Med Students Unaware of Their Bias Against Obese Patients

An anonymous reader sends news of a study which found that "two out of five medical students have an unconscious bias against obese people." The study, published in the Journal of Academic Medicine (abstract) examined med students from many different cultural and geographical backgrounds. "The researchers used a computer program called the Weight Implicit Association Test (IAT) to measures students’ unconscious preferences for 'fat' or 'thin' individuals. Students also answered a survey assessing their conscious weight-related preferences. The authors determined if the students were aware of their bias by seeing if their IAT results matched their stated preferences. Overall, 39 percent of medical students had a moderate to strong unconscious anti-fat bias as compared to 17 percent who had a moderate to strong anti-thin bias. Less than 25 percent of students were aware of their biases. 'Because anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity, teaching medical students to recognize and mitigate this bias is crucial to improving the care for the two-thirds of American adults who are now overweight or obese,' Miller said. 'Medical schools should address weight bias as part of a comprehensive obesity curriculum.'"

Comments

Med students

[Anonymous Coward]

And you are unaware of your bias against med students, 2 out of 5 makes 40% I don't see how that justifies your title.

Re:Med students

[tysonedwards]

Are you unaware that "Less than 25 percent of students were aware of their biases" means that 75% were unaware of their biases?

Sounds as though that is a pretty apt title.
Sure, it is biases against "various weights" not just "overweight & obese", but the point still stands.

Re:Med students

[WillKemp]

Are you unaware that "Less than 25 percent of students were aware of their biases" means that 75% were unaware of their biases?

Or it means that less than 25% were honest about their biases.

Re:Med students

[Dahamma]

Actually, it's even worse - 25% of students were aware of the bias, and 39% were biased against obese people, so it's really only 30%.

Other reasons this study is stupid:

* half as many students instead have an anti-thin bias
* about 40% of med students never even graduate and become doctors anyway
* it was done at a single "Southeastern university"
* one of the assumptions they were worried about was that they "are more likely to assume that obese individuals won’t follow treatment plans." Given the number one thing an obese person can do to improve their health is exercise, eat less, and subsequently lose weight (all achievable goals for the majority of obese people, who honestly already knew those things anyway) they probably have a reason to worry about that, and it's therefore medically significant to their treatment recommendations!

Re:Med students

[Runaway1956]

Let me ponder this for a minute.

A health care professional can be expected to have a bias regarding healthy vs unhealthy life choices. Being fat indicates that a person has made one HELL of a lot of unhealthy choices. Like - every single day, he eats to much.

Bias. Healthy, vs unhealthy. I'm weighing this in my mind.

Question: What would happen if physicians just decided that it's alright to be obese? When a fat bastard comes to visit the doctor, Doc says "You look FAAHHHBULOUS, you fat bastard! Are you getting enough to eat?"

IMO, there is something wrong with that 25% who are NOT biased against fat and obesity!

Re:Med students

[ebno-10db]

A health care professional can be expected to have a bias regarding healthy vs unhealthy life choices.

No shit. That is not what they mean by bias in this study. RTFA:

“Bias can affect clinical care and the doctor-patient relationship, and even a patient’s willingness or desire to go see their physician, so it is crucial that we try to deal with any bias during medical school,” said David Miller, M.D., associate professor of internal medicine at Wake Forest Baptist and lead author of the study.

“Previous research has shown that on average, physicians have a strong anti-fat bias similar to that of the general population. Doctors are more likely to assume that obese individuals won’t follow treatment plans, and they are less likely to respect obese patients than average weight patients,” Miller said.

Re:Med students

[GrumpySteen]

Well, you completely missed the point. Doctors who don't recognize their biases are more likely to misdiagnose patients that they're biased against.

Take me, for example. My kidneys failed due to IGA nephropathy, which has absolutely nothing to do with weight. I'm overweight, however, so for the first year of me feeling run down, getting sick often and having other health isuses my doctor insisted that I just needed to lose weight. He never bothered looking for other potential causes because, in his mind, the problem had to be that I was too fat and therefore didn't deserve any further attention.

Re:Med students

[GrumpySteen]

I explained it in simple terms and offered a real life example and you still can't figure out why a doctor that doesn't recognize his biases is a bad thing?

Re:Med students

[ebno-10db]

* about 40% of med students never even graduate and become doctors anyway

Cite?

* it was done at a single "Southeastern university"

Which means a follow on study should cover a broader group, not that the study is invalid. Starting with a small sample and expanding it as time and money allows is common practice.

* one of the assumptions they were worried about was that they "are more likely to assume that obese individuals won’t follow treatment plans." Given the number one thing an obese person can do to improve their health is exercise, eat less, and subsequently lose weight ... they probably have a reason to worry about that, and it's therefore medically significant to their treatment recommendations!

They said "treatment plans", not "treatment plans related to obesity". Treatment plans specifically related to obesity are, as you observed, not necessary except in extreme cases. Dealing with a broken finger or taking the entire course of antibiotics even though you're feeling better also involve treatment plans. Being fat usually means a lack of self-control or excessive self-indulgence in one particular area. The same is true about people who do any number of things, like have unprotected sex with multiple partners. It does not mean they won't follow recommendations in other areas. Your prejudice demonstrates exactly what the study is concerned about.

one thing an obese person can do to improve their health is exercise, eat less

Putting aside that that's two things, there is growing evidence that getting insufficient exercise is worse than being moderately overweight (not fat though). There are plenty of thin people who get little exercise, and exercise is not the biggest factor in loosing weight. However the amount of exercise you get is something that's easy to lie to the doctor about. Additionally a lack of aerobic/cardio exercise is not something that's immediately obvious to people you meet, hence less prejudice.

Re:Med students

[Jiro]

*Are* they less likely to follow treatment plans? It stands to reason that someone who won't do what's necessary for his health in one area might be less likely to do so in another area as well. If the doctors' assumption is accurate, it's not bias in the sense implied.

Re: Med students

[Anonymous Coward]

I wonder if they used a weighted averaged......

Re:Med students

[ebno-10db]

You couldn't have expressed it in clearer or simpler terms, or found a better example of the problem. Let's hope "some old guy" is not a doctor.

Re:Med students

[Anonymous Coward]

Since when did most doctors respect patients, listen to them or were even able to write coherently?
Ok, I've met one or two doctors in my life, but for the most part they seemed like smart-assed bureaucrats who wants the whole ordeal over with.
Why not start with _proper_ examinations and holistic mapping of overall health and lifestyle?
The _nicest_ doctor I met was this muslim lady who actually took time to ask relevant questions, same with a regular male doctor I once had in a private Red Cross clinic, but overall my experiences with doctors and anecdotal histories, indicate the profession is pretty much useless for helping ANYBODY.

Re:Med students

[beelsebob]

Let me ponder this for a minute.

A health care professional can be expected to have a bias regarding healthy vs unhealthy life choices. Being fat indicates that a person has made one HELL of a lot of unhealthy choices. Like - every single day, he eats to much.

Actually, not necessarily, for two reasons:
1) There are plenty of medical causes of being fat, e.g. polycystic ovarian syndrome, type 1 diabetes (which causes fatness rather than the reverse), etc. Not just eating too much every single day.
2) Studies have repeatedly shown that overweight and moderately obese (grade 1 obese) people actually live longer, healthier lives than people of "normal" weight. Only at grade 2 and 3 obesity do these people start to live shorter less healthy lives due to type 2 diabetes and kidney disease. Underweight as a category leads to shorter lifespan than all of overweight, normal and grade 1 obesity.

Re:Med students

[Anonymous Coward]

Welcome. You must be new here. Look up pseudoskepticism, and you'll know why you've just been blindsided. Happens all the time, especially with those who _think_ themselves intellectual.

Ur welcome and best of health to you Sir! ;-)

Re:Med students

[Anonymous Coward]

As long as you don't have data supporting that association, you can't make that claim in a meaningful way. It is is an error in reasoning that a failing in a single area must necessarily extend to other areas, or even that it has an influence on other areas. By your implication, obese people are more likely to take up smoking, work in loud environments without hearing protection, and won't shield themselves properly if they work in high radiation areas.

Re:Med students

[Anonymous Coward]

Studies have repeatedly shown that overweight and moderately obese (grade 1 obese) people actually live longer, healthier lives than people of "normal" weight.

Mostly because fat people live sedentary lives; the guy with a beer gut isn't going to die rock climbing. That doesn't mean they're healthier.

And it's not simply "normal" weight, it's based on actual fitness. Your body can not do as many things if it has lots of fat and little muscle, so you are functionally disabled. You don't see fat people out running because on the odd occasion that they do, they can't keep it up for very long. They can't have sex as long. They can't climb flights of stairs. They can't physically defend themselves.

They're not just sitting on their couches because they're lazy, but because it is physically painful for them to engage in long periods of strenuous activity. They are stuck in their living rooms, prisoners of the pounds of fat they carry with them all the time, and the reduced capacity of their bodies to function.

Re:Med students

[beelsebob]

Mostly because fat people live sedentary lives; the guy with a beer gut isn't going to die rock climbing. That doesn't mean they're healthier.

Actually, no, but because the BMI scale is significantly off. Most people who go rock climbing will be considered "obese", or at very least overweight by it, because they have significant muscle mass.

And it's not simply "normal" weight, it's based on actual fitness. Your body can not do as many things if it has lots of fat and little muscle, so you are functionally disabled. You don't see fat people out running because on the odd occasion that they do, they can't keep it up for very long. They can't have sex as long. They can't climb flights of stairs. They can't physically defend themselves.

Again, wrong. Not fat, and fit are very different things. It's possible to be overweight and extremely fit and active, and its very easy to be underweight or "normal" weight, and not at all fit.

Re:Med students

[Anonymous Coward]

They're extrapolating possible conclusions, not actual obseved behaviours. Bias can manifest itself in many different ways, not all of them negative even. These researchers' (singular?) conclusions are that bias is bad, and that these are possible negative consequences. However, until actual behaviour studies are done, it is just as plausible that med students spend more time because they don't like seeing people fat.

Re:Med students

[Anonymous Coward]

Is it possible for medicine to be the problem?

Re:Med students

[Anonymous Coward]

"Being fat indicates that a person has made one HELL of a lot of unhealthy choices." no it doesn't, I have cushings disease as a result of prolonged steroid use for addison's disease, I didn't make any choices to become overweight, in fact I used to be a cyclist with very low body fat.

Re:Med students

[tlambert]

Let me ponder this for a minute.

A health care professional can be expected to have a bias regarding healthy vs unhealthy life choices. Being fat indicates that a person has made one HELL of a lot of unhealthy choices. Like - every single day, he eats to much.

Alternately they have hypothyroidism, for example, as a result of Hashimotos. It could also be Prader-Willi syndrome, or Bardet-Biedl syndrome. There are other genetic factors and diseases which can also result in obesity. Candida Albicans infections of the gut have also been implicated. There are also medications which can result in obesity. Prednisone, which is often used to treat very severe allergies, and also as an anti-rejection drug following organ transplantation, or to treat autoimmune disorders, is one. Others include antidepressants, seizure medications, and certain high blood pressure drugs, such as atenolol and metoprolol (both beta blockers).

Re:Med students

[jedidiah]

You can quickly and directly observe this problem just by watching some lardass trying to walk down the street. Mind you, we're not talking about RUNNING down the street, just walking.

It's very trivial do demonstrate fitness.

Trying to claim that every lardass is really some buff slav is just delusional. You're desperately trying to clutch at any straw yo can to avoid holding people responsible for themselves.

Although slavs with pre-agricultural metabolisms still have to eat right and get some exercise.

A doctor with an anti-fat bias is not a bad thing. There are objective tests that can be run to easily separate the lazy lardasses from the ones that are really "big boned".

Re:Med students

[geekmux]

Are you unaware that "Less than 25 percent of students were aware of their biases" means that 75% were unaware of their biases?

Or it means that less than 25% were honest about their biases.

Exactly. This is likely about as accurate as any sex survey.

Re:Med students

[DoubleJ1024]

I must be one of the lucky few people in the U.S. then. I have two doctors who actually cared enough to get to know me as a person and realize why I have the problems that I have. One of those doctors is my E.N.T. He spent a lot of time and energy clearing up a chronic ear infection and has helped me with some other issues related to my health. The other "doctor" is a nurse practitioner who performed a yearly physical and found that I had a HORRIBLY under-active thyroid that lead to me gaining 30 pounds in just over 4 months. I have spent most of the past year on medication, adjusting the dosage to be correct for my needs. I figure between that and my joining a crossfit gym (if you need to know what it is use some Google fu) I will be loosing most of the weight I have gained. I had a coworker state that I am "unhealthy" because of my weight, yet this same person eats Chinese take out crap 6 days a week, and the other day he eats McDonald/taco bell/fast food and sees nothing wrong with this. He also thinks because he is thin he is in good shape. I have also seen some people who are rail thin, but have an astonishing high problem with diabetes, arthritis, high body fat percentage, and other issues. Yet the doctors tend to take one look at them and say oh you are perfect because you fit the model of health we are taught by the school/government. I have a friend who is overweight, and she knows it. She realizes she has a problem and is working on fixing it with medication, diet, exercise, and a support group. She has a medical condition that was found by a doctor, AFTER she demanded the appropriate tests. Her nutritionist and doctor spent a lot of time going round and round with the results from the test, the doctor did not believe it and thought that diet/exercise was the only reason for the problem. The nutritionist realized that it was a metabolism issue and that it would take some medication in addition to the normal move more, eat less regimen. She physically could not get appropriate nutrition from food, and that lead to eating more to get the required nutrition. This cycle lead to a bunch of other issues, the least of which being weight gain. The medical industry in the U.S. is BROKEN and requires a complete reboot. I have a friend who went to college and graduated with two undergrad degrees and had NO debt. This friend then went to medical school and racked up over three hundred thousand dollars in debt due to tuition, fees and expenses. This is after fighting to get a slot in med. school due to the AMA setting up a limit to how many slots can be made in a given year. He will now be spending the REST OF HIS LIFE paying off student loans from medical school. This same "education" taught outdated skills and minimized critical thinking outside of the industry standards. Thankfully he had an amazing bit of training from his grandparents who were doctors in another country, and knows how to fix things without resorting to over-used, over-priced medications. And he knows what it means to be unconsciously biased against as he is an openly gay man.

Re:Med students

[Anonymous Coward]

Sure, there's always lots of possible causes for any presenting symptom and for most sets of symptoms.

But at the med student stage they're still getting it beaten in to them that "when you hear hoofbeats look for horses not zebras".

Try going to a GP as an adult with whooping cough: 99999 times out of 100000 they'll diagnose whooping cough as the flu instead. Specialists aren't much better: "pick your specialist and pick your disease".

Re:Med students

[geekmux]

A health care professional can be expected to have a bias regarding healthy vs unhealthy life choices.

No shit. That is not what they mean by bias in this study. RTFA:

“Bias can affect clinical care and the doctor-patient relationship, and even a patient’s willingness or desire to go see their physician, so it is crucial that we try to deal with any bias during medical school,” said David Miller, M.D., associate professor of internal medicine at Wake Forest Baptist and lead author of the study.

“Previous research has shown that on average, physicians have a strong anti-fat bias similar to that of the general population. Doctors are more likely to assume that obese individuals won’t follow treatment plans, and they are less likely to respect obese patients than average weight patients,” Miller said.

So, care to tell me how the healthy and fit patient is supposed to feel walking into a doctors office to find the nurse waddling up to their industrial-strength chair?

And then finding yourself growing impatient as you have to wait an extra 10 minutes for your obese doctor to come wheezing in from his smoke break to talk to you about lifestyle choices?

Funny thing about bias and obesity. It tends to swing both ways. Seems the arrogance of the med industry thinks this is a one-way door.

Re:Med students

[beelsebob]

Again, no –fit, and not fat are not the same thing at all. I know a couple of people off hand who are significantly heavier than me, and significantly larger around the waist than me, but who can cycle significantly faster and further than me, and who can happily walk at just the same rate as me for pretty much any distance.

Re:Med students

[Anonymous Coward]

All doctors make educated guesses. That's their job. I've also been misdiagnosed before.From what you've described it sounds as though the doctor looked at the symptoms and assumed the most probable cause. As it is IgA is a relatively less common than fatigue/getting sick frequently caused by being overweight. Doctor's also tend to follow the Occam's razor principle until the patient has proven to be an extraordinary case. I wouldn't think it wise to assume that just because you've felt "OK" being overweight in the past you wouldn't ever experience extremely common symptoms of being overweight in the future.

Re:Med students

[Anonymous Coward]

Unfortunately (or fortunately, depending on your outlook), given the limited amount of time and money to diagnose such issues, it is far more sensible to "think horses, not zebras".

I have no sympathy for you regarding the doctor's diagnosis. Are you aware of the fact that obesity has been shown to have an impact on the occurence and severity of IgA nephropathy?

Your doctor was right. Losing weight would have helped.

Re:Med students

[AthanasiusKircher]

*Are* they less likely to follow treatment plans? It stands to reason that someone who won't do what's necessary for his health in one area might be less likely to do so in another area as well.

Studies have shown that the most common assumption is that fat people are lazy, undisciplined, unwilling to work hard, etc. -- not just in terms of health choices. Your comment is playing directly into that bias.

I think this bias, like most, actually does have some relationship to reality -- i.e., a greater percentage of fat people are likely to have these traits than others.

HOWEVER -- pre-judging an individual on the basis of a single characteristic is the very definition of "bias."

Even if 90% of obese people are lazy bastards who won't even try to listen to their doctor's advice (and I don't think the number is that high), that does not excuse a doctor who provides inferior treatment to the other 10% because of assumptions.

If the doctors' assumption is accurate, it's not bias in the sense implied.

That's like saying -- If a black person is driving around a rich neighborhood, he must be looking to steal something -- because "black people are more likely to commit crimes" is an "accurate" statistic.

Even if X is often correlated with Y, it doesn't justify the assumption that X always implies Y. When dealing with healthcare, these sorts of assumptions can literally be deadly, such as when a physician fails to search for secondary contributory causes of obesity in a particular patient because the assumption is just that the patient must be a lazy bastard who can't follow directions.

Re:Med students

[xavierpayne]

>> Being fat indicates that a person has made one HELL of a lot of unhealthy choices. Like - every single day, he eats to much.

With respect Runaway, that thinking right there is exactly the problem.

Obese != unhealthy life choices (at least not in all cases)

Take for example the 250lb person who eats right, jogs, and works out every day vs the 145lb person who never exercises, eats cookies, and pounds beer and soda but for some reason never gains a pound. The 250lb person could have a thyroid problem or other hormonal imbalance causing their metabolism to be too slow. Thus they burn less calories and keep weight easier. But they have strong lungs and a good heart. The doctor brow beats them every visit harping on whatever diet and exercise they claim to be doing as not enough, or (if they are bolder) outright lies. This does not help this patient stay healthy.

The 145lb person could have the opposite problem with imbalances causing their body to burn too many calories. They could be skinny as a rail with hypertension and be bordering on becoming Type II diabetic. But the doctor doesn't bother to run any tests or take the results too seriously because they are at their "target weight". This does not help this patient stay healthy.

Doctors should diagnose based on full spectrum data collection. Not simply based on what they see and think at first glance. That's like a climatologist looking at a clear blue sky on a good day and saying "look, no smog. Clearly climate change is not caused by man made pollutants!!! No need to look any further into this."

On second though, perhaps a car analogy would work better. Can somebody help me out here? :)

Re:Med students

[phantomfive]

Problem is the doctors don't recognize their bias. You can't make a clear decision if you aren't aware what it's based on.

Re: Med students

[Anonymous Coward]

There is exactly one medical cause for excess adipose tissue: consuming more calories than you expend. Everything else you mentioned helps pursuade people to do this. Hypothyroidism and depression make you feel like you have no energy, so you burn fewer calories. A ghrelin mutation makes it difficult to ever be "full". It's not like these disorders generate fat out of nothing, the laws of physics prevent that. I'd be more sympathetic if someone had one of these conditions, but the only way to be fat is to take poor care of your body.

Re: Med students

[Anonymous Coward]

BMI isn't *that* far off, and the only example ever given is athletes. And not just any athletes. Body builders, mostly.

Rokk climbers tend to be slimmer, lithe types. No sense in making yourself heavier, in a sport where the primary goal is to lift yourself repeatedly. Likewise runners, swimmers, cyclists, or people who play soccer, baseball (mostly), basketball, etc ... All in the healthy BMI range, despite your claim that BMI doesn't work for athletes.

Re:Med students

[ph0rk]

Even if X is often correlated with Y, it doesn't justify the assumption that X always implies Y.

While that is true, the safe bet is still going to be that X implies Y.

If the first premise is true (X is highly correlated with Y), then to expect Y when one finds X is only natural (and takes less processing time).

Now, if we had some clear cases where X doesn't lead to Y, for example when Z is present, then we can solve the problem of unfairly expecting Y by also looking for Z. Hunting for Z will probably be more fruitful in the long run than trying to train people to ignore stereotypes that have evidentiary support.

Re:Med students

[quenda]

I'd say only 40% is fewer than the general population.
In other news, 40% of police are biased against criminals, and 40% of dentists are biased against people who do not clean their teeth.

Re:Med students

[TapeCutter]

The message is I got is that if I want to be treated with respect I need to find a cuddly doctor, I'm guessing you already have an ego boosting slim one.

Re:Med students

[TapeCutter]

Studies have shown that the most common assumption is that fat people are lazy, undisciplined, unwilling to work hard, etc. -- not just in terms of health choices. Your comment is playing directly into that bias.

Bulls eye!

Re: Med students

[Kell Bengal]

The problem here is that the only signal people have for what their body needs energy-wise is mediated by their hormone balance and brain-chemistry. If you have a condition where even too much energy feels like you're starving (a painful condition), it's readily understandable that you are going to eat too much, even with the best intentions. The problem of simply blaming "eating too much" is that it becomes synonymous with gluttony - a vice and failure of virtue. Even though yes, you are simply eating too much in the thermodynamic sense, it rapidly becomes a stigma where the patient is 'at fault', rather than the underlying medical condition. In this way, victimisation of obese patients is counter-productive.

Sure some people simply have no self-control - but is that because they are bad people, or because there is some factor at work that makes it hard for them? The blame game for obesity is a bit like accusing people with a birth mark of being in league with the devil and burning them - we should know better by now.

Re:Med students

[Ost99]

People who are overweight and obese grade 1 are usually not so fat their life quality is reduced. They can walk, run and exercise with no or just small discomfort.
An overweight person who is somewhat fit has a *significant* higher life expectancy than any other combination of fitness and weight.

Muscle mass above a certain amount does more harm than good and reduces life expectancy
Excessive exercising over time damages the body and leads to a shorter life expectancy
  - Life expectancy both for body builders and competing marathon runners are low
Body fat above a certain amount does harm to the body and reduces life expectancy
Body fat below a certain amount does harm to the body and reduces life expectancy
  - The ideal amount of body fat is far more than what we perceive as "normal" weight -- it's much closer to the medieval beauty ideal then the modern one

Re:Med students

[AthanasiusKircher]

Even if X is often correlated with Y, it doesn't justify the assumption that X always implies Y.

While that is true, the safe bet is still going to be that X implies Y.

That is absolutely false. Particularly since in this case we have examples of not-X that have Y, it may in fact be that Y implies X, but only in some cases, or even that there is no causality at all between X and Y.

I personally don't have statistics about the incidence of "laziness" and "failure to attempt to follow doctor's advice" in non-obese patients. Do you? I'm guessing that it is probably higher in obese patients, but I don't know that.

Obesity is easy to spot. Doctors who see obese patients and recommend that they lose weight can easily tell if those patients aren't successful in following their advice (though, whether the patient actually tried and how hard they may have tried is less easy to evaluate).

On the other hand, for non-obese patients, doctors might recommend a better diet and more exercise to lots of them too. Short of major changes in blood indicators or something, how do they actually know if the patients complied?

Thus, it's pretty hard to have good data about compliance for non-obese patients, or the incidence of "laziness" among them in conforming to medical recommendations. Whereas doctors can easily make assumptions about obese patients who don't slim down, thus giving the appearance of greater incidence.

Now, if we had some clear cases where X doesn't lead to Y, for example when Z is present, then we can solve the problem of unfairly expecting Y by also looking for Z. Hunting for Z will probably be more fruitful in the long run than trying to train people to ignore stereotypes that have evidentiary support.

Maybe. Except your reasoning doesn't take into account the possibility of confounding variables. It could be that X doesn't lead to Y at all, and actually Z is the cause of both X and Y.

In the present case, for example, since there are lazy people and people who don't follow medical advice who aren't obese, perhaps we might be better off searching for commonalities between all lazy people, since they are the actual problem for medical treatment -- rather than searching for exceptions to a stereotype. Maybe there are questions that could be asked in a questionnaire or interview that would give greater insight into whether a patient might be likely to listen to a doctor's advice, and perhaps even whether there might be better strategies. I don't know. But that would be a reasonable place to start.

However, one strategy that does NOT seem fruitful is just to continue to assume that the only people who can't hide their inability to comply are the only ones not listening to doctors... and the reason for that is because they're lazy fat bastards.

Re:Med students

[KiloByte]

No such condition can result in obesity. All they affect is feeling of hunger. Ie, it's somewhat harder to control yourself but it physically can't make you fat.

