When Your Doctor ONLY Cares About Your Weight. Response to Santa Cruz Medicinals

[@trapsaltnburn]

And that kind of mentality is why I'm likely to get a late diagnosis on any problems I have. Because I don't have the patience for that kind of bias so I just won't go to the doctor. Do I need to lose weight? Yes, absolutely. Is it the cause of some of my problems? Yes, very likely. But so are other diagnoses that I have. Thank you for calling this out, Ben.

[@carolwilson7309]

This happened to me at 31. Granted I was overweight but I was having issues with my periods. I knew something was wrong but doctor kept telling me I needed to lose weight. After persevering they eventually diagnosed me with early menopause. It was the worst time and my symptoms were so bad I thought I was having a breakdown.

[@MirwenAnareth]

I'm not fat. I used to weigh around 86 kg when I went to an ENT doctor, reporting I've been coughing for 12 years and so far no other doctor was able to help me. 86 kg is considered slightly overweight for my height, but it's not terribly fat. I looked ok. The doctor didn't examine me properly and just told me that I have GERD and need to lose weight. I was rather furious, but in the end I decided to try and lose that weight. When I was about 75 kg and officially not overweight anymore, nothing had changed. I went to another ENT doctor in a remote city and gave her all my medical documentation. She said she was missing some basic tests there and examined me for bacteria. Turns out I had mycoplasma, and for 12 years, no one had bothered to even check. According to this last doctor, this examination should be the first thing an ENT doctor does when seeing a patient. So yes, I can attest to that, the bias is real.

[@seattlegrrlie]

It's also not about body fat. I dumped a doctor who refused to acknowledge that lean muscle and big biceps on a girl is indeed healthy and that I was well inside healthy far levels for a female. My next doctor totally understood, my current doctor supports my bodybuilding. Some doctors just see a number on a paper, not a human

[@Shveaygdjbffgcsj147]

Omg saaaaame I love the gym and I’ve gained 30lbs since I started going to the gym and being serious about it so according to BMI I’m overweight even though I’m just muscular.

[@DeborahFishburn]

I first started with a new G.P., and almost the first thing I said to her was "I know I'm obese. I am gradually losing weight, but I need you to pretend that's not an issue, and treat me as though it wasn't, so we can focus on my immediate health conditions" She wrote it in my file, and has done exactly that. Diagnosed me with a chronic condition, gotten me with a specialist for that, working with me on my digestive issues. She's just brilliant, and she actually LISTENS. I really think all medical schools should have four or five obese people come in to be part of the assessment for EVERY class, amongst 15-20 others, and give a list of symptoms. Assess how many of the students' first response is "You have to lose weight", and then have those students have to stand in front of the class, and be told that had they been in practice, they would likely now be being sued or struck off, for missing the broken leg/sepsis/Endometrosis/whatever. Med. schools spend a LOT of time teaching how bad obesity is, instead of teaching Doctors to treat patients like PEOPLE.

[@terryenby2304]

weirdly I had the exact same health issues when I was underweight too. Gender plays a huge roll in this too. I remember one time my husband and I went to an out of hours service with chest infections. Both the same symptoms, he was given 4 more days of the same antibiotics as I was. Guess who recovered better?

[@Dragonmoon1598]

I also wonder if insurances play a role. Basically, denying people certain medical treatments as "unesicary" because it's clearly "weight" related.🙄

[@FeniksGaming]

I was hit by the bike couldn't walk for a week doctor was obsessed with my weight more than my accident. Like I get it being heavy at a time made it harder to recover because there is more strain on my back but at least acknowledge that my accident had nothing to do with my bmi at a time

[@ChubbyKittyMeow]

He was telling you the truth as you all of a sudden you have bigger problem thank normal weight person. Your weight is in the way of any kind of recovery.

