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chapotraphouse @hexbear.net NotLuigi [they/them] @hexbear.net

Going to the doctor as a fat person sucks

I’m 370 lbs and today I had a doctor tell me that people who are skinnier than me are all like that because they work out and eat right. Can I get a roll call for the people who are less than 370 lbs and eat like shit or don’t work out? Because I’m pretty sure you exist.

Also, one time I had a doctor ask me “are you sure?” 4 times after I said I didn’t have any breathing problems. Like nah I’m just big.

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89 comments

  • I used to be 360 pounds, but I turned my eating habits on their head and actually exercised and dropped to 190. Been there for almost a decade. I thought I was eating fine, but after a severe health scare that actually could've killed me, myself and a nutritionist went over my habits and I was actually straight killing myself. Once I did eat less, eat better, and started exercising regularly, I did lose weight and lost it fast. Not even on purpose. I dropped about 100 pounds in the course of a year. The rest of it over the course of the year thereafter.

    I mean, yeah, there are outliers who have super high metabolism who eat like garbage and can't gain weight. A friend of mine is like this and she'll never be above 140 pounds due to it. But the general knowledge is that, if you want to lose weight, creating a calorie deficit and exercising is the foolproof way to go about it.

  • I've never seen shaming help anyone when it comes to health.

  • "eat like shit" is relative. Thin people do tend to operate on a smaller calorie surplus and exercise more, exceptions don't violate trends.

  • Here's one for your doctor. A meta analysis that correlated obesity with bad outcomes during h1n1. However, a different group took a second look at the same data. They realized that fat people were treated differently by the care team. Specifically, they were allowed to get sicker before being given medication. If you adjust for late treatment, there actually wasn't a difference.

    And of course we know that fat people delay going to doctor/hospital because of their many bad experiences, trying to avoid getting harangued etc. So they are already getting treatment later. So even if you get a great individual doctor you're already at a disadvantage.

    citation

    Results: We identified 22 articles enrolling 25,189 laboratory confirmed patients. The pooled estimates indicated obesity significantly increased the risk of fatal and critical complications of influenza A(H1N1)pdm09 infection (for fatal, OR = 1.81, 95% CI: 1.23-2.65; for critical complications, OR = 1.67, 95% CI: 1.13-2.47). However, we found significant interaction between early antiviral treatment and obesity (β = -0.28). After adjustment for early antiviral treatment, relationship between obesity and poor outcomes disappeared (OR = 1.14, 95% CI: 0.94-1.39).

    Conclusions: The results of the meta-analyses showed obesity significantly increased the risk of death, critical complications, and severe complications for influenza A(H1N1)pdm09 infection, especially among high-quality studies and in Asia region. Importantly, the result from our meta-regression indicated that the conclusion should be interpreted with caution, because early antiviral treatment might be a key confounding factor.

    Weight and prognosis for influenza A(H1N1)pdm09 infection during the pandemic period between 2009 and 2011: a systematic review of observational studies with meta-analysis

    I heard about this study a long time ago. It's from 2016 so maybe it has been replicated or refuted by now. Given the method of reinterpreting existing data it should be easy to bang this kind of thing out. But I don't know stats so wouldn't even start to look.

  • Anti-fat bias in medicine is so harmful. It literally kills people. I’m sorry you have to go through this.

    Honestly, I’m a small fat (I like to say TV fat) and they still treat me like shit, assume I am sedentary, assure me that all my health issues will be solved by losing weight, and casually tell me to

    CW: ED trigger

    eat literal starvation level calories while exercising

    I’m sorry people here are being shitty in the replies, too. You deserve to be treated with respect by your healthcare providers and you deserve support from your community.

  • My partner is the thin guy who ate everything all the way up to middle age and then covid gave him type 2 diabetes. He has always been treated decently at the doctors. He is very thin and also has sleep apnea, imagine that. Everytime it is brought up, people comment with "but you are not fat". And that is a perfect example of what this crap does.