There were no obese people at Auschwitz, hormones or not. Uncle Adolf's diet went to the other side, by being nutritionally deficient, but you can't deny it prevented being fat. Limit food intake, and you will not get obese, period.

Re:Med students

[Anonymous Coward]

How does Type I diabetes cause fatness? If you don't take insulin that your body will eat its own fat reserves and you would die looking like a skeleton. To become fat as a Type I actually takes a fair amount of effort. You have to overeat AND take the correct amount of insulin for all of those carbs. If you don't take enough insulin then you'll only convert the carbs that you took enough insulin for. Next you'll just have high blood sugar and start breaking the rest of your body. In the majority of cases it takes effort to become fat.

Re:Med students

[Belial6]

There are objective tests. Doctors with a bias won't give them. I went and got hydro-statically weighed. I know that my lean body mass is 169 lbs. My height is 5'11" and at my last physical I was 212 lbs. That put my body fat percentage at 21%. This is at the high end of "ideal". On the other hand, the BMI put me at the high end of "over weight" and only 3 lbs shy of "obese". According to the BMI I should not weigh more than 178 lbs. That would be 5% body fat. This is the point that you start eating into your essential body fat. So, according to the BMI my body fat should be between 5% and -30% body fat. That is right. The BMI says I should be between sick and dead.

At this physical, my doctor is telling me that I need to lose weight because 212 is "a lot of weight". He didn't car that my body fat % was fine. He just kept pointing out that BMI is "the best indicator of healthy weight". He has a bias against fat people. Even worse, his definition of "fat" is completely twisted and dangerous.

Even worse is that I have been 5 lbs over weight. 5 lbs overweight isn't even close to obese. It also isn't "some buff slav". But, what I hear is from dumbasses saying "Your not Mr. Universe, so the BMI is correct."

Re:Med students

[MikeBabcock]

A healthcare professional should give you the same advice as any other person with the *actual conditions* you have.

Being obese is not a state of health. A heart condition is, as are bad joints. Being a smoker is not. Lung cancer is.

There's no room in my mind for a healthcare provider showing bias for or against any* patient, healthy or otherwise.

*My mother being a retired RN, I've heard many stories about bias against failed suicide cases -- I can understand bias against those who try to purposefully do themselves harm, but again, the job is to help them, not to be their guidance counsellor.

Re:Med students

[MikeBabcock]

True story to back this up -- I was 140 lbs at 6'5 in highschool with very bad joints and asthma I sadly seem to have inherited. Both limit my exercise immensely, as does my job in computers.

Having subsequently moved and having a different doctor now than then and weighing substantially more, I have no new health problems than then but my new doctor upon hearing of my breathing and joint issues blamed my weight and told me to lose it, which obviously won't help, as I had the same problems when clinically under-weight.

Bias is wrong -- and leads to poor assumptions.

Re:Med students

[Belial6]

Go to a GP with any general illness and 99999 times out of 100000 they will diagnose it as either the flu or allergies.

Re:Med students

[Belial6]

If I lost the weight my doctor recommended, I would die. Not figuratively. Literally. My doctor recommended that I achieve the weight shown by the BMI chart for my height. That would put my body fat % between 5% (dangerous) and -30% (long dead). EMEL is bumper sticker medicine along with the BMI that goes with it.

Re:Med students

[Anonymous Coward]

Well, you completely missed the point. Doctors who don't recognize their biases are more likely to misdiagnose patients that they're biased against.

Take me, for example. My kidneys failed due to IGA nephropathy, which has absolutely nothing to do with weight. I'm overweight, however, so for the first year of me feeling run down, getting sick often and having other health isuses my doctor insisted that I just needed to lose weight. He never bothered looking for other potential causes because, in his mind, the problem had to be that I was too fat and therefore didn't deserve any further attention.

It's about probabilities. If a vast percentage of people with your symptoms and weight have those symptoms because of said wait, then it's a reasonable place to start. If you attacked that cause by losing weight with exercise and proper diet for a reasonable amount of time and that didn't help, then it would be time to look at other things. It's like if you go to the doctor with a sore throat and a stuffy nose, the first thing they're reasonably going to is a cold or possibly allergies.

Re:Med students

[Anonymous Coward]

I am biased against obese posts. ;-)

Re:Med students

[dasunt]

There were no obese people at Auschwitz, hormones or not. Uncle Adolf's diet went to the other side, by being nutritionally deficient, but you can't deny it prevented being fat. Limit food intake, and you will not get obese, period.

Technically correct. But you aren't assuming that all people's hunger drives are the same strength, are you? Because that would be rather foolish.

Re:Med students

[tbird81]

And what happens?
Nearly all of the time you get better after a few days, and if things persist they can investigate more.

What else would you want? 100 tests every time you got sick?

Re:Med students

[tlambert]

No such condition can result in obesity. All they affect is feeling of hunger. Ie, it's somewhat harder to control yourself but it physically can't make you fat.

Sorry, but you're wrong:

Prednisolone: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011824/?report=details#side_effects
Possible side effects: ...Rapid weight gain ...Swelling in your hands, ankles, or feet ...Gaining weight around your neck, upper back, breast, face, or waist ...Increased appetite ...Unusually full or round face

Methylprednisolone: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0011173/?report=details#side_effects
Possible side effects: ...Swelling in your hands, ankles, or feet, rapid weight gain ...Weight gain, increased hair growth, roundness or swelling of your face, thinning skin.

Synthetic corticosteroids cause weight gain, pretty much "period".

Re: Med students

[bogjobber]

You have no idea what you're talking about. Many rock climbers are very, very muscular. Mostly boulderers, but bouldering is probably the most popular type of rock climbing currently.

And even your other sports don't check out. Lebron James, for example is 6'8" 250 lbs. That's a BMI of 27.5 - overweight. Mike Trout (baseball player) is 6'2" 230 lbs. - 29.5 - borderline obese.

What's the most popular fitness activity in the US? Weightlifting. BMI was developed almost 200 years ago, when bloodletting was still standard medical procedure. We should be using body fat percentages if we do population-wide statistics, and not demonizing mass. Mass isn't the issue.

Re:Med students

[KiloByte]

...

Then tell me where do they magically pull nutrition from?

They increase the appetite, making people feel like they want to eat more, nothing else. They do not cause weight gain. Otherwise, you could go breatharian consuming nothing but this drug and still gain weight :p

Re:Med students

[dargaud]

Kudo to that. I have an aunt who's been obese for the last 20 years or so. Last year they found a pineapple-sized tumor inside her, pushing against her kidney, thus making her fat (bloated rather than fat actually). Why didn't they find that monster before ? Because they probably thought her 'health choices' were the cause (she works in a restaurant).

Re:Med students

[Anonymous Coward]

Pray tell us, how does Hashimotos, Prader-Willi, antidepressants or genes produce energy out of thin air? My friend, you have found a solution to all world's energy problems! These factors you list, as well as countless others, can influence the way our body's metabolism works, but nothing - absolutely no-thing - will make your body produce excess fat when it doesn't have the energy it needs to do so.

When all is said and done it boils down to what you eat and how much energy you expend in your daily life. Some people who are genetically predisposed to it may eat an extra large hamburger for lunch and dinner and not gain a single pound, others will tend to get fat even if they lead a moderately healthy lifestyle.

Medications, illnesses and the like do not magically make you obese if your diet and exercise regime are in order. What they can and do though is make you alter your lifestyle so that the end result for many is tendency towards obesity. Don't confuse these things and make ridiculous claims that "I'm fat because of X" where X is anything else than your lifestyle (if you want to be accurate, say that X made my lifestyle obesity inducing).

Re:Med students

[Anonymous Coward]

...

Then tell me where do they magically pull nutrition from?

they obviously can't generate free energy out of nowhere but they can make your metabolism process the food you eat more efficiently - which results in gaining weight without having changed eating habits.

Re:Med students

[Anonymous Coward]

Sure, it *could* be something exotic, but Occam's Razor says that it's probably not.

Re:Med students

[mellyra]

Doctors should diagnose based on full spectrum data collection. Not simply based on what they see and think at first glance.

I had this discussion a dozen times with my brother who is a medical student and the tl;dr is "nobody has the time or money for that".

A doctor will always assume the most likely cause for any given combination of symptoms (even if they don't match 100%) and only start thinking about less likely alternatives if his treatment doesn't lead to improvements. Yes, sucks to be someone with a rare disease (that will only be diagnosed correctly very late if at all) but symptoms are often so unspecific and a thorough examination would be so expensive (let's do a blood screen every time you catch a cold because you might have some ultra-rare disease?) that this is the only practicable way.

Hormonal causes for obesity are possible but pretty rare - a much larger share of obese patients claims to suffer from e.g. thyroid issues than statistically possible. "Just eat less" is the right answer for the vast majority of obese patients and as they will lie to you about their food intake and exercise (admittedly often unconsciously, but then they don't tend to cooperate well when you ask them to keep a diary of every single thing they eat to make the more self-conscious) you never know if your original attempt at treatment did work or not. The share of patients who will lie into your face about having tried everything is probably still much larger than the share of patients who have actually followed your advice and it didn't help because they have some underlying physical issue.

The standard medical procedure of most likely diagnosis -> treatment -> in-depth examination if treatment doesn't show results just breaks down as the doctor has no way of knowing whether the treatment ever took place or not.

Re: Med students

[dunkelfalke]

Dude, I am a lard ass, but at tue same time I am an avid cyclist (800-1000 km per month) and I also can run and XC ski.

Re:Med students

[sjames]

The problem in this case that if the patient has X but complains of Z, the doctor will only discuss Y. Same if the patient has A, B, or C, none of which are ever due to Y.

Re:Med students

[Anonymous Coward]

Here we go again. "Genetics result in ". Genetics make people fat or thin. "No matter what you eat you will never get fat": they have the "good genes". Then the fat ones have the bad genes: "no matter how less they eat, they still get fatter and fatter". The truth lies somewhere between the two extremes. And remember: when output > input, all of you will get thinner.

Re: Med students

[jawtheshark]

As someone married to a "failed suice case", I can assert it's not only medical personnel biased against them. It's pretty much everybody. The reason for this is that most people do not understand fully what goes on in someone whi tries to kill herself. My first reaction was also "how could she?", but after nearly four year, I have a slight idea. I will never really comprehend it.

To be in topic. My wife always battled with being overweight. She has managed to bring it down to healthier levels, eg when we got married, but it is an eternal struggle. If your body keeps yelling "I'm hungry", try stopping eating. Anyway, given her mode of suicide,, she seriously limited her mobility and I don't see how she could ever lose weight again to "medical accepted levels". She's overweight, but constantly the same weight.

Re:Med students

[lxs]

Funny you should mention that. The majority of obese people I come across happen to be smokers. And here's mention of a study that seems to agree.
Also weight problems and heavy smoking both are more prevalent in schizophrenics.

Re:Med students

[Anonymous Coward]

Cool story, bro!

Re:Med students

[Anonymous Coward]

This is not accurate. There are many conditions that can lead to obesity (metabolic disorders, pathogen-based inflammatory disorders, medications) with a healthful diet that under normal circumstances would not cause the individual to gain weight and become obese. It would take "limited food intake" as you imply to a level that is actually harmful to the individual in these circumstances, not to mention incredibly uncomfortable. Starving the patient is not a solution. If you are feeding someone a reasonable calorie diet full of healthful, whole foods etc... and they are still not losing weight, you need to fix the underlying problem. Maybe their thyroid is messed in what often turns out to be a complex way (hint: diagnosing by TSH alone, or even TSH and Antithryroglobulin, is NOT sufficient for the assay. 90% of doctors, even endocrinologists, dont' look at T3, T4, Free T3, Reverse T3, and other hormones like (saliva test only) cortisol etc...). Maybe their birth control pills are coaxing their body into a hormonal condition that says that says "We're having a baby, put on a fuckload of weight because we've got to protect and feed the thing". When you (as a male) lose testosterone (or a balance of estradiol etc...), you're going to gain weight - period. This isn't just because you were coaxed into eating too much, this is because your entire metabolism isn't working. This is not simply about the feeling of hunger (that is a whole other ball of wax - leptin inhibitors for instance. High fructose corn syrup, artificial sweeteners etc.. for instance inhibit the feeling of fullness and exacerbate hunger), but circumstances where someone is eating well for their body and some dysregulation is causing them not to lose weight, or to gain weight where they normally should't.

Offering starvation is not a solution.

Re:Med students

[Imrik]

The title only implies that at least two med students are unaware of their bias.

Re:Med students

[KiloByte]

The body can't store energy if it has no excess. Even if it tried for some reason if would pull it back from fat stores later the same day for normal operation.

If they're still gaining weight, then your "reasonable calorie diet" is set too high.

Re:Med students

[KiloByte]

gaining weight without having changed eating habits

I used to have lightning fast metabolism when I was young, but can't eat as much nowadays (or I get fat). The solution is simple: eat less.

Being addicted to overeating doesn't make it a good decision, yet like any addiction can be treated, by strong will or other means. It's just that people are offended by the thought they might be mentally ill.

Re:Med students

[m1ndcrash]

Your metabolic and self-recovering abilities are weak when you're overweight, buddy. It's a fact that chubby people have more health problems.

Re:Med students

[lightknight]

Hmm, it does appear to be a popular diagnosis these days: "The problem is you're fat, and you need to lose weight to cure the disease." "Yes doctor, but what led to the change to a sedentary lifestyle, when I was fairly active before?" "That would be the at." "Right...med school isn't doing so well these days, is it?"

Re:Med students

[lightknight]

More bothersome is that doctors are not pursuing the cause of the disease like a wanted criminal, investigating every avenue. This is, after all, someone's life we are talking about.

Re: Med students

[lightknight]

Indeed. Off the top of my head, I can think of several things responsible for unintentional weight gain, and which are not going to fix themselves through 'exercise and working out.' #1 is cancer (tumors, etc.) which are always fun to find...is it in the person's brain, is it in the thyroid gland, is it...etc., #2 is H.Pylori...nasty bacteria which, once it colonizes a stomach, coaxes you into eating more to prevent feeling pain, and is also a PITA to destroy, #3 is diabetes, which is a catch-all these days, and the first thing I discount, as the pharms have a rather unhealthy fascination with it, #4 would be mono, or rather any viral disease that would affect someone's metabolism / energy / comfort level / etc., #5 is malaria, always a fun thing, might as well check for protozoa in the blood, #6 is actual gastrointestinal damage...i.e. are the walls of the stomach still there? Do we have Crohn's Disease lurking somewhere lower?, #7 is depression, another thing I place on the watch list because of the unhealthy fascination from pharms with it (it's a catch all, IMHO, and usually a sign that you're missing something).

But then, IANAD. ;-)

Re:Med students

[GrumpySteen]

Much like my former doctor, you're dismissing a genetic condition as being caused by weight. It's an idiotic thing to do and it shows that you have the same bias which blinds you to the actual facts. The moment you found something that suggested that weight had an effect, you completely dismissed the genetic aspect of the disease. Your response is exactly why doctors need to be able to recognize their own biases.

You clearly don't understand the article you linked. At best, losing weight might slow down the destruction of the glomeruli, but the destruction is inevitable. It's a genetic disorder which cannot be fixed by losing weight.

My doctor dismissed them my symptoms saying "just lose weight and you'll feel better", which was absolutely wrong. Losing weight would have reversed the damage that was causing my symptoms.

In fact, the one thing that would have helped more than anything else would have been going on a protein restricted diet. No such advice was offered, however, because protein restriction isn't something you would prescribe unless you'd diagnosed a condition that called for it and my doctor was too much of an asshat to do any testing. I wasn't diagnosed properly until I was in full renal failure and then it was too late to do anything other than go on dialysis.

I'm not surprised that you have no sympathy for what happened to me. Frankly, you're a lot like my former doctor; an asshole who jumps to the conclusion that any problem a fat person has must be due to their weight. God forbid you should actually look beyond that and search for underlying causes.

Re:Med students

[GrumpySteen]

IgA nephropathy isn't something you recover from. It's a genetic disorder. If you have it, the destruction of your kidneys is inevitable.

Re:Med students

[GrumpySteen]

I wouldn't think it wise to assume that just because you've felt "OK" being overweight in the past you wouldn't ever experience extremely common symptoms of being overweight in the future.

You're seriously suggesting that someone who felt okay in the past should dismiss new symptoms that they're feeling and not bother trying to find out if they have a life threatening illness?

That's the absolute dumbest response I've seen on here so far.

Re:Med students

[GrumpySteen]

I was still active. I gradually dropped from hiking ten to fifteen miles in the mountains every weekend (hooray for living close to a national park) to barely being able to finish a two mile hike over a period of about two years. I knew something was wrong and it wasn't a sedentary lifestyle. Unfortunately, there was no way for me to figure out what the problem was on my own and the doctor I was seeing at the time was an idiot.

Re:Med students

[spineboy]

probably less than 5% of obese people are obese from the above listed medical conditions. The rest are obese from too much eating.

http://endocrine.niddk.nih.gov/pubs/Hypothyroidism/

http://www.annualreviews.org/doi/abs/10.1146/annurev.publhealth.29.020907.090954

Re: Med students

[Anonymous Coward]

Well, if u lost the weight he would have then been able to cross obesity off the list and look for other causes, without it taking a year.

Re:Med students

[gonzonista]

Any chance that the camp had a bias against fat people and executed them first?

Re:Med students

[saleenS281]

So what is this condition that wouldn't allow her to absorb nutrients but would allow her to absorb fat (which is itself a nutrient...)?

Re: Med students

[Anonymous Coward]

Also, asshattery is more common in Aspies, and Aspies are very common in IT, and most /. readers work in IT. Therefore you must be an Aspy asshat!

Re: Med students

[Anonymous Coward]

Eating fatty foods does not necessarily make you fat, having an excess caloric intake does.

Re: Med students

[saleenS281]

Exactly what kind of calories do you think you're going to intake when you can't absorb nutrients from food? The calories are a direct result of the nutrients absorbed.

Re:Med students

[niftymitch]

Well, you completely missed the point. Doctors who don't recognize their biases are more likely to misdiagnose patients that they're biased against.

Take me, for example. .

Sure... where do you want to be taken?
That is part of the issue.... Patients have bias too.
I recall a lady from my childhood that told the doctor she had XYZ problem.... and she got pills for XYZ.
A couple years later the pills proved to be noneffective so they did surgery to remove her gall bladder.
The surgery discovered ADVANCED cancer... All they could do was stitch her back up....
While the issue about doctor bias is important, patient and family bias are equally important because as much or more than doctor bias other bias sets the stage as much or more.

Re:Med students

[robsku]

So, care to tell me how the healthy and fit patient is supposed to feel walking into a doctors office to find the nurse waddling up to their industrial-strength chair?

And then finding yourself growing impatient as you have to wait an extra 10 minutes for your obese doctor to come wheezing in from his smoke break to talk to you about lifestyle choices?

Funny thing about bias and obesity. It tends to swing both ways. Seems the arrogance of the med industry thinks this is a one-way door.

Of course it goes both ways, and the study makes no claim it doesn't, or does it now?

Btw, I've had a doctor a bit like you describe (not as over the top, but the drift is same), and he was one of my best doctors. He never judged people but did his best to help with whatever was their problem. If he thought the patients life choices may affect how he/she follows the treatment he might have verbally pushed the importance of it, but never did he mistreat at least me.

I wouldn't know, but maybe the fact he knew that he too was only a human might have had something to do with it.

Re: Med students

[Anonymous Coward]

many nutrients don't have calories. vitamins, minerals... fiber, if you want to define 'nutrient' rather broadly. But a deficiency in one, perhaps caused by poor absorbtion, can cause cravings, and in the course of satisfying those cravings you can take in a lot of excess calories.

Re:Med students

[Anonymous Coward]

HOWEVER -- pre-judging an individual on the basis of a single characteristic is the very definition of "bias."

It is a pretty telling characteristic, though. It's not like you're judging someone on the color of their tie or whether or not they shaved that morning. Nobody woke up one morning to find that they were suddenly obese. They started getting fatter and fatter over a long period of time and just kept right on doing what they were doing. In essence, they chose to become obese.

Smoking one cigarette is a thing anyone can do, but becoming a smoker is a lifestyle choice. Likewise overeating once or twice doesn't make you obese. Overeating day after day while watching yourself become obese is a lifestyle choice.

Re: Med students

[Occams]

Other things being equal, being overweight is unhealthy. I want my doctor to see that as a negative.

Re:Med students

[haruchai]

Sounds like your new doctor is unaware of your medical history.

Re: Med students

[Man Eating Duck]

Even though yes, you are simply eating too much in the thermodynamic sense, it rapidly becomes a stigma where the patient is 'at fault', rather than the underlying medical condition. In this way, victimisation of obese patients is counter-productive.

Sure some people simply have no self-control - but is that because they are bad people, or because there is some factor at work that makes it hard for them? The blame game for obesity is a bit like accusing people with a birth mark of being in league with the devil and burning them - we should know better by now.

I'm very lucky that I stay relatively thin and somewhat athletic without significant excercise, despite eating whatever I want. But I can imagine how hard it would be to accept that I'd have to change my food- and exercise habits in order to lose weight, knowing that I basically have to keep doing it for life. I am not sure I would be able to do so myself, if the need should arise down the line. I did gain about 7 kgs over the past 6-7 years (I'm 37), so I might have to start considering it :)

However, your AC parent is correct, although he stated it in a somewhat aggressive manner. "A small percentage" of overweight people (I've read about 1% cited from an MD in a news article which I can't find at the moment) have some physiological condition which makes it impossible or extremely difficult to lose weight. Thus the cold, hard reality is that the vast majority simply eats too much and moves too little. To be flippant, "being too fond of cake" is usually not a medical condition. Of course there are also various mental "disorders" of different severities, often connected with the overweight itself, which can make it very hard to focus on a healthy lifestyle.

This still indicates that the vast majority of overweight people need to be aware of the fact that yes, they are responsible for their weight, and that they themselves are ultimately the only ones that can do something about it, even though it can be damned hard. There is no need to go it alone, there are a lot of programs one can join, I imagine that is also the case in the US, but you need to instigate the change *yourself*.

On a side note, there are some loud people who skew the public opinion against obese people. A notable example in Norway is Jørgen Foss, the spokesman for the Norwegian National Association of Overweight People, who is a complete clown. He might possibly be the worst spokesman for any organisation ever, as he keeps harping on about how he's completely innocent and unable to to anything about his weight, that some people prefer to be huge, and stuff like that. He dismisses lifestyle changes as a measure (claiming it's impossible), and frowns on programs which could actually help people (there's supposedly no reason for him to even try, as a program wouldn't help him anyway; he would just continue overeating). That doesn't exactly tend to instill any sympathy in me.

Another spokesperson for the same organisation famously complained that "Not even the chairs at McDonald's are big enough. Some of us have experienced that the chairs are stuck to us when we get up." This is not a satirical article, nor did the statement seem to be uttered in jest. In the QA session she very aggressively dismisses any suggestion that laying off the snacks and junk food (of which she consumes a substantial amount) is a viable course of action.

Shit like this seriously harms their cause, and is very much the wrong message to send to people in that situation IMO.

Re:Med students

[Man Eating Duck]

Doctors should diagnose based on full spectrum data collection. Not simply based on what they see and think at first glance. That's like a climatologist looking at a clear blue sky on a good day and saying "look, no smog. Clearly climate change is not caused by man made pollutants!!! No need to look any further into this."

On second though, perhaps a car analogy would work better. Can somebody help me out here? :)

Sorry - no car analogy [they usually suck in any case :) Yes, a thorough examination should of course be done, that goes without saying. To be fair, only "A small percentage" (I've read that the real number is slightly above 1%) *actually* has any physiological excuses, but a doctor should be on the look-out for those, and additionally be able to work with attitudes and mental "disorders" affecting the patient's weight control. In the end, except for those 1%, it comes down to eat less, move more. Even though actually doing that could prove somewhat hard, it's the only way weight loss is going to happen.

With respect Runaway, that thinking right there is exactly the problem.

Obese != unhealthy life choices (at least not in all cases)

Take for example the 250lb person who eats right, jogs, and works out every day vs the 145lb person who never exercises, eats cookies, and pounds beer and soda but for some reason never gains a pound.

I used to know a guy of the former variety, except he weighed about 250 kg. His body mass was a lot of fat, but his personal best bench press was 243 kg. In a Norwegian strength thest where you lie on your back and use your feet to push weights straight upwards on rails, he piled on all the weights he could find (about 600kg), and subsequently asked me and a buddy to perch on top, and he nailed it. I've also seen him on the ski slope. He's quick and agile, because he has almost superhuman strenght, ample to support his large bulk. Working as a door man a trick of his was famous; he grabbed two ~100kg sacks of food waste in *each hand* and carried them two flights of stairs down and then 100m to the container. In another situation, written up in the local paper, he restrained a huge body-building type by lifting him up, putting him gently face down on the ground, and placing his hand on the guys back. He couldn't move.

He started losing weight after being told to do so by his doctor to (his body is *hard* on his heart and other organs), but he dropped it because "I couldn't maintain my strenght, and suddenly everything was wearying". He obviously was comfortable being enormous. In most cases, though, I agree with Runaway that obesity stems from unfortunate life style choices.