[@bethanp3453]

Why would your doctor acknowledge that your accident has nothing to do with your weight when your doctor doesn't know that? It's not a doctor's job to analyse crashes or determine causes of accidents. That's an insurance investigators job. Maybe the police. It sounds like you're seeking acceptance or validation about something from someone who, it isn't their job to give it. It's their job to stay focused on their role. Your doctor has one concern. Your overall health. A person comes in with injuries after an accident which, you said yourself, healed fast so relatively superficial injuries right? Ok, so your doctor is also assessing your overall health. Your doctor isn't a stranger to you. They know your medical history. They're trying to work with you to improve your health, help reduce risk of injury or health issues, increase longevity, increase recovery times. Getting and keeping you in good health is their objective. They're not stupid. You're not their only patient. They observe things like recovery time, reaction times or even the ability to take a hit and bounce back up. They measure it against different ages, fitness, weight and they notice how much pressure extra weight puts on injury, illness, mobility, recovery. It's undeniable and the research backs up what all these mean doctors say to patients. They are doing your job. You don't have to like it or like them, you don't have to understand it. Unless you're a doctor too, you don't have the same knowledge base as them. Think of them as a robot. They're not going to stop putting weight high up (if not the top) of the priority list with a patient who is overweight. Bias. Patients are biased. Doctors are a lot less biased than patients. It's not their body. You're not their only patient. It's not personal to them. They don't have any dog in the race to improve your health. They are the people out of everyone else to listen to about your health. Saying something like, 'I hear you want to lose weight, I wouldn't bother if I were you, you'll probably fail.' That would be biased. Bringing up your weight as an issue if you're over or under weight is not biased. What do you want? Them to lie? Come on. This is internet mania. Don't get caught up in it. Doctors call people out on their shortcomings. It's annoying. It's applicable to everyone. It's necessary. No one is telling you that you have to like doctors, but this internet exposé. Some problematic personality types start these things, you know? Then other people go, 'oh wait a minute yeah, I don't really like when my GP brings up my weight either now that I think about'. Yeah, well I'd be surprised if you did. Doctor's have their aims, patients have their beliefs. Patients aren't expected to fully understand doctors reasoning. Fitness professionals should though, so what's up with that Ben Carpenter you little pot stirrer you? Why are you inserting yourself into this circular mess and causing trouble?

[@FeniksGaming]

@bethanp3453 Jesus that is some deep psychoanalysis you got there going based on 1 sentence coment mate. Have you considered stepping away from the internet for a little bit?

[@FeniksGaming]

@Gromobran I have acknowledge that in my coment yes. The way it was presented was in no way helpful. If your doctor doesn't present things in approachable way they are harder to accept. It's a job of professional to communicate in best way for recovery. This isn't dr House show mate

[@bradraughley6206]

I'd had an unidentified inflammatory issue for years, had seen 8 different specialists, and the endocrinologist essentially said " there's nothing we can do because you're fat and the inflammation is caused by being fat." I mentioned this to a my psychiatrist years later when getting ADHD meds, who is the only supportive medical professional I've had recently and he was super pissed. Breathwork, exercise, a change in diet, and seeing a proper allergist who discovered some unknown grass allergies, and some other things have helped the inflammation but there are so many times that I've hit "we can't be bothered to look further because you're fat." I was mis-diagnosed with Crohn's for years (was diverticulitis and IBS) because my GI at the time couldn't be bothered to look further, I was on Remicaide, a year of antibiotics, and had a surgery because of it (again that's better after I had the proper treatment and surgery). It's no wonder people end up looking to quacks when that's the response many people get. I think part of why I didn't tackle my weight before is because of how the medical system treated me. I'm now shrinking, and dealing with all that stuff, but it's such a betrayal when the people who are supposed to help cause more harm.

[@Mr.N0.0ne]

Did you used to be an English teacher in a foreign country? I only ask because you enunciate your words so perfectly.

[@leightonolsson4846]

There's also good clinical evidence that losing weight and putting it back on again (yo-yo dieting) is even more detrimental than staying at a constant overweight weight. I would add also that going too far for the ultra ripped/shredded hyper vascular look until you are basically less than 5% body fat and look like you've been almost flayed alive or an anatomical model, is not healthy long-term - fat reserves of certain level are essential for a healthy immune system.