    I however am the weight lifting large and medically fat woman and have for example several sporting injuries that were never treated because of shitty treatment by medical staff due to my bodysize. I was also told at age 25 after giving birth that I would leave my kid motherless unless I lost weight because I would die young because I am fat. I was put into a special fat shaming program and shown boxes of healthy foods because apparently my at the time genetics studying ass was just that uneducated. I could go on and on with these stories and they start from school nurse appointments when I was just a kid.

    I've never eaten more than once a day, I tend to forget to do it. I have dieted most of my life, almost to my death until I decided to stop consuming the images and ideas my body will never meet. After I stopped dieting I got healthier and of course my body went back to the size it likes to be.

    My latest doctor visit however was different, been avoiding doctors for some years because of all the past shaming, but this time a young woman doctor chose to:

    -not start talking about weight as I wasn't there for that

    -not open the write in she did with my bodysize, but instead mentioned it accurately later within other desciptors and mentioned the muscle mass as well

    -never needed me to go on a scale or assign a bmi to me, yet was able to treat me for what I was there for just fine.

    The younger doctors are doing better, there is hope.

    Edit. Gonna have to hide this thread if i can so if anyone replies, might not see it. It's starting to show issues that bother me about Hexbear and body size /weight talk.

  • Can I get a roll call for the people who are less than 370 lbs and eat like shit or don’t work out? Because I’m pretty sure you exist.

    I know what you're trying to do but you do have a problem and need help. People can eat like shit and still eat their maintenance calories. People can overeat on healthy foods. Both still lead to lasting health effects if taken over a long period of time. It's not mainly genetics, if your metabolism was so significantly low that you got to that weight eating a normal amount of calories then it'd be too dysfunctional to keep you alive.

    If you don't have any health effects now, you will in the future. Your joints will wear at an increased rate, your heart and lungs will age faster until you can't continue. Even if it doesn't cut your life short, your quality of life drastically decreases. Yes, otherwise healthy people can suffer these problems too but excess adipose tissue is a major risk factor.

    This isn't to scare you, it's your life at the end of the day. Sincerely, someone who went from 300lbs and a 16 minute mile to 167lbs and running half marathons. stalin-heart

  • Can confirm, I'm one of those lucky good metabolism bastards that can eat like shit without thinking too much about it

    • When I was about the same weight as OP (a little heavier actually) people would say this to me, that they have great metabolism and pig out all the time but just never get fat, and when I would ask them to elaborate on what they specifically ate, it was universally a fraction of what I was eating. One guy described a day where he went totally nuts and ate a bunch of food, and after listing all the food he ate on that day I was like, "Aight cool now eat that same amount every single day for a decade and you'll get on my level."

      Anyway I guess my point is that it was very demoralizing for me when I was trying to lose weight to hear people brag about their souped up metabolism, and conversely very encouraging when literally all of them were exposed as over-blowing their actual calorie consumption once I started asking them for details.

      *my other point being, variable metabolisms aside, not a human on this earth is eating 3500+ calories a day with little/no exercise and staying fit

      • Yeah the body learns, like for examples stomachs have elasticity so (as I understand it, crudely) the sensation of fullness is something that will incrementally change if you overeat to the point of really stretching your stomach.

        I learned this from an ex who liked to eat them fancy 7-12 course meals at restaurants and taught me the importance of pre-gaming so our stomachs wouldn't shrink over the course of a day waiting to eat big for two+ hours straight. So it's in the "folk knowledge at best" category of what I know, but I assume those gastric band things work the same way in reverse etc.

        The impression I get with big people who are "just big" and who don't want to be, that it's a multifaceted issue they have to address, and often a fairly unique-to-them combination of factors.

        Like, I remember listening to how Kevin Smith would talk about food and eating before his heart attack and his philosophy of, essentially, hedonism-first life fulfillment. I could never have imagined he would lose all that weight. Even after the heart attack and his tearful realisation that he wasn't gonna live to see his daughter grow up and go through all the interesting phases of life (ie the moment that genuinely in retrospect did change and likely extended his life by decades) even after that I was like, nah he's going to try, but there's no way a man like him can drop the weight and keep it off and start a whole new health oriented lifestyle this late in life. I just didn't think he had the psychological discipline to make such drastic changes to both his philosophy on life AND his tolerance for discomfort etc.

