The High Cost of Weight Stigma

2013WSAWparticipantbadgeIt has become quite a popular practice to calculate the “costs” of obesity. (As if it’s ok to decide that a group of people with shared physical characteristics should be eradicated to make things cheaper.) There are many, many problems with the calculations, but I think it’s important to realize that in our society fat people live under intense, constant, stigma and oppression.  That means that any calculation about the “cost” of fat people is actually a calculation about the cost of that stigma and oppression.

Let’s start with healthcare costs since that’s one of the most popular things for people to calculate.  Studies from Yale showed that over 50% of doctors find fat patients “awkward, ugly, weak-willed and unlikely to comply with treatment” and 28% of nurses said that they were “repulsed” by their obese patients.   Mary Huizinga of Johns Hopkins found that “The higher a patient’s body mass, the less respect doctors express for that patient.  And the less respect a doctor has for a patient the less time they spend with that patient and the less information he or she offers.”

This leads to increased healthcare costs in a number of ways:

Fat people are treated so poorly by health care professionals – given no respect, called liars, told that all of our problems are due to our fat, lectured extensively about our weight regardless of the reason for our visit – that some of us start avoiding the doctor.  This leads to us not getting early intervention and, for some, only going to the doctor when the situation is more advanced and therefore more expensive.

When we do brave the poor treatment, discrimination and bigotry and go to the doctor our actual complaints are often ignored and whether we have tendonitis, strep throat, or a broken toe we are told that the cure is to eat less and exercise more.  Thin people get all the same health issues as fat people but they get interventions that have been shown to effectively address their health problems. Fat people are given an intervention intended to change our body size, which not only hasn’t been proven to effectively address health issues, but hasn’t been shown to effectively change our body size.

Because of fat stigma we are denied evidence-based care which means that instead of taking part in interventions that address health issues, those issues continue unabated while we try to change our body size because our health care provider tells us that is miraculously curative.  So sometimes we don’t get evidence-based healthcare until our health issues are in the advanced stage (and therefore much more expensive) and sometimes we never get evidence based healthcare and we die trying to lose weight.  Then all of those costs are chalked up to our fatness rather than the fact that we aren’t able to access good, evidence-based medical care.

Because our society enjoys blaming people for their health, there is shame and stigma attached to diseases that can often be effectively treated – like Type 2 Diabetes.  That shame and stigma are especially bad for fat people since despite the fact that thin people get these diseases, and despite the fact that a thin person and a fat person can have the same eating and exercise habits but very different weights, we are told that these are brought on by being fat, and that our fat is our fault.  Because of this stigma and blame, fat people are often too ashamed to seek medical care and so we don’t get good early treatment, and delayed treatment means higher costs and worse health.

Nobody is obligated to prioritize health.  However, for those who are interested, a mountain of evidence has shown that healthy habits are the best chance for healthy bodies, and yet medical professionals ignore this evidence and instead tell us that if our healthy habits don’t make us thin then they aren’t making us healthy.  So fat people give up on healthy habits because they almost never make us thin.  So because stigma leads to misinformation, our health hazard ratios go up along with our purported “costs”.

Although eating disorders are dangerous and in some cases deadly, fat people who present with disordered eating are often encouraged to continue and even escalate the behaviors. The fat stigma that these professionals hold means that they mistakenly believe that becoming thin by any means necessary is better than being fat.  Then all the costs that ensue from the disordered eating are chalked up to body size.

The costs of weight loss attempts, especially those that are “medically supervised”  are often folded into people’s calculations of how much fat people “cost society”.  The problem is that these interventions should never have been recommended in the first place since they do not meet the requirements of evidence-based medicine.  The people supervising these programs do not have a shred of evidence that would lead them to believe that the intervention will succeed, but they keep prescribing it and taking money for it, and in the end the fat people who are victims of a scam also get blamed for the cost of the scam.

Even when we lose weight and gain it back, which studies show us is the most likely outcome, we are encouraged to diet again. This leads to weight cycling (also known as yo-yo dieting) which has been correlated to the same diseases as obesity.  So again, bad medical advice can lead to health issues but they get charged to the accounts of the fat people who were poorly advised.

Now let’s look at the cost of societal discrimination, bigotry, oppression and stigma:

Movement is beneficial for everyone’s health, and though nobody is obligated to exercise, when fat people who are interested in it attempt to engage in physical activity we often find ourselves the subject of ridicule.  Being “moo’d” at in the gym, having people throw thing at us from cars, and being humiliated for wearing a swimsuit are all things that are reported by fat people as regular occurrences.  A lot of my “normal weight” friends complain about having trouble finding the time to exercise, imagine how much harder that is when carving out time to exercise also means carving out time to be ridiculed and humiliated.

