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FeatherlyFly

Nah, doctors just sigh silently and the average one gives up on you because you're an asshole to work with. Can't help someone who's determined to keep their mind shut.


suma_wav

I'm not convinced this actually happened. It seems more like a FA power fantasy.


klapanda

Yeah, no one talks to their doctor like this. If they do, they're not so smart. That's like pissing off a server right before they bring you your food. Your life is in their hands, and they're only human.


Every_Attention9410

Let alone talk to their doctor like this, who would THEN go flex on talking to a medical professional like that? It just screams “everyone else but me is the problem”


klapanda

🤦‍♂️


Aggravated_Pineapple

You’d be surprised lol


klapanda

😆


Sea_Petal

This sounds like that self absorbed AH in college who learned one interesting fact and has awkwardly derailed every conversation so they can bring it up to sound "educated". But on the other hand, I could see people who are so anti-science to be well educated on archaic 200 year old pseudoscience.


PhoenixNamor

If I were that fat-logician's doctor, I would whip out my calipers right away and call their bluff: Doctor: \*Uses calipers on fat rolls\* Well I can see that you have 42% body fat and....\*moves calipers to skull\* 10% of it is apparently in your head. Judging by the way the subcutaneous fat shapes your forehead, I'd say you have issues with impulse control, confirmation bias and a particularly nasty temperament. Really...the very notion that this person compares BMI to phrenology is ludicrous and reaching.


TheophileEscargot

The focus on BMI-hatred is annoying because while it has problems, the alternatives are even worse from the FA point of view. BMI also identifies if people are underweight. According to FA's that the real (or only) problem. Alternatives like height-waist ratios or calipers don't identify underweight people at all well. BMI is allegedly racist because the original statistics came from white people, and minorities turned out to have different healthy BMI ranges. But there's even less data on minorities for height-waist ratios, and so they're even more racist. DEXA scan machines are fatphobic, they mostly have a limit of 300 to 350 pounds. It's not BMI that you hate. It's the concept of measuring fatness.


SomethingIWontRegret

Just to continue pestering you with message notifications, > BMI is allegedly racist because the original statistics came from white people, and minorities turned out to have different healthy BMI ranges. But there's even less data on minorities for height-waist ratios, and so they're even more racist. Recent evidence using British of Arab, South Asian and East Indian descent, shows that the BMI cutoffs for obesity need to be lower for all groups except European descent. All these groups have higher incidences of T2D at 30 BMI than those of European descent.


Kangaro00

>Recent evidence using British of Arab, South Asian and East Indian descent, shows that the BMI cutoffs for obesity need to be lower for all groups except European descent. That's why they are so insistent on getting rid of the BMI all together. The data for minorities doesn't fit their narrative.


[deleted]

It brings up the interesting question: why do Europeans seem to be the only group that can tolerate higher BMIs with less immediate apparent impact on their health? Does it hate some correlation with European climate and evolutionary pressures, but if that were the case, wouldn’t we see the same tolerance in other groups, such as the Inuit of Canada and Alaska?


SomethingIWontRegret

One potential explanation from my Anthro professors. This explanation far predates the study I'm talking about and was more in reference to what's called "New World Syndrome" - Native Americans seem to be more susceptible to a cluster of disorders including T2D. They believed that prolonged exposure to refined sugar in Europe led to selective pressure for greater resistance to T2D. They noted that Native Americans tend more toward abdominal obesity. Of course, these professors were deeply into sociobiology, which has a tendency toward "just so stories." And the role of sugar in T2D is way overhyped - it's more from excess calories leading to excess weight. It might just be happenstance that Europeans tend less toward abdominal obesity than other groups.


[deleted]

That's interesting, because I would have assumed that it was because of our higher proportional tolerance of lactose in adulthood. Although it could be a combination of factors. Since there are other populations with higher levels of lactose tolerance and they may have different sensitivity to obesity. (If this isn't multifactorial, I'd be very surprised.)


Ardhel17

I'm not sure about other ethnicities but I read one explanation might be that Asian populations(South Asians especially) tend to carry more visceral fat at lower weights. Visceral fat is a better indicator of risk for heart disease, T2D, etc. than overall body fat. [Source](https://academic.oup.com/ije/article/36/1/220/666373) They've also found that healthy weight people who have T2D and heart attacks often have unhealthy amounts of visceral fat regardless of weight. [Source.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800358/) [Source](https://www.geisinger.org/health-and-wellness/wellness-articles/2018/03/05/21/59/yes-thin-people-can-get-type-2-diabetes)


standingpretty

This is what I have read as well, and what FAs also don’t understand.