        Now I feel slightly ashamed that he was able to fix his shit in what now looks like the blink of an eye and here I am still with all the same bad habits and poor discipline I've always had. I know there's (apparently) a lot to hate on Smith for but I genuinely admire the way he just started holding himself accountable and streaming his early walks up the hills and complaining like a baby the whole time. Look at him now. It's hard not to be impressed.

        I'm skinny tho, so nobody gives me a hard time about my shitty self destructive lifestyle (and useless philosophy lol.)

        None of this is commentary on OP. I don't know a damn thing about them except their doctor sucks and that they're heavy.

      • I do think it is true to an extent, my sister had a pretty high metabolism and would never gain despite what she ate.
        She was decently active though which also increases your metabolism...either way I do think there is a difference it makes, but like you said I don't think it's a massive difference where someone on a Super Size Me diet would remain bone thin (or the inverse someone on a moderate diet gaining a crazy amount of weight.

        I was posting something in a similar vein on the trans mega actually , where you hear about how much someone eats and it's more than you despite them being skinner because of their height and metabolism.

      • I’ve had that experience and I’ve also known people who out eat me by a long shot and are still pretty skinny. I think people are just bad at estimating others’ relationships with food and weight in general. People are always so surprised when I tell them how much I weigh.

      • I had two friends for a time that had really inefficient metabolisms, one of them had a condition where his intestines would simply only absorb a third of what went in, and no one knew what was going on with the other guy but he would eat over 10k calories a day.

    • I always thought I was the same but apparently we don't actually scientifically exist.

      Turns out I was eating like shit, but just never actually a lot of shit.

  • I exist, but I wouldn't recommend using me as an example of anything (especially since i have body dysphoria). Do what is right for you instead of comparing yourself to other people.

  • I’m going to drop some studies here that seriously cast doubt on the idea that there is a causational link between weight loss and health.

    https://compass.onlinelibrary.wiley.com/doi/abs/10.1111/spc3.12076

    https://pubmed.ncbi.nlm.nih.gov/26841729/

    Also Health at Every Size is challenging the weight loss paradigm within healthcare:

    https://asdah.org/haes/

    https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-9#%3A~%3Atext=Evidence+from+these+six+RCTs%2Cmood%2C+self-esteem%2C+body

    Fatphobia in the healthcare system is MAJORLY behind the poorer health outcomes of fat patients.

  • I am now roughly 80kgs, so I've lost around 5kg since moving from Australia back to China without actively doing anything.

    I think the west (but especially the USA) has created an environment that facilitates obesity and shames people to pay their way out of it.

    I don't actively exercise, but living in a walkable city vs living in a suburb (without a car) has probably doubled the amount of exercise I get. Like in Australia, I'd walk to work, walk around for several hours (line cook), walk home, and usually at night on weekends walk from home to pub to pub to pub to home. But on my days off from work/drinking, nothing was close enough to my suburban ass house so I'd just stay at home unless I was particularly motivated. Also I had a diet of white people food since that's what my work serves and it's therefore obviously what I steal from work.

    Back home now in the People's Republic, I've been walking 9-20km per day. Night or day. It's safe to walk around alone. There's people out and about in common spaces so you don't look/feel like a weirdo. Pedestrian friendly, bicycle friendly, parks, plazas and monuments everywhere. Seen everything in your immediate surroundings? Drop 4 RBM round trip on the metro to another part of the city with another dozen vistas and attractions and parks and running tracks. And most of the things you can do on a stroll are free. I find myself enjoying going for a light jog/stroll in sub zero temperatures in China more than a lovely spring afternoon in the Australian suburbs.

    My advice is to leave the USA as soon as possible (I assume you're American because you used lb). Wash your hands of the evil empire. I can't imagine the motivation for exercise is as great if your options are to walk past cookie cutter houses in a suburb that might not even have a footpath, a stroad with no barriers where American motorists drive an arms length past your body at 100km/h, a cookie cutter gym playing terrible music and costing money.