The media giving fat people tons of negative messages about our bodies, and having those messages reinforced by everyone from our parents to our doctors to strangers at the gym is an effective way of convincing fat people to hate our bodies.  It also turns out that people don’t take good care of things that they hate, and health issues and costs ensue.

To be crystal clear, it is not ok to find a group of people you can identify by sight, calculate their cost on society, and then have a national campaign to eradicate them because you’ve decided things would be cheaper without them.

But since that’s what’s happening let’s understand that until we end stigma, oppression and bigotry against fat people it is impossible to calculate the costs (if any) of our body size separate from the cost of our stigmatization.

Thus, any attempt to calculate of the cost of being fat will, in fact, be a calculation of the cost of being stigmatized and oppressed for being fat.   Therefore, if the current cost calculations about being fat indicate that it’s the “greatest threat to public health”, then the actual greatest threat to public health is fat stigma and oppression, making people like Meme Roth a public health threat.  This is actually good news since we have no idea how to make people thinner but we do know how to stop stigmatizing fat people and we could do it right now.

Of course when you point this out you are told that the cure for social stigma, oppression and bigotry against fat people is…wait for it…weight loss!  Yes, people actually suggest that the problem isn’t that we’re being bullied, the problem is that we aren’t giving the bully our lunch money.  In other words, if we do what our oppressors want us to do and lose weight, they promise they’ll stop oppressing us.  The cure for social stigma is not weight loss, it’s ending social stigma, and I, for one, will not have the cost of the bigotry, hate, stigma, and bullying that I deal with charged to my account.

For a list of the research used in this post, go here and scroll to the bottom.

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Published in: on September 23, 2013 at 7:02 am  Comments (39)  

39 CommentsLeave a comment

  1. Thank you SO MUCH for writing this blog post!❤ "if we do what our oppressors want us to do and lose weight, they promise they’ll stop oppressing us." This reminds me of Rocky and Bullwinkle "That trick NEVER works!" cue the canned laughter.

    • I gotta get a new hat!

      (hearts moose and squirrel all to pieces and back again)

  2. I’ve always wanted to do a project where I calculate the financial benefits of obesity to the economy. Think about it: things like CT scanners and hospitals beds that are better able to bear weight have to be re-imagined by engineers and then specially built. I’ll bet there are innovations out there that benefit everyone, including more robust equipment and furniture. If people would stop stigmatising weight and actually work with it, imagine how much more it would add to the economy, e.g. in fashion, furniture etc etc.

  3. Wow! My husband has been saying something like this for years. We are both fat people with very healthy eating habits and regular exercise. He’s always pointing out that there is so much talk about fat-related health care costs but no one ever mentions sports injury-related health care costs. Chances are there are way more costs associated with sports injuries and yet no one seems to have a problem with that. Clearly this shows an unfair fat bias.

    • Yeah, I know. I watched a commercial for a physical therapy clinic where a woman who had been running for 20 years cheerfully talked about how they get her back on her feet every time she’s injured. If people want to run, and damage their body because they’re passionate about it or they get a runner’s high, then that’s their business, but for some reason no one ever complains about runners driving up health care costs. Based on our society’s treatment of fat people, shouldn’t was be telling runners that they should stop running, and should swim or use an elliptical because it’s not as hard on the body?

      Besides, America’s staggering healthcare costs aren’t caused by “obesity,” and probably not by sports injuries either.
      There was one man who had his hip replaced in Belgium and paid $13,660 for EVERYTHING, including therapy and the plane tickets. In America it would have cost him over $100,000. This interview with former doctor (and current NYT correspondent) Elisabeth Rosenthal, who is investigating why our costs are so high, is very interesting: http://www.npr.org/2013/08/07/209585018/paying-till-it-hurts-why-american-health-care-is-so-pricey

  4. Calculating the cost of a group of people with certain physical characteristic…that sounds familiar. Where I have heard that before? Oh yeah, NAZI GERMANY. What’s wrong with those people? Can’t they hear what they are saying? How is that calculating the cost of the physically disabled or alcoholics is a no-no and calculating the costs of the fat is?