[@paulmalhotra8037]

What do you think about the scale?

[@Mekias]

This woman has come to expect that her weight will be brought up as a major issue by her doctor. It's frustrating and embarrassing certainly. I'd always leave my doctor feeling bad about myself and wanting nothing more than a cheeseburger or pizza to pick up my spirits again. That being said, now that I have lost the weight, my health markers are way better across the board. I feel bad for both the patients and doctors in this case.

[@bethanp3453]

Agreed. I've been overweight and I've been underweight and I've been called for both by doctors. It's not a good feeling and it's nice to be nice, but you have to consider what a doctor's job is. Especially a GP. They have to consider the big picture in the long-term and not just the individual's because they can only help a certain amount of people in a day. People who are in a pattern that will cause their health will deteriorate (people with obesity, other eating disorders, addiction, self-harm generally) their appointments will only get more frequent and when you compare it to fit patients who take care of themselves, then its not bias. It's obvious. I have been overweight and can tell you I could've hurt my neck yawning. I've been in good physical fitness and I could haul heavy crates all day for years without injuring myself enough to go to a GP and if I did then they would know that it was a freak, serious injury. The injuries and health complaints will continue to increase in people with underlying low fitness levels and it has to be a futile feeling to prescribe painkillers or some other kind of band aid fix if they know the person will be back more and more often, with more and more severe issues when addressing the root cause would be beneficial to everyone involved. The individual, the staff, the practice, other patients in need of treatment. Yeah some people are just unpleasant. You get them in every profession but generally, GPs have a job to do. Very little of their role actually requires them to be friendly. Especially if they thought that kindness was enabling or brushing a problem under the rug. If I was a GP I would actually feel as uncomfortable as the patient but I would still bring it up. It would be negligent not to. It's just a horrible situation. The best thing patients can say if they're really not interested in accepting advice on that subject is, 'Noted, but what can you do about my bad neck in the short-term?' That way everyone knows the score. Everyone has ticked all their boxes for that appointment, and just try not to take it personally. They probably say it to hundreds of people a day whether they're a stone overweight or 15 stone overweight. It's their job.

[@frankdabros9054]

Hey Ben - you've taught me to be informed and use logical thinking, regarding health claims you're the only resource I believe 100%, I've been on Mounjaro for > a year and used the weight loss as a springboard to revamp my entire lifestyle, I'm now a gym rat and a yoga enthusiast but have a question - been reading a lot on "recomp" but don't trust what I'm reading, can you point me to a trusted source on the subject? I can't wait until your book in February (pre-ordered of course) for an answer but need some direction (must I be in a calorie deficit to lose weight? a calorie surplus to gain muscle? does that mean I need to go through stages e.g., lose weight first then focus on muscle gain)? You provide a much needed perspective, please keep it up

[@lachouette_et_le_phoque]

Hmm, I think he might have a video addressing the point about whether you can build muscle in a calorie deficit. Iirc the bottom line is that it's possible, but harder, and that's why it's not generally recommended. In the end though, it's up to you to decide what you want to do. You could eat around maintenance (eat enough to keep weight on the scale the same) while you train, if you don't want a surplus. Based on the videos I've seen so far and his first book, it seems to me that he'd probably recommend that you do whatever works the best for you and keeps you most motivated long-term. As for losing weight, yeah, you have to be in a calorie deficit (though it can be hard to know what your actual calorie requirements are, and of course you have to take activity levels into account), that's just how physics works. If the number on your scale goes down consistently, that means you're eating at a deficit. I'm just responding because I think he probably won't, not because I'm an expert or anything, so take it with a grain of salt :)

[@frankdabros9054]

@@lachouette_et_le_phoque- thanks and appreciate your sharing, I’m in a caloric deficit and have been lifting hard at the gym, my weight loss has completely stalled for the past 2 months, I thought that I may be building some muscle mass that was offsetting the fat loss but then was reading that you can not gain muscle with a caloric deficit, but then I saw stuff on recomp that said you can, but you’re right, we’re all different, since what I’m doing is not working for the goals I’ve set, I’m going to cut my strength training in half and focus more on cardiovascular work while under a caloric shortage for the next month or two, hopefully I’ll see the weight loss I want and then can shift back into weight lifting and put myself into a modest calorie surplus so I can build muscle mass

[@jlb127]

Medical industry is dated and it shows.