    If you're very lucky a nearby hiking trail or public park... that requires you to drive there and back and probably pay for parking.

    God forbid if you're a POC and some right wing chud with a gun doesn't like the notion of a coloured person strolling through their neighbourhood.

    Not even to mention all the "healthy" food in the US apparently sucks ass, costs double and might not even be available due to food deserts.

    • I think the west (but especially the USA) has created an environment that facilitates obesity and shames people to pay their way out of it.

      This is very much true. I would love to be able to ditch my shitty car for a bike, and I would be in much better shape if I did. However doing so is extremely dangerous, because I have to drive 15 minutes down a 55mph stroad just to go get groceries, and I don't even really live in the suburbs. I live in a shitty apartment block that is 5 minutes (again by stroad) away from my manufacturing job.

      If this were a sane society everything would be built to scale with the travel abilities of the human body in mind, but it's not, it's built exclusively with the private automobile in mind; and everything else flows out from that.

    • My advice is to leave the USA as soon as possible (I assume you're American because you used lb). Wash your hands of the evil empire.

      It's good advice generally and I enjoyed reading your comment bragging about how nice PRC is and how shit Australia is. But I think you may have misunderstood the post, OP was complaining about always advice to get more physical activity etc in relation to their weight. And here you are just doing that.

      Just about the only situation in which an adult person can lose weight long term is if there is a specific, identifiable cause for them to have gained weight as an adult and that cause is modifiable. Your example of a person who moves to US/UK/Canada/Australia and gains weight is a known phenomena, for the reasons including which you described. And they may be able to lose some of it if they are able to make their life (not lifestyle) more like it was previously. Another example would be like if someone is taking a medication that causes them to gain weight; stopping the medication will likely result in some weight loss. Especially if the weight gain has been recent/brief. Often these causes are extrinsic to the person, like your example of living in a shit country.

      However, most people do not have something like this in their life. If they do, they have one thing. You lost 5 kg by moving back to PRC. You might continue to gradually lose for a little while (don't know your timeline) but eventually it'll plateau when you back to your baseline balance for your body. Once that happens, it would be very difficult to lose another 5kg permanently.

      People who are fat as adults and were fat as children have very little chance of becoming permanently skinny (or even much less fat) other than by illness, surgery or ozempic for the rest of their lives. It's just how they are. And people who have been fat for a long time, regardless of their age, will probably be fat forever too. So offering advice about losing weight is a strange and unkind thing that everyone always wants to do, which was the gist of the post.

  • people who are skinnier than me are all like that because they work out and eat right

    As a skinny person, no we fucking don't

  • I am the opposite polarity. I am a big guy. At my lightest I was 200 while going to the gym six days a week. I haven't been able to stay in that kind of shape for a while. It isn't easy but medically losing weight is the correct option. However the ammount of support that requires is more than most people can access under capitlaism. I am way below a doctor. However when I have been. Working with patients I do always try to get them to lose weight. The most that can be reasonably expected of a person is to make small lifestyle adjustments and hope they increase functional capacity. Just saying, " lose weight" is counterproductive per the literature I have seen. Most people are the size they are because of factors outside of their control. It starts with childhood. Both my parents were big and fed me the same so I grew up big and as such was never that active as a child. By the time I had the ability to manage my own life I had my entire childhood to correct and I have never really succeeded.

  • I weigh less than you and I never exercise. Even before I developed a chronic illness that literally gets more severe if I exercise, I didn't exercise. I'm so sorry you're dealing with medical fatphobia comrade, that's never okay. The studies on medical fatphobia are increasing, I just skimmed through this one. I'm also interested in reading The Fat Studies Reader at some point. Hopefully things will change for the better but the state of it all is really disheartening and I hate that you're dealing with this right now.