  5. In our “politically correct” society, it’s not okay to bully others who are of a different sexual orientation, religion, gender, etc. but it IS perfectly okay to bully fat people. I’ve spent the majority of my life being the “fat chick”. I’ve lost weight, I’ve gained it back. I’ve always been told it’s because I’m lazy and lack will power. Way to encourage someone to get healthy. I so appreciate your blog. You present facts, figures, and studies that show that being fat consistently does not prove someone lazy, lacking in will power, etc. I wish the rest of society would get with the program and look at the facts. But unfortunately, even though it’s not okay to discriminate against someone for their skin color, their religion, their gender, discrimination will continue. Period.

    • There’s still plenty of discrimination on the basis of skin color, religion (or lack of it), gender, ability, etc. to go around. It doesn’t make the discrimination against fat people any better, but let’s not erase what members of other minority groups (some of which I’m a member of, but that shouldn’t matter) also experience.

      • Don’t think she was trying to erase that – the point was that it is “frowned upon” by virtually everyone to discriminate against people of color, sexuality, etc., etc. Political correctness comes into play over those issues, no matter what an individual may think about said group(s). However, it is perfectly acceptable in this society to discriminate against fat people. It’s even politically correct to discrimate against us! The point is, it should be equally abhorrant to discrimate against anyone for any reason PERIOD. Fat people are pretty much the only group of people in this country where discrimination/bullying/poor medical care, etc., etc. happens and nobody (except those of us who happen to be in this group and maybe those who love us) gives a damn! In fact, it seems to be encouraged. “Those fatties must be taught a lesson and conform to the correct body size!” What other group of people is treated that way at this point in time in this country?

        • Right… it’s not okay to suggest that black people who are discriminated against for the color of their skin alone should bleach their skin. There are still some assholes who might suggest that, but it’s not considered a widely acceptable suggestion, nor is it ENCOURAGED. Discriminating against fat people is encouraged in magazines, on the news, in doctors’ offices… you get the point.

          I went to a doctor once for strep throat and got a 15 minute lecture on why I should consider weight loss surgery. Sorry, how was that relevant?

          The point is, yes there are other groups that still get discriminated against, but for the vast majority you’ll never hear the nightly news anchor suggest it’s for their own good.

          • First of all, thanks for the kind words about my work. For me, I think it’s best not to draw generalizations or comparisons about differences across oppressions especially since lived experiences between people can be so different.

            At this moment there are people trying to build an all white town in North Dakota. The Baton Rouge police just admitted that they’ve had an ongoing sting to arrest gay men for sodomy (not prostitution, sodomy) – even though the Supreme Court invalidated those laws over a decade ago. Trans* people are fighting for basic rights like being able to use public restrooms. Police routinely stop people for not being white, often aided by immigration and stop and frisk laws. Businesses argue about why they shouldn’t have to accommodate people who are disabled.

            Those are just a few examples. There is blatant prejudice and discrimination out there and I think that we can fight against size discrimination without ever comparing it to other types of discrimination. The Oppression Olympics are not my thing – I would rather fight oppression of everyone rather than argue about which oppressed group has it worst.

            ~Ragen

            • Well said! Amen.

            • Oppression sucks on any level. I definitely don’t claim to have won the Oppression Olympics (I like that) gold just because I happen to be fat. I’ve been discriminated against for other reasons, too. I’m bisexual and disabled.

              Whatever the reason, it just plain sucks.

              For me, it’s just the mainstreaming of fat person discrimination, and EVERY sort of oppression has that at some point. It’s a common thread. At some point in the life cycle of the oppression of a specific group, it will be acceptable in the mainstream to encourage and support that oppression. Right now, the group most front and center are those of us who are fat. There are far fewer voices saying, “wait, this isn’t okay… no matter how you feel about fat people, it’s not okay” than there are voices jumping on the bandwagon of hate.

              But I agree… fighting oppression of any and every kind is really important.

      • You know what would be great? If fat people could discuss the unending institutionalized oppression towards them, without their conversations being derailed to remind people groups that get more protection than fat people also face discrimination. People protected by political correction have no place butting in going “But other people face discrimination too!” It is just as bad as people who insist fat people must acknowledge thin shaming too.

        If you are protected by political correctness, you know when you go out and about in the world if someone calls you a name, others will be shocked, and empathize with your pain. When fat people are called names, not only do people see it as a non-issue they join in the laughter. There is no consequence for making fun of fat people, if you pick on someone for their race or sexuality, you can depend on most people aggreeing it’s wrong. That is a privilege fat people do not have.

        It is absolutely despicable to me that people who get heard and acknowledged on a regular basis for being discriminated against have the audacity to make fat acceptance about their struggles. We are medically experimented on as other discriminated people were. Now the people who survived that have the nerve to shut down fat people for facing the exact same struggles. You know why you get to do this and get away with it, your privilege.