Re:Med students

[Belial6]

In my case, I dealt with a stuffed up nose for ~7 years. Every time I would mention it to the doctor, they would tell me that "it was allergies". It didn't matter that it never got better or worse no matter what city I lived in or what time of the year it was. Turns out that 2 months of ultra low carb eating, and my nose cleared up. When I started eating carbohydrates again, it didn't come back. I can't say for sure what the problem was, but I suspect that I had some kind of infection that couldn't survive when I cut out the sugar.

No matter what the problem was, the doctors were completely uninterested in figuring it out.

Re:Med students

[Hognoxious]

Kudo to that.

Just the one?

Re:Med students

[Anonymous Coward]

Much like my former doctor, you're dismissing a genetic condition as being caused by weight.

No I'm not. Some particular part of 'has been shown to have an impact occurence and severity' you're having trouble with?

Learn to read, you blob.

Re:Med students

[Hognoxious]

perhaps a car analogy would work better

Sure. If it won't start, what do you check first? Fuel in the tank, battery charged. Then pop the plugs (if any) out & check for a good strong spark. Is fuel reaching the engine? Your nose will tell you that.

I'm going to guess that's 99% of cases cleared up. Only then do you assume goblins stole the crankshaft to make a scepter for their king.

General principle: investigate the most probable causes first and then (if necessary) consider the more exotic ones.

Re:Med students

[Anonymous Coward]

http://www.youtube.com/watch?v=dBnniua6-oM

Perhaps you won't be able to completely lose all your weight, but there can't be anything bad about refusing to eat a poison :). Perhaps this will aid you manage your weight even if you are prevented from exercising.

Re:Med students

[Anonymous Coward]

The simple solution to your problem is to eat less. Physical exercise is quite terrible at keeping you thin hence all the muscle heads with beer guts. Your physician was dumb for not checking your medical history first. That being said obesity can significantly exacerbate the problems you described so you probably should heed his advice and do something about it. Its not out of some anti-obesity mentality that I say this, its out of genuin concern. Once you hit your 50s and 60s your body is going to degrade with a vengeance if your obese. Thin and active people can stay fairly mobile well into their 70s and even 80s.

Re:Med students

[Anonymous Coward]

So, judging by what you've said, the breakdown between treatment -> in-depth examination if treatment doesn't show results is almost entirely dependent on whether the doctor believes the patient followed the treatment (regardless of what the patient has told them). Given that, one could see why a doctor with a bias may actually be very harmful to a patient.

Re:Med students

[Anonymous Coward]

BMI was never supposed to be used to determine whether someone is healthy, though it's often misused that way by health professionals, and it's nearly always misunderstood in that way by everyone else. It's intended to be an easy calculation to provide the practitioner with a quick indication of whether someone likely needs further attention in the area of fitness - a sort of "fatness triage" tool. It's supposed to be a bit slanted, so that few people fall through as false negatives. I blame the mainstream press for propagating its misuse.

- T

Re:Med students

[Anonymous Coward]

True but suggesting it is a choice is bullshit. It's like saying a schizophrenic should choose to stop being crazy. Base compulsions cannot be controlled by willpower alone and unless you have been on predisone for an extended period you can't say otherwise.

Re:Med students

[c_woolley]

And they run with scissors. You hit the nail on the head. People who are overweight or underweight are not necessarily that way simply due to eating. There may be a pre-existing condition other than too much or too little food. Genetic disposition, mental condition and the individual's overall environment come into play with each and every person. I am lucky enough to have been blessed with great health when it comes to my weight, and I don't even have to work at it. My sister, on the other hand, has to be very strict about her diet and exercise or will quickly gain weight. If the Jiro's comments were true, my sister would be regarded as fat and lazy, while I would be seen as restrained and responsible. I assure you that is simply not the case (as I am eating a pizza by myself right now).

Re:Med students

[KiloByte]

The problem is that people refuse to accept that obesity is a mental health issue (as that carries a stigma) and either glorify it or try to fix its consequences rather than source.

Re:Med students

[MikeBabcock]

I don't have a weight problem -- I could care less about my weight. I have a joint and asthma problem, neither of which is helped by your suggestions.

cf. actual studies on how fat people spend less time in hospital than skinny people in the UK before you assume so much based on pop culture rather than actual medicine.

Those patients aren't fat!

[Anonymous Coward]

They're just big-boned.

Worse on Slashdot

[Rob the Bold]

As of this posting, the vast majority of ACs took the opportunity to make disparaging comments about the overweight. Classy.

Re:Worse on Slashdot

[Anonymous Coward]

How dare you say that to my face!

Well, I'd say it behind your back but my car's only got half a tank of gas.

Re:Rightly So

[Anonymous Coward]

Hear, hear!

Fat Hatred

[WOOFYGOOFY]

Fat hatred and blaming people for being fat is so universal and so conscious that it's hard to take any methodolgy seriously that finds that people are "unconscious" of their hatred of obese people.

Want to get at the real socially redeeming value of this journal entry? Study the methodolgy, understand where it went wrong, and above all never, ever use it.

Re:Fat Hatred

[Pinky's Brain]

I "blame" fat people for being fat for the same reason I blame criminals for being criminals ... not because I don't recognize hereditary and environmental aspects, but because the concept of personal responsibility is rather important to a functioning society.

PS. if they don't feel self pithy, aren't fat enough to suffer health problems and don't care that I find it ugly then I don't really blame them ... it's just a lifestyle choice which doesn't really impact me.

Re:Fat Hatred

[davester666]

That's just it. In 20,30,40 years it will impact you.

The rising proportion of the population that is obese or worse is going to cost everyone a crazy amount of money to 'save' them [as in, keep them alive, with a variety of illnesses like heart disease, diabetes and a variety of other maladies which become much more likely as you gain weight].

And at that point in time, it's too late to do anything about the problem. Even if they lose weight then, they still have one or more 'rest-of-their-life' illnesses which won't be cheap to maintain. And most of them won't have the money to pay for it, so it's like all kinds of other problems we have, it's down the road and not happening to us right now, so we'll worry about it then.

Re:Fat Hatred

[Pinky's Brain]

Being obese will generally impact your health quite immediately, but I was more talking about people who are simply overweight ... which still has some impact, but in the bigger picture it's just not that big a deal.

Re:Fat Hatred

[Anonymous Coward]

Some have argued (sorry I don't have the citation handy) that the OPPOSITE is true: people who live unhealthy lifestyles are far cheaper to maintain for one simple reason: they die before they get old (that time in your life where your maintenance becomes FAR more expensive).

The article I read had some interesting numbers that stated health care in the developed world would be substantially cheaper if everyone smoked and ate badly.

Re:Fat Hatred

[Anonymous Coward]

Citation: http://daveatherton.wordpress.com/2012/03/17/the-true-costs-of-treating-smokers-the-obese-and-the-healthy/

It is just a summary but they link to their more official sources. The core values, as quoted from the blog:
The lifetime costs were in Euros:
Healthy: 281,000
Obese: 250,000
Smokers: 220,000

So, obesity saves more than 10% of lifetime healthcare cost.

Re:Fat Hatred

[ebno-10db]

Citation: http://daveatherton.wordpress.com/2012/03/17/the-true-costs-of-treating-smokers-the-obese-and-the-healthy/

It is just a summary but they link to their more official sources. The core values, as quoted from the blog: The lifetime costs were in Euros: Healthy: 281,000 Obese: 250,000 Smokers: 220,000

So, obesity saves more than 10% of lifetime healthcare cost.

Thank you! I knew that was true of smokers, but wasn't sure about obesity. Despite silly things like objective data (which Slashdotters otherwise rightly insist on) people will still use "fat people raise my healthcare costs" as an excuse for their sanctimony.

Re:Fat Hatred

[AmiMoJo]

I'm not quite obese but I am overweight, and it's because I suffer from two conditions (CFS and arthritis) that making losing weight extremely difficult. It isn't a lifestyle choice, and before these two things got bad I was able to stay fairly trim.

I feel bad. I don't like the way I look. Thing is though, it really isn't my fault. I wish it was because then I could do something about it.

Don't make assumptions about people you don't know.

Re:Fat Hatred

[Anonymous Coward]

This is why universal health care is a horrible idea and needs to be abolished.

Re:Fat Hatred

[ebno-10db]

I "blame" fat people for being fat for the same reason I blame criminals for being criminals

It's interesting that you compare fat people with criminals. What next, people who talk obnoxiously loud in restaurants are like perpetrators of genocide?

it's just a lifestyle choice which doesn't really impact me

How generous of you to include that as an afterthought. You forgot to mention that that's the important difference between fat people and criminals. BTW, even people who are fat enough to cause health problems are not your problem. They have lower lifetime healthcare costs.

Re:Fat Hatred

[l0ungeb0y]

I don't really blame them ... it's just a lifestyle choice which doesn't really impact me.

Except when you blame them for destroying society.
Same as I blame you for destroying society by being such a god damned moron.
Do you even listen to yourself?

You're worse than those who say "not to be a jerk" -- then say some extremely dickish thing.
You go and say some real dickish thing then say, "but I'm not really a dick see?"
So don't bother speaking next time you think you have something to say.
Because you have nothing to say. Nothing at all.

Re:Fat Hatred

[zoffdino]

It does impact you. Being obese have been proven to lead to a whole bunch of other health problems and worsening a whole bunch of others. I have yet to find a study that find obesity can prevent any health problem. Think about the impact this gonna play on the society:

• - More sick days to take care of health problems, leading to reduced productivity
• - Increased health care costs for obese individuals. This will filter to you personally either via workplace health insurance or a public health program like Medicare and Medicaid
• - A distortion of supply in health care professionals: since obesity will grow faster than all other health problems, more medical students will choose bariatrics (treatment of obesity) as career

Like smoking, or substance abuse, or street racing, the impacts extend beyond the individual making the decisions. Society eventually pay for them.

Re:Fat Hatred

[AthanasiusKircher]

The lifetime costs were in Euros:

• Healthy: 281,000
• Obese: 250,000
• Smokers: 220,000

So, obesity saves more than 10% of lifetime healthcare cost.

Yes, exactly. This should be obvious to anyone with half a brain. A lot of people develop chronic diseases that require intensive care late in life, whether it's due to diabetes in middle-aged fat people or dementia and various cancers in retired elderly "healthy" people. So, overall, the best way to reduce costs is to get people to die off earlier.

And these figures are probably even worse because they only take into account healthcare costs, without considering lifetime contributions to healthcare.

As I recall from this study, on average the years "lost" due to obese people dying earlier are mostly during retirement: obese life expectancy was reduced from 84 to 80 years or so. (Obviously there are people who have heart attacks and die in their 40s or 50s too, but this is the average.)

If an obese person and a normal weight person both retire around age 65, the greatest drain on societal resources will occur after that. If the average retirement time is reduced by 25% or so (which is suggested by the study), that's an even greater effective reduction because it occurs while the person is often contributing the least toward the healthcare system. It's the otherwise "healthy" person who lives to 95 or 100 and spends the last 10-15 years with a major degenerative illness that really costs a lot to society overall; almost half of their adult life is spent "in retirement" and probably not contributing as actively to healthcare costs.

If the U.S. government actually wanted to save healthcare costs overall, they would have adopted an official diet plan that tends to make people fat back when the Baby Boomers were younger. And they would have subsidized food production through farm bills and additives in manufacture that would make people fatter.

Oh, wait... they actually did that starting in the 1970s! Maybe the government actually is developing policy to save healthcare costs: just trying to save money by getting fat Baby Boomers to die earlier??

Re:Fat Hatred

[Anonymous Coward]

that making losing weight extremely difficult

Bullshit. Losing weight is just as easy as it used to be. Eat less. That's it.

You may be thinking of bodyfat percentage instead. Keeping that down is a lot harder with your conditions, true. But overall weight is easy.

Re:Fat Hatred

[definate]

self pithy

If they don't feel self [concise and forcefully expressive]...?

Re:Fat Hatred

[Anonymous Coward]

Can't help you with the CFS, but I would suggest taking some turmeric capsules (or just get some powder and using it your cooking) for the arthritis. I've found that it helps a fair bit.

Re:Fat Hatred

[Anonymous Coward]

Shut up, you fat fuck.

Re:Fat Hatred

[Anonymous Coward]

He didn't compare fat people to criminals. I know you were really excited to shit all over him but you have outed yourself as a dipshit.

Re:Fat Hatred

[Anonymous Coward]

I have CFS too so I know what you're going through, I've been overweight because of it as well, but I've recently found one thing that has allowed me to lose weight and actually become healthier. There is only one diet that has worked, and it's basically a variant of low carb, it's called Keto(ketosis) and I've lost 50 pounds in a year from it, and all I've done is changed my diet. I don't exercise more than I already do (sometimes not at all), I don't starve, and I don't have to go without eating or skip meals or anything, I would seriously suggest as a fellow CFSer to try it.

http://en.wikipedia.org/wiki/Ketogenic_diet
http://josepharcita.blogspot.com/2011/03/guide-to-ketosis.html
http://www.ncbi.nlm.nih.gov/pubmed/22905670
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/

Re:Fat Hatred

[Seumas]

There's a difference between blame and hatred. I don't know any fat people that dismiss their weight as being the fault of someone or something else, but I know a ton of people who express an absolute vile hatred of fat people simply for being fat. A level of incomprehensible bile that you only really see from the likes of Westboro against gay people or maybe against someone who has murdered their beloved mother. On top of that, the very people they're supposed to go see regularly when they're trying to get their shit together and take control of their lives are, apparently, biased against them, too. So they're fucked if they do and fucked if they don't.

I mean, seriously, I don't have much sympathy for someone who is obese and goes around calling it baby fat or blaming it on any number of silly imaginary causes ("I have a virus, I read it in the medical journals, this month!")... But I also don't go around telling them how bad they are, ridiculing them, telling them they should die, and threatening them. All things that you see on a regular basis from a large segment of society (and that is not expressed against drug users, smokers, alcoholics, etc).

Re:Fat Hatred

[Seumas]

Yeah, davester666 has an inherent hatred and wish of harm to fat people, because he cares so much about the environment and is a humanitarian just looking out for everyone's best interest, you guys!

Re:Fat Hatred

[Anonymous Coward]

I have CFS and I lost weight by eating less food.

Re:Fat Hatred

[Bender0x7D1]

Except obesity also reduces life expectancy by 6-7 years. link

Therefore, you get 6-7 years of productivity from healthy people, which is worth far more than$31k. Plus, you probably get more productivity for all the other years as well. (Obese people have higher rates of absenteeism and disability claims. link)

Re:Fat Hatred

[Dcnjoe60]

Citation: http://daveatherton.wordpress.com/2012/03/17/the-true-costs-of-treating-smokers-the-obese-and-the-healthy/

It is just a summary but they link to their more official sources. The core values, as quoted from the blog:
The lifetime costs were in Euros:
Healthy: 281,000
Obese: 250,000
Smokers: 220,000

So, obesity saves more than 10% of lifetime healthcare cost.

You are confusing correlation with causation. While obese people tend to have a shorter life span, it is not directly from the obesity but some other related condition. For instance many diabetics are also obese. The obesity. Diabetics have a shorter life span than non-diabetics, so if an obese diabetic dies before a non-obese non-diabetic, what was the cause of the early death?

In addition, while there is no definition of healthy. Healthy what? BMI? Weight? How about a healthy BMI but stage 3 lymphoma? Then there is overweight versus underweight and one fares better medically if one is somewhat overweight than if they are underweight.

So, unless you are actually comparing similar health conditions along with their weight, the statistics are worthless. Of course, maybe you already knew that and it is why you posted as an AC.

Re:Fat Hatred

[Dcnjoe60]

Citation: http://daveatherton.wordpress.com/2012/03/17/the-true-costs-of-treating-smokers-the-obese-and-the-healthy/

It is just a summary but they link to their more official sources. The core values, as quoted from the blog:
The lifetime costs were in Euros:
Healthy: 281,000
Obese: 250,000
Smokers: 220,000

So, obesity saves more than 10% of lifetime healthcare cost.

Thank you! I knew that was true of smokers, but wasn't sure about obesity. Despite silly things like objective data (which Slashdotters otherwise rightly insist on) people will still use "fat people raise my healthcare costs" as an excuse for their sanctimony.

People will use whatever excuse they can find as a reason to say that they are better than somebody else. Weight is just an obvious one as is skin color or ethnic background.

Re:Fat Hatred

[Dcnjoe60]

Except obesity also reduces life expectancy by 6-7 years. link

Therefore, you get 6-7 years of productivity from healthy people, which is worth far more than$31k. Plus, you probably get more productivity for all the other years as well. (Obese people have higher rates of absenteeism and disability claims. link)

Even if that were true, are the higher rates of absenteeism and disability from their being overweight or from an underlying medical condition such as diabetes, which is common in overweight people? Besides, the statistics the AC posted were talking about medical costs, not the cost to an employer. But if you are basing your argument soley on weight and no other factors, then maybe the person with a normal BMI and stage 3 lymphoma is a more productive worker with less absenteeism. It seems counter-intuitive, but like med students, I'm sure wikipedia isn't biased either.

Re:Fat Hatred

[Anonymous Coward]

Wow, I'm really sorry about all the assholes responding to this. I hope you know that they in no way represent the majority, it's just that the majority doesn't have much to say in response.

Re:Fat Hatred

[u38cg]

Now repeat that calculation, but include the contribution the individuals make to their healthcare cost. Suddenly, the obese and the smokers don't look so cost efficient.

Re:Fat Hatred

[sjames]

And if those damned lazy "handicapped" people had an ounce of initiative they'd quit whining and stand up like everyone else, right?

Yes, that's what you read like. Now, are you going to be persoinally responsable for that or whine about how wrong *I* am and how right *you* are?

Re:Fat Hatred

[sjames]

Haters gotta hate. It's no longer socially acceptable to use the N word or call black men 'boy', and the feminist movement spoiled misogyny for them, so they have to resort to dumping on fat people.

Re:Fat Hatred

[TFAFalcon]

Aren't the years you lose the years when you're retired? So the productive period is the same, but the 'leeching' period is shortened for the obese. Or do obese people get to retire sooner?

Re:Fat Hatred

[Anonymous Coward]

Thing is though, it really isn't my fault.

I find that hard to believe. Even if you can't exercise, you can control how much you eat.

Re:Fat Hatred

[Anonymous Coward]

My SO is very nearly a complete quadriplegic due to a neurological disease. She can just barely move her hands (but not her upper arms), and is on a vent 24/7. Needs help for everything, can never be alone due to the vent etc.

She is trim (if not fit) for her height, as she limits how much she eats. Eating healthily also helps.

I'm somewhat overweight due to a combination of low activity and overeating, but I do not blame my disabilities. I just eat too much, compared to my level of physical activity.

Re:Fat Hatred

[mellyra]

Except obesity also reduces life expectancy by 6-7 years. link

Therefore, you get 6-7 years of productivity from healthy people, which is worth far more than$31k.

Or you get 6-7 years of super expensive cancer treatments from "healthy" people whereas the obese patient just dies cost-efficiently of his heart condition.

Re:Fat Hatred

[Anonymous Coward]

The real problem with what you said is that you could pretty much justify ANYTHING by just saying "don't make assumptions about X". Assumptions are part of life, get used to it.

Re:Fat Hatred

[Anonymous Coward]

If it's as impossible as you sat it is to do any exercise and eat responsibly (which is bullshit), then it's your responsibility to remove yourself from the gene pool.

Re:Fat Hatred

[Anonymous Coward]

I'm in the same boat. For the past decade I've suffered from severe depression and social anxiety. Add on to that the fact that many medications used to treat depression and anxiety cause weight gain, well.. It's not fun. It's definitely not by choice.

I hate that so many people think it is a choice. Do they actually think I choose to weigh as much as I do? I can barely function on a daily basis, let alone worry about doing something about my weight. I can barely take care of myself.

The only time I do leave the house is to see my therapist. My life is hell enough, I really don't need people discriminating against me because of my weight. I have enough problems in life.

People should think before they open their mouths. The one group that it seems is socially acceptable to discriminate against are overweight people. It's sick.

Re:Fat Hatred

[gl4ss]

..eat less. it works wonders.
YOU DON'T NEED TO EXERCISE TO LOSE WEIGHT. it just makes it faster.

seriously. that's just how fat reserves work, fattie.

Re:Fat Hatred

[m1ndcrash]

You're just find excuses, lay off pizza and pop and you'll notice the results

Re:Fat Hatred

[Anonymous Coward]

"blaming people for being fat" ?

Is that like "blaming people for smoking"?

Of course we blame people for being fat. Everyone controls what they eat.
Well not everyone...Below 18, the parents control food consumption.

For adults, yes, we can blame their parents for bad habits, blame the media for bad suggestions, blame the government for lack of regulation and blame metabolism for being too efficient.

But at some point adults have the ability to understand their metabolism and their health and control their food intake to better suit themselves.

Yes, genetically we all have different metabolisms, different susceptibility to addiction, and possibility different levels of self control.
You are free blame over-eating (or smoking or some other unhealthy habit) on external factors, but they are under your control.

Re:Fat Hatred

[Charliemopps]

Now see, comments like this drive me nuts. If you're fat, in the vast majority of cases, it's your fault. Yes, there are some medical conditions that can make you gain weight... usually due to the medications you're taking and not the disease itself, but most people that are obese have no such disease and usually don't even have an eating disorder. They just eat what they want to when they want to.

I'm sure there is a psychological reason for each individuals choice to eat until it kills them. But I can't do much about that. When we see a heroine addict we don't mew and cry about the sociological reasons for their addiction. We have to be firm, tell them their continued abuse of drugs is not ok, and we will not abide it. The same should happen with people that are obese. We're enabling them. Fat is not beautiful, it kills you, stop treating it as if it were some sort of unavoidable birth defect. It's a choice, and it's not ok.

Re:Fat Hatred

[AmiMoJo]

Sounds very interesting and I'm going to look into it. Doesn't it affect your brain function though? My problem is that I am holding down a programming job so need to be able to think during the day, and then am completely mentally wasted by about 5:00PM.

Re:Fat Hatred

[faedle]

If it was that simple, a lot of fat people would be thin.

"Eat less" often has repercussions as well. Your body needs vitamins, minerals, and certain complex proteins (and yes, and even cholesterol and fat!) to function properly. Calorie reduction often automatically means reduction of these things as well: sometimes to dangerous levels unless carefully managed. And if you, as a "fat person" have any other illnesses to contend with (such as, say, an intolerance to certain foods, diabetes, or even a mild mental illness) that complicates that too.

I have HHC (and "bronze diabetes" as a result). I'm supposed to avoid foods high in iron like the plague. That's a whole column of "healthy foods" I simply cannot eat at all, or extremely small quantities.. say, like 1 serving a week. OK, so green leafy vegetables and lean red meats are out the window.. but that means that to compensate in other areas I might have to have a higher carbohydrate load..oh, damn, can't increase carb load without increasing my insulin.. and guess what has "weight gain" as a side effect? Point here being: it can be very hard to eat a properly balanced diet AND avoiding foods that might make a condition worse AND keeping calorie intake between 2,000 and 2,500.

Re:Fat Hatred

[Tyler Durden]

That's strange. Here in the US the majority of people are overweight.

How can a majority be persecuted?

Re:Fat Hatred

[Charliemopps]

Bullshit. I'm sorry but both of those diseases are excuses, not causes for you being overweight. Swimming would be excellent for you, if you can't afford it the YMCA offers free programs for those that can't. I donate regularly. If in the end you can't exercise, then eat less. That's your choice. I've been to Africa, I've seen people with far worse diseases than CFS and arthritis and they sure as fuck weren't overweight. The only fat people there were rich people... because they could afford western food. If you really want to lose weight, stop eating so much, and yes, I realize a non-excersize diet for you is going to be around 500 calories and be terrible, but you WILL lose weight. The only hard part of this equation is convincing YOU it's worth it. And I don't mean me, or your family convincing you. I mean you convincing you. Remain overweight and die earlier, likely more painfully, and with many complications throughout your life... OR... eat less. Those are your choices. And don't give me shit for being disappointed in you for making the wrong choice. I'm not going to be so worried about your feelings that I let you kill yourself. You're fat, it's your fault, and I'm disgusted by your body. You don't give a fuck what I think? That's fine... but how are your kids going to grow up? If you have any I'm willing to bet you're teaching them the same eating habits. It's time to take your life back... make me look like a fool by losing a bunch of weight.

Re:Fat Hatred

[gonzonista]

Don't forget to add the sin taxes. Up here in Canuckistan, smokers pay a heavy tax to smoke and there is tax on junk food. Now the obese and smokers look more like a revenue stream.

Re:Fat Hatred

[Duncan J Murray]

I feel bad. I don't like the way I look. Thing is though, it really isn't my fault.

Let me respectfully disagree and say that fat reserves can always be decreased by decreasing your calorific intake.

Re:Fat Hatred

[ultranova]

When we see a heroine addict we don't mew and cry about the sociological reasons for their addiction. We have to be firm, tell them their continued abuse of drugs is not ok, and we will not abide it. The same should happen with people that are obese. We're enabling them. Fat is not beautiful, it kills you, stop treating it as if it were some sort of unavoidable birth defect. It's a choice, and it's not ok.

