To think a doctor telling you that you need to lose weight isn't "fat shaming?"

[FrankieDoyle]

Genuinely interested in opinions.
I follow a plus size Instagram blogger/influencer who normally posts about fashion, inspirational quotes etc.

Today she posted about a trip to hospital that she had. The doctors there were apparently unhelpful and told her that they couldn't operate on her because, amongst other reasons, her weight. They told her she would need to lose weight before they could consider it.
I think she's about a size 26-28, from her posts about her wardrobe where she's mentioned the size she wears.

So she posted a video stating that she was sick of being fat shamed, something needs to change, and the doctors don't take her seriously etc.

It got me thinking that actually I disagree with her viewpoint that it's "fat shaming" to inform a patient that they need to lose weight? The doctors have to check that it's safe to perform an operation on someone don't they?

I say this as an overweight person myself (currently a size 20 but following a diet plan and trying to lose weight. )

Maybe I'm wrong I don't know, but it seems unfair to criticise doctors on a public platform with thousands of followers, simply for doing their job.

I understand some doctors can be patronising or seem to focus on a person's weight, and that can't be a nice experience. But I really disagree that it's "fat shaming" actually I quite dislike the phrase being used to criticise these medical professionals.

It may not be fat shaming, but it is not helpful.
Addicts af all kinds are offered help from the nhs to beat there additions, smokers can get gum and patches.
If your overweight you just get told to eat less, why don’t we tell heroin addicts to just stop injecting?
Unless you are over a massive BMI the nhs will do nothing.
Untel there is some real help, the obesity crisis will just get worse.

Obesity isn't always a symptom of MN struggles. Sometime it can be the cause.
It needs very individual approach. Some of us are just fat and if someone tried to tell me I must have MH issues, I would not react well. But someone else has them and it would be needed for them.

I am also of the opinion that anyone presenting mh issues should have blood tests done. I had anxiety attacks which gave me incredible chest pains. I still get anxcious about things when my vit D is low. I am pretty sure from description of my symptoms that if I had a different GP I would get antidepressants or anxiety medication, rather than treatment for deficiency. Hollistic approach is needefld with everything medical.

@bebanjo

It may not be fat shaming, but it is not helpful. Addicts af all kinds are offered help from the nhs to beat there additions, smokers can get gum and patches. If your overweight you just get told to eat less, why don’t we tell heroin addicts to just stop injecting? Unless you are over a massive BMI the nhs will do nothing. Untel there is some real help, the obesity crisis will just get worse.

What do you suggest? Genuinely trying to work out if you mean food addiction counselling?

@bebanjo

It may not be fat shaming, but it is not helpful. Addicts af all kinds are offered help from the nhs to beat there additions, smokers can get gum and patches. If your overweight you just get told to eat less, why don’t we tell heroin addicts to just stop injecting? Unless you are over a massive BMI the nhs will do nothing. Untel there is some real help, the obesity crisis will just get worse.

I would be careful. People always say "treat it like addiction" bit how are addictions treated generally? You don't see a drug addict showing injection scars proudly while telling people to fuck off and stop drug shaming them, you don't see local heroin dealer collaborating with them on insta... Now I know that's illegal drugs, but the same goes foe alcohol. You don't have an obvious alcoholic promoted and hailed as a role model and getting money from promoting stuff.

Either people want to treat it as an addiction, or not. But pussyfooting in the middle and picking just handy bits, is not right.

Also, smokers can get patches, obese can get gym for a pound, at least i did. And dietitian. And I wasn't even morbifly obese then

@Flatdisco

It's not actually proven weight has a negative impact on health but doctors have been taught this is true and have no reason to learn off their own backs so keep spouting this as truth.

It's been proven many times and for numerous different aspects of health.

It's not fat shaming lol, be fat and be happy but don't be surprised when it comes with health issues or a literal medical professional brings up your weight in relation to a surgery/medical issue you have .. it's like, as an example, if a very thin woman with a six pack was struggling to conceive, they would possibly tell her she needs to gain more body fat, that's not shaming it's just facts

@SchrodingersImmigrant

Obesity isn't always a symptom of MN struggles. Sometime it can be the cause. It needs very individual approach. Some of us are just fat and if someone tried to tell me I must have MH issues, I would not react well. But someone else has them and it would be needed for them.