        Stop shoving in our faces that other groups that now possess more protection than fat people face discrimination too. It’s no different than going, “NANI NANI BOO BOO! YOU CAN’T SILENCE US BUT WE CAN SILENCE YOU!” Your ancestors would be horrified that their struggles have come down to forcing the oppressed to listen and acknowledged the privilege. Yes, you are being just as bad as your oppressors once were by making things that much harder for fat people, by saying they are not allowed to speak of their oppression freely. That they MUST acknowledged other oppressed groups. Fat people are reminded again and again their voices are not as important as the P.C. protected. Shame on you for doing that! Fat acceptance groups should be able to block derailers like you, but they can’t. You’d be sure to make trouble for them, and you know you can, because people will listen to you. Why the fuck do you think it’s okay to parade about how you’re understood in front of those who aren’t? It’s not just arrogant, even narcissistic, it’s cruel.

        • People protected by political correction have no place butting in going “But other people face discrimination too!” It is just as bad as people who insist fat people must acknowledge thin shaming too.

          How would someone like the late Trayvon Martin fit into this schema? And who are these “fat people” white fat people are talking about? Seriously, how many times does that same error have to be made? That a person being black/Poc/not middle class and fat is outside this conceptual framework kind of undermines the point being constructed. Which is what?

          That after many long, costly struggles where people have GIVEN THEIR LIVES in courageous acts of sustained rebellion, Black and other oppressed peoples have imprinted some recognition of the impact of racism and other institutionalized systems of bigotry on human lives?

          Because I think you’ll find, fat people or should I say more accurately, white fat middle class people have done virtually fuck all to protest even in the most elementary way to any infraction made against them and fat people in general, no matter how grotesquely stupid, offensive and odious.

          They are everywhere in academe, medicine, surgery, psychiatry, psychology, yet barely a peep from them as this nearly half century of increasingly intense campaigning has been going on. No body has sold themselves out so utterly and consistently- without any real threat as stupid fat lackeys and continues to as if their lives depended on it.

          The only reason we think better of others who are on the medical shit list is precisely because none of them would dream of it.

          Even to this day, people still use the term obesity/obese as if its neither here nor there. No body on earth would be pathetically abject enough to define themselves as disease, merely because someone else thought that was a good idea.

          A lot of fat people who know better through personal experience of intersections could have helped inform the FA discourse, to raise it to a higher level. But what is effectively a white middle class fat acceptance movement can’t even stand that. They always have to be in charge, even when they’re as clueless as the above. The truth is, fat of this type would rather lose white than win with a rainbow. And that is exactly what’s happening. So what the hell are you complaining about?

          The lead has been the desire to uphold racial solidarity about the inherent rationality and logic of white people whom people the world over know epitomize reason for all humanity.

          Except they don’t. Nobody does.

          So the next time you are gently told you are out of your depth, kindly take note. Or you really can shove your stupid racist so called movement up your arse.

          • Just…WOW. I’m shocked at the defensiveness, unexamined privilege, and logical fallacies of that comment. Thank you wriggles for expressing a better response than I could have come up with.

  6. thanks for the timely words. I sometimes get an odd trigger feeling, when I’m eating a fruit (or vegetable) and someone takes it to mean that I’m going flat-out on weight-loss. Healthy can mean that.

    I’ll have my broccoli …and my cake, too! –Jen

  7. Thank you so much for contributing to the conversation during Weight Stigma Awareness Week. Yours is a powerful voice, full of truth, hope and humor. Each time I read your work I come away with a new idea or tidbit of salient point that I CAN’T WAIT to use at the Thanksgiving dinner table🙂 Keep on blazing the trail my friend! – Lizabeth

  8. Very eye-opening, thanks. I wish that I could get beyond oppressing and stigmatizing myself. I don’t think I will ever get to that point.😦

    • Keep fighting, southern. It’s not easy. I still struggle with some of it myself.❤

  9. A fringe possibility: A good bit of standard medical care is *not* evidence based. I leave the possibility open that part of the reason “overweight” and low end “obese” people live slightly longer than “healthy weight” people is less access to medical care.

    • I have another theory on that. I think it’s the other cost – and consequence – of this “thin = healthy” mentality that has overtaken our society. I suspect a lot of naturally thin people have the notion they can do whatever they please without a cost. Whether that’s dietary habits, not getting preventative care, or exercise habits, it means they believe, mistakenly, they are automatically healthy.

