[AKA_Monet]

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....