I am also of the opinion that anyone presenting mh issues should have blood tests done. I had anxiety attacks which gave me incredible chest pains. I still get anxcious about things when my vit D is low. I am pretty sure from description of my symptoms that if I had a different GP I would get antidepressants or anxiety medication, rather than treatment for deficiency. Hollistic approach is needefld with everything medical.

Yes it is an extraordinarily complex area. Many GPs try and treat all mental health issues with medication which in the long term very rarely solves the problem unless the cause of the mental health problem is only a chemical imbalance.

Physical issues can also replicate symptoms of mental health issues as well as causing them.

The medical profession are extremely incompetent at dealing with mental health issues or anything presenting as such. Usually, like you say antidepressants (many of which themselves cause weight gain) are just prescribed.

I think what we agree on is that the medical profession repeatedly fail to look beyond what is immediately presented and spends a lot of time and money trying to sort the symptoms rather than underlying causes.

@Flatdisco

It's not actually proven weight has a negative impact on health but doctors have been taught this is true and have no reason to learn off their own backs so keep spouting this as truth.

This is why they do have to keep mentioning it @Flatdisco is not the only person thinking this, some people realise the risk but don’t equate it with themselves and much more commonly people don’t realise all the risks.

Flatdisco being obese is absolutely proven to affect health in multiple ways including increasing the risk of some cancers.

Eg overweight risks anaesthetic increase, but also increases surgical risks, increases risks of wound problems etc. So sometimes the risk outweighs the benefit unless someone looses weight.

For some health conditions it only increases risk, so not every overweight person will become type 2 diabetic and some “healthy” BMI will become type 2 diabetic. This is not because the overweight person is eating lots of sugar, it is because the large amount of (particularly abdominal) fat causes insulin resistance. So the very fact they have higher BMI contributes to the increased risk, irrespective of exercise/ healthy diet etc

Not fat shaming. Required and should include sources of help such as dietitian.

Medical professionals and MNetters that are obese will often explain medical reasons for the obesity- physical and mental.

Just as for those threads it is fat shaming to assume that advice from a professional about weight loss is invalid just due to the weight (high or low) of that person.

It would be a start to acknowledge and treat hypothyroidism appropriately if they really do want to help. This is not always the GPs fault as they have guidelines to follow, although enough of them are reluctant to even follow those regarding thyroid. It’s the national health organisation that sets these guidelines that is failing thousands of people who are not getting the treatment that they should be and would be getting in other countries.

You're right- it's not fat shaming, just a medical fact that being obese puts you at risk of complications from surgery.

However I'm sure GPs can be very condescending to obese patients (I'm currently obese but haven't been to the GP since I was healthy weight!) and there are ways of saying things- maybe the GP was unpleasant and judgemental in their tone or choice of words.

Also I agree that obesity is usually due to addiction or a state of eating disorder so just telling someone to lose weight is unhelpful and shows a level of ignorance about the complexities of Obesity as a state of disorder- it's a tricky one really!

It’s not fat shaming, it’s just medical advice. It would be negligent of any doctor to put a patient forward for a procedure where the risks outweigh the benefits.

That said if a doctor is telling someone to loose weight then that advice should come with some support and signposting.

I think some doctors can be unhelpful, any complaints DH has (he has long term aches and pains) dr just says lose weight and isn't interested in helping. Surgery of course its riskier on the obese so it isnt fat shaming to refuse on those grounds!

@Longdistance

It’s not fat shaming per se, but would be more helpful if the GP gave some dietary advice or referred them to a dietitian.

She went to hospital.

I doubt she goes to a GP that regularly, otherwise she'd have been all over SM telling us about the GP (or family physician) fat shaming her as well.

At BMI of 40 and over, anaesthetic risks increase. Issues include intubation difficulties, increased risk of stroke, high blood pressure, angina, heart attack and DVT. So when we say no to a general anaesthetic its because we don't want to be responsible for your death whilst you are in our care . So unless your life depends on it, its too risky.

Great post I believe.

It still confuses me how they'll recognise anorexia as an ED caused by poor MH but will not recognise use that overeating is the same - just an opposite effect.

Then being overweight causes further MH difficulties.

I'm in Italy, my Dr tells me on every visit that I'm overweight and must lose some. I'm 167cm and 72kg, I agree with him, I really need to, it's his job to tell me. I'm also told often my my DH, in laws and friends I need to and it's not offensive in the slightest to me, they simply care about my health and the impacts of being overweight on the rest of my health. It's a very accepted thing to say here and not labelled fat shaming, which I find ridiculous and might explain my shock at the size of some very young women on my last visit to UK. I don't recall young women being so large when I lived there 25 years ago. While we're on the subject, I'm two sizes smaller in UK clothes than I used to be despite being fatter, have they change the sizing?

