surgeries? As far as I’m aware “reducing risk” is most of the game in medicine

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-9 points

I’m just sitting here waiting for the point of what you said. 60 people upvoted, but you didn’t say anything.

The phrase of the day (which you should Google of you downvote this) is pseudo-profound bullshit.

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8 points

You count just say you disagree and explain why it upset you.

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4 points

I think their point is that doctors don’t want their patients to become entrapped by obesity into lifelong poor health, which also traps them as sources of revenue for corporations that profit from sickness and fat: pharma, companies that sell fad diet and/or exercise plans, etc. So if your doctor tells you to lose weight, it’s probably coming from a good place, regardless of what else might be going on with your health.

(And just in anticipation of some replies I might get: yes, it’s absolutely a real and shitty thing when doctors only see the fat and assume it’s the cause of all the patient’s problems. You deserve better healthcare than that. But also recognize that while the fat might not be the cause of a given problem, it might be exacerbating that problem.)

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-34 points

You are ignorant of the genetic factors at play here and I think you need to realize that your rhetoric is identical to victim blaming eugenics ideology. You sound like RFK Jr. and I’m guessing you would want me dead if you could have things that way. It’s honestly despicable and I don’t know how people like you sleep at night.

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23 points

Hear me out. You’re villainizing me because what I said struck a nerve. You don’t actually believe I want you dead. You’re just upset that I pointed out a deep flaw. Maybe it’s an insecurity, or cognitive dissonance, or whatever. I’m very familiar with this type of response. Whatever it is, realize that someone likely depends on you and that an unhealthy lifestyle is not good for them. I’m encouraging you to do better, if not for yourself, the people in your life you care for. I recognize my ignorance. I’m not a therapist. I’m just stating something I’ve personally observed.

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13 points

Buddy, you’re over stating the importance of genetics. Time and time again it shows that getting bigger is more nurture than nature. Papers and research retounely come out saying its a two-sides of the same coin issue, but then fail to support their nature/genetics claims, which are often refuted. Slender families get children who end up obese because of lifestyle, and their children become obese. That’s not genetics. The grandchildren end up obese because obese parents place their lifestyle and diets onto their children.

Claiming something is victim blaming is insanely disrespectful to the people who actually get blamed for things out of their control. Your weight is in your control for the vast, VAST majority of people.

People with disabilities who can’t get an opportunity to do something about it? Sure. Can that disability come from genetics, sure. But that’s a small minority of people who are overweight.

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-5 points

it shows

[citation needed]

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5 points

Used to see the odd “genetics” fat person and they’d just be built a bit bigger. Now I’m seeing fucking waddling planetoids and that’s not genetics man. Part of that blame belongs to individuals but part of it belongs to the food lobbyists and their quest to add sugar and corn syrup to everything.

Incentivise people to grow their own vegetables (or source them locally from those who already are) and disincentivise the purchase of processed and sweetened food. Have our agencies promote healthy recipes using weight rather than volume measurements and show people how to use scales to properly weigh ingredients and help make it as easy as possible to count calories.

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4 points

And you sound like a moron. OP didn’t say anything and you said even less.

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30 points

I’ve had almost exclusively military doctors for nearly two decades, and I can tell you they aren’t trying to respect your feelings (not that they’re dicks). If your tests come back with high cholesterol, they aren’t jumping to Lipitor or some shit, they’ll refer you to a nutritionist and tell you to exercise more. They have no problems telling you that your health troubles come from that weight crushing your organs and joints.

And that’s as a person in the military, who has to maintain a certain level if fitness to keep my job.

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94 points

I can’t blame doctors for letting obesity color their opinion. Look around your doctor’s waiting room. Everyone is fat. Imagine the suffering and illness they see daily due to fat. How can those observations not color their general attitude?

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7 points
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Look around your doctor’s waiting room. Everyone is fat.

Lots of people are old and age correlates with weight gain. But the volleyball player who blew out her ACL isn’t fat. Neither is the chemo patient who is back for a final round.

How can those observations not color their general attitude?

Doctor: “Feels like everyone I see is either sick or injured”

Nurse: “Try spending less time in the ER”

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1 point

Lots of people are old and age correlates with weight gain.

Only in the US and countries with similar shitty feeding habits.

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12 points

I’m not sure your second point works, or maybe I just don’t understand it. It’s not like the doctor is making judgements that people are fat outside a hospital- they’re doing their job. You’ve got a car and it’s starter goes out every year, last time being a year ago. Your car wont start. Whats the first assumption?

It’s not ableist or bias to assume that the most common issue is the most likely issue. They see a ton of people whos problems are irrefutably due to their weight. It’s not the doctors job to make judgement calls on whether that person is wholly responsible for their situation, it’s their job to doagnose the problem and help take steps to fix it. The problem being their weight, the steps include: burn down capitalism and replace it with a system that doesnt incentivise companies to use the cheapest least healthy ingredients, or tell the patient unless they lose weight they’re going to die. One of these is completely pointless to tell the patient, the other gives them an unfair opportunity to potentially save themselves.