[@margaretcharmley1965]

What bugs me is doctors often refuse to look for the reason a person may be overweight. It’s not always because of diet or lifestyle. In my case I have insulin resistance due to a medical problem I’ve had since my teens but wasn’t actually diagnosed until my late 30’s because I wasn’t taken seriously because of my weight. I spent well over a decade eating properly and exercising regularly and still only gaining weight. Now the insulin resistance is being addressed, as well as the other problems, and guess what, I’m losing weight. Slowly, as I can’t be as active as would help at the moment, but it’s nice to see the healthy diet I’ve been on for years is finally making a difference just because I was finally given what I needed to address the underlying issues.

[@santhoshmythreya7085]

But I'd still say obesity is related to a quadrillion problems in the body...

[@philrab6696]

It was the other way around for me. I was feeling very fatigued because of my weight. The doctor sent me here and there to get checked out. After all the tests come back he said maybe it’s your weight. They were to polite to say it when I went.

[@lokoflipz5344]

I was 18 years old, 340lbs and it was a personal wake up call when I seen my blood pressure was 180/120. My doctor didn't say anything other than blood pressure medicine since high blood pressure runs in my family. Being overweight is extremely tough mentally even when pretending it doesn't affect you. (For me anyways) It was so bad that now I'm 180lbs, fairly lean and I still have random negative thoughts about my weight all the time. Anyways I took it upon myself to lose the weight and now my blood pressure stays on the lower side of average. In no way shape or form is being overweight healthy and even if it's not directly causing these issues for the individual. Losing weight WILL keep them healthier than before and living longer.

[@lachouette_et_le_phoque]

As he said in the video, it can go both ways of course. Being obese is unhealthy and can cause a number of health issues. Addressing that as a doctor can be their duty. However, it can also easily go the other way around, or be unrelated. Just telling a patient to lose weight if the underlying issue is making it harder for them to lose weight is not compassionate or helpful. For example, think: - A depressed patient who binge eats due to depression - Someone with thyroid dysfunction - Someone with a mobility issue, preventing them from exercising (that can look like it's caused by obesity, but of course being forced to be more sedentary due to chronic pain or mobility constraints makes gaining weight easier and losing harder) - sleep apnea: I'm not an expert in this, trusting a specialist surgeon on KZbin (Vik Veer) who says that for many patients, losing the weight is very hard until the sleep apnea is fixed, at which point they go on to lose the weight. This makes some sense to me since sleep is important for hormone balance, including a satiety/hunger hormone, which leads to overeating for people with worse sleep Just some examples off the top of my head, I'm sure medical professionals could come up with more. I think the correct response would be to address how obesity could be a potential cause of various health issues, but also run some tests to figure out what is really causing it. Especially if it's a simple, cheap blood test like for thyroid hormones. Not ok is sending the patient away with nothing else other than a glib "you gotta lose weight", and not even any advice on how to achieve a goal that is really hard for most people. There's nothing saying they can't both receive the tests AND constructive weight loss advice!

[@lokoflipz5344]

@@lachouette_et_le_phoque Don't disagree in the slightest. I was on break when I made my initial comment and didn't really word it how I wanted. The examples you provided are reasons for people being obese that lead to medical problems. Yes those are true but the bottom line is obesity causes a large amount of issues. I'm not saying doctors should ever be an a-hole. Compassion is a human job, regardless of occupation. But yes, being told you should lose weight is needed imo and then a helpful outlook to see what the root cause is. (thyroid, mobility, exc.) An overwhelming majority of overweight people are so by choice. Not choice of being obese, but not choosing to do better. Honestly the biggest reason I wanted to change is to try to help my future generations to do better. My family comes from a long line dysfunctionality that has seemed to have gotten a little better the more it's moved on. And I wanna do my part and firmly believe everyone else should too.