Your implicit asumption that you have a right to tell other people what they may eat or otherwise input into their bodies "for their own good" is not okay. Your continued abuse of your freedom of speech by advocating depriving other people of their freedom is not okay, and we will not abide it. Authoritarianism is not beautifull, it has killed over hundred million people in the last century alone, and you must stop treating it as if it were some sort of unavoidable birth defect. It's a choice, and it's not ok.

Also, let me tell you a terrible little secret: no one, no matter how fit, gets away alive. No one.

Re:Fat Hatred

[Anonymous Coward]

Oh for fucks sake there is a bias against fat people sure, but also ugly people, short people, loud people, blacks (if you are white), whites (if you are black), Chinese (if you are not into studying), show-offs, people who fart, people who don't wash, people who smoke crack (if you don't), people who lie, people who are too good, people who are tattle-tales, people who show off about their money, athletes who earn lots of money and get off murder raps.....the list goes on and on.

And of course, there is bias for beautiful women (if you are a man or a lesbian), good looking men (if you are a woman or a gay), women who will sleep with you (again men and lesbians), people who are politically correct (if you are an effete liberal and increasingly if you are a /. reader).....the list goes on and on.

So yes, no doubt doctors (and dentists) do have a bias against fatsos. Most people do (except other fat people). A dentist friend of mine told me he has a bias against people with halitosis..... next week I plan to have a /. entry on dentists who have a bias against fat people who have halitosis and fart with fear while sitting in the dentist chair. Of course, most dentists don't realize their bias.

The government too has a bias. They go for black crippled lesbian socialists who have converted to Islam and who have been the victims of discrimination by (preferably) a white privileged man who has an off shore account and avoids taxes and doesn't like The Religion of Peace. They'll get a job with the Obama administration for sure, the IRS will classify them as tax exempt and Harvard will give them an honorary degree. (Not to be outdone the U. of Wisconsin will make them Emeritus Professor of Black Suffering.)

Re:Fat Hatred

[Anonymous Coward]

Its not discrimination, you just don't know there's a cure. Exercise, probiotics (to get that gut microbiota back to norm), eating plenty of leafy vegetables and fruits (more than one of each per day), and avoid fructose. (Table sugar is half fructose and half glucose.) Limit meats, eliminate them if you can.
It really is that simple. Nobody has the follow-through to take my advice though.

Re:Fat Hatred

[dandelionblue]

Oh come on, don't blame CFS for being overweight. The last CFS group I attended, there was only one overweight person there. They aren't correlated. Okay, we can't exercise as much - but we can control our calorie intake as easily as anyone else, and food intake is more strongly linked with obesity than lack of exercise (since few people exercise enough to burn a substantial amount of calories).

Re:Fat Hatred

[Anonymous Coward]

I couldn't really comment on that personally since the CFS already retards my brain function as it is, I'm not feeling any different however, and in some cases a bit better. I do know there are plenty of people that are on the diet that haven't mentioned any negatives like that, usually there are other issues like Keto rash that sometimes develops but it's fairly rare. If you're really curious about those details, there's a subreddit for it, quite popular too, so you're bound to get some good anecdotal information. http://www.reddit.com/r/keto/

Re:Fat Hatred

[Anonymous Coward]

When we see a heroine addict we don't mew and cry about the sociological reasons for their addiction.

You have a problem with people being addicted to female heroes?!? You sexist!

Re:Fat Hatred

[Anonymous Coward]

...BTW, even people who are fat enough to cause health problems are not your problem. They have lower lifetime healthcare costs.

Oh, I'd love to hear all about how my possible healthy-but-old issues somehow financially override the lard-ass rolling in for the quadruple bypass ('cause they have BOGOs on those surgeries all the time, right?)

Obese people don't even have to wait until they get old to start having issues, or have you not seen any teenage diabetics that were unheard of half a century ago?

Re:Fat Hatred

[Anonymous Coward]

Citation: http://daveatherton.wordpress.com/2012/03/17/the-true-costs-of-treating-smokers-the-obese-and-the-healthy/

It is just a summary but they link to their more official sources. The core values, as quoted from the blog:
The lifetime costs were in Euros:
Healthy: 281,000
Obese: 250,000
Smokers: 220,000

So, obesity saves more than 10% of lifetime healthcare cost.

Ah, not including the massive revenue generated from tobacco taxes would be a start to not skewing the shit out of these numbers.

As would not punishing the healthy due to longer times paying pensions out of taxpayer coffers.

We're talking HEALTHCARE costs here, so let's try comparing apples to apples next time, instead of apples to apples...and the rest of the fucking fruit basket thrown in there to "justify" being an obese smoker (because obviously doubling down on being an obese smoker would save 15 to 20% with this logic, so it must be the right thing to do for society.)

Re:Fat Hatred

[Anonymous Coward]

To counter this point, How productive are people who live longer, are healthier longer to work and pay taxes into the system, stay off welfare, and otherwise care for themselves? And thats just monetarily.

Re:Fat Hatred

[AmiMoJo]

Swimming would be excellent for you

This just shows how ignorant you are.

CFS is caused by mitochondria not getting enough energy to your muscles and organs, making you feel like you just ran a marathon all the time. I get up out of bed and feel completely exhausted, muscles aching like I just did a day's physical labour.

I can push through it but the consequences are dire. When you are extremely tired you can't think straight. I need to think for my job (programmer) so I can't just decide to go swimming one day when I know I have to work the next because I won't be able to function.

So yeah, maybe I could reduce my calorie intake even further (it's already low just to maintain my weight). I'd have to take even more supplements to make sure I get all the required vitamins and minerals, and I'd probably start suffering from other problems related to a poor diet. I could do more exercise but then I'd lose my job and the rest of my life would fall apart as I'd have no energy left to do basic stuff like shopping for essentials.

500 calories a day is just insane. Below about 1500 a man's body switches into starvation mode, conserving as much energy as possible. I'd be pretty much unable to move and the psychological stress would be terrible. I'm not morbidly obese, I don't need that kind of drastic measure.

Re:Fat Hatred

[Anonymous Coward]

>> Thing is though, it really isn't my fault. I wish it was because then I could do something about it.
>> Don't make assumptions about people you don't know.

I'm sorry, this are all only excuses made of poor wisdom. I can't google this now, but you can find interviews with people on youtube, who for example end up very fat sitting on a wheel chair unalbe to move and doctors told them they will never walk again. Not surrendering and going raw fruit + vegetable diet (you eat mostly fruits, becouse they have more energy) this women is slim, walking and healthy today (after 8 years on this diet - don't know how long she's been slim already).

You can't fool the law of physic. If you eat less calories, you will be slim without moving. Your health will probably improve too. You may argue, that fruits are expensive in your country. but that's all that can hold you back.

Re:Fat Hatred

[Anonymous Coward]

Except that you've ignored a critical factor, that obese people die earlier and due to the 'lost years' in most cases being after retirement age, this saves society a lot of money.
Various comments in this thread cite studies that show that smokers are cheapest for society, obese people next, and 'healthy' people are the most expensive (since they live longer in retirement and often require expensive healthcare at the end of their life).

Other comments dispute the validity of these studies.

But at the very least it seems that it is *not* an established fact that obese people are more expensive to society; it's a matter of dispute and needs further study.
Too many people are assuming without proof that 'it must be so'.

Re:Fat Hatred

[Anonymous Coward]

How can a majority be persecuted?

AFAIK In Syria the Alawites (about 10% of the population) have been doing quite a good job of persecuting the remaining 90% of the population.
Similar situation in apartheid South Africa.

I'm not saying it necessarily applies in the case of obesity, but minorities *do* persecute majorities when they have the power, money, guns etc.

Re:Fat Hatred

[Anonymous Coward]

and it's because I suffer from two conditions (CFS and arthritis) that making losing weight extremely difficult. It isn't a lifestyle choice

No, it's because you're consuming more calories than you're burning. CFS and arthritis are the excuses you use to justify your lack of physical activity.

I feel bad. I don't like the way I look. Thing is though, it really isn't my fault. I wish it was because then I could do something about it.

You should feel bad. I don't care how you look. It is your fault. You can do something about it.

But you don't. Instead, you go out and shop doctors until you find one who tells you you have "CFS" or some other bullshit term which amounts to "the patient is complaining of a symptom but doesn't have any identifiable condition to explain it."

Re:Fat Hatred

[Anonymous Coward]

CFS is caused by

I'll stop you right there. CFS stands for "Chronic Fatigue Syndrome" and there is no known cause for it, and the condition often persists even when there is nothing physically wrong.

I can push through it but the consequences are dire. When you are extremely tired you can't think straight. I need to think for my job (programmer) so I can't just decide to go swimming one day when I know I have to work the next because I won't be able to function.

And that's where you are wrong. Exercise makes you tired for two reasons- burning calories and buildup of lactic acid in your muscles. Neither of which have anything to do with CFS. If anything, regular exercise will reduce the severity of the symptoms of CFS, but it will not make them any worse.

I could do more exercise but then I'd lose my job and the rest of my life would fall apart as I'd have no energy left to do basic stuff like shopping for essentials.

No. Again, CFS is about feeling like you don't have the energy, when in reality you have plenty. That's why you're fat- you have too much energy for what you're using.

Re:Fat Hatred

[Anonymous Coward]

Wow, I'm really sorry about all the assholes responding to this. I hope you know that they in no way represent the majority, it's just that the majority doesn't have much to say in response.

Don't presume to apologize for me, dickhead. I know what CFS is, and what it isn't, and the guy you're responding to either doesn't have it or is using it as an excuse to not do something about his problems.

Every time someone says anything about being overweight a bunch of fatbodies come out of the woodwork to bitch about some medical condition that makes it "impossible" for them to lose weight. Yes, there are a few people who have situations that makes it very difficult to lose weight. A FEW people. But for every fatass with a legit medical condition, there are 1,000 more waddling up screaming about how they have it too.

The reason you feel tired and fatigued all the time is BECAUSE YOU'RE FAT.

Re:Fat Hatred

[Anonymous Coward]

I'm not quite obese but I am overweight, and it's because I suffer from two conditions (CFS and arthritis) that making losing weight extremely difficult. It isn't a lifestyle choice, and before these two things got bad I was able to stay fairly trim.

I feel bad. I don't like the way I look. Thing is though, it really isn't my fault. I wish it was because then I could do something about it.

Don't make assumptions about people you don't know.

Twenty to thirty years ago I, and most, would make the assumption that you did indeed have a medical issue as that was the reason that most people were overweight or obese. Now, however, the overwhelming majority of individuals are obese as the result of poor nutrition and a lack of exercise. According to the CDC only about 7% of obese people have a legitimate health reason. Obesity is seen as a "life choice" by our culture for lack of a better description. Much like smoking is recognized as a "life choice" and those that suffer the consequences are not to be pitied. I am sorry for your condition AmiMoJo, and wish you good health, but it is the larger issue of a self inflicted fat epidemic that is the focus of much of our cultural attitudes towards obesity. Those with legitimate health issues like you have become "cultural" collateral damage.

Re:Fat Hatred

[Anonymous Coward]

Yes, and those that play in traffic have a lower lifetime healthcost too. The problem with this analysis is that it is from the perspective of the Dutch health care system which like most of the other European health care systems lets people that are going to die...well die. They do not spend half a million Euros trying to extend lives a few months like the American health system or put them into "special programs" because they can't control their behavior. If America were to "harden up" thier health care system and deny end of life treatment to self inflicted disease then our costs would probably fall into line with those of Europe.

Re:Fat Hatred

[Anonymous Coward]

Bullshit. I'm sorry but both of those diseases are excuses, not causes for you being overweight. Swimming would be excellent for you, if you can't afford it the YMCA offers free programs for those that can't. I donate regularly. If in the end you can't exercise, then eat less. That's your choice. I've been to Africa, I've seen people with far worse diseases than CFS and arthritis and they sure as fuck weren't overweight. The only fat people there were rich people... because they could afford western food. If you really want to lose weight, stop eating so much, and yes, I realize a non-excersize diet for you is going to be around 500 calories and be terrible, but you WILL lose weight. The only hard part of this equation is convincing YOU it's worth it. And I don't mean me, or your family convincing you. I mean you convincing you. Remain overweight and die earlier, likely more painfully, and with many complications throughout your life... OR... eat less. Those are your choices. And don't give me shit for being disappointed in you for making the wrong choice. I'm not going to be so worried about your feelings that I let you kill yourself. You're fat, it's your fault, and I'm disgusted by your body. You don't give a fuck what I think? That's fine... but how are your kids going to grow up? If you have any I'm willing to bet you're teaching them the same eating habits. It's time to take your life back... make me look like a fool by losing a bunch of weight.

And people in wheelchairs are just too fucking lazy to get up and walk, amirite? It's an excuse, pay for PT, it'll be horribly expensive, but take fucking charge you lazy fucks! Right?!

Re:Fat Hatred

[Charliemopps]

All complete horseshit. Make up all the excuses you want. Go to your doctor, tell him/her you want to lose weight, DO WHAT THEY TELL YOU, and you will. Period. I found out my cholesterol was terrible for the first time a while back. The doctor told me what to eat to get it down, he said after I try the diet for a couple of months he'd test me again and then put me on pill. So I went home, did the diet, went back and he was shocked "Your cholesterol is better than mine now!" So I asked about the pills "Oh no, most people just don't do the diet so I assumed we'd be putting you on medication at this point." Most people can not control their eating well enough to keep from having to take powerful medications that have dire side effects. That boggles my fucking mind. I've never met a doctor that's told me there was any other cause to obesity than poor diet. I've met plenty of obese people that claim so however.

Re:Fat Hatred

[Anonymous Coward]

Hey fatso, stop complaining and stop eating.

Re:Fat Hatred

[Synesthes]

I'll pipe in as well. After doing my research, I found the Ketogenic Diet and it was fantastic. I lost 100lbs in a year (from 299 -> 199)

I'd highly recommend reading 'The Ketogenic Diet' and 'The Rapid Fat Loss Handbook' both by Lyle MacDonald, particularly if you have a scientific interest in it, as well as a nutritional one.

In response to your question, I did not feel like I lost any mental faculties during it. The first week was fairly difficult, hungry and all, but after that, it's pretty easy. Best of luck!

Re:Fat Hatred

[Tyler Durden]

So I guess us thin people have to hold on to the money and the guns, or we're screwed. ;)

But yeah, apartheid as a counter-example did spring to my mind shortly after I made my post. D'oh!

Re:Fat Hatred

[Magius_AR]

Or you get 6-7 years of super expensive cancer treatments from "healthy" people whereas the obese patient just dies cost-efficiently of his heart condition.

If that were true, that cancer cost would already be factored into the aforementioned 281,000 Euro lifetime cost of the healthy person from the study.

Re:Fat Hatred

[Magius_AR]

"Eat less" often has repercussions as well. Your body needs vitamins, minerals, and certain complex proteins (and yes, and even cholesterol and fat!) to function properly.

Supplements solve most of those concerns.

I have HHC (and "bronze diabetes" as a result).

But you're an exception, not the norm. "Bronze diabetes" is rare (1 in 200 says most of the internet cites). Obesity is _far_ more common than that (about 1 in 3 in the US). If 1 in 200 people can't do anything about their obesity, but the other 199 can, people still have a valid complaint when they say "just eat less". Whereas I sympathize for your situation, using an outlier to attempt to forgive rampant irresponsible behavior of far larger masses of people (pun not intended) is a foolish approach.

Re:Fat Hatred

[Anonymous Coward]

It is your fault - the sooner you accept that the sooner you can do something about it.

Saying that, do you want to do anything about it?

If losing weight is really, really hard and your current weight is not affecting your physical or mental health, what's the problem?

obese people don't follow diet..

[gl4ss]

..and having a bias for thinking so is a bias in this study.
can't blame them though. because people who stay obese can't follow a diet, obviously. too thin people might have some "respectable" reason for being unable to digest or eat enough, it's much harder to eat on purpose more to gain weight than it is to lose it - the other just needs you not to buy food and put it in your mouth and chew it while the other needs you to have appetite to be able to put it in your stomach and the stomach to be able to digest it(personal bias experience, had both).

also it's hard to have respect for some obese guy - at least when it comes to respecting them with knowing about them only that they're fat and have a medical problem from being obese.

next up: medical students keep sexy patients in higher regard.

Re:obese people don't follow diet..

[hedwards]

It's slightly complicated by all the bad advice that's given on how to manage ones weight.

However, when all is said and done, eating less and moving more solves the problem for most people. Sometimes there's a need to fix ones sleep and or stress in order to lose the weight.

But, doctors themselves are a terrible source of information on diet and exercise. Unless it's changed recently, they only get a few weeks of training on diet and none on exercise.

Re:obese people don't follow diet..

[sjames]

Obese people have to ignore one of the few basic drives stronger than sex for the rest of their lives. Not completely ignore it, mind you, that leads to death. No, they have to tickle the dragon.

Thin people just have to take wierd Al's advice.

yes, I know that latter isn't necessarily true, but it's as true as your claims.

Re:obese people don't follow diet..

[Anonymous Coward]

Can you really blame someone for having poor impulse control? Being good or bad at controlling your impulses is not a choice anyone makes. Not eating is not as easy as you imply since we evolved to want to eat and we need to eat to live, and it isn't as though people can just give up eating completely.

Re:obese people don't follow diet..

[gl4ss]

Can you really blame someone for having poor impulse control? Being good or bad at controlling your impulses is not a choice anyone makes. Not eating is not as easy as you imply since we evolved to want to eat and we need to eat to live, and it isn't as though people can just give up eating completely.

it wasn't about actual blame, it was about a bias that one who can't follow a diet can't follow a dietary plan - it's a tautology. it's just obvious that fat people who can't lose the weight can't stay on diet.

next up, it's not alcoholists fault that he drinks? come on now.

and it's not neo-nazis fault that he is a nazi? taken that road, nothing is fault of anyone - it's a philosophical angle you can go with, but that doesn't garner automatic respect(and if you respect everyone just the same, you respect nobody really, same old story).

4th year med student here

[Anonymous Coward]

I'm not unaware. I know exactly what I think about fat people and It's not good.

Re:4th year med student here

[ebno-10db]

I know exactly what I think about fat people and It's not good.

I feel the same way about sanctimonious people. Sounds like you'll make a shitty doctor.

Re:4th year med student here

[Rob the Bold]

I know exactly what I think about fat people and It's not good.

I feel the same way about sanctimonious people. Sounds like you'll make a shitty doctor.

I don't think the OP's trying to be sanctimonious, but admitting to a bias. As they say, that's the first step.

There are, of course, too many docs who don't concern themselves with any aspect of a patient's health till they lose weight. Or quit smoking, or drinking, or doing drugs, or whatever. Sure, all those changes can dramatically affect overall health, but the "magic bullet" approach isn't the right one. Unless one's physician takes a comprehensive interest in your health rather than just tell you to "eat less, fatty", then it's gonna be hard to get the patient to comply with any advice. After all, if the doc just thinks of you as a fat guy (or smoker, etc.) then you'll just think of the doc as the "person who nags me about my weight." Hard to work as a team with that kind of rapport.

Re:4th year med student here

[Anonymous Coward]

I'm not unaware. I know exactly what I think about fat people and It's not good.

Juvenile. Also typical of a culture that can't grasp simple concepts like bias affecting treatment, or the amount of time you choose to spend with a particular patient, or whatever. In the modern American conservative mindset, every single thing wrong with every single person is absolutely and completely the fault of some moral failing that person has, because the alternative might mean that religion/corporations/capitalism/etc. aren't perfect and that makes their brains tilt like an abused pinball machine.

Poor people are poor because they're lazy and don't want to work. Fat people are fat because they won't stop eating. People only get fired from their jobs because of something they did wrong. People who are arrested for crimes are always guilty because the police would never arrest an innocent person. The rich are job creators.

All of those statements are sometimes true. Some of them are true more than false, and others not so much. The thing is, they are not always true. They are not always false, but with way too many people it's black/white, this/that, on/off, binary reasoning. "I oppose this because somebody I don't like is in favor of it" (the current operating model of the House of Representatives, for instance). "This can't be true because it has to do with emotional parts of the brain and emotions are for left wing communist socialist hippies, unless of course the emotion in question is anger in which case it's OK for me." pretty much describes a decent number of the postings on this topic too.

The merest hint that people might not be perfect logical reasoning machines AND that sometimes they do things or think things without meaning to is an alien concept because it isn't binary, it isn't simple, and it doesn't fit in a conservative sound byte. Just another example of why our society is crumbling rapidly.

Re:4th year med student here

[ebno-10db]

I don't think the OP's trying to be sanctimonious, but admitting to a bias.

Anything is possible, but it sure didn't sound that way. I would expect such a person to use the term "bias" or in someway indicate it's a problem they have.

Re:4th year med student here

[Anonymous Coward]

LOL You talk of black and white, false vs true, and logic. You precede it with a blanket statement about conservatives and their intelligence. You're not even an ass, you're an idiot.

Re:4th year med student here

[Seumas]

That's okay, because most people have a shitty opinion of doctors and the entire medical industry.

By the way, at least 40% of the doctors and nurses I have come across in my life are overweight or obese.

Re:4th year med student here

[Jessified]

Unless the next sentence is, "And now that I'm aware of it I'm going to make an effort to not be so hateful," then you need a different profession.

Re:4th year med student here

[Anonymous Coward]

I'm not unaware. I know exactly what I think about fat people and It's not good.

Same way I feel about people who don't understand their duty?

Doctors are like policemen in a sense - we expect more from them because of the path they have chosen (and doctors receive the remuneration to prove it). If you continue to show such biases as these then we will start to regard you the same way we do the police. Yes, we will continue to need you and continue to use you, but we won't respect you the way we do now. If you don't understand what that respect means for you and your profession then carry on the way you are - but I pity your esteemed colleagues.

Re:4th year med student here

[Anonymous Coward]

I would expect such a person to use the term "bias" or in someway indicate it's a problem they have.

He was being honest, nothing more. If you want people to lie to you, just say it. Don't try to spin your problems into other people's problems. Your problem is you can't handle the hard truth and you want at least softened version of it, not blunt and in-your-face version.

Re:4th year med student here

[Anonymous Coward]

Do you let it influence the treatment that you give them? If so, you are an evil fuck and I hope you fail.

If you don't, then there's no problem. I'm black and as your patient I don't give a shit if you are a member of the KKK, so long as you are doing your absolute best to use your professional skills to heal me. I'd rather you didn't bring the full hood and gown to the operating table with a burning cross, though, that would kind of freak me out.

Re:4th year med student here

[Anonymous Coward]

There are, of course, too many docs who don't concern themselves with any aspect of a patient's health till they lose weight. Or quit smoking, or drinking, or doing drugs, or whatever. Sure, all those changes can dramatically affect overall health, but the "magic bullet" approach isn't the right one.

No one claims that those are magic bullets, they're just very obvious things that one can do to improve one's health.

It's like refactoring code. If you give me a code base that sort of works but is poorly written, my initial approach is going to be attacking all the low-hanging fruit. I'm going to run a bunch of static analyses and make all those warnings go away. Then I'll do some refactoring to make the logic clearer.

And only once I've cleaned out the obvious cruft (and then retested it and burned the new code in) will I look for obscure problems. By removing poor practices, I've lessened the likelihood that my fix will cause new problems, or that I'll be fixing a symptom that was really caused by something else.

If you're smoking, yes, it's hard to quit, and no, it won't fix everything. But it's going to be causing a whole raft of symptoms and exacerbating other problems. A person who is basically fit is much easier to diagnose and treat. So when you have some readily identified and seriously problematic issues, like smoking, drugs or being overweight, you want to address those first, just because they're so obvious.

I don't mind fat people

[ozduo]

but I couldn't eat a whole one

Fat and Fit

[Aerynvala]

is a real thing. Despite how well my mother's bloodwork was all through chemo her doctor kept telling her to lose weight. She was doing amazingly well for someone on chemo and over and over all they could talk about was her weight. It's ridiculous.

Re:Fat and Fit

[Anonymous Coward]

Healthcare is a limited supply, get over it. How you want to divide it up is a matter of debate, but it's still fucking limited. Maybe the doctors don't want to save her from cancer just to have her die from diabetes or heart disease in 5 years. If she is not going to take a better care of herself, then maybe those health resources would be better spent elsewhere. Don't make apologies for her.

And before you throw something personal into the mix, yes my father has died of heart disease brought on by his obesity when I was young, and my mother is currently fighting cancer most likely related to her chain smoking for 30 years. I consider both selfish assholes. Oh and my stepfather drank himself to death (his liver died basically), good residence.

Re:Fat and Fit

[Anonymous Coward]

Yeah and the people running their mouth the most about fat people are just the lucky faggots who genetically simply don't store fat and can't comprehend in their fucking retard ape brains how anyone else could, despite the thin person having just as shitty a diet as the fat person.

Re:Fat and Fit

[Anonymous Coward]

And before you throw something personal into the mix, yes my father has died of heart disease brought on by his obesity when I was young, and my mother is currently fighting cancer most likely related to her chain smoking for 30 years. I consider both selfish assholes.

Looks like it is hereditary.

Re:Fat and Fit

[Anonymous Coward]

Source: your ass. "Good residence" indeed.

Re:Fat and Fit

[Anonymous Coward]

There are people that are *genetically* unable to store fat? You say that right before admitting your diet is shitty too.

