If he had said this to a man we wouldn't blink an eye about it. In fact we would think the guy just needed to suck it up and lose the weight . . . why? Because we know the doctor was right.

So why the ridiculous double standard?

Because, James, women are delicate little (er, maybe not so little) flowers who will spend hours crying after their fragile little egos are crushed by the cruel words of such an evil man who does not understand that every woman is beautiful just the way she is, even if she's likely to drop dead of a heart attack tomorrow.

Although I'm not as big as the woman in the article, weight's a battle for me too. The things that have been the most helpful have been concrete suggestions about how to change behavior, and positive feedback for even small improvements. It can also be good to set modest goals. The idea of losing 80-100 pounds might have been overwhelming to the woman, but starting with 5 could have been more attainable. Feeling shamed or rejected can backfire, because it can make it harder to get out and be active. Some of the women I exercise with are smaller than me, but they're very supportive, so it's still a good experience. What guys think seems like a non-issue - do I really want an SO who'll love me only if I look a certain way?

The medical reasons for quiting often aren't very motivating. Many people have an invincibility complex and when they're told about cancer, heart disease, etc. they just hear "blah blah blah". Telling someone they're not going to score b/c of their smokers' breath might be more effective on some people.

You expect a doctor to be accurate.

I am not sure that tactful in the way that its being used here is what they are supposed to be.

Tactful, the way its being used in this thread, means offering information in a sugar coated form that lessens the emotional impact of it.

Therefore lessening the overall impact of the effect and making it less likely the information will be acted on.

I am not sure thats even rational to want that.

But if you don't like a Docs bedside manner you don't have to go to him. Also, if he is "mean" to a lot of his patients he won't have much of a practice.

Exactly, I want a doctor to be honest and blunt with me. If something's wrong, tell me how I can change my behavior to fix it. Am I making too much out of something, or not enough? Just give me the straight answer.

I don't think it's their job to sugarcoat things, especially since they're dealing with people's health.

I saw the CNN interview too...
 

My take...

Dr. dude totally attended a 1-day CME course about obesity.

His level of understanding stats is limited.

He may know his patient population and their behaviors, but he's no psychologist or psychiatrist. And it doesn't sound like he's board certified to be a psychiatrist, but just a family practioner or GP--which is cool, for some patients, but without much information on the patient and no feedback, and the fact that some MD's are arrogant for whatever reason, I do think the patient was not empowered to be her own health advocate.

I have not done any searching on communication with patients from a psychological level--what do the research articles say, bluntness vs. sugar-coating, etc.

Yes, the chick who was from the Acceptance of Fat People was very defensive and activisty, however, I myself have been inappropriately judged by many an MD for other health issues and I know what it feels like when you do not get the best of care.

But either way the Dr. did have some assumptions that were inaccurate.

Obesity in and of itself does not kill the patient directly. The heart attacks and type 2 diabetes vascular complications (i.e. stroke) do. There is a huge flurry of reports that discuss lean fat and white adipose tissue--it's where your fat is placed that causes the problem to organs. How it does it, is under intense research.

The Dr. misunderstood how obesity affects longevity. Longevity may have nothing to do with the levels of fat you have. However, there are genes that are involved with metabolism that also shorten or extend lifespan in mice. The gene products directly affect insulin levels that are the main culprit in obesity. If you have too much insulin, you have problems, if you have no insulin, you have problems. Why this yin and yang? Who knows...

Then NOBODY COMPREHENDS how obesity causes cancer. That is just a correlation in rats and some humans... Most cancer patients are thin, with the exception of colon cancer patients and that research I do not even have an answer... In fact, I study a gene when mutated causes mesenchymal cancers, however, I feed a nasty diet to the mice, they little guys get fat as hayle, sugar levels jump up and so do insulin resistance levels. There may be issues with the insulin response mechanism. But, when I looked at the mice, there were no cancers anywhere. These guys are chillin'...

So, I can see if the patient was shocked and pissed off...

Moreover, size for women is a cultural issue. What some cultures call fat, others call "big boned" or "healthy". What some cultures call skinny, other call "sickly".

However for the morbidly obese--i.e. those who are well over their weight by 100lbs, men and women, the best that can be done without exercise is bariatric surgery--an NOT liposuction, because lipo-ing causes the fat to come back with a vengence... And bariatric and gastric bypass are extremely dangerous surgeries compared to ultra workout that takes years to get going...

There is something wrong with folks metabolism in the US... No one is really discussing this issue alone... I think it's a conspiracy of the processed food companies covering some chit up... But that's my psychosis for today....

And, I have a gastroenterologist who celebrates every pound I gain because to him, that means my Crohn's isn't active and I'm absorbing calories. He'll say "You've gained weight, that's great!" and I tell him "I've gained enough already, thanks". But, he did point out that if I'd been at my ideal weight when I originally got sick and lost 65 pounds as fast as I did, that I'd have been dead. He has FORBIDDEN me from intentionally losing too much weight. He wants me at 40 pounds above my ideal weight because that's about how much a Crohn's patient will lose from an acute bowel obstruction or emergency re-section. I tell him I love him for that...lol.

Interesting that colon cancer patients are not usually thin. Crohn's and UC make you high risk for colon cancer and generally make you thin too. Although, perhaps all the prednisone we take alters that some.

I find this no different than a doctor telling a man who's been in for several STDs and is in danger of permanently wrecking his fertility (or worse!) to either start practicing safe sex or stop sleeping with partners who haven't been tested. People just don't want to be reminded when they should be taking better care of themselves.

Yeah, and a lot of people can't stop eating, and they pitch a hissy when someone tells them to be more responsible about their bodies. It's the same thing in my mind.

The majority of morbidly obese people could very well help it. If someone is honestly and truly overweight due to hormonal imbalances and thyroid issues, then that's a different story. But, if that was the case with this woman, her doctor probably would not have warned her on how her obesity could eventually kill her.

This isn't always the case. Obesity can be genetic, and in those cases it can be very hard for people to lose weight.

The thing is, I don't think anybody is saying it's not hard for people to lose weight. BUT IT CAN BE DONE.

I don't mean this to sound rude at all (:)), but have you consulted a nutritionist or dietician? If you really have decreased your caloric intake and started working out consistently you should have lost weight or seen some results within a few weeks. Sometimes people think they're eating healthier by modifying their eating, but really they are just replacing calories with other calories and aren't going to lose weight. You should talk to your doctor and maybe he/she can recommend someone who can design an eating and exercise plan for you!