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-1 points
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Medical care for obesity is currently in most cases like telling someone with a broken starter that they need to run their car more instead of replacing the starter.

If eating too much compared to energy usage is unhealthy then there’s already something wrong with the patient that’s causing them to eat too much or expend too little energy. Telling them to lose weight might be the only thing within a provider’s abilities to do, but it’s equivalent to telling someone with a broken starter to leave the engine running.

It is abelist and biased to pass judgement on ones patients for having symptoms of physical, mental, social, or environmental ailments. When a symptom is already socially stigmatized a provider has a responsibility to care for the social impacts of that stigmatization as well, at the bare minimum in one’s own dealings with the patient.

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-4 points

They see a ton of people whos problems are irrefutably due to their weight.

Weight is a symptom not a cause. Metabolism, age, injury, psychology - these are causes.

burn down capitalism and replace it with a system that doesnt incentivise companies to use the cheapest least healthy ingredients, or tell the patient unless they lose weight they’re going to die.

Everyone dies. And big people have existed far longer than the advent of processed sugar. But asking people to adopt unhealthy eating habits in pursuit of a tiny waistline isn’t healthy.

Too often I see people conflating “Looking healthy” with “looking pretty”, absent any of the trade offs necessary to maintain appearances.

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6 points
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Everyone is fat

Exactly, which points squarely at an environmental cause, not at individual sloth/gluttony or some shit like that.

The conclusion you’re saying doctors arrive at—which I don’t doubt you’re correct about—is actually completely fucking backwards.

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73 points

Yeah but your doctor cant prescribe you burning down capitalism, they can prescribe you lower your caloric intake.

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32 points

Yeah but your doctor cant prescribe you burning down capitalism

Unless…

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11 points

which points squarely at an environmental cause

No, it points to people eating processed food and other shit. Guess what, you can still be healthy if you eat healthy.

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5 points

That’s the cause I think they were referring to.

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1 point
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So then the question becomes, why is processed food and other shit so pervasive in the average American diet? That’s what an environmental factor is.

Refusing to think about the problem in terms of systems because you’ve got a hard-on for blaming individuals is absolutely missing the point.

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1 point

The environmental causes are availability of options we crave but are still not forced into, so individual responsibility is absolutely a thing.

I was obese and it sucked but I got down to a healthy weight, and keeping it off kind of still sucks but it doesn’t take a lot of time or money, in fact it’s generally cheaper.

Fast food is constantly highlighted as an impossibly unhealthy reality, the nicer places cost more and take too much time. Except you can choose passable choices in fast food.

If you can freely pick, there are fast food places that offer salads with maybe some grilled chicken, which can be healthy unless you opt to drown it in ranch.

But let’s say you are in a group and they pick a restaurant without an option like salad. Just asking for water instead of a big sugary drink gets you so much closer to healthy. Skip the fries, skip the mayo, get a smaller burger. All these things are cheaper and friendlier to a reasonable caloric budget.

It sucks because it means eating to feeling “ok” while skipping the most awesome foods and rarely getting to feel just utterly full, but that was just life when people had healthier weight.

Similarly on activity. It does suck that work has people sedentary, but our idle pursuits are similar. When I was a kid, TV was stuck on a schedule and video games were only so engaging, so we would get bored and want to do something. Maybe it was walk amongst some trees to see if anytime interesting was around. Maybe do something with a ball. Nowadays we can get endless engagement from streaming, video games, and Internet. So tempting to just be on the couch. We can still choose those more active things, but we don’t want to.

Note all this awesome stuff is still great in moderation. I just went full on gorging at a restaurant a week ago on pretty much whatever I wanted. The thing is this is maybe like once every 2 or 3 weeks, not daily like we really want to.

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-16 points

That’s the trick!

They believe everyone is gluttonous and slothful because they’re misanthropic.

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17 points

Or a mentally troubled patient. Or a black patient. Or a woman.

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5 points

Yeah. I’ve a friend who kept getting dismissed by the doctors when they came with worries about their heart, because they were diagnosed with generalised anxiety. Apparently if you’re living with anxiety you’re also immune to heart problems!

Doesn’t help that someone close to them died because of late medical intervention, which only happened because the person’s partner insisted that they fake a fainting episode as the medical system had repeatedly dismissed them when previously asking for help with their problem. Everything was fine and dandy until they didn’t pass out, then oops, too late to treat the cancer, have a nice rest of your life.

Can’t even blame individual doctors though, I think it has a lot to do with understaffing and overworking. The people who matter aren’t cared for and thus can’t properly care for the people they are obliged to care for. It all serves the bottom line of the elite because they can pocket more money.

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-4 points

If you say so

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50 points

Have you tried not being fat?

reminder: shitpost

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13 points

I’ve not not tried it

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5 points

I can’t believe it took me 45 years to try that but man am I happy I did. Well, I’m almost there. None of my clothes fit anymore though.

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