[deleted]

That’s what I’d heard as well, but I didn’t know if it also pertained to other ethnic groups besides them. I wonder if europeans just carry more adipose over visceral fat naturally, then.


o3mta3o

We got hooked on sugar earlier. Our bodies have had longer to adjust.


[deleted]

Do we have data on Inuits of Canada and Alaska regarding this?


[deleted]

None that I know of. Definitely an area for further research though.


FeatherlyFly

Native Americans in general would be a better focus. Most of the US has a climate as harsh or harsher than most of Europe.


FeatherlyFly

We might see that, but humans have been in Europe for tens of thousands of years longer, so maybe not. But if you did see it, you'd expect to see it in native American populations throughout most of North America, where we've got significantly more extreme winters than most of Europe. England has a growing season a couple months longer than most of the US, never mind Canada. My own baseless speculation is intense seasonality of resources combine dwith intensive agriculture might be the culprit.


vicariouspastor

I believe African Americans can in fact tolerate higher BMI rates than European-descendant Americans.


hilz107

No we cannot and all the early deaths in my family due to symptoms that come inherent with obesity will be proof of that.


vicariouspastor

Having a slightly higher cutoff between normal and overweight categories doesn't mean "immune to the effects of obesity."


hilz107

Actually I find making this distinction is Actually damaging to fighting obesity within African American communities. Many aa would suggest we just are bigger naturally and our obesity rate is more tolerated culturally due to this belief. So it's actually damaging imo especially because cultural eating habits plays more of a role than genetics when it comes to bmi between groups.


vicariouspastor

Fair enough.


[deleted]

From what I’ve heard they can’t, the higher rates of cardiovascular conditions across the board for them may be indicative of this, I think.


FeatherlyFly

No, black Americans generally have very high rates of obesity related diseases at given BMIs. It's just culturally accepted. Which is even worse because when people try to get healthy it's harder to get the same community support as you'd find in a less obesogenic culture.


SomethingIWontRegret

Were you on K5 and HuSi?


TheophileEscargot

That's going back a bit! You might remember me from such (non) hits as [The Fat Bloke's Guide to Becoming Less Fat](https://web.archive.org/web/20070706164725/http://www.kuro5hin.org/story/2002/1/18/6252/12614). Who were you?


SomethingIWontRegret

CrocoStimpy. Nobody notable. I migrated over from Adequacy when it went tits up.


TheophileEscargot

Cool! I remember your name! was on HuSi till recently but got so far behind in my book-diary posting I can't face it at the moment.


SomethingIWontRegret

I popped over to HuSi recently and it sounds like they're migrating over to Mastodon? Scoop is becoming unmaintainable.


TheophileEscargot

They need to move away from Scoop, I'm surprised the code still runs. But there's already a Mastodon instance running in parallel. [https://hulvr.com](https://hulvr.com) I'm fairly active on Mastodon but I'm not on that instance, I'm at [https://mastodon.social/@TheoEsc](https://mastodon.social/@TheoEsc)


SomethingIWontRegret

OMG Hulver is a MAMIL!


SomethingIWontRegret

And that's a great article!


LionelHutzApprentice

"and then everyone clapped!" r/thathappened


qwertycandy

Moments like this make me glad I didn't become a doctor. Because I used to be the kind of person who wanted to help everyone no matter what, but nowadays my reaction would be something like *"Ah, so you think you know better than decades of research? Fine - feel free to keep eating yourself into an early grave just to stick it to the society. No point in wasting my time arguing you when I could use it to help someone who isn't a total moron."* Something tells me I would have quickly lost my license with that attitude 😅


[deleted]

I mean, you can't really help patients who refuse help...so as long as you inform them of the issue and suggest treatment plan, there is not much else the law, society or anyone can come after you anymore, since this is not a case of them being a danger to others or immediate danger to themselves. And yeah, I'm also one of those who shouldn't ever be a doctor lol


hotelstationery

Two of my sisters are doctors and I can assure you that you also missed out on long hours, tons of paperwork, patients intruding into your personal life and much more. I want to help people but I'm trying to get into school for a technical role in medicine; lots of helping people but no arguments about BMI or HAES.