Why don't you listen to yourself whine for once in your fat life.

Re:Fat and Fit

[Anonymous Coward]

No, it's really not. You can pretend and there of course are always people who don't show overt effects, but you are wrong. And we are talking obese people here, not someone who needs to lose a few.

It's a proven fact that it puts a much higher strain on your joints (knees, hips, etc), your heart (BP, apnea, etc), your arteries (higher blood pressure), your brain (again, sleep apnea/or other metabolic issues), and a significant increased risk of many cancers (as it sounds like you may have found out).

Show me an obese person who performed better/the same physically (since "fit" here really means "physically fit") before they lost significant weight and *maybe* you would have a shred of proof. But probably not.

Re:Fat and Fit

[hedwards]

LOL, nice try fatty.

There is some luck involved, yes, but not that much luck. It's a matter of choice and priorities, if you don't choose to watch your weight then you'll likely become obese over time. Nobody ever got to be 100 or 200lbs., overweight just through genetics alone. And zero people got so fat that they can't fit through the doorway without a lot of help from friends.

If you don't want to put up with the crap, I'd recommend losing the weight. It's not like retaining the weight is doing you any favors anyways.

Re:Fat and Fit

[Anonymous Coward]

Sounds like it was a pretty bad one, in fact.

Re:Fat and Fit

[Anonymous Coward]

Yeah and the people running their mouth the most about fat people are just the lucky faggots who genetically simply don't store fat and can't comprehend in their fucking retard ape brains how anyone else could, despite the thin person having just as shitty a diet as the fat person.

I lost 40 pounds, kept it off for two years now. So my weight goes up a few pounds, and then I push it back down. And when I'm pushing my weight down, my lucky fucking genetics are telling me "hungry hungry, fuck I'm goddamned hungry" all goddamned day.

Here's the secret to you fatties who want to lose it: when you feel hungry, that's your body telling you you're losing weight.

Re:Fat and Fit

[Anonymous Coward]

Hey asswipe monkey brain *I'M* one of the unlucky ones. *I DO* have health reason to be fat. *I DO* have genetic reasons. Oh and there are mental depression reasons too but frankly exercise helps fix those.

I'm not because I fucking well dont want to be a 10 ton lardass. The real, genuine reason for obesity is that person is just simply too fucking lazy to give a shit. *I'M* the exact reason why lard asses should be given a boot up the arse - if I can do it then so can everyone else. No goddamn excuses - if you are 50 kgs overweight it's *YOUR* fault. Most to lose weight dont need to exercise or watch their diet like I do - to keep myself stable I *need* 50 kms of cycling a day. Think about that - if that doesnt' scream I have issues that I need to overcome when almost all of you cant even think about doing that and you woul be losing plenty of weight then I dont know what does.

So don't fucking tell me you have genetic or health issues keeping you the size of a small bus. You just cant be bothered to do anything about it and to make that do something a lifestyle.

Oh I'm sure there's sob stories about no time or no money or whatever. Bullshit. It's excuses. And that's why people are scorned for being fat. It's YOUR CHOICES than made you a land whale. No your health, not your genetics, not your state of wealth or time.

Fat acceptance? Go fuck yourselves. If I can be a normal size, so can you. STFU and do it.

Re:Fat and Fit

[Swarley]

Genetics isn't magic. It doesn't spontaneously conjure lipid molecules from nothing. Fat is made of matter. Matter that enters a person's body when they eat it. The fact is that every person on the planet is losing weight every time they breathe. Where do you think those carbon atoms in exhaled CO2 come from? All you have to do is eat less and do more and, with few exceptions for certain rare diseases, you will lose weight. No X-men style genes are magic story telling required.

Re:Fat and Fit

[Anonymous Coward]

It's ridiculous.

It is ridiculous. My ex-wife's doctors kept telling her to lose weight, but she kept eating a bowl of ice cream before bed each night and a huge plate of pasta for dinner. She walked and moved very slow and hated to do anything that would raise her heart rate. She's still fat and lazy last time I saw her and probably still blaming everyone else including her doctors for it. Some people just refuse to listen. It's ridiculous!

You're in control of your body, your lifestyle, your weight. Don't pass the blame to others.

Re:Fat and Fit

[Anonymous Coward]

fuck you and your family shitface

Re:Fat and Fit

[Stormwatch]

lucky faggots who genetically simply don't store fat

Being unable to store fat is a crippling, extremely rare condition.

Re:Fat and Fit

[aztracker1]

Then show me an instance of twins separated when very young, who later in life have one thin, one fat... There's been several cases of paternal twins separated at birth to come together later in life, and in every case, their body types are similar... raised in differing environments... similar outcome.

I followed the "recommended" diet by several doctors for "normal" intake, including the USDA recommendations, and a lot of others.. it's only in the past year that I eliminated the vast majority of starches and processed carbs from my diet that has a persistent dent ever been made. I had a case of Guillain-Barre about 3 years ago, that sapped a lot of what little mobility I had... was using a cane for several months after. I was put on so many medications over the years, and so many negative reactions, that late last year, I finally said fuck it... stopped taking everything.. cut most of the starches from my diet (so my blood sugar had half a chance of staying in check, and I'm full-on insulin resistance at this point)... I'm doing better now than I was before the Guillain-Barre event... finally.

I hate the "nutrition" industry as a whole, I read labels, I avoid trans-fats, I avoid starches, carbs and a lot of other things.. I eat more fruit and vegetables, I eat a lot of meat. And, I'm doing better... there are almost no grains of any kind in my diet (I slip about two meals a week, and grab a sandwich, or something similar)... It's a lot more expensive eating this way, and more year over year lately than I can remember... If I knew now at 19, I would have been a lot better off... I've yo-yo'd at least a ton of weight (literally).... My highest was 460#... at 19, I was 290#, strong as an ox, and healthy... nearly 20 years of "diet and exercise" have done more harm than good, my knees are shot, I've got pretty bad type 2 diabetes, and not nearly as strong or healthy. I enjoyed a lot of activity back then, walking/hiking... I also much preferred a diet closer to what I eat now... If I'd not tried to exercise (what was too much, injuries) and just walking/hiking, or eat a recommended diet (lots of whole grains, low fat)... I'd be better off than I am now.

Re:Fat and Fit

[Anonymous Coward]

Wow. Congratulations! You can cycle 50 KMs a day? In fact, you have to, regardless of how you eat? That's amazing. Of course, some people can't do that. Namely people with whatever issue you have in addition to having no legs (an extreme example, but only one). But don't let that stop you from thinking EVERYONE can do it. I'm normal weight but I wasn't always. I quit my job and focused quite heavily on my health during my time off. I'm going to be reentering the job force soon and am scared to death I can't maintain my health. I'm scared even after the confidence and determination I've managed to dig deep and find in myself over the past few months. Sometimes it is time. Sometimes it is genetic predisposition. Sometimes it is laziness. You sound like the filthy rich guy who worked hard and thinks everyone can be rich if they only worked as hard as him. The truth is, some can't ever be rich. If everyone even could earn as much by working as hard, it would just make the rich guy another mediocre schmuck surrounded by people just like him (and that large bank account would be meaningless). Same for fitness. If everyone could be as healthy as you by working as hard, you'd be among the mediocre healthy people and the super-healthy would still be looking down on you as if you aren't trying hard enough. Get over yourself.

Re:Bias sounds reasonable.

[Stumbles]

With dumb asses like you everything is a mental illness.

Somewhere in the U.S.

[smittyoneeach]

Is a homosexual, minority, disabled vet with PTSD person, with massive food allergies, who is an unemployed whole lotta Rosie.
This benighted person is on the receiving end of more bias, bigotry, and prejudice than anyone else.
I must publicly scourge myself, as penance for my direct and indirect contributions to her hypothetical plight.
Because I am bad, and she is a victim.
[weeps]

Yes but is this different

[Anonymous Coward]

than doctors having a bias against smokers, recreational drug abusers, sex addicts with lots of partners, etc? Each of these groups are doing things that is typically detrimental to one's health, so there seems to be an issue of self control there.

Re:Yes but is this different

[Intrepid imaginaut]

sex addicts with lots of partners, etc?

I never got that, in what way is having lots of sex detrimental to the health or well being of a person? Seems like puritanism masquerading as medicine, a bit like circumcision which is meant to stop young men masturbating.

I don't care if you don't like it, that's how it is.

Re:Yes but is this different

[Anonymous Coward]

Lots of sex, with lots of partners (as stated) increases your risk of getting an STD. Especially if you don't wear protection. People (in general) only wear protection a fraction of the time they have sex (don't know the numbers, but if you are an adult, can you tell me you/he wore a condom 100% of the times you got a blow job, or had sex, etc.) This just means you are playing the odds of getting an STD. It is not a religious or judgmental thing. Just like being overweight is not a bad thing, just it makes you more susceptible to other medical maladies which are bad things. I know a dude that is over 300 pound and is a triathlete. He is considered obese by any standard on the planet. However he is in excellent physical shape and just blessed to be 6'9" and build like a Scandinavian god. According to all medical charts, he is overweight at like 225 pounds. He would like some female model at that weight and barely be able to carry his own frame.

Re:Yes but is this different

[hedwards]

If you're talking about a sex addict, then it definitely is detrimental to their health. And yes, it does have very real consequences. These aren't just people who like to sleep around, these are people who sleep around because they can't stop it. And it does ruin marriages, assuming they can get a partner in the first place. Increased risk of STIs and accidental pregnancy.

So, no, the isn't a matter of puritanism, there are very real consequences to sex addiction and trivializing it does nothing to help these people.

Re:Yes but is this different

[Chris Mattern]

sex addicts with lots of partners, etc?

I never got that, in what way is having lots of sex detrimental to the health or well being of a person?

Nothing really unhealthy about having lots of sex. Having lots of different sex *partners*, on the other hand, will make it rather difficult to avoid STDs.

Re:Yes but is this different

[Intrepid imaginaut]

...unless you use condoms? See this is the kind of comment that makes me immediately wary of people talking about 'sex addicition'.

Re:Yes but is this different

[Chris Mattern]

...unless you use condoms?

Condoms help. In some cases, such as AIDS, they help a lot. In other cases, like syphilis or HPV, they are far from foolproof, because some STDs do not require contact with infected semen to spread. They still help some, but if you're relying on condoms as your one line of defense while having lots of partners, you're in for a nasty surprise.

Re:Yes but is this different

[fuzzyfuzzyfungus]

than doctors having a bias against smokers, recreational drug abusers, sex addicts with lots of partners, etc? Each of these groups are doing things that is typically detrimental to one's health, so there seems to be an issue of self control there.

I suspect that the problem arises when a given bias impairs the doctor's ability to do diagnostics properly. In some cases(as long as they can avoid being overtly unprofessional about it) the effect is probably minimal: even if your emotions lead you to over-estimate the STD risk of somebody with lots of sex partners, the odds are still pretty good that, if they bother to come and see you, their problem will either be an STD, a different flavor of infection that the standard labs you'd do for a suspected STD will pick up, or something obviously unrelated. With, say, a druggie, the situation probably varies more sharply: I certainly wouldn't want a doctor trying to do pain management under the assumption that I'm "just a pillhead using him for a fix"; but outside of pain-related medicine it would probably work out.

Obesity has the inconvenient problem of being inaesthetic; but also being a potential cause of lots, and lots, and lots of various symptoms. If the doctor is working under the assumption that you just have fattieitis, almost anything you come in with, short of something that allows you to spurt blood, mucus, and/or pus on the doctor, can be dismissed as 'eh, just lose some weight and you'll feel better'. This isn't bad advice, and it's probably even the correct answer a fair portion of the time; but there are numerous conditions that overlap those symptoms that a doctor would otherwise investigate further. That's where the real trouble starts.

Re:Yes but is this different

[girlinatrainingbra]

Exactly correct. It's like the politically correct mafia that also wants us to "feel" for the poor addicts who continue to use drugs when they ought to know better, or the parents of kids who die from drug overdoses and go out of their way to blame the drug dealers for their kids' deaths, rather than realize that their kids had everything to do with their ingestion of drugs.

It's not that there is or even whether there is a bias against obese people: doctors in general ought to have a bias against obesity if they want to do no harm. Obesity harms individuals and is comorbid with many other dangerous diseases. Doctors should have a bias against obesity, but not against obese patients. Hate to use this one but "hate the sin, not the sinner".

Re:Yes but is this different

[Seumas]

IT professionals have a bias against those who do silly things and make their work life harder, too.

NEWSFLASH: People who do something for a living have a bias against people who make them have to do more work and put in more effort in their job. Ideally, a doctor would prefer someone in peak health who only has to come in for a very basic checkup every year. I, for one, am fucking shocked. *gasp*

Re:Yes but is this different

[Seumas]

The poster didn't say "lots of sex". They said "sex addiction".

Those are entirely different things.

Re:Yes but is this different

[Anonymous Coward]

If the doctor is working under the assumption that you just have fattieitis, almost anything you come in with, short of something that allows you to spurt blood, mucus, and/or pus on the doctor, can be dismissed as 'eh, just lose some weight and you'll feel better'.

One guy I know had a bad ear infection. Doctor's full diagnosis was: "Get rid of some of that weight and it goes away."

Re:Yes but is this different

[aztracker1]

The problem is when they have the fat-haze glasses on and assume every condition is related to their weight, and a more serious condition goes untreated for years because of it. It happens a lot with overweight people.

Another difference between being fat and addictions like alcohol, drugs or even sex... is you can live without alcohol, drugs, or sex.... you can't live without food. Most addictions you cut what you are addicted to out of your life... how does that work with food?

Re:Yes but is this different

[sjames]

Remember back when ulcers were the patient's fault and if they would just learn to be calm and relaxed they would be healed?

Then they discovered "oops" it ws an infection. But nobody got their money back for all that bad advice.

Re:Yes but is this different

[fuzzyfuzzyfungus]

Given the (typical) rate at which ear infections clear up without treatment and the (rather vague) amount of time it would take to 'get rid of some of that weight', that statement might actually be nonfalse as well as nonuseful. After all, it doesn't explicitly claim a causal link...

Re:Yes but is this different

[ultranova]

It's like the politically correct mafia that also wants us to "feel" for the poor addicts who continue to use drugs when they ought to know better, or the parents of kids who die from drug overdoses and go out of their way to blame the drug dealers for their kids' deaths, rather than realize that their kids had everything to do with their ingestion of drugs.

Yes, blaming drug dealers for drug related deaths is a clear example of political correctness gone mad. These upstanding businessmen are especially blameless for adding varying amounts and types of adulterants into their wares, thus making their actual dosage essentially random and causing interesting and often unhealthy medical side effects beyond those of the drug itself. Thank you for bringing this extremely valid and not at all insane point to our attention.

Re:Yes but is this different

[girlinatrainingbra]

dude, you miss the point entirely. Normally, "whoosh" is used for people who don't get the joke, but in this case you deserve a "whoosh" for not getting the point. WTF do I care if the drug dealer puts adulterants in his crappy drugs? The point is that the deaths from overdoses are not because some insanely careful and meticulous dosage-calculating drug user OD'ed 'cause he counted on the drug dealer to give him a calibrated and accurate and precise amount and strength of drug as the USP would give him. These fuckers die because they used illegal drugs and they took too much of the damn drug.

It's no use blaming the drug dealer for getting your poor widdle kid addicted: your kid chose to use the drugs. Blame your kid, not the drug dealer, for the kid's decision to seek out and use drugs.

To take a phrase from the NRA types: drug-dealers and drugs don't cause the overdoses, the fucking idiots who ingest the drugs cause the overdoses.

Re:Yes but is this different

[Anonymous Coward]

...unless you use condoms?

Condoms help. In some cases, such as AIDS, they help a lot. In other cases, like syphilis or HPV, they are far from foolproof, because some STDs do not require contact with infected semen to spread. They still help some, but if you're relying on condoms as your one line of defense while having lots of partners, you're in for a nasty surprise.

It never ceases to amaze me what kind of bad information the "don't have sex with people" crowd can come up with. There's a vaccine for the 4 most common types of HPV, if you're a dude you have to pay out of pocket but it will still work on you. HSV2 is the biggest thing that can't be stopped entirely by condoms, but if you know what to look for you can virtually eliminate chances of contracting this even if your partner isn't honest (risk of infection during non-outbreak periods is very low). Syph is bad but if you have this lifestyle, get 3-6 month screens, problem solved. Even then, you're not too likely to miss the fact you picked it up. Only HIV is an issue, because it doesn't show up for 6 months on screens. So if you have an oops with a condom then you need to be extra cautious until you rule it out.

But frankly, get screened regularly, use a condom, if your partners are doing the same you have very low risk.

Re:Yes but is this different

[Stuarticus]

You know you are likely on a highway to nowhere if you start using NRA logic in an argument.

Re:Yes but is this different

[robsku]

Lots of sex, with lots of partners (as stated) increases your risk of getting an STD. Especially if you don't wear protection. People (in general) only wear protection a fraction of the time they have sex (don't know the numbers, but if you are an adult, can you tell me you/he wore a condom 100% of the times you got a blow job, or had sex, etc.)

Not in a trusting relationship, but other than that I've been very strict about using condom 100% time during random sex slash with friends with benefits. Especially with men/anal with women, but that's not important as it already was 100% anyway.

Re:Yes but is this different

[robsku]

Not. Difficult. At. All.

Re:Yes but is this different

[ultranova]

Normally, "whoosh" is used for people who don't get the joke, but in this case you deserve a "whoosh" for not getting the point.

I get the point, it's simply incorrect.

WTF do I care if the drug dealer puts adulterants in his crappy drugs?

If you don't care about the facts related to a subject, don't make claims about the subject in the first place.

The point is that the deaths from overdoses are not because some insanely careful and meticulous dosage-calculating drug user OD'ed 'cause he counted on the drug dealer to give him a calibrated and accurate and precise amount and strength of drug as the USP would give him.

Yes, that's precisely what overdose deaths are often from.

These fuckers die because they used illegal drugs and they took too much of the damn drug.

Yes, and the reason they took too much of it is often because the amount of actual drug in a given amount of street drug varies.

It's no use blaming the drug dealer for getting your poor widdle kid addicted: your kid chose to use the drugs. Blame your kid, not the drug dealer, for the kid's decision to seek out and use drugs.

And a drug dealer chose to sell them, and randomly dilute them, sometimes with outright poisons. Why on Earth would it be okay to blame someone for making a decision that might hurt themselves, but not okay to blame someone for making a decision that will almost certainly hurt others?

Also, your claim is absurd. Of course drug dealers are trying to get poor widdle kids addicted. They depend on customers to make a profit, after all, and long-term customer relationships are pretty unlikely for obvious reasons.

Finally, the category of "drugs" included alcohol once upon a time. Does that mean that those moonshiners who bottled and sold methanol are blameless for the consequences, since their victims were criminals who ingested illegal substances?

To take a phrase from the NRA types: drug-dealers and drugs don't cause the overdoses, the fucking idiots who ingest the drugs cause the overdoses.

And yet someone who made a gun that randomly explodes when fired and kills its user would get sued post haste.

Why not solve the actual problem?

[Anonymous Coward]

"Medical schools should address weight bias as part of a comprehensive obesity curriculum."

Uh, or Americans should stop eating so much and get some exercise once in a while?

Re:Why not solve the actual problem?

[Anonymous Coward]

Uh, or Americans should stop eating so much and get some exercise once in a while?

No. I like their ideas. Also I can't wait to see their comprehensive smoking curriculum and comprehensive unsafe sex curriculum. Hatred and discrimination against unhealthy behaviour need to be rectified. The politically correctness of the society is at stake!

Compassion

[Dunbal]

Compassion is supposed to be a hallmark trait of the medical profession. Any doctor who lets his personal beliefs get in the way of his practicing medicine in the best possible way to ANY patient - be s/he fat, thin, muslim, atheist, black, green, prisoner, retarded, or just an average joe - is a bad doctor. If a patient is obese then yes, it poses a serious health risk and a problem. My job as a doctor is not to lecture that patient or make fun of them, but to try to help them as much as I can with the tools I have at my disposal. The same for alcoholics, drug addicts, and anyone else. Because at the end of the day said behavior is usually just a symptom of a different, underlying problem.

Re:Compassion

[Anonymous Coward]

Learn to read: "unconscious bias", hence everyone has their own thoughts and preferences.You may not even know they exist and it's research like this which helps drive the medical profession forward. Not your snooty "but, but we doctors are so special we would never succumb to any external factors which interfere with our thought process".

Re:Compassion

[Dunbal]

You misunderstand me. It's not about being "snooty", it's about professionalism. And I only speak for myself. Whether I am biased or not stays outside the exam room but first I have to realize that such bias is possible. If I was "snooty" and "special" then I could do no wrong in my own eyes anyway. That's not true. I know I am very human, so I make a special effort NOT to be biased in any way. All patients deserve the best medical care no matter what shape or size. I fail to see what is "snooty" about that attitude.

Re:Compassion

[Anonymous Coward]

Whatever "your job" is, biases will creep in. Moreover, the bias against obese people is a *well founded* one for medical concern. It correlates with low self esteem, diabetes, depression, self-destructive behavior, and non-compliance with treatment plans. *All* of these related factors complicate a patient's health, as much as being female or being old complicates a software engineer's life. So while it may be illegal or deemed immoral to discriminate, *of course* it's still going to occur.

Re:Compassion

[Frosty Piss]

Compassion is supposed to be a hallmark trait of the medical profession.

Compassion and bias are not mutually exclusive. And, "bias" is not always unfounded.

Re:Compassion

[ceoyoyo]

Absolutely. This study isn't about that. They used a sensitive test for bias. If you don't like fat people (like the majority of the population) then you'll likely test positive. That has nothing to do with how you treat fat people. What they're saying is that med students should be taught about anti-fat bias to make sure that, despite their quite natural biases, they're treating fat people well. They're already taught to manage their biases against assholes, mass murderers and other difficult patients.

Re:Compassion

[CanadianRealist]

With all due respect, you may still be missing the point about unconscious bias. You sound completely sincere and your attitude about professionalism is commendable and I completely agree with what you say about how a doctor should behave.

But what if you have a bias that you are not aware of? Have you ever taken an implicit association test? Are you sure that you could counter a bias that you are not even aware of?

As mentioned in another post, I have taken such tests and was surprised by some of the results. I found out that I had biases that I was not aware of. Even after learning about them I was not able to alter my results.

Consider the issue of using double blind studies when testing new drugs or therapies. Do you believe that double blind studies are necessary or are single blind studies ok as long as the person conducting the study is aware that they may be biased? Does that awareness allow them to be objective? How about "no blind" studies if the test subjects are properly informed about the placebo effect?

Re:Compassion

[Mr. Slippery]

My job as a doctor is not to lecture that patient or make fun of them, but to try to help them as much as I can with the tools I have at my disposal.

One of the tools a doctor has at their disposal is the lecture -- often dubbed "patient education". It has far fewer side effects than drugs or surgery.

OTOH, to give a good lecture, one must understand the subject. Most doctors know fsck-all about nutrition, or healthy lifestyles in general. An astounding 44 percent of male physicians are overweight. Maybe this bias is frustration at their own failures.

Re:Compassion

[khallow]

But what if you have a bias that you are not aware of? Have you ever taken an implicit association test? Are you sure that you could counter a bias that you are not even aware of?

I think here the answer is yes. If the bias is in any way relevant, it will eventually manifest in a way that can be consciously observed, if not by Dunbal (let's say due to the insidious nature of "unconscious"), then by a coworker or patient. He has to be aware, receptive, and willing to try to change himself. I think he's already demonstrated that.

But the problem with such subtle biases is that they don't necessarily manifest in a harmful way. And we already know that due to our limitations we will have biases.

Things like implicit association tests can show biases, but you already indicated that some of these are hard to impossible to change. It is possible that it might even be undesirable to succeed in removing such deeply embedded biases since they might require changes in how we think and that might have a worse outcome than leaving those biases, such as they are, in place.

Re:Compassion

[Anonymous Coward]

Compassion is supposed to be a hallmark trait of the medical profession. Any doctor who lets his personal beliefs get in the way of his practicing medicine in the best possible way to ANY patient - be s/he fat, thin, muslim, atheist, black, green, prisoner, retarded, or just an average joe - is a bad doctor. If a patient is obese then yes, it poses a serious health risk and a problem. My job as a doctor is not to lecture that patient or make fun of them, but to try to help them as much as I can with the tools I have at my disposal. The same for alcoholics, drug addicts, and anyone else. Because at the end of the day said behavior is usually just a symptom of a different, underlying problem.

If you are actually a doctor, as your comment implies, let me be the first to say "thank you" for giving a crap about people. I know a lot of people truly frustrated by their inability to find a family doctor that actually does care and tries.

...reader sends news of a study...

[Anonymous Coward]

Another submission about an article about a study. Why doesn't the submitter read the actual study and post their own conclusions as the submission? These regurgitated press-releases do noting to advance knowledge or invite insightful discussion. The last several times I read a publication that was widely-reported it became clear not a single 'journalist' actually read the paper itself, let alone challenge any of it's conclusions. Now I'm always skeptical of research results released this way.

Implicit Association

[CanadianRealist]

For those not familiar with implicit association tests, they are based on measuring your reaction times when matching certain types of data according to different specified criteria. For example a gender association test might measure time for matching gender with staying at home raising children versus working outside the home.