      My primary care doctor told me point blank she often has to tell her thin patients that many of her fat patients are actually healthier than they themselves, despite the “thin vs. fat” aspect. Why? The fat patients don’t take their health for granted in the same ways.

      We’re not only doing a disservice to fat people. We’re ultimately harming EVERYONE with this inaccurate and deeply flawed picture of what health “looks” like.

      • Luciebluebird – now that’s a doctor!!!! You are blessed! Love to hear about some of the good ones. Thanks for sharing.

    • That is interesting. I’ve read in a few places that when doctors go on strike, the death rate at hospitals go down. It ties in with iatrogenetic (doctor caused) deaths as the #1 cause of the death in the US, with #2 being car accidents, and #3 being murder.

      So maybe you’re right, longer life because we don’t see the doctor. I also think over-medicalizing everything is a bad move on Big Pharma’s part, as we have no idea how these things affect us (at least not over 1000 yrs). The 20th century was a the drug century.

  10. Thank you so much for this and all of your posts. The lack of evidence based medicine and the use of “lose weight” as a “cure-all” for any ailment of someone over 150lbs is infuriating. I’ve been trying to find a HAES doctor up here in Alaska, but I have had no luck so far. It’s really disheartening to find a doctor that you think is great only to get the same runaround.
    Thank your for continuing to push the truth that it’s not us, it’s them.

  11. Besides being over 50 and there being wonderful FA blogs like this one I feel a bit more empowered to face some of my oppressors but not always sure if I should attack first or just be on guard. I have to go to the endocrinologist in two weeks and it’s the same group that last time told me “don’t think taking this metformin will help you lose weight because it won’t”, actually never was in my thought processes, but it’s a different doctor so I’m “hoping” that I won’t be treated this way again. I have a feeling it’s difficult in the world of endocrinology to find one that is fat friendly, it’s difficult enough just to find one period! Anyway having some health issues and not really sure what they are related to and am hoping they don’t just look at me and make a diagnosis, wish me luck!

    • Nanook, I too am over 50 and, at this point in my life and after many doctors treating me as if weight loss was “the cure” for virtually everything, I have become the “squeaky wheel!” This surprises even myself, as I have always been one not to rock the boat and try not to be noticed so I wouldn’t get picked on. But, for some reason, I became quite irate about these weight issues in the medical community. It suddenly dawned on me that a doctor has got to know how bodies work – some are small, some are large, tall, short, etc., etc. In my mind, they know that they can’t expect someone who is 6’5″ tall to work their way down to being 4′ tall. It isn’t possible, right? The same applies to weight. They have to know this – yet, they keep after us, tow the medical community/political line, as it were. If there are thin people with these problems – Type II Diabetes, Thyroid Conditions, etc., etc. and the doctors have to try to diagnose and work with that patient to overcome or minimize the condition, how can it be that for people with weight issues, the cure for the same exact disorders need to lose weight to be “cured?”

      When I made these connections in my mind, I got really pissed off. I am no longer willing to put up with inferior medical treatment. I will call, email, research and bug the crap out of my doctors if they try to push things off on my weight. It’s not acceptable to me any longer. I have had to leave a couple of doctors and find ones that treated me well. When you need help for a medical condition, weight loss is not the answer! If you’re really ill, how can any doctor expect you to wait until you drop 100 pounds to be treated?

      When I first moved to the area where I currently reside, we had to find a new family doctor. The first one one I went to, walked in the door and told me I should be ashamed of myself and that I would die before my child grew up. I called and reported her and left a review online for others to see. The thing that still irks me about that is, I was so shocked that I didn’t say anything back to her while I was there.

      Last time I had blood work, I had to do some research and I requested that the doctor order the tests that I felt were necessary. Granted, not every doctor is going to be so accommodating. It’s hard to find one. At this point, I think my doctor does some of the things I ask him for, just so I’ll leave him alone! If that’s what it takes – I am more than willing to do it. I shouldn’t have to, but….. Even at that, I have to keep after him about abnormal results – what do I need to do about them? He’s just looking for a good A1C reading. Other than that, oh well! Not optimal for any patient, but it’s best to be aware and be an advocate for yourself. Apparently, nobody else is going to do it for you.

      I hope that you will do more than “hope” for good treatment from your doctor(s). Don’t be afraid to expect and, if necessary, demand it. You have every right to expect good medical treatment. Good luck to you!

      • Good for you for reporting that awful doctor!! No one should have to sit through that! In my younger days I would not have been that brave.