  • Fuck that doctor, I eat like shit and used to be really inactive and have always been on the small side. I have family who eat better and exercise that are much larger, it's definitely more than just eating right. I used to want to be a doctor, for such an 'admirable' profession they really can be massive assholes often.

  • cw: weight

    I am underweight at like 93lbs? something like that, and I am not healthy at times. Since I also don't work out and eat terrible or not eating at times. It seems ridiculous reasoning that anyone skinny is like that because they work out or eat right.

  • Can I get a roll call for the people who are less than 370 lbs and eat like shit or don’t work out?

    I'm 64kg (141lbs) with a BMI of 21.1, and while I do work out (although admittedly way less than I should, just an hour or so each morning), I also overeat and eat a lot of shitty, fatty foods.

    So much of medicine seems to be trapped in viewing body weight via a lens of, like, a perceived moral failing of the patient.

  • Yeah I weigh probably 200 ish at 5'5" ish (I refuse to measure or weigh myself because screw that) and my frigging Suboxone doctor dropped a "if I were you right now I would be thinking about getting fit". Quite proud of myself for just dropping "actually I cycle about an hour or two a day, every day, and have done for the last four years" rather than going into all the shit he never bothered to find out about me, my history, and my lifestyle before telling me I need to work on being "fit" (to be seen in public, which is of course the only thing that could actually mean given his complete lack of knowledge)

    Can't imagine how much shittier it would get if I were any kind of visible minority. Hate to see it.

  • I'm like 350 so I get it it fukken sucks man. Like 99% of people just eat without really thinking about it too hard, and they end up the weight they end up at as a result of how their genetics react to the diet that's available to them. Some get lucky and can eat the same slop I do and wind up 200 pounds lighter, and some will then choose to act like they're superior because of it. "Just eat only when you're hungry" yeah buddy I never fucking thought about that before thank you.

    I used to be in shape too so its not like I've never seen the other side of the coin. I've always been a big guy but I ran half marathons in my twenties, and even back then I had to work twice as hard to get half the results of my peers. The worst part is that even "in shape" me from ten years ago would still constantly catch shit for being visibly larger than average, so I guess at some point I decided that I was putting in all that work for nothing and just stopped.

  • Doctor sounds like a quack.

  • I have a friend who was told "at least covid usually makes people lose weight".

  • i exist.. i was always skinny as fuck as a kid due to being poor and when i got older and got money of my own i started eating like absolute trash and that has pretty well stuck with me for the rest of my life... i'm bigger now than I've ever been at about 190 lbs but i've also never worked out at a gym in my life and the only real exercise i get is walking the dog and going for longer walks with my partner whenever she wants to

  • 220, and I definitely exist. Weight and health may be correlated, but not always. I know plenty of unhealthy skinny people and plenty of healthy overweight people. It's not a 100% fit. Yes, I'm trying to lose weight, mainly because my knees are shot and I want to make life easier on them. But I generally eat very healthily, mostly sauteed vegetables and rice. I just happen to be genetically predisposed to having a larger body.

  • I have food issues like a malamute and struggled with my body image / weight from age 12 to present (3 decades and change).

    aging has made everything harder except I guess my capacity for understanding and being honest with myself have improved.

    I do still care more than I should about if others find me pleasant to look at, but the stakes are lower than they ever have been lol. so now I legitimately just try to find the courage and will to improve myself for general health. I quit booze completely and have accepted how awkward I am at social functions. I don't have to feel like I'm funny or cool anymore. I'm an old fuck. I quit tobacco . I get good sleep, I stay hydrated, I stretch daily, I take my medications, I monitor my BP, I walk all over the goddamn place, and I have cultivated a deep well of affection for those vegetable heavy dishes that use heat and acid instead of salt and sugar.

    my personal quality of life has improved enough from these things that I'm much less emotionally invested than I was in my pcp's interpretation of my lifestyle based on how my teat panels came back. like I just never get sick or get headaches anymore. that alone is an enduring source of strength for me.

    of course, unlike the last 10 years, now everything is always moving in a good direction, so there's no conflict.

    • congrats on quitting the booze and the tobacco!