Harvard has plenty of sample tests.

Having taken some of the tests I can say that the results can be quite surprising and point out biases that you are unaware of. I definitely found that some associations were much easier for me than others. (Happy to say that the gender example above was not a problem for me.)

Re:Implicit Association

[WillKemp]

Having taken some of the tests I can say that the results can be quite surprising and point out biases that you are unaware of.

But in this case were they unaware of their biases or just not prepared to admit to them?

Re:Implicit Association

[devwild]

Thanks for this info, it would be nicer if the article was clearer on what it meant by bias. It's not what they think about obesity, it's what they associate with it, and that's an important difference.

I like to think of myself as a fair person, but I'd probably have at least a mild bias as well. I've had a lot of friends and family who have had and struggle with obesity in different ways, and had associated health problems (my father died of a heart attacked and spent his life dealing with health complications mostly stemming from obesity and smoking). Then I watch people who work at my hospital, but are grossly overweight, go to the cafeteria and get three donuts for breakfast. Also, while not universal by any means, there are frequently apparent physical differences between those who stuggle with weight, are trying to manage it, or have health problems which contribute to weigh gain, and those who simply don't care what it does to them and choose to be that way despite what it does to themselves, their family, and worst of all their children when they pass those habits on.

So yes, sometimes when I look at very obese individuals I can't help but feel little respect for them. Travelling to other countries where people are more active and obesity is less of a problem just reinforces that feeling when you come back to the US and see "Walmart specials" all around you. Similar thoughts go through my mind about smokers, especially heavy smokers - not only did both my parents have health problems from smoking, but two of my grandparents died of lung cancer. At least my parents taught me not to make the same mistakes, but it makes it really hard not to have some preconception about what others are doing to their own bodies.

Re:Implicit Association

[CanadianRealist]

I can really only answer for myself, which is what that statement was about. I found out that I had biases that I was not aware of. At least some associations gave me much more trouble than other ones did, and I don't have any other explanation for that. For some I didn't even need to see the reported times, I was aware of the difference while doing the test.

Maybe everyone else is aware of their biases and is simply not willing to admit them, but I doubt that. I suspect that for these biases:

reality > what people will admit > what people are aware of

Re:Implicit Association

[Anonymous Coward]

Are you saying that women should not be staying home looking after children?

Re:Implicit Association

[Anonymous Coward]

Happy to say that the gender example above was not a problem for me.)

Nice try. You're still not going to get laid. ;)

Re:Implicit Association

[Anonymous Coward]

I just tested a few of those myself. After finding out what the actual testing methodology was in the first test (age) I didn't even have to see the results of the second test (race) to know how I scored. Which was actually a bit surprising. That said I think some of the faces really weren't clear enough when you try to go through them fast.
I was aware of having a bias already, noticing it in some small but simply everyday things, but doing the test, I immediately got the feeling that it was rooted pretty damn deep.

Re:Implicit Association

[Anonymous Coward]

I have never seen these tests before, and just took two of them out of curiosity.

I took the gender/science bias test and the weapons/race test.

The gender/science test turned out exactly as I would have expected. Having been through a physics/math curriculum at university, with almost no females in any of the high-level classes and a total of zero females in my graduating class, I expected that I would have a strong male-science bias. And I did.

However, I live in a somewhat remote rural location that is probably 95% white, and everyone around me is armed to the hilt. In discussions with peers regarding potential economic collapse and social unrest, my feelings are that -- outside of the ghettos -- the blacks are vastly out-gunned. Though I would admit to having a bias against blacks for certain things (like, propensity toward robbing or beating you if you accidently drove into the wrong neighborhood), I strongly associate weapons with whites, including myself.

But the test told me that I strongly associated weapons with blacks.

If the test had told me that I _moderately_ associated weapons with blacks, I might be able to write it off as an anomaly or fluke. But the _strong_ association suggests that something might a little screwy with these tests.

Unconscious?

[WillKemp]

The fact that people don't admit to their preference doesn't make that preference unconscious. From the journal article:

[......] possible answers on a seven-point
Likert scale ranging from “I (strongly)
(moderately) (slightly) prefer fat people
to thin people” to “I like thin people
and fat people equally” to “I (slightly)
(moderately) (strongly) prefer thin
people to fat people.”

That doesn't seem like a very sophisticated way of assessing someone's unconscious feelings.

Re:Unconscious?

[CanadianRealist]

You're ignoring the part about the implicit association test. See my post above.

I agree that what someone admits to doesn't say anything about unconscious feelings. But an IAT can demonstrate feelings that you're not even aware of.

Re:Unconscious?

[WillKemp]

Yeah, of course. But (and i admit i didn't read the whole paper), the point seems to be comparing the results of the IAT with the answers to the preference questions. If the answers to the preference questions are lies, it means nothing.

Re:Unconscious?

[CanadianRealist]

You raise a valid point. My reply was about assessing their unconscious feelings. Maybe it would be better to say that they are unaware of their bias, or even worse are willing to lie about it.

Re:Unconscious?

[WillKemp]

Yeah, i probably didn't phrase my original post as clearly as i could have done!

Re:Unconscious?

[Rockoon]

If the answers to the preference questions are lies, it means nothing.

Its complete fools like you that think your are safe from being tracked by Google/Facebook/Whatever because you lie about shit.

The fact is that it doesnt matter even if 100% of people are intentionally lying.

Re:Unconscious?

[WillKemp]

I dunno what you've been smoking, but i want some!

Re:Unconscious?

[Rockoon]

Reality.

Maybe you should take the time to learn something about data mining before acting like you know something about data.

Re:Unconscious?

[WillKemp]

Wtf has data mining got to do with this discussion???

Re:Unconscious?

[Anonymous Coward]

Are you retarded?

Fatties

[Anonymous Coward]

Ooorrrr people could just get in shape.....

anti-fat stigma

[Pinky's Brain]

"anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity"

Being fat-positive would help with the treatment of obesity?

Re:anti-fat stigma

[Rob the Bold]

"anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity"

Being fat-positive would help with the treatment of obesity?

You can't treat a patient you never see. If you know the doctor is just gonna nag you to lose weight again, why would you go back?

Re:anti-fat stigma

[Pinky's Brain]

But I was talking about the "treatment of obesity" ... to treat your obesity he needs to tell you (how) to lose weight, there is no alternative.

It might be more humane to accept the patient is a fat fuck who is never going to help himself in that regard until things get a whole lot worse and treat symptoms in the mean time and simply not talk about the real problem, but that will not help with the treatment of the actual obesity itself.

Re:anti-fat stigma

[Anonymous Coward]

If you know the doctor is just gonna nag you to lose weight again, why would you go back?

To stay alive longer.

Re:anti-fat stigma

[ceoyoyo]

Because you want to be healthier?

Re:anti-fat stigma

[AmiMoJo]

Obesity is a medical problem but not always a sign that the person has poor willpower or doesn't look after themselves.

I struggle with my weight a bit, and it's because I suffer from CFS and Reactive Arthritis. My doctor is a dick. When I ask for help he just blames me for not doing enough. He probably does see a lot of patients who just want an easy way to loose weight with no effort, and this bias means I am having to go around him to get any treatment. Needless to say I am switching doctor.

Re:anti-fat stigma

[Rockoon]

You can't treat a patient you never see. If you know the doctor is just gonna nag you to lose weight again, why would you go back?

Exactly. If when you go to the doctor for something unrelated to weight they spend over half the time talking about your weight, then the next time you have an issue that also isnt related to weight they will obviously again spend over half the time talking about your weight.

They do it because its easy. Its become part of their script even when there is a complete lack of any health issues related to weight present in the patient, even when obviously the patient doesnt even have a weight problem but simply falls outside the threshold of an archaic measure like BMI.

True story: Co-worker had recently had a C-section get infected, and the doctor nagged her about her weight. She just gave birth you lazy cocksucker!

Re:anti-fat stigma

[AthanasiusKircher]

"anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity"

Being fat-positive would help with the treatment of obesity?

No. But harboring anti-fat biases can inhibit effective treatment.

Numerous studies have shown that people with biases against fat people make lots of assumptions -- fat people are lazy, undisciplined, lack willpower, etc. In many (and possibly most) cases, this may be true.

On the other hand, lots of fat people have other medical issues that contribute to their obesity. Others have factors like mental illness and clinical depression.

If a doctor assumes that a person is fat simply because he's biased to think that fat people are fat because they are lazy and lack willpower, that will significantly affect treatment options. It may cause him not to look harder for possible underlying causes or lifestyle factors -- and treating those underlying causes might actually help the person to solve the obesity problem... rather than just assuming that all you need to do is say, "You need to eat less. Be disciplined about it."

Re:anti-fat stigma

[ebno-10db]

Co-worker had recently had a C-section get infected, and the doctor nagged her about her weight. She just gave birth you lazy cocksucker!

Not lazy, incompetent. Possibly also diverting the focus from that fact that they fucked up her C-section.

Re:anti-fat stigma

[Anonymous Coward]

I'm not fat! I'm just calorically challenged.

p.s. I think your fancy schmancy obesity tests are giving false positives because I eat a lot and I have big bones.

Re:anti-fat stigma

[geekmux]

"anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity"

Being fat-positive would help with the treatment of obesity?

You can't treat a patient you never see. If you know the doctor is just gonna nag you to lose weight again, why would you go back?

Yeah, it's a real bitch when your doctor is honest, isn't it...

I suppose we should just start contacting Hollywood now to see if they want to play the part of doctor. Apparently the truth is just too hard to handle.

Re:anti-fat stigma

[Anonymous Coward]

Unless the incision was in the spot where the fat on the stomach folds over, causing a breading ground for bacteria over a recent incision. It is the patients responsibility to keep clean, and if being over-weight is causing an issue, I don't see how it's the doctor's fault for not being there to hold her stomach flap up so it can breath.

Re:anti-fat stigma

[Pinky's Brain]

It was more a semantic argument really ... when I hear anti-fat stigma or anti-fat bias I interpret that as being biased against fatness (ie. being fat is not beautiful or being fat is not healthy). Similar to how fat positive generally glamorizes fatness rather than assign positive personality traits to fat people.

Anti-fat person bias would be better term for what they and you are describing IMO.

Re:anti-fat stigma

[Rockoon]

Yeah except what she says agrees with my experiences. I am not obese, but I am larger than thin. Bit of a beer belly.

Last time I went to the doctor it was because I came down with some pink eye. Guess what we mostly talked about?

Hint: It wasnt about what was ailing me. She might of had to do research into methods of reducing or eliminating my risk of getting pink eye, which is actually common in my industry. Research is hard. Repeating what she told the last patient? Thats easy...

Re:anti-fat stigma

[CrimsonAvenger]

obviously the patient doesnt even have a weight problem but simply falls outside the threshold of an archaic measure like BMI.

Wilt "the Stilt" Chamberlain had a BMI in the 27-29+ range while he was playing pro basketball. Which is hardly "obese", but is more than high enough for a doctor to tell you to lose weight.

Never mind that he looked thin in spite of his weight....

Re:anti-fat stigma

[ebno-10db]

Unless the incision was in the spot where the fat on the stomach folds over

Uh, you do realize that women who've just given birth aren't known for flat stomachs, right?

Re:anti-fat stigma

[Anonymous Coward]

So yes, yes you are retarded.

Re:anti-fat stigma

[Anonymous Coward]

Yeah BMI doesn't work that well for 7 foot tall professional athletes. You really scored a great point in this discussion, you should celebrate by horfing down a pint of Ben & Jerrys.

Re:anti-fat stigma

[Anonymous Coward]

I can relate to such doctor assumptions.

For as long as I can remember I've been a heavy built fellow, but rarely obese.

However, for a while about four years ago I had a death in my close family, lost my job due to cutbacks and as a result found myself in a terrible state of depression. Jobless, completely alone for the first time in my life, I was helpless, at the brink of despair. I turned to food and gained about 50 lbs in less than eight months. Finally I decided to look for help and went to see a psychiatrist. I laid out everything for him, how my life was complete madness, how I had no control over myself, how I sought comfort in food, etc. Basically, his answer was: "Life is hard, you have to deal with if. If you don't make an effort, no one is going to make it for you. There is no future for you if you keep living like a lazy glutton." After I left his office I felt like garbage. There I was, crying for help after having summoned the courage to get out my house, and was just ruled as a good for nothing lazy fuck. I am ashamed to say that suicide did cross my mind more than once during that period, although I never acted on it, thankfully.

Eventually I went to different doctors, started seeing a nutritionist, a good psychiatrist and managed to lose 60 lbs. Things aren't the greatest still, but I'm much better.

Anyway, I expect being chewed out by friends and relatives, after all, they are not physicians and they do what they can to help. But when I go to a doctor I don't expect to be lectured every single time. What I do expect is to find a caring person who is willing to help me to get better. I'm all for tough love, but bullying patients to overcome incompetence is a whole different issue.

Re:anti-fat stigma

[Anonymous Coward]

Hey, I had pink eye. A course of antibiotics, and it was done in a day. Eliminating it is possible through washing your hands.

Being fat can cause diabetes, and you can literally lose your hand or foot, or it can fucking kill you. And heart conditions can fucking kill you.

Tell us, which do you think is more important to talk about? The thing that you can fix by washing your hands, or the thing that can fucking kill you or require amputations?

Re:anti-fat stigma

[Anonymous Coward]

Obesity is a medical problem but not always a sign that the person has poor willpower or doesn't look after themselves.

I struggle with my weight a bit, and it's because I suffer from CFS and Reactive Arthritis. My doctor is a dick. When I ask for help he just blames me for not doing enough. He probably does see a lot of patients who just want an easy way to loose weight with no effort, and this bias means I am having to go around him to get any treatment. Needless to say I am switching doctor.

What do you think "weak willpower" means? Eat less. Throw away half your plate.

Alternatively you could start smoking crack.

Re:anti-fat stigma

[dmr001]

Probably the most common underlying cause of post-operative infections in the typical C-section incision is obesity. If much of the subcutaneous tissue is fat (easier for fluid collections to form), or there is a large pannus (fold of fat at the bottom of the belly) leading to poor wound drainage and colonization with various skin bacteria, one is asking for trouble. Other risk factors for surgical site infections in general include age, smoking, and diabetes.

1.SHEA, APIC, CDC, SIS. Consensus paper on the surveillance of surgical wound infections. Infect Control Hosp Epidemiol 1992; 13:599.
2.Cruse PJ. Surgical wound infection. In: Infectious Diseases, Wonsiewicz MJ (Ed), WB Saunders Co, Philadelphia 1992. p.758.

Re:anti-fat stigma

[dmr001]

Your doctor may indeed be a dick, and if he's truly blaming you he's certainly not being fair or helpful. Among my patients with reactive arthritis, they find exercise challenging and they complain of pain but it doesn't seem to be much more of a barrier to them than patients with non-inflammatory arthritis - for whom the most useful therapy I probably prescribe is appropriate exercise. For chronic fatigue syndrome (I suspect that's the CFS you're talking about) the mainstays of treatment are cognitive behavior therapy and exercise. As you might expect, lack of exercise in chronic fatigue sufferers worsens the symptoms of physical weakness. Overly ambitious exercise can worsen symptoms in chronic fatigue sufferers, but that's a prescription for graded exercise regimens. Everyone feels more tired after exercise - more so in chronic fatigue - which makes initiation and maintenance of an exercise regimen more challenging.

Your doctor may be frustrated because he doesn't know how to help you, or because he doesn't have enough time to provide the help you need. Most of us really did get into this profession to help people (in my experience anyway) and when a patient can't readily be helped despite our efforts I confess you may see my frustration leaking through.

I hope you can find someone more sympathetic, but I suspect what's going to be most successful for you is someone who can help figure out a way for you to effectively exercise without making you more miserable.

Re:anti-fat stigma

[AmiMoJo]

Actually exercise is probably one of the worst things a lot of CFS patients can try. If you have a job and need to use your brain at work then exercise is just going to reduce your performance for an eventual small gain in physical stamina. So it's "I can go shopping for half an hour longer" vs. "losing my job".

If exercise actually works then the diagnosis wasn't CFS to begin with.

Similarly CBT can help if you are also suffering from depression, but it isn't really suited to CFS. CBT is based on the idea that you stop doing things like exercise because you fear they will make you ill. Well, it does make you ill. At best you end up doing exercise instead of other things, not in addition to them, which means you get worse because now you have less energy to run your life or do things you actually enjoy.

Re:anti-fat stigma

[dmr001]

Citations, please.

Cognitive behavioral therapy compared with active control has been shown in multiple studies to produce persistent benefits, including decreased fatigue and better physical function. One trial even showed Internet-based cognitive therapy helpful (including 85 vs 27% absence of severe fatigue, and 78 vs 20% normal physical functioning).

Graded exercise therapy has been shown in randomized trials to improve fatigue and physical functioning (albeit not always with overwhelming success, such as 51% vs 27% self-rated improvement).

I'm always happy to challenge my assumptions, but I cannot find any references in a brief search of the literature to suggest that appropriate exercise in chronic fatigue is harmful or worsens cognitive functioning, or that it decreases energy or promotes anhedonia (lack of enjoyment in life). It's possible exercise had these effects on you, but I confess I'd wonder if you might benefit from a more organized graded exercise regimen perhaps with the initial supervision of a physical therapist conversant with chronic fatigue - it may not be something you can start out on your own - graded exercise really means starting out more gently than people may otherwise think is beneficial.

White PD, Goldsmith KA, Johnson AL, et al. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet 2011; 377:823.
Sharpe M, Hawton K, Simkin S, et al. Cognitive behaviour therapy for the chronic fatigue syndrome: a randomized controlled trial. BMJ 1996; 312:22.
Deale A, Chalder T, Marks I, Wessely S. Cognitive behavior therapy for chronic fatigue syndrome: a randomized controlled trial. Am J Psychiatry 1997; 154:408.
Deale A, Husain K, Chalder T, Wessely S. Long-term outcome of cognitive behavior therapy versus relaxation therapy for chronic fatigue syndrome: a 5-year follow-up study. Am J Psychiatry 2001; 158:2038.
Fulcher KY, White PD. Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome. BMJ 1997; 314:1647.
Sharpe M, Wessely S. Putting the rest cure to rest--again. BMJ 1998; 316:796.

Re:anti-fat stigma

[Bhisma]

CBT can work wonders. What is somewhat hilarious(sad) about threads like this is that all the negativity and blaming are almost the polar opposite to a proper CBT program to help someone with an obesity problem. I could see a person in the middle of CBT for obesity reading this thread and eliminating months of progress from all the attacks they would take personally.

Re:anti-fat stigma

[Anonymous Coward]

If when you go to the doctor for something unrelated to weight they spend over half the time talking about your weight

If you're obese enough that your doctor is constantly bringing it up, then I'd be curious as to what conditions could have no relation to it? Surely your lifestyle and diet that contribute to your obesity are going to have a significant impact on just about any condition you could possibly have?

Re:anti-fat stigma

[Anonymous Coward]

Cock and Ball Torture as obesity treatment? I mean, I guess it might work, but how would you treat the fat chicks?

Re:anti-fat stigma

[Anonymous Coward]

If the doctor isn't going to tell you what you can do to be more healthy, what would you go back for?

Re:anti-fat stigma

[Anonymous Coward]

I'm glad I don't have the kind of doctor that Michael Jackson had. Maybe I should be thankful for not being stinking rich, because this way I still have a chance of meeting people who speak their minds around me.

It's not a bias if it's true

[Anonymous Coward]

"Doctors are more likely to assume that obese individuals won’t follow treatment plans"

The primary goal of our treatment plan is often to get them to lose weight to cure their hypertension and type 2 diabetes. It's not a bias if you see the same patient in clinic every few months for years and they continue to gain weight and ignore your recommendations.

**** ********* M.D. , PGY-4 Resident

Re:It's not a bias if it's true

[Anonymous Coward]

Whoa, if you type M.D. after something, it hides it? Let me try.

hunter2 M.D.

Re:It's not a bias if it's true

[Anonymous Coward]

No, he did it cause he wanted us to know he is an M.D. and has experience.

But of course he doesn't want any repercussions for posting on an intertubes forum, for reasons that might escape the mentally challenged amongst us.

Re:It's not a bias if it's true

[Rockoon]

The primary goal of our treatment plan is often to get them to lose weight to cure their hypertension and type 2 diabetes. It's not a bias if you see the same patient in clinic every few months for years and they continue to gain weight and ignore your recommendations.

So the first them they visit, you arent a complete asshole about their weight? Just when its been years?

Yeah.. thats what I thought.. you are a complete asshole about their weight from day 1.

Re:It's not a bias if it's true

[Anonymous Coward]

Doogie Howser, MD

???

Re:It's not a bias if it's true

[Anonymous Coward]

And I don't think you understand that my lifestyle is a thousand times more important than my health.

I would rather die young doing the things I want to do than live a long life living like a monk and hating myself.

Re:It's not a bias if it's true

[Anonymous Coward]

The GP was making the stupid hunter2 / stars in password joke, and it had nothing to do with the GGP using MD in their post.

Re:It's not a bias if it's true

[AthanasiusKircher]

It's not a bias if you see the same patient in clinic every few months for years and they continue to gain weight and ignore your recommendations.

If an otherwise healthy obese patient comes to see you for years and this is true, you're right -- it's not a bias.

However, it is a bias if:

• You assume every fat person who walks into your office is the same.
• You assume that the cause of obesity is the same in all such patients.
• You fail to look for other causes of obesity, including physical problems or mental problems, instead assuming you just need to tell them to "lose weight" and come up with a diet plan. Perhaps there is an underlying cause -- particularly mental -- whose treatment would be helpful.
• You ignore other complaints about other symptoms or don't spend enough time talking about other problems the patient actually has (some of which might possible be unrelated to weight), and instead use excessive time during office visits to give them the same stock advice about weight.
• You fail to look into other medical problems a patient has that significantly affect their quality of life (and solutions to them) because you decide that the weight problem must be dealt with first or is more significant in your opinion... even if these other problems may be treatable or even unrelated to weight.

In sum, if you end up giving worse care to overweight patients, you are exhibiting a bias. And since studies have shown that overweight people do seem to get worse care a lot of the time, it is an issue in the medical profession.

Re:It's not a bias if it's true

[Anubis IV]

That's simply poor logic.

Finding an example that proves the rule may mean that your bias is justified in this case, but it doesn't negate the fact that your bias may still exist and interfere with your work in every other case involving overweight people. To put what you've said in a different light, if someone accused me of believing the stereotype that all Asian women are bad drivers, I can't disprove them by providing anecdotal evidence of this one Asian woman I know who's really a terrible driver and suggesting that it lets me off the hook for believing the thing I do. All I would be proving is that I've managed to take a single experience and wrongly expanded it to encompass an entire group of people.

Similarly, just because you know an overweight person who holds to the typical stereotypes we have for such people in our society, that doesn't mean that other overweight people conform to that stereotype, nor that you should approach them with those same expectations and biases. There are already several other comments here with firsthand accounts of people who are overweight due to causes that are out of their control. If you approach those people with the bias that they are simply too lazy to follow the treatment plans their previous doctors have set for losing weight, and you allow that bias to interfere with your diagnosis, then you're simply a bad doctor.

Re:It's not a bias if it's true

[argStyopa]

What does it say when an alleged MD can't be bothered to actually RTFA about his/her own unconscious bias?

Is that irony, or coincidence?

Re:It's not a bias if it's true

[Seumas]

The problem is that bias could easily lead to a lack of interest and attention in treating your patient. Since not all individuals are the same, that means fucking over those who truly want and try to do something about their health (even if it is a losing fight or an ongoing difficult one). You are doing them a massive disservice by assuming the worst about them. If a medical professional isn't going to treat everyone with the same enthusiasm for helping them, then you might as well just turn them away at the door and maybe send them off with a card for Kevorikian, if the attitude is that they might as well be dead (and without proper medical supervision as they try to make healthy changes, that's certainly a possibility).

Also, the study is kind of dumb. What's next "doctors take a greater interest in extremely wealthy patients or smoking hot chicks with fantastic racks". Well, fucking duh.

Re:It's not a bias if it's true

[Anonymous Coward]

You assume that the cause of obesity is the same in all such patients.

The cause of obesity IS the same in everyone. They're taking in more calories than they're burning. That's it, there's no other way to become obese that doesn't violate the laws of physics.

The solution is simple, modify the equation. Usually this involves eating far less than they normally do since nobody seems to have the self control for exercise.

Re:It's not a bias if it's true

[sjames]

It is if it turns out your recommendations are either impossible to follow without intense suffering or if they're sinmply ineffective.

If you recommend leeches for a broken leg, when the patient visits next week and still can't walk, it may not be because they ignored your prescription.

Re:It's not a bias if it's true

[Anonymous Coward]

There are lots of reasons for obesity. Mental, like depression and alcoholism, and physiological, like Cushing's syndrome and growth hormone deficiency. And the majority of obesity can be cured by the magic "eat less, exercise more" treatment.

If you really are a medical professional and you don't make any attempt to find out why your patients are fat, guess what - you are a shitty doctor.

If you think that you can help obese people by giving an identical boring two minute speech to all your patients, you are a shitty doctor. I could train a homeless guy to do that part of your job as well as you do, maybe better.

