I hate to be a cliche but I’m going to start with a dictionary definition today. Diagnosis – the act or process of identifying or determining the nature and cause of a disease or injury through evaluation of patient history, examination, and review of laboratory data.
That’s because that would obviously be stupid. Except it’s exactly what modern medicine does now. They take a ratio of weight and height and then start making guesses about people’s health or lack thereof, eating habits, physical fitness, etc. My fit fat friends and I have even had doctors prescribe medication that we didn’t need based on just our size.
Maybe that could be justified in 1832, but considering the actual diagnostic tools available to us now, looking at someone’s body and making guesses is just completely unnecessary. This isn’t just about fat people either. Obviously if we gave every obese person medication for type 2 diabetes that would be incredibly bad medicine since we know that every obese person doesn’t have Type 2 Diabetes and therefore obesity is not an automatic affirmative diagnosis for the disease What we often forget in our hurry to assign medical conditions to fat people is the tremendous disservice we are doing to all of the thin people who do have type 2 diabetes but aren’t being tested for it because their doctor thinks that their body size constitutes a negative diagnosis.
To be clear, health is not fully within our control, and it is never a barometer of worthiness. The prioritization and path to health that we choose is an intensely personal decision and public health should be about making health options available to the public, not making fat people’s bodies the public’s business.
The thing about body size is that it is never an affirmative or a negative diagnosis of anything. There may be some things that are more strongly correlated to certain sizes of body but that doesn’t mean that those things are always present in a body that size. The only thing that you can tell from the size of someone’s body is how big they are and (to paraphrase Marilyn Wann) what your prejudices about a body that size are. Trying to diagnose anything else based on body size is a shamefully lazy way to practice healthcare.
Confusing body size with actual health issues: bad idea when lay people do it, worse idea when reporters do it, worst idea ever when trained medical professionals do it. Don’t do it.
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