    • Good luck with the new doctor. When I was assigned a new diabetic specialist, she first started to talk about recording all my intake… blah blah blah.. and then brought out a bmi chart.. I stopped her and said, look, you need to not use those tools with me. You need to treat my like a recovering bulimic or anorexic and not use trigger language. She folded up the bmi paper and put it away.

  12. Thanks guys I appreciate your support it’s just difficult to find out what the problem is right now and have to see many different specialist but am kind of helping my GP direct the search. He’s always been fairly FA and I appreciate that about him and why I’ve stuck with him for the past 20+ years but when it comes to new specialists you never know what you’ll get especially in a field of endocrinology where they always appear to specialize in diabetes. Even if my diabetes has come back or come back in a different way due to the fact of my previous rerouting of my intestinal tract due to my RNY 4 years ago. Once you have a gastric bypass and start suffering from possible residual issues it’s hard to find a specialist and a bariatric surgeon is only focused on one thing and that’s getting you in and getting it done but if you have a problem have blood work and if it’s “normal” they’ve done all they can do. Sorry it was so wordy but I’ve been having some issues for a while and it’s frustrating finding out what is actually wrong but thanks again for your support, I truly find it here!

  13. I read your words every day and every day I just want to cry. I recently had a nerve damaged in my arm from a blood draw (LOTS of pain) and was basically told by the doctors they didn’t want to hear about it as if it wouldn’t have happened if I wasn’t fat. WHAT?!? No. failure in professionals is failure on their part not mine. and if I’m exercising and get mooed at by non-exercisers or dissed by doctors because I’m not doing “enough”? No magic bullet can ever change your body. Your words are so right, so right, so very right. Thank you.

    • That absolutely SUCKS! I hope you went up the chain of command to demand some butts on a platter! I’m so sorry that happened to you!

  14. “As if it’s ok to decide that a group of people with shared physical characteristics should be eradicated to make things cheaper.”

    But hey, it’s a fine ol’ ‘Murican tradition, like the way we’ve dealt with indigenous peoples and African-Americans. Can’t stop progress, right? (Weeping softly now…)

    • There there, the US isn’t alone in this anymore, there’s also New Zealand.

  15. I’m of the solid opinion that doctors should have to better Google in information provided in answer to a question in order to qualify for pay. Really, if you can’t best Google with a half-million dollar degree behind you, why do you even exist?

    Just my not-so humble opinion. But then I’ve definitely been exposed to the half of doctors who don’t give a toss about obese patients.

    ~Shaunte’

  16. after gaining 80lbs within months after a surgery i desperately went to my doctors trying to find out why? After listening to me for a whole 3 minutes he shoved his stethoscope into his pocket & told me to go to weight watchers. within a year i had such medical issues that i went to a different Dr who was brave enough to tackle the idea that this possibly could be something other than “all my fault” and ordered an ultrasound of my thyroid (after all the lab “tests” declared it was fine) & wow- guess what, my thyroid gland, ( prob. damaged by anesthesia during the prev surgery the Dr said) had a huge goiter & benign tumors all over it…surprise surprise! ive never been the same since.In hindsight i wish i would have gone back & sued the pathetic piece of sh*t Dr while shoving his stethoscope somewhere other than his pocket!

  17. Don’t forget the negative health effects of stress! It is stressful to be discriminated against, to deal with a constant barrage of microagressions and comments and advertisements and so on. It is hideously stressful to go to the doctor and be told that whatever is wrong it is your fault. I would love to see a study of this – except that I cannot imagine where they’d have to go to get a control group of fat people who aren’t stressed in this way.

  18. Excellent article, Regan. Most people are not at all interested in what genuine scientific inquiry reveals about obesity and body fat regulation.

    The most recent science demonstrates that with regard to body weight, the body has a mind of its own- its own agenda independent of what we are doing. The caloric hypothesis is in its death throes. It cannot even begin to explain “normal weight obesity.” What DOESN’T fit is what is interesting and must be instensively invegsitaged and explored. Fat cell regulation/disregulation, as well as the chemical behavior of fat cell receptors could potentially explain a lot about “normal weight obesity.”

    Many obese people live great lifestyles- being generally active on top of thei dedicated exercise regimens. Many eat very reasonable portions and nutrient dense- yet remain fat.

    Society and their lack of understanding of biology, as well as theior assumptions ( doctors included) are the problem. They are all very opoor scientists.

  19. I always wanted to have 2 people go to the same dr for the same issue and see how they are both treated one overweight and the other normal weight


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