[@lachouette_et_le_phoque]

@@lokoflipz5344 That sounds nuanced, and I'm very glad you were able to make that change! I'm currently losing a largeish amount of weight too (about 20-25kg, hopefully), and speaking from how I previously felt about it, I think it's good to have compassion for how difficult it can be to actually lose the weight. I struggle with a chronic illness (long covid/CFS) that entirely prevents me from exercising, and while I've previously been able to lose weight by cooking low calorie density meals, leaving the house and taking healthy food with me, keeping busy and exercising regularly, none of those strategies now work with an illness that keeps me stuck on the couch or in my bed for the majority of the day, or else I risk making my illness worse. That had me depressed and hopeless for a long time, and additionally, the enjoyment of food is one of the few things my illness has not taken away from me. I didn't feel that it was possible to lose weight, even if I tried everything I possibly could. About two months ago, a medication change gave me more energy and motivation and some other factors changed, which helped me push through and decide I had to make it work, even if it was hard. My spouse is now helping me by cooking healthy meals that are calorie counted, without his support it would have been infinitely harder. I also found that berberine works to make me less hungry, so I am not forced to eat the same 3 low calorie meals again and again, which just would not have been sustainable. I am very glad that it worked out (so far) for me, but I also empathise with all the reasons why I previously thought it just wasn't an option given the limitations of my illness. Perhaps now that new weight loss medication is available, it will be more feasible for people who struggle with unusually strong hunger cues to lose weight, once it's more accessible to everyone. A lot of people who are obese struggle with poor nutritional education and possibly things like poor emotional control, depression, difficult life circumstances etc. I agree with you that it is always a choice, I just think that the more effective way to go about it is to try and be non-judgmental and encouraging, and try to help people address what the roadblocks are. I really had to understand that it was feasible for me to lose weight before I could become motivated to actually try it. Sadly, I don't think my health will change much from this, since I was a healthy weight when I got sick a few years ago and my symptoms have not changed with the increased weight, but at least I'll feel better about my body and avoid possible complications from it down the line.

[@AllisonMariePhD]

On the other hand, I, as a former obese individual, now have body dysmorphia and am addicted to exercise to the extent that when I went running while exhausted, fell, and broke my finger. While getting it reset for a second time after not giving my body proper rest to heal, had a doctor say, "There are definitely worse things to be addicted to. I wish I was addicted to exercise." Doctors fall victim to the internalization of social norms and stereotypes just like everyone else.

[@ResistanceQuest]

If he had the insight to see this, though, he wouldn't be able to use blame as a marketing tactic, so that he and his knuckle-dragging audience can feel better about themselves

[@natethegr8230]

Disgust is an involuntary response. People generally don't fake it on purpose either. It's because what you see is disgusting.

[@lachouette_et_le_phoque]

Perhaps we should hold medical professionals to a higher standard than the general population, then? I've heard lots of stories of nurses hiding disgust reactions when dealing with bodily fluids. Surely, if they are able to do patients that curtesy, dealing with obese patients should be a breeze? Same as I expect my therapist to be non-judgmental, even though it's perfectly human and normal for people to react with judgment. It's simply professionalism that ought to be expected for someone with this much education, in a service profession.

[@DeborahNorris77]

Society programming where higher weight bodies are considered disgusting... It can absolutely be re-educated out of people. But no, there's just doubling down. Fat phobia is not just tolerated it is actively promoted within society. It is discrimination. And most of the poor health outcomes attributed to overweight are actually related to mental health, stress, body image and poor medical treatment.

[@Blackandwhitecat-u9v]

@@DeborahNorris77Fatphobia lol. Yeah ok.