Re:It's not a bias if it's true

[gl4ss]

The primary goal of our treatment plan is often to get them to lose weight to cure their hypertension and type 2 diabetes. It's not a bias if you see the same patient in clinic every few months for years and they continue to gain weight and ignore your recommendations.

So the first them they visit, you arent a complete asshole about their weight? Just when its been years?

Yeah.. thats what I thought.. you are a complete asshole about their weight from day 1.

bias wasn't defined in the study as being a complete asshole. it was defined among other things as "not following a treatment plan". if the guy stays fat while following the treatment plan then he is somehow gaining energy from thin air and a freak of nature..

ignore obesity?

[aahpandasrun]

Because medical professionals should just ignore obvious health problems such as obesity?

Being biased against the obese is bad?

[Anonymous Coward]

I couldn't find the context in which this bias exists (to they give them worse care, consider them less attractive, estimate their health to be worse, estimate their wright to be higher?). The lack of this context makes it a bit hard to make fun of the article, but I'll try anyway.

Remember folks, bias is a mathematical thing: people are biased toward thinking obese people are obese. Duh. Bias is not a any more universally evil than addition. Sure, bias has some other connotations, but in a article about a statistically study results, I'm gonna use the statistical definition since they provided no context at all for what they intended. (Pro tip: if you have real interesting results, explain what the heck they are, since anyone can get sensationalize context free statistics)

I suspect obesity is correlated with a lot of things I dislike in others: lack of care for one's heath, lack of fitness, lack of intelligence (doing stupid things can make you fat, and bad nutrition early in life can lower your IQ). I am obviously biased against the obese. All other factors the same, I'd prefer someone more healthy on my team in sports, as a mate in life, as a friend etc.

Would I admit this on a study of bias at a school? Maybe: it depends on the context. Its so easy to say no bias, everyone is equal on studies. Its faster and easier to respond that way, so people tend to. No surprise there. Thus, this bias is categorized as unconscious. Not only that, but this bias isn't really prejudice, obesity really is a negative characteristic.

Re:Being biased against the obese is bad?

[Ambassador Kosh]

The issue I see is that movies and tv have taught people a value of normal healthy that is actually too thin to be healthy. Too many people are chasing an idea of unrealistically thin and they do a lot of damage to themselves in the process.

I do think it is not very healthy to be overweight or fat however depending on how far overweight you are the health problems actually tend to be pretty minor. Doctors believe a lot of things that medical studies don't actually back up. Many of them still believe there is a connection between eating fat and being fat while research mostly shows that eating more things like breads, pasta etc is much more likely to make you fat.

You do need to exercise, eat well etc but the advice that doctors give is often not very helpful for that.

Mostly though we need to have real guidelines for what is a healthy weight with actual medical evidence behind it, not what someone thinks looks unhealthy.

Re:Being biased against the obese is bad?

[Anonymous Coward]

Pretty simple: If you're a woman and your stomach sticks out past your breasts, fat. If you're a man and you bounce in front of a mirror, if anything is still jiggling after you stop bouncing, fat.

Re:Being biased against the obese is bad?

[Anonymous Coward]

The issue I see is that movies and tv have taught people a value of normal healthy that is actually too thin to be healthy.

And yet we have an obesity epidemic and not a too thin epidemic.

Re:Being biased against the obese is bad?

[Anonymous Coward]

Some day you'll realize a woman's stomach sticking out is natural.
Real men drinking beer will also develop a stomach. Hopefully one day you'll be able to deal with it.

Re:Being biased against the obese is bad?

[Anonymous Coward]

It's not normal

Re:They should be discriminated against

[Anonymous Coward]

Obesity is a choice. Those fat fucks put a strain on our hospitals and take the places that could be given to other more deserving people. Fat bastards should not be allowed hospital treatment. period.

Driving an automobile is a choice. Those reckless fucks put strain on our hospitals and take place that could be given to more deserving pedestrian. Driver bastards should not be allowed hospital treatment. They knew the risk when they entered their motorized vehicle.

Re:Rightly So

[Anonymous Coward]

I think you're probably a very lonely and unhappy person.

There is a mental illness aspect to obesity.

[Anonymous Coward]

If I repeatedly hit my penis with a hammer three, four, or even five times per day, every day for years on end, it'd be clear that I have a mental illness.

If I soaked my scrotum in sulfuric acid three, four or even five times per day, every day for years on end, it'd be clear that I have a mental illness.

If I burned my glans with a cigarette lighter three, four or even five times per day, every day for years on end, it'd be clear that I have a mental illness.

Yet if I eat greasy fast food, snacks that are mostly sugar, sodas laden with chemicals and artificial sweeteners, and other food that don't promote good health three, four or even five times per day, every day for years on end, I don't have a mental illness? BULLSHIT!

Yet if I refuse to even attempt exercise of any sort, even something as simple as walking around, all day, every day, for years on end, I don't have a mental illness? BULLSHIT!

Aside from a small number of very isolated cases, obese people are obese solely because they show an utter contempt and disrespect for their own bodies and health. It is indeed a mental illness, even if it affects 60% or more of the American population today.

Don't pretend that obesity isn't a mental illness, because in almost all cases it is exactly that.

Re:There is a mental illness aspect to obesity.

[Anonymous Coward]

Ah well there are a few important differences in your examples. Your first three all cause pain and instant, obvious injury, which normal people (and even animals) won't do when given the opportunity.

Eating sugary foods, on the other hand, brings instant pleasure with no instant, obvious injury. Normal people (and even animals) often do this when given the opportunity.

Over doing it, of course, makes one unhealthy over the long haul. However, our instincts and desires make us a bit more fit to survive in an environment where overdoing it is a lot harder than our modern environment, making most obesity just a matter of failing to exercise conscious self-restraint. Maybe that still qualifies as a mental illness, but it is nothing like the sorts of mental illnesses you describe. It also doesn't require the sort of contempt that you seem to think it does...it just requires laziness and a difficulty saying "no."

Some people fall into this state upon realizing that they are going to die no matter how healthy they keep their bodies. They decide that sacrificing a few years of being old and miserable at the tail end of their life is worth greater enjoyment throughout their lives. From this perspective, the behavior is a normal enough emotional response to an objective take on reality.

And, just in case you are unaware, there are other categories of mental illness that involve a need to feel unnaturally superior to everyone else, driving one to exaggerate any excuse they can find to disparage those around them. Such people usually wind up a lot more frustrated than they think they should be..

Re:There is a mental illness aspect to obesity.

[negRo_slim]

It's not mental illness, it's addiction. Yet, I really don't like that word as it implies a removal of personal responsibility. No, like so many other things, overeating has to do with abuse of our pleasure systems. If we taught people to be self aware enough to recognize when they are engaging in actions that will subvert physiological systems into a habit then they would (hopefully) be able to self limit early on.

Re:There is a mental illness aspect to obesity.

[Anonymous Coward]

I contend that it is more usefully thought of as an addiction, rather than a mental illness. Of course, some may think addiction == mental illness; I do not.

Re:There is a mental illness aspect to obesity.

[FuzzNugget]

That's a nice sentiment, but analogies don't automatically make a point valid.

Please be so kind as to point us to the scientifically founded data to support your claims that obesity is largely due to mental illness and not laziness.

Re:There is a mental illness aspect to obesity.

[bogjobber]

Addiction *is* a mental illness. If I smoke a pack of cigarettes a day, my brain will become ill with nicotine addiction in the same way my body will become ill with the negative effects of inhaling smoke. The words addiction or illness do not imply a removal of personal responsibility. Illness means your mind is not healthy and addiction is a description of the *way* in which you are unhealthy.

Re:There is a mental illness aspect to obesity.

[Anonymous Coward]

> Addiction *is* a mental illness.

There's no reason to think that, other than it has unpleasant consequences. Our body is wired to do things it likes, just like any animal. Mice get addicted to substances. Physical and mental. This isn't a case of miswiring (mental illness), it's a case of exploiting a design flaw.

Why shouldn't they?

[Anonymous Coward]

These people obviously don't care about their own health, why should the doctor have to deal with the problems that arise from it? It's just like smokers...

Re:Why shouldn't they?

[Anonymous Coward]

These people obviously don't care about their own health, why should the doctor have to deal with the problems that arise from it?

Well duh! Because they are paid vast sums of money to do this? It's their freaking job?

nd how many of those medical students

[mark_reh]

were obese? When my wife was in med school about half the class was obese, a few morbidly so.

Re:nd how many of those medical students

[ceoyoyo]

Obese people don't like to look at obese people either. We're evolutionarily programmed to prefer to look at and be around healthy, fit people.

Re:nd how many of those medical students

[Anonymous Coward]

Nope. I like fleshy, thick women with lots of curves and extremely wide hips. I'm not attracted to thin women because they look like little boys, and I am neither gay nor a pedo.

Re:nd how many of those medical students

[Anonymous Coward]

You just like what you can get. Makes sense fatty.

Re:nd how many of those medical students

[Anonymous Coward]

That's bullshit. Evolutionary it would be better to be around well fed people. And this trend to extremly thin role models is just a relatively recent developement.
Being heavy used to imply wealth, even health and the ability to provide for your family.

Re:nd how many of those medical students

[sjames]

Actually, in other eras, the ideal that everyone assumed we were naturally supposed to appreciate was considerabl;y more padded than today's ideal. In the middle ages, a modern model would probably be seen as grotesque and sickly at best.

Re:nd how many of those medical students

[Anonymous Coward]

"Considerably more padded" is not the same as morbidly obese. Artwork from previous times is readily available, go look at it. The attractive people depicted have a bit of extra weight on them but they're not land whales.

Re:nd how many of those medical students

[Anonymous Coward]

Padded, yes, obese, no. There is a difference.

Doctors are biased towards sick people!

[scotts13]

They get all the care and attention, and healthy people are left out in the cold. Equal treatment for all!

No, seriously, I don't see a bias against obese patients as a problem. And I say that as someone who's pretty heavy, and by my own hand - the hand putting pizza in my mouth. Despite the laughable number of people who say "they have a glandular condition" or some such, 99.9% of the time obesity is a self inflicted injury. The doctors with this bias are, in fact, ahead of the curve. At the end of our slow march towards socialized medicine, there's a world where, if you smoked, ate too much, or didn't wear a motorcycle helmet, you government medical card isn't going to work.

Re:Doctors are biased towards sick people!

[Seumas]

People are biased against people who make them do more work for a living. IT people hate people in the office that cause more IT issues. People in fast food hate a certain type of customer. People in sales hate a certain type of person. People in the medical profession would rather have super healthy people that don't require them to do any actual work. This all seems pretty obvious and not a surprise.

Re:Bias sounds reasonable.

[Cinder6]

My brother-in-law is a nurse. He says that the overwhelming majority of his patients are in the hospital due to poor lifestyle choices, with obesity being the most common cause of the illness. Naturally, some people are obese due to something outside of their control, but not most. I can see it being frustrating helping a patient who wouldn't be there if they'd just done a better job taking care of themselves.

Furthermore, it's my understanding that providing care to a skinny person is easier than giving it to an obese person for a number of reasons. Combine that with the fact that we're essentially programmed to prefer skinny people, and it's obvious that there would be a bias.

Does that mean that I think obese people should receive subpar treatment? Hell no. You signed up for the job, now go and do it. I just get tired of studies that confirm something everyone already knows.

Everybody does

[Anonymous Coward]

I have been working out like mad for over two years now 4 times a week, but people's comments oftens make me wonder why bother and not just give up.

This bias is good for patients

[Anonymous Coward]

When you hold the knowledge that you need to EAT PROPERLY and EXERCISE A NOMINAL AMOUNT OF TIME PER DAY... and then you go ahead and don't do it, and you get fat -- then why should doctors have to put up with you, if you're not willing to put in the effort and discipline to get into shape? You have only yourself to blame for your illness, fatties.

is this news?

[Anonymous Coward]

so people prefer good things, why is anyone surprised doctors don't like people who waste their time and ruin their own bodies

Re:They should be discriminated against

[Anonymous Coward]

As a person in 30s who does not drive, I sincerely agree. If now you are puzzled, and on the defensive then you are a dumbass. I can of course choose not to drive since I live in NY metro area, but I sure as fuck don't have a choice when it comes to traveling.

Whether you travel or not for work, school, and life in general is not really a choice in most places in the US. Whether you drive within speed limit while paying attention and obeying all traffic laws or speed while on a cell phone is a choice. Whether you eat or not is not a choice. But whether you eat 2000 calories or 5000 a day is.

I hate sanctimonious people

[ebno-10db]

I hate sanctimonious people, and that holier-than-thou nonsense is what the prejudice against fat people is about. By prejudice I mean being biased against people with regard to things that have nothing to do with their weight. It does not mean not wanting a fat girlfriend (or in the case of Slashdotters, not fantasizing about having a fat girlfriend), or suspecting that they wouldn't be good on the track team, or even about charging them more for life insurance. It means being biased about the guy two desks down who is fat as a pig but is a great programmer, or simply that fat people aren't as good as you. Do you feel like you're so much better than the next person simply because they're heavier than you? Congratulations, everybody needs somebody to look down on. BTW, what sense of inferiority are you trying to compensate for?

It's socially unacceptable these days to be prejudiced against people because of the color of their skin or their sex, so "those people" become fat people. There are lots of other possibilities, but fat is good because you can tell just by looking at people. I'm not interested in the argument that race and sex are something that you're born with, whereas fat is something that a person has much more control over. That's an intellectual argument, and prejudice is not something that rises to an intellectual level. It comes simply from the crude desire to have a clearly defined group of "those people" that you can complain about and feel superior to.

Re:I hate sanctimonious people

[Anonymous Coward]

Oh put down the fork, tons'o'fun.

Re:I hate sanctimonious people

[Anonymous Coward]

Someone steal your cheetos fatty?

Re:I hate sanctimonious people

[PhamNguyen]

or in the case of Slashdotters, not fantasizing about having a fat girlfriend

It's socially unacceptable these days to be prejudiced against people because of the color of their skin or their sex, so "those people" become fat people. There are lots of other possibilities

Is the irony intentional?

Re:I hate sanctimonious people

[Anonymous Coward]

As someone who has a morbidly obese mother (and a pile of other relatives), whose health issues have caused enormous damage to our family over the years, you don't know what the fuck you're talking about.

I'm not prejudice, I'm fucking angry that people like that are damaging themselves and the people around them because they won't maintain the self-discipline to improve their health. I'm not talking about being chubby or whatever - I'm talking about people who deny there's any health consequences for years and assert their freedom to do whatever they want, then act like it was genetics and bad medicine when their knees blow out, their diabetes kick in, and they start spiraling down the drain 20 years early and emotionally and financially dragging everyone around them down too.

These people talk shit about doctors all the time. They're angry the doctor won't fix their problems. They say the doctors are lying to them about health and medicine. They want the doctor to make them as healthy as a fit person but not through diet and exercise - no, because that would require them to demonstrate self-discipline on a consistent basis.

You don't want to hear about how people have more choice over it? Go suck a bag of dicks. When I cook for my mother her weight drops. When she cooks for herself it goes up. I took eight goddamn months off from work to live with her and cook for her to show her how she could improve her condition because she said it was impossible. Everything I did with her worked. She lost 60 lbs. She couldn't maintain it. It's not genetic unless you want to absolve all actions as being genetic. So whence your prejudice against murderers and rapists?

You call people sanctimonious to defend against the fact that (if I read between the lines) you are hurting yourself and you will hurt those around you. It's textbook addict behavior. My crack smoking cousin uses that one too: criticize her drug use? You must be holier-than-thou.

Get real. You (or whoever you're defending) isn't going to have a happy future unless they wake up. Trust me.

Re:I hate sanctimonious people

[ebno-10db]

No irony. The first is a joke. Since I'm obviously a Slashdotter, it's making fun of one's own group. If self-deprecating humor is un-PC now, we're all screwed.

Re:I hate sanctimonious people

[ebno-10db]

As someone who has a morbidly obese mother (and a pile of other relatives), whose health issues have caused enormous damage to our family over the years, you don't know what the fuck you're talking about.

Nowhere did I say obesity wasn't bad for your health. You're angry at your mother because she's your mother. If she wasn't a relative or friend, I'd say her obesity was not your concern.

Re:I hate sanctimonious people

[Anonymous Coward]

Judging by all the white knight posts, I'm going to guess you're a fatty? Stop making excuses.

What a dick.

[Anonymous Coward]

I have a friend who moved recently. When she saw her new doctor, he told her flat out: "You're fat. You need to exercise more" What the doctor didn't realize was that she had already lost 100 lbs over the past 8 months by diet and exercise. I couldn't believe a doctor could be so insensitive and inept in human relations .

Re:What a dick.

[Anonymous Coward]

Companies spend billions advertising sugary processed food. People eat the food, glug the HFCS beverages & get fat. TV stations fill the airwaves with hundreds of food programmes encouraging people to scoff more. Food corps make tons of profit.

Media then tells said fatties they're wretched and they should lose weight via a gym, weird machine, exercise videos etc. and show lots of example of Hollywood superstars/models/athletes to aspire to. Those companies make profit off machines/gyms and the like.

Fatties get horribly depressed because they don't look like Olympic athletes, go to doctors, get antidepressants. Profit for docs & drug companies. Antidepressants may cause weight gain in some people. Double win!

Now thing is, if we sorted out our food supply - make fresh stuff cheaper & get people to lay off the crap, then that's a big part of the economy which goes up in smoke.

Its far easier to just scream about personal moral failings and keep the money tree a shakin'.

Obesity is a complex problem that mixes bad food, genetics, shady food ethics, psychological manipulation, physical and/or mental illness & yes personal behaviours together into a chubby disaster. Using the personal responsibility argument as anything other than an ideal guideline is useless though because it can be applied to anything.

Anorexic? Take responsibility and eat more.
Bulimic? Be responsible and throw up less.
Alcoholic? Drink fewer things with alcohol.
Druggie? Stop taking drugs.
Nerd? Take responsibility and lay off the Star Trek & meet girls.
A bit mental? Be less mental, be responsible like other people!

What, you have psychological issues? ASD issues? You're depressed? Your life sucks? Thats no excuse!!!!!!

And so on.

Re:What a dick.

[dadelbunts]

What would you rather tell her? You are perfectly fine and dont have to excercise? If she is fat and has to exercise then she is fat and has to exercise. If she lost 100 pounds over the last 8 months thats cool, obviously he thinks she should lose more, i dont see the problem here.

Re:What a dick.

[Anonymous Coward]

Not scoff. Scarf is the usual nomenclature. Scoff means something akin to treat with derision. If the fatties treated food with derision they might not be fat.

Re:What a dick.

[Anonymous Coward]

i dont see the problem here.

That's because you're a fuckwit, and surely you don't see a problem with me calling you a fuckwit.

Reasonable Bias

[Anonymous Coward]

While not politically correct there is a reasonable basis in a bias against people who willfully undermine their own health as is the case with the vast majority of obese people. Same goes for drug addicts, alcoholics and smokers. Doctors are in the business, so we assume, of attempting to help people be healthy. People who choose to be sick are thwarting the doctors's goals and thus a reasonable subject for animosity.

anti-thin bias

[Anonymous Coward]

And, what are they going to do about those with an anti-thin bias?

We're missing the most interesting results

[Idarubicin]

First, I'll note in passing that the 'implicit bias' test found a significant bias against thin people in 17% (52 out of 310) students. While that group is smaller than the group significantly biased against the obese (39%, 121/310), it's by no means small. For every two future doctors out to get you for being fat, there's one that hates you for being thin--but for some reason, it's only the obese patients that get the column inches.

Second, and by far most intriguing, is the 33% (101/310) of students who openly acknowledged an explicit personal bias. Given that 39% (121/301) were found to have an actual bias on the implicit test, on the surface this result isn't surprising - but the 101 who think they're biased, and the 121 who actually have an implicit bias, don't overlap very closely. Just 40 students who thought they had a bias actually did. The study authors (and the journalists who have summarized their results) decided to frame this in the form of two-thirds of anti-fat students don't know they're biased! It's much more curious, I think, to note that a healthy majority of students who thought they were biased against the obese - 61% (61/101) - actually aren't.

Indeed, it turns out that there wasn't a significant correlation between believing one was biased and actually having a bias. So why do three out of five students who think they have an anti-fat bias hold that belief mistakenly?

Re:We're missing the most interesting results

[Anonymous Coward]

The test they took wasn't actually measuring bias?

Yay fat acceptance

[dadelbunts]

I love how we are supposed to not only accept but encourage obese people to stay obese. We have to say they are beautiful, healthy, and that being fat is not their fault (somehow 100% of fat people have mysterious genetic and glandular problems that only they know about). How did we as a society become so PC that we put up with this shit. Guess what, if you are 5'3 and 350 pounds, you are not only unhealthy, but unattractive to the majority of the sane population, and its YOUR fault and no one elses.

Re:Yay fat acceptance

[ebno-10db]

I love how we are supposed to not only accept but encourage obese people to stay obese. We have to say they are beautiful, healthy, and that being fat is not their fault

Do you have any evidence for such absurd ideas, or do you suffer from the mental equivalent of the sort of laziness and self-indulgence that fat people have about food,

Re:Yay fat acceptance

[Anonymous Coward]

shh... it's called "a solution."

Re:Bias sounds reasonable.

[ebno-10db]

My brother-in-law is a nurse. He says that the overwhelming majority of his patients are in the hospital due to poor lifestyle choices

Some people would cite a study, but you cite your brother-in-law the nurse. First, "poor lifestyle choices" are about more than being fat. Second, what are his prejudices? The prejudices we all have is why an objective study is better than your brother-in-law the nurse.

we're essentially programmed to prefer skinny people

No. In various societies at various times (including today) what we consider overweight or fat is preferred.

Also, it's a job and can be more work

[Anonymous Coward]

My wife is a PGY-3 or 4 Radiology Resident. She says reviewing images for morbidly obese patients can be (much) easier or harder depending on what you're looking for. I don't know how she would score on this test; morbidly obese patients have health risks that concern her. Of course, melanoma patients concern her more and in a similar way. And people that refuse to vaccinate make her angry.

For most surgeons OTOH it typically takes extra work every time - you have to dig around the mass to get the surgery done. I know some trauma surgeons that get angry when the patient is morbidly obese.

But if the bias isn't against the patients but rather against the diagnosis itself and resulting complications, we can argue over whether that's a problem, but it's quite different from a simple bigotry against fat people.

My body, my Choice

[Anonymous Coward]

Do you hate obese people? Unless you celebrate obesity as a valid and commendable lifestyle choice then you're a hater. Or does that kind of attitude only work for homosexuality? And like homosexuality, obesity often has a genetic predisposition. "God/Nature made me this way" sure gets a lot of mileage in that debate.

And another thing, you want to ban trans fats, or sodas, or cigarettes, or HFCS? Where do you get off? How DARE you tell me what I can and can't do with my body. Or does that sort of thing only work for abortion?

And don't even think about playing the [in a nasaly whiny voice] "but it's BAAAAAAD for you" card. Puh-leeze, both abortion and homosexuality carry health risks, and people make all manner of other unhealthy lifestyle choices that we're supposed to not only tolerate, but celebrate. And if you don't like paying for obese people's health care, then vote conservative next time.

Re:My body, my Choice

[Anonymous Coward]

How about this? Since you're taking MY money to pay for YOUR medical care, you have no right to act with reckless violation of my rights.

This holds now that we have taxpayer-funded medical care in the US, and I have no choice but to pay for your bad decisions. At least with insurance I could sign up with a company that doesn't accept fat fucks like you. But, now I have no choice, and your actions directly violate my rights.

Re:My body, my Choice

[Anonymous Coward]

Is that really what you want? Ok fine. But if you want to be consistent, we need to broaden our list of disallowed activities.

Homosexuality is out. It's well documented that anal and even oral sex comes with health risks. So we need to go ahead and make that illegal. Abortion is out too for similar reasons. Skydiving, driving in the rain, surfing, contact sports, -- all out.

In fact, I'm not going to be satisfied until everybody has a completely risk-free lifestyle. Only the most healthy of women may get pregnant, and then only between 19 and 28 (I'm guessing here). The universal speed limit will now be 10 mph and will be zero-tolerance enforced. Fire inspectors will survey your house once a week to make sure you're up to code. Actually let's make that once a day.

Don't like that scenario? You don't want to have to pull your 10mph car to the side of the road and wait out the rain? But hey, "Since you're taking MY money to pay for YOUR medical care, you have no right to act with reckless violation of my rights."

But hey, I think we are in agreement about the lack of choice on the part of the insurers. Obama has set up a system where we have a strong financial incentive to limit other people's freedom. Only problem is, we are selective about our freedom-limiting to only those risky activities that we personally dislike.

Re:My body, my Choice

[erroneus]

ALL sex comes with health risks. I get it though. You're pointing out risky behaviors. And I rather agree with you on this.

People who engage in clinically risky behavior should receive fewer public benefits and not be a burden to the public. I say this while knowing that I too have engaged in risky behaviors -- who hasn't? I have been heavily into bicycling in the Washington DC area -- if that's not risky, I don't know what is.

But I accepted the risk and the possibility that I could get injured or killed. I had no expectation that the world owed me anything.

Reality: We are a society. What people do affects everyone else at some level.