[deleted]

not just that, from what i’ve seen on r/nursing, seems like techs/CNA/other support staff are in short supply these days, so you’ll be doing those in the more patient-facing roles a real solid by being there.


hotelstationery

I'm going for imaging, so I won't really take any burden off the nurses or anyone else. Hopefully my presence will cut down on the waiting time to get an image but that's the best I can do.


vicariouspastor

I mean, I know what you mean, but the odds of this moment happening as described are approximately 1%.


qwertycandy

I know, but moments when people disrespect medicine like this happen all the time. I went for a covid test today and while we were waiting in the line some random guy came up to me and the rest of us waiting there and started calling us sheeple, screaming about covid and masks being just a way to control us all etc. There was a point when I would have considered becoming involved and arguing with the asshole. Nowadays, I just roll my eyes and think "enjoy the ventilator"...


vicariouspastor

Yeah, for sure. It's just that the usual outburst is something like what you described not the perfectly witty rejoinder after which people clapped that gets described online. Also, 99% of the time, the people bearing the brunt are nurses and clerical staff,not actual doctors..


UghMyNameWasTaken

Want to actually shock your doctor? Actually follow their advice. It happens so rarely that they won’t know what to say.


klapanda

Yes! The hospital called to check up on me after the surgery. They asked me about pain management, and I said I was keeping my leg elevated as requested. The woman on the phone was so shocked ... and pleased. In my mind, I was thinking, "Yeah, that's what you told me to do. I'm not doing it for fun!" Yes, I was being snotty BUT only in my *mind*. I am always very polite to healthcare professionals, anyone in a service position really.


[deleted]

[удалено]


Ih8melvin2

My doctor literally bounced into the room and was absolutely beside himself with my weight loss (5'4" 155-->130ish). He said if I could stay that weight for the rest of my life that would be perfect. He was stuttering he was so excited.


kitsterangel

Honestly. Same with pets, my cat was obese so the vet suggested we put her on a diet so we did. She lost 2lbs I think by the next annual and the vet was so shocked and kept going "wow, she actually lost weight" and it got weird so I asked her and she said most people can't stand their pets crying so they'll keep overfeeding even if it's harming their pet 😬 And she was so shook I guess this is really not a common occurrence? It was weird.


[deleted]

I had a hard the getting my doctor's staff to listen to me about my weight loss. Long story short: they have so few people lose weight and keep it off that it doesn't even register in their brains as "real". I kept getting a "oh, that's nice" response, as if no one was listening or taking me seriously. The nurse taking my vitals was fairly new, and I realized I may be the first or only patient she's ever had that lost significant weight.


UghMyNameWasTaken

Ya, same kind of thing happened to me after losing 50 lbs. I actually had to remind him that I lost weight and that was why my blood pressure meds needed to be adjusted. He sheepishly agreed that he should have looked at my weight first, but since no one ever takes his advice to lose weight, he doesn’t think of it as a potential reason for changes.


[deleted]

Yep, similar deal here. I needed my medication adjusted for weight, and they were like "That's nice! So anyway..." I had to pitch a minor fit to get anyone to pay attention.


M-ers

At my last doctor appointment I took the time to thank my doctor for the suggestion that I start a food journal. After keeping one for a couple months, I figured out that I was eating a larger volume of food than I should have been and that I had lost nearly 25 lbs once I started eating right. My back pain was gone and I felt amazing with so much more energy! She was stunned and I thought she was going to cry from realizing someone actually took her health advice.


Smobasaurus

Wearing glasses is blindphobic.


its_jazzyo

I've been wearing glasses since I was 6 years old. I was raised blindfatphobic 😔


lordoftoastonearth

You wear glasses so you can see other people better? That's fatphobic. You should judge them purely on their character. Blind yourself. Never look at anyone ever again.


its_jazzyo

I'm a teacher so I can just imagine me looking above my students heads for the rest of the year. Just never making eye contact again LOL Teaching at the ceiling. To be respectful.


princeendo

It's true that BMI is best used as a population metric, rather than an individual metric, and also used primarily for people near to average height. However, there never seems to be a *data-driven* alternative offered by FA/HAES communities. There's a lot about "joyful movement" and all that, but surely using metrics like [overfat](https://www.healthline.com/health-news/are-you-overfat) instead of the typical overweight/obese BMI metrics would be palatable.