@Longdistance

It’s not fat shaming per se, but would be more helpful if the GP gave some dietary advice or referred them to a dietitian.

In this age of internet and information literally everywhere, do people really need someone else to tell them what food is low calorie and what food isn't? I mean, I reckon most reception kids know that carrots are healthy and Big Macs aren't! I think that weight loss groups can be helpful, but expecting a dietician to tell you what you should and shouldn't eat to lose weight is really quite shocking.

@thestrawberrygirl UK has really different approach to it than other countries in Europe.

@LittleRedPill

I don’t think this is fat shaming.

However, we do know that lots of HCPs are dismissive of overweight people and that they can take longer to get diagnosed with serious illnesses because many GPs tell them to just ‘lose weight’ instead of investigating symptoms. I read a good, peer reviewed study on this recently but for the life on me cannot find it now!

I am not obese now but have been in the past. I used to follow a lot of plus size bloggers for style advice/clothing tips. And many do look fabulous. But it did start to bother me. Being fat is just not an alternative body shape as is often suggested. It can have real, serious health risks. I remember reading a blog about an influencers trip to New York. All these shots of her looking amazing in beautiful dresses, shorts and dresses. A while later there was another blog saying how had that trip had been for her. How her knees had been agony after all that walking, how tough she had found the heat, how she was unable to do some of the things her slimmer companions enjoyed. She got very mixed comments for that one I think. It wasn’t what many of her followers wanted to hear.

Good points. I also saw another Instagram plus size blogger who was shunned by the plus size community for having weight loss surgery and losing lots of weight. She apparently received online abuse for it too. I don't understand their mentality. Why not just be pleased for her?

Definitely not fat shaming.

This reminds of a few years ago when Cancer Research had a new ad which highlighted that obesity was now the #1 cause of cancer, which attracted some Twitter airheads to claim the ad was fat shaming.

The wilful ignorance is staggering.

We were on holiday in the north east the majority of adults were visibly overweight they can’t all have MH issues. Something has gone wrong in how our society deals with food.

It's complicated. Of course many people would be better off with a lower BMI. It does reduce risks from surgery and do on. Aching joints may be caused by, or exacerbated by excess weight, and if it's not, it's easier to diagnose without the weight clouding the picture. It is intimately mixed up with mental health. You mental health can stop you eating enough, and it can mean you self medicate with fatty, sugary foods. Food answers other needs besides mere nutrition. Sometimes it's the texture. Runner beans just don't feel the same in the mouth as a Curly Wurly or crisps. I have certainly eaten foods for how they feel as much as how they taste or smell or look. Even hearing is involved, sizzling and hissing and crunching and oozing and so on. Diets tend to focus on mainly nutrition and portions, and if that was all that was involved, probably loads more people would find losing weight easy.

I agree that if a patient is overweight, HCPs should mention it, particularly it's going to impact on pathways like surgery. It would be negligent not to, rather than fat-shaming. But there are ways and ways of doing it, and it can be particularly frustrating as a patient if you feel you're not being listened to. People who don't feel listened to are less likely to comply or ask further questions. Listening skills are an important part of healthcare, but not a skill all HCPs possess. (Fortunately, I think there are enough who do at my practice, with one or two notable exceptions.) I am sure that many HCPs would wish for better listening skills among their patients, too.

Not that I have any answers on how do we improve it.

its not fat shaming, its factual.. and speaking as a fatty (20st) she is being stupid.

There is however a HUGE issue in the medical world over diagnosing women as 'fat' rather than looking at the symptoms and diagnosing an issue.

I have back problems, had them since i was a teen (Who wasn't overweight) but recently they became chronic, i am in constant pain.. took years to get a referral for an MRI and they found spinal issues and hip arthritis. My specialist was nice about it, he told me my weight was NOT the CAUSE of my problems, but losing some would help with my mobility long term.. i'm currently 21lbs down on what i was in March.

Thats how it should be handled.. ignore the fat and investigate the symptoms.

There is a phrase in the medical world about looking for a horse, not a Zebra.. i think with fat people they need to be better about asking the Zebra for fucking directions.