Re:My body, my Choice

[jbonomi]

I would actually prefer to spend public money keeping people healthy, no matter what risks they take. The way I see it, I benefit more from living in a society in which more people are kept healthy than not. We spend much more money than that would require on shit that I hate all the time anyway.

Re:My body, my Choice

[erroneus]

That would depend largely on where the money is spent...or not spent. For example, no more corn subsidies. We've got MORE than enough corn. If there should be subsidies, do it on things which people need more of -- fresh vegetables. Feeding people things which lead to diabetes and obesity is not good and worse when it's subsidized. You know? If I didn't know any better, I'd say this was being done intentionally.

Replace the word "obese" is the article with "hero

[mbeckman]

Make any sense? Are doctors really required to eliminate all bias and treat everyone equivalently? The premise of the study, that bias is bad, is wrong. Bias, which by definition means altering ones behavior based on circumstance, seems to me to be quite essential in medicine.

Re:They should be discriminated against

[Anonymous Coward]

Obesity is a choice. Those fat fucks put a strain on our hospitals and take the places that could be given to other more deserving people. Fat bastards should not be allowed hospital treatment. period.

Driving an automobile is a choice. Those reckless fucks put strain on our hospitals and take place that could be given to more deserving pedestrian. Driver bastards should not be allowed hospital treatment. They knew the risk when they entered their motorized vehicle.

They're also the fucks who pay for all the hospitals you fucking moron, since you have to drive the fuck to work to earn a goddamned living. The same is not true about shoveling a quad-whopper down your gullet, following it with three shakes, two tubs of butter and a diet coke.

Re: Replace the word "obese" is the article with "

[mbeckman]

The splorky mobile slash dot interface truncated "heroin addict" to "hero.

Freaky!

Do you believe gay people are mentally ill, then?

[Anonymous Coward]

Then don't pretend that homosexuality isn't a mental illness, either. Evolution has conditioned us so that the desire to pass on our genes is a strong imperative. If you actively go out of your way to not pass on your genes, to seek partners who are incapable of doing so, then something must be wrong with your mind. On top of that, anal intercourse has a much higher chance of passing on infectious diseases than vaginal intercourse. Regularly having anal sex must be a mental illness then, too.

Does the above paragraph sound like bullshit? Then stop being a fucking hypocrite. Either both obesity and homosexuality are mental illnesses or neither is. Funny how leftists claim they support alternative lifestyles when in reality they refuse to support alternative lifestyles that are common in red states.

I'll tell you the TRUTH: my obesity is a deliberate lifestyle choice. I eat greasy food, sugary sodas, and other unhealthy food because they taste good and I enjoy it. Simple as that. My lifestyle is infinitely more important to me than my health. I would rather die young after living a life of fun and taste than waste a long life living like a monk. Now, I have no problems with homosexuality, because I recognize it as an alternative lifestyle just like my own, but go fuck yourself if you consider one person's unhealthy lifestyle choice fine but another's a mental illness.

/. is stupidly truncating the subject lines in com

[mbeckman]

I won't think or people as idiots anymore just based on their possibly munged comment subjects.

mesurment

[issicus]

I'm wondering how exactly one determines fat Bias . the whole idea seems kind of ridiculous, it's like being cigarette smoker bias.

Thank you for exposing the left

[Anonymous Coward]

Leftists claim they support alternative lifestyles, but if they encounter somebody who has an alternative lifestyle that's more common in red states than blue states, they start foaming at the mouth and calling for government regulations telling people what they can and can't do with their bodies.

If you support homosexuality but oppose obesity, then YOU ARE A FUCKING HYPOCRITE.

I fucking hate the left.

Re:Thank you for exposing the left

[StephenJesse]

I hate politics,what the fuck does what color state have to do with what he said, the stupid party system show be abolished since no one ever does what they say they will anyway. What I took from the comment is why is it ok to be homosexual and not obese? Most people who are overweight already know its an issue, but most lack the will power to change. Doctors should look at the cause of an underlying condition, instead of taking the easy route of blaming it on the easy thing. Same thing occurs during flu season, 5 years ago I started getting something that is similar to acid reflux too the point where if I didn't closely monitor what I ate I would get sick. The blamed it on the flu for years and if I get a new doctor they try still.I also saw the same things working in technical support, techs that would always blame and issue on either being a bad hard drive or a virus. It was the easy way out and they would try to get them to by a new hard-drive or reload. These people have to stop being lazy and learn how to diagnose properly. You can warn people about the dangers of obesity which most people already know but not making sure that's the issue is dangerous.

3 out of 5 Med Students

[Anonymous Coward]

Are over Weight.

OTOH

[rossdee]

Nursing Assistants are completely aware of their bias against obese patients who are harder to turn and reposition in bed, and to transfer to a comode or the bathroom.

And management doesn't give a shit, otherwise they would have 2 staff on the floor at NOC when there are such '2 assist' patients.

I'm consciously biased against obese patients

[Anonymous Coward]

I am a family physician, and I have a conscious bias against obese patients. And, it is well-deserved. Obese patients need to be lectured heavily about their poor lifestyle choices and the behaviors they engage in that not only take years off their lives, but cost the economy billions every year in excess medical spending, lost productivity, and other costs.

The most common response I get from obese patients when I urge them to pursue a healthier lifestyle usually goes something like: "well I have a right to eat whatever I want so fuck you very much." (the redneck response)

Problem is, when you are taking money from other people to pay your medical bills, either through insurance or, more directly, the ACA, you give up that moral right, since you have no right to exact the consequences of your poor decisions on others in any way, shape, form, or fashion.

But, more generally, the redneck response comes more from resistance to change and an unwilling to admit to being a slovenly, irresponsible fucktard that doesn't deserve the air he/she breathes.

In any case, fuck obese people. Yes I am biased against them, but anyone too stupid to do even the basic human task of maintaining their health doesn't deserve anything other than a firm punch in the face for dragging down the rest of humanity.

Re:I'm consciously biased against obese patients

[Anonymous Coward]

The medical care for fat people costs less than it does for healthy people as they die sooner and the years that they lose are the most costly elderly years. So, basically, you're an idiot. There are links in this thread, as there are in every thread about this, to the many studies that prove this. You have seen those links, you have ignored the science, and you have continued your faith-based belief system. You're a drain on society and not really a doctor. Why would you lie online? It is the one place you can be perfectly honest.

Re:I'm consciously biased against obese patients

[Anonymous Coward]

You only think this way because you are unaware of the rest of my belief system, which also says that the moment you cannot be kept alive with routine medical care, you should be allowed to die.

Because I really AM a doctor, and see the gutwrenching practice of spending an entire family fortune keeping someone alive for just one more week, I can say on pretty good authority that we should stop allowing family members to make end-of-life medical decisions for their unresponsive or otherwise terminal family members. They do not make the right decisions for the patient, and this is the ONE AND ONLY reason that these so-called "studies" can claim that fat people cost less - because emotional, irrational people are sitting there with a bag of life savings ready to blow it all for one more week with dear old dad, who is laying there in intense pain, or laying there without his marbles, or laying there in a coma, just waiting to die.

On the surface it may be true, but only because of the other elephant in the room - and that is the fact that we erroneously allow emotional family members to make the wrong decisions at end of life.

Forgot the disclaimer

[TapeCutter]

Early 50's, 100kg, 6ft. I'm also able to recognize that I have the same instinctive bias toward (the not insignificant number) of people fatter than me. I don't know if other "cuddly" people have it or if it comes from my fit and fantastic youth ( one of the few "perks" of the "strong back, weak head" type of work I did back then ).

A Choice

[Anonymous Coward]

When confronted with a 400 lbs African-American woman on the slab unconscious from having inserted a 3 foot dildo coated with a mixture of vaseline and raw cocaine with 'modeling' glue that broke off 2 feet into her colon ... and tasked with donning a condom glove up to my elbow with the task of retrieving the broken portion of the dildo ... I walked out of ER and never returned.

Re:A Choice

[Anonymous Coward]

Is this a true story? (the part about abandoning your career, the story about woman is 100% solid)

Re:A Choice

[Anonymous Coward]

Cool story, bro.

Comments on "Lifetime Medical Costs of Obesity"

[Guppy]

"Until age 56 annual health expenditure was highest for obese people. At older ages, smokers incurred higher costs. Because of differences in life expectancy, however, lifetime health expenditure was highest among healthy-living people and lowest for smokers. Obese individuals held an intermediate position."

As mentioned by the authors, there are studies that have reached opposite conclusions, as there are assumptions which can dramatically change the conclusions. In the comments section of the paper, there are reader comments which point out some very important problems with this particular paper (most of which seem to revolve around Ecological Fallacy-type assumptions):

Thomas Mittendorf: "It seems that the study has a major flaw in the inclusion of cost. The authors incorporated average health care costs in the model. These costs of course are higher the older the individual gets. But, as they are taking a prospective incidence orientated approach analyzing what happens to 20 year olds in the rest of their individual life it is not correct to use average costs. The average cost figures have to be differentiated between those costs that are incurred by persons that die and those who survive in the respective year. This has to be done for all cohorts. If the healthy people get older healthy and die five years later than the rest, dying gets cheaper. On the other hand dying is more expensive in younger cohorts."

David Strip: "Much in line with the response by Mittendorf, the validity of the results lies very strongly on key assumptions that are not demonstrated. The analysis assumes that the cost of an incidence of the 22 key diseases is independent of the risk factors being tested. Likewise, remaining health care costs, which account for 85% of health-care spending in the Netherlands , are assumed to be uncorrelated to risk factors. Given that this latter class of spending dwarfs the former, the importance of demonstrating the lack of correlation is particularly important. The incidence of numerous co-morbidities with obesity argues, in fact, that one might reasonably expect to find that the annual health costs are higher in the obese and that the cost of treatment in the last months preceding death may be quite different from the non-obese."

Re:Do you believe gay people are mentally ill, the

[Anonymous Coward]

Laugh out loud! LOL!

Was this in "Amerika"?

[Cammi]

Was this in "Amerika"? It was wasn't it? After all, the majority of fat people in this county is no thing but lazy f-tards.

so?

[Anonymous Coward]

Yeah, being fat increases your risk of most diseases and is a huge drag on society. We need to further stigmatize the obese and put more emphasis on personal responsibility and self-control.

Firefighters biased against arsonists! Shocked?

[erroneus]

Let's remember that obesity is an unhealthy condition. It is unhealthy and overwhelmingly self-inflicted. Medical students are quite often idealists and are all about the science of medicine. Combine the two and what do you get? What's surprising is the 2 of 5 number isn't 4 of 5 or higher.

Re:Do you believe gay people are mentally ill, the

[Anonymous Coward]

they refuse to support alternative lifestyles that are common in red states.

The fucking hilarious thing is that it's the red staters screaming about how they don't want to support fatties whenever socialized healthcare and/or insurance comes up.

duh

[Anonymous Coward]

Title should be: Americans unaware they are giant gaping assholes.

So let me get this straight...

[Dcnjoe60]

also it's hard to have respect for some obese guy - at least when it comes to respecting them with knowing about them only that they're fat and have a medical problem from being obese.

So let me get this straight. For women, men are supposed to see beyond their breasts and hips to see them as a person not as an object, but you can't do the same thing for an overweight person, male or female? Same thing for people of color or ethnic and religious background. In all of these things we can see the person as an individual but you are saying you cannot do that for an overweight person?

It seems that we should have respect for all people, regardless of whether they are fat or thin or black or white or Muslim or Atheist. Anything less speaks more about us than it does about the other person.

The usual self-justification

[Anonymous Coward]

Er...so let's see: one day you discovered you had medical conditions preventing you from maintaining a healthy weight via adequate energy output i.e. exercise. Obviously then, without adequate energy output, some of the energy you consumed was going to be stored, wasn't it? So then how come you didn't reduce your energy intake to compensate? And how come you still don't?

Re:The usual self-justification

[AmiMoJo]

I am already on a very low calorie diet just to maintain my current weight. CFS means your entire body is using less energy than it should which is why you feel tired all the time. On top of that I have a job that I need to keep, and my brain needs energy to function so there is a minimum level I can sustain.

Doctors hate

[Anonymous Coward]

A lack of self control. It's their antithesis.

Re:Firefighters biased against arsonists! Shocked?

[dbIII]

Another bit I've heard from a couple of surgeons is that they hate operating on obese people because it is far more difficult and the chances of survival is lower. Apperantly that's why many operations for conditions that are not immediately life threatening are put off for months with the patient given instructions to lose weight. I'll spare you some anecdotes about cutting through a lot of fat because they were disgusting even though I didn't fully understand the details.

Re:They should be discriminated against

[Anonymous Coward]

If you chose to live where automobiles are a necessity then you chose to drive. Nothing force you to live in a shit hole.

Here we go again

[Anonymous Coward]

When output > input, you get thinner. Simple laws of nature and no explaining can change it. Med students as intelligent people know it and now they are forced to "fat acceptance".

Lots of Fat = Rich country ?

[Anonymous Coward]

Most fat people are fat because .... they eat too much compared to their body absorbance capability and their energy requirement.

Beeing Fat was known during the middle age as a synonym for beeing rich, because only the rich could afford of eating a lot of food with a lot of energy. The poor were eating only soups with mostly water, some vegetables and could dream of meat ;-)

Nowadays, in rich countries fat peope are mostly poor people, because food is seen as a replacement for "enjoying life". And among the rich, beeing fat means you are not taking care of yourself, so not a smart person. These are all cliché, but unfortunatly true :(

Think of it, do you see lot of fat people in poor countries ?

When food was scarce, beeing able to take the best out of the food was a great capability. But nowadays where food is everywhere, the same people that had those great skills are now getting fat, bad luck.

Remeber that aside from few people with serious illness, you don't get fat by only drinking water .... but soda, burgers & FFries helps a lot ;-)

If you are fat, you have 3 choses :
  - stay like this because you don't care
  - move according to what you eat (can be very chalenging for some of us)
  - eat less according to what you move

An forget all those regime/diets or meds that are suppose to make you thin with muscle & all thos bullshit. All you need is to choose (your) life :)

Re:They should be discriminated against

[Anonymous Coward]

If you need to drive to work then maybe you need to move closer to your workplace or find a job in your neighbour. Non-shit hole city has public transportation. You could also use a bicycle. The road would be lot safer if only professional(bus, taxi, delivery)* were driving motorized vehicle.

Also nobody eat what you described, such a person would be unable to get up or leave his house. But if they do exist, they are nobody's business and you are just jealous they make more money then you and can afford to stay at home and eat all day.

* INB4 But I am good as a professional! No you are not, professional drivers have more experience, have more patience and are subject to more accountability.

Pro tip

[Anonymous Coward]

Eat less.

Your body is a closed system. If energy in energy out you will lose weight. It's not rocket science.

Re:Pro tip

[AmiMoJo]

The problem is that food is a kind of all-in-one energy source that provides all the different things your body needs. Minerals to build new cells. Vitamins. Different forms of energy (fats, carbs etc.). It is really difficult to cut out the stuff that ends up as body fat while keeping enough of the other stuff to not suffer from deficiencies or not have enough energy to think clearly during the day.

Having said that even counting calories is difficult. I can manage it but a lot of CFS sufferers can't think straight at different times of the day (brain fog) so keeping track of intake is tricky, especially when you are worrying about not killing yourself through an overdose of paracetamol at the same time.

Re:Pro tip

[Anonymous Coward]

http://www.abc.net.au/science/articles/2012/07/24/3549931.htm

Even without eating, it took him over a year. And as mentioned in the article, fasting like that can easily become life threatening, and you also need to make sure you get all the stuff your body actually needs daily, which you usually get from your food.

Re:Firefighters biased against arsonists! Shocked?

[erroneus]

Oh no, I totally get that. I have a friend who was a med student -- doctor now... chose anesthesiology no doubt because of his disgust of obesity -- told me all kinds of bothersome stories like that.

Perhaps while this story is about 2 of 5 maintaining "unaware" bias, the remaining 3 of 5 are quite aware of it.

Are you fucking kidding me?!

[m1ndcrash]

Bias? I think I missed the memo on when "fat" became healthy.

Re:Rightly So

[hawkinspeter]

I'm not sure that will necessarily help with the general levels of obesity. On the one hand, I know that being overweight is due to consuming more energy than you're using, but we've got god-knows how many generations of evolution fighting against our appetites.

Over the last year or so, I made an effort to reduce my weight a bit as I'd bought a nice new road bike and thought the most cost-effective way of increasing its speed/lightness was to reduce my own weight. Obviously, increasing energy output is an easy way to reduce weight as long as you keep an eye on what you're eating (it's so easy to justify eating a pack of biscuits if you've just burnt the equivalent calories, but it's not going to be the best for your health).

What has amazed me is the sheer amount of calories found in typical food. Food manufacturers are so busy trying to cram calories into us that it takes a continual, conscious effort to eat the appropriate level of calories. I think it's a matter of training your mind/body about the amount of food you consume, but once you get used to a certain level of nutrition, your appetite tends to normalise and you no longer feel hungry most of the time.

However, society puts a huge amount of weight on being thin and this means that most overweight people end up having a really poor self-image which doesn't help them fix the problem (if their weight is a problem to them). When you're food choices are governed by emotions rather than rational thinking, then you're going to opt for the low-fat, high-sugar, diet options out of guilt and the high-fat, high-sugar options due to wanting to feel good.

It doesn't make sense to make fat people feel worse about themselves in public as they'll then find it even harder to lose weight in private (eat salad for lunch, then eat a whole packet of chocolate biscuits every night).

If anything, we should start glorifying chubbies. We need to start having celebrities and catwalk models being a bit on the larger side of average to redress the balance. It seems ridiculous that the modern fashion is for an incredibly low body-fat when so much of socialising is based around eating and drinking.

I knew when I saw the title...

[Phrogman]

That I could read the comments and be sure they would be full of people saying essentially "Fat people are fat because they eat too much" which is pure ignorance. Admittedly eating a high calorie diet will make you fatter if you don't burn off the calories at the same time for a typical person, but there are a lot of other reasons why someone ends up obese, ranging from lifestyle choices (where they are at fault) to depression, medical conditions, bad diet due to poverty (the cheap processed foods that poor folks often end up buying are also the least healthy shit sold as food), etc.
But I knew I would see the "blame the fat people" line first and foremost, scattered throughout the comments for one simple reason: even in our age of political correctness, fat people are the one public group everyone feels okay about laughing at or making cruel comments. Everyone seems to agree its okay to be biased against fat people, period.
The results of this study come as no surprise to me at all.

other 10%

[Anonymous Coward]

"Even if 90% of obese people are lazy bastards who won't even try to listen to their doctor's advice, that does not excuse a doctor who provides inferior treatment to the other 10% because of assumptions."

How did you come up with 10%?

Please explain how 10% of the obese are not in control of what they eat?

Is there a percentage of smokers who are not really responsible for smoking?

40% med students don't graduate? - WRONG

[spineboy]

Absolutely not - it's about 96% of medical students graduate

http://www.aamc.org/data/aib/aibissues/aibvol7_no2.pdf

My office ...

[PPH]

.. is on the sixth floor. No elevators. New patients welcome.

American Doctors are Filth & Scum

[Anonymous Coward]

American Doctors are Filth & Scum. Can I post that 1,000 times? Red Flag? OK. Consider it intended. American Doctors are Filth & Scum

Most people have an ati fat bias

[rhalstead]

I know quite a few fat people and many of them are my friends, BUT I have to admit it does lower my opinion of them and my willingness to accept their technical opinions over other equal or even less qualified people. I have observed this bias is wide spread in society in general. For a few it is a legitimate medical condition and those have my deepest sympathy and concerns. I do know a couple of people where it is medical and not a choice, but unlike many they work very hard with their doctors to keep it in check. Now when I say obese, I don't mean 30 extra pounds or that belly bulge common in older men although they are an indication that they should do something about it.. I mean really obese. Legs that look like pantaloons or a butt that looks like two bear cubs fighting in a gunny sack. I mean people where it affects their life style. With these people "for most" it is a life style choice and is reflected in most of what they do. They let them selves go, they let their house go, they let their car go, and they let their personal hygiene go, and their personality reflects it.. Course the poor car is just a victim. When they get in the car it drops down so far on one side you think it's going to capsize. I know one guy who has no restraint he can no longer walk because he's too heavy for his legs.. Like eating, if his wife let him have the check book or credit card they'd be bankrupt in a week. Look on the net for "photos from Wall mart" they treat fat and sloppy as a joke. If we ignore all but the health issues, these people are "usually" a load on the medical system and their life choices use limited resources that are needed by people with illnesses that are not by choice.. The over weight problem causes many serious medical conditions that use a lot of resources, drastically shortens their lives, and makes then and those around them miserable. Many can't work because of their weight so they are supported by you and me. They require special assistance to travel, at stores, at restaurants, and you hope you never get next to one on a plane. There may be hope there though as some airlines ticket prices are by weight as they are with freight. Probably never happen in the US because of discrimination law suits. More weight means more fuel burn. Obesity is a nation wide problem in the US and creates a heavy (no pun intended) and unnecessary load on the economy of which most people are aware and although they may not recognize it, the problem does create a bias. Often a very strong bias. They have to be careful what they say, but I think that % of bias in students just grows after they become professionals. I know Therapists in Physical rehab hate to see them coming. Instead of working with the therapist to get better, they just complain.

Or...

[WillyWanker]

Maybe we as a species have a built in biological disgust of obesity, so trying to change or alter our attitudes is probably pointless. And before anyone flames me, you all know it's true. Just think, how many times have you seen a morbidly obese person and felt disgusted? Admit it, all the time. And studies have shown that morbidly obese people are actually disgusted by themselves. I'm telling you, it's genetic. Our brains are just wired that way.

If you think about it it makes sense too. Throughout most of the course of human history food has always been scarce and a valuable commodity. Someone who was morbidly obese meant they were clearly getting a disproportionate amount of food than other people, meaning they were a hindrance to a community. Not only could they not physically contribute, but they were consuming far more than their fair share of food. Very easy to see why such people would be shunned, despised and disgusted.

so...

[Anonymous Coward]

So of the 2/3rds of overweight americans, how many are actually due to medical problems that keep being brought up every time ?
Cause it surely looks to me that you're using them as a scapegoat to block all thought about the problem. Are we having an epidemic of thyroid and CFS problems, or are these "legitimate fat people" really a small part of the entire group ?

Fat people.

[Anonymous Coward]

They eat more food than they should. They are usually proud of it too.

I'm sorry but there is nothing virtuous about addiction. I have to hear shit from people all the time because I smoke, do you people think it's fair (justice being a virtue) that their addiction is supposed to be morally acceptable and mine isn't?

I can at least admit I have a problem, why shouldn't Fatty McFrench Fries think the same about his hamburger habit? I can admit I smell like an ash-tray and set a poor example for children, why shouldn't they own up to their problems?

Doctors SHOULD have a bias against fat people. I suppose they should hide it, LIE and say "you're 100% healthy and don't need to change anything because it might hurt some big person's little feelings? If so, I assume you feel the same way about "biases towards smoking", otherwise you're nothing but a hypocrite and a double standard is no rhetorical platform anyone respects.

If I were obese I would love for a doctor to show me some bias and tell me how and how important it is for me to alleviate my condition, just like I want the truth when he listens to my lungs for smoking damage.

Re:Fat people.

[Anonymous Coward]

I mean what's next.

Should we start telling people they shouldn't screen sexual partners for AIDS or STDs because it might make them feel bad? What kind of monster would reject a partner just because their junk was covered in warts and boils? I mean, if you really loved them you'd die for them anyway right? No? MONSETR!

What if someone has full blown leprosy, I guess we shouldn't show them bias either, let them go swimming in the public pool with a bunch of little kids; don't want them to feel bad do we?

SMH

Re:Fat people.

[Anonymous Coward]

Only complete bigots have any kind of sexual preference. What you only sleep with women? Nice double standard there you BIGOT!

You only find healthy women attractive? Bet you'd prefer having a healthy child over a sick one too wouldn't you, you god damn MONSTER!

Re:Fat people.

[Anonymous Coward]

One more thing. I need to loose a few pounds myself. I'm not exactly a health-nut. I don't fault any women that don't find me attractive because of it and accuse them of having a mental disorder though. I know I'm overweight, I haven't exercised in too long and my diet is total crap, I can admit I have a problem, I drink way to many sodas and like to eat junk-food when I watch movies. And no, I know I'm not beautiful, and I don't accuse every woman who doesn't love a pot belly and man-boobs to be a closet lesbian bitch or a bigoted mental case, like big fat women like to say about men that don't find them sexy.

isn't that backwards.

[rhalstead]

It's 25% were unaware: so 75% must have been aware

Re:Fat bastards

[Hognoxious]

Are you unaware that "Less than 25 percent of students were aware of their biases" means that 75% were unaware of their biases?

Correct, if in 100% of cases a bias actually exists.

Re:Fat bastards

[Hognoxious]

*Are* they less likely to follow treatment plans?

Assume a fat fucking bastard has been to a doctor before. Assume that the doctor told him to lose weight, in order to not be such a fucking fat bastard.

If they're still fucking fat fucking bastards the answer would appear to be "fucking-a yes".

I excersise and eat well

[Anonymous Coward]

and fuck me I'm not a big fat blob. Output is more than input, its not rocket science.