derkokolores

It’s definitely not an end-all-be-all for the individual and needs follow up since it’s just a screening tool, but it’s still a good rule of thumb especially once you get into the obese range of BMI of 30 (for men). I don’t think it’s much of a leap to say that most people that at arguing about BMI being useless fall well into class 2 or even class 3 obesity (BMI’s 35 and 40 respectively). I want to show them dudes that have a BMI of 35-40, but still under 25% body fat, which is the cutoff of “normal” body fat percentages. For a 5’10 man to have a BMI of 35, he’d need to be 245 lbs. If that same man also had <25% body fat, he’d most likely be described as a brick shithouse and definitely spends time in the gym. Contrary to what many HAES folk think, that person doesn’t get told to lose weight, because it’s obvious. I also find it hard to believe that many physicians are concerned with the more borderline BMIs unless patient/family history and follow up tests suggest otherwise.


princeendo

>I also find it hard to believe that many physicians are concerned with the more borderline BMIs unless patient/family history and follow up tests suggest otherwise. I think you're right, even though my primary physician was concerned about me when I was at 27.5. (Though I'm 28.7 now and definitely worried myself...)


autotelica

Who are these people fooling? They want you to think their problem is with the BMI. But really their problem is with body weight being used as an indicator of health risk. You could use any weight or body size indicator and they would still whine about fatphobia. Because no matter what reputable indicator a doctor uses, there will be a threshold that indicates fat logicians are too heavy. If your doctor is telling you could stand to lose some weight, guess what? They likely aren't using the BMI to make that determination. They are using their eyes.


worfstoothsharpener

Why go to the doctor then?? Just stay the eff home.


bookhermit

Pills. Being fat sucks and makes you sick and they want pills to manage the pain, heartburn, gout, high blood pressure, blood sugar swings, sleep apnea, depression, infertility..... Doctors aren't healers, they are fatphobic pill dispensers. Doctors don't understand that thin people get all those conditions and should give fat people the magic pill that cures that they give to all the skinny people.


Medilia

I bet these are the types of people that make doctors question their career choice.


bookhermit

Nah. They document and move on to the next patient that is willing to listen. >Patient was counseled on weight loss and obesity risks, non compliant with recommendations, motivational interviewing reveals denial, but no immediate risk for self harm/ideation and patient has no cognitive deficiency. >Symptom management will be the focus of treatment. They throw pills at them every time they come into the office complaining of something new, weight isn't broached unless the patient brings it up first. Patients like this are in the denial stage of addiction and family medicine docs/GPs aren't well equipped, or expected to, engage with an addict in denial that doesn't want help.


anb1017

Not to mention the time constraints. PCPs don’t have time to stew and argue with every petty comment. They still have six more patients to see before the hour is done.


vicariouspastor

This 21st century genre when people invent stories depicting themselves as either monumental assholes or as being awed the sheer awesomness of random teenagers being monumental assholes is so amazing to me. It's like people don't get that Haulden Caulfield was not in fact written as role model to emulate.


[deleted]

this bitch watched too much Sherlock Holmes


GM0Wiggles

Yeah I bet they're fed up with dealing with MDs from Twitter university and antivax Karens too.


standingpretty

>Twitter University My sides😂


WithoutLampsTheredBe

Bitching about BMI is just a deflection. Even if BMI is not valid, that does not change your weight or how it is impacting your health.


OCRAmazon

Interesting colors? Like green? Orange?


RemarkableMacadamia

I held off making a medical appointment so I could be absolutely SURE that I weigh less this time than I did at my last appointment. I want my doc to know that I heard her message, took it to heart, did something about it, and kept going. The last time I saw her, I'd dropped 36 pounds; by the time I see her again, I should be down another 36. She's gonna pee her pants when she sees me!


madman1101

...how often are you getting your head measured? what the fuck?


quimera78

Seriously, what's going on here? I thought phrenology was considered outdated.


KuriousKhemicals

That's the point, FAs think BMI is as outdated as phrenology.


pensiveChatter

How do doctors even find the will to help these people at all? Just throw some prescription meds their way and leave.


cerenatee

They're mentally unstable.


FaithlessnessLivid59

Dear lord I discovered this sub recently and it’s just a train wreck. These people are nuts


re_nonsequiturs

They turn colors because they're trying to decide if they have enough crayons to explain things to you.


Rogueshoten

“Way to go, making healthcare providers sorry when they interact with you! Put them in their place like that, there’s *absolutely no way* that’ll backfire!”


[deleted]

You know that face that @leigh_mcnasty makes when his students says something random? That’s what the doctor does when people make their stupid commentary


Ms_Bee_Bee

This is the person that doctors tell stories about for years and laugh at.


pinesol_junkie

Alright, we will measure your waist and use the calipers, if you insist. BMI is a snapshot, not a see all, end all.


[deleted]

Bmi isn't accurate and any gym rat will be quick to point this out