      • thanks. I think quitting the booze was necessitated by quitting the tobacco. having a drink was generally a trigger for wanting a drag and I guess in the evaluation of it, I couldn't justify continuing to drink if it was going to threaten by goal to quit smoking for reasons of health. it's not like drinking itself was promoting my health either, even if I ignored it's impact on me making good decisions otherwise.

        I wasn't a heavy drinker by the time I quit by any means, but I used to be in my late 20s/early 30s.

    • doggirl-thumbsup

  • i can confirm i treat my body like shit and i'm sub 170

  • Someone on here linked to the online text of the book "A Chemical Hunger" 3 years ago. I thought it did a good job of elaborating all the complicated things that go into weight gain and why it's really not as simple as willpower or "calories in, calories out".

  • 220 here. I used to be 150lbs damp until about 27, and I used to consume at least 1.5 liters of cola a night. I once got a double pack of 2 liter bottles of Cola for christmas, that's how much I would drink it. I was always 150ish while eating like shit.

    Now I hover around 220. I haven't been able to "workout" regularly since we had kids. When I was I never lost weight because I was gaining muscle.

    Your doctor is a quack.

  • Yo FUCK that doctor dogg. I'm skinny as fuck and deadass past the "youth boosted" metabolism excuse I was hearing in my teens, twenties, early thirties, etc. Still waiting, still can't put on weight. I mean I can, if I really really REALLY try, I can put on some weight.

    But yeah, it's bullshit, I'm not like this from hard work, good eating or, generally, ever making a conscious, or intelligent decision, in my life. In fact I will probably die prematurely from preventable disease, while still "but she looked so in shape and youthful."

    Horse shit. Hope you can find a smarter doctor one day, that one sounds straight up ignorant as in failed to learn a damn thing before opening their mouth on the subject. Not just ignorant as in lazy bigot. Not a good look, "DOCTOR".

    • If you want to put on weight maybe the thing to do is hit the gym if you can or do some at-home bodyweight exercise a few times a week and snack between meals. I was similar till I started doing these things and I've put on like 20lbs.

  • Can I get a roll call for the people who are less than 370 lbs and eat like shit or don’t work out? Because I’m pretty sure you exist.

    Edit: I have been informed that I am probably off-base here and am not substantially outside the norm. Leaving the comment up for posterity.

    Winner of the genetic lottery here, 200lbs and 6'. My diet consists primarily of different kinds of slop, and I'd wager I average around 3000cal/day (Edit: actually went back and did a rough count for yesterday and got 2900 so maybe a little lower). The extent of my physical activity is walking around at work for maybe an hour a day, occasionally taking the stairs in my apartment building, and riding a stationary bike for 20-40 minutes a few times a month. I have gone to the doctor once in the past because I was worried that I was sick after people kept asking if I'd lost weight when I hadn't changed my habits at all.

  • The highest I ever got was 190 back when I was eating like shit and not really doing much (pandemic + just being worn out from work).

    But yeah, as others have said, its not really helpful that that's how your doctor wants to approach it.

  • I don't work out and I eat like shit.

    Been 55kg for years.

    I'm also like, 22.

    But I do walk like a few km everyday.

  • I was pretty skinny when I was younger. Got on some psych meds and I’m not slightly overweight. I’ve always haven’t been a big eater. When my dad hangs out with me he says I eat so little and am overweight. He eats a shit ton or food and is super skinny. Other factors other than diet and excercise.

  • Fuck that doc. I don’t work out and eat like crap sometimes, probably have some type of eating disorder though. I generally eat one meal and might snack throughout the day depending if I’m working or not.

  • Sure, you can eat like shit and not work out and maintain your weight. But if you want to lose weight, start eating a bit healthier / less and move more. Just walk a bit more than you usually do, primarily drink water. Small steps like these matter.

    Is it easy both mentally and physically and will you see changes in 1 month? No. Can you do it? It's up to you.

  • im pretty skinny esp for my age, and i dont eat particularly healthy things, but i probably undereat sometimes too.

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