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Going to the doctor as a fat person sucks
(hexbear.net)
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.
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.
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.
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.
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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:
Fatphobia in the healthcare system is MAJORLY behind the poorer health outcomes of fat patients.
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.
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.
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".
I've never seen shaming help anyone when it comes to health.
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 3800+ 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.
This was well written, it was pleasent to read. Idk, like how something can roll of the tongue, it was like that but with reading. Disclaimer: am not a native speaker of English
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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.
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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.
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.
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.
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 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.
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.
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.
Doctor sounds like a quack.
He looks like he’s about 200 lbs with a bit of pudge on his belly and was talking about “people like you and I”. Like I’m not a professional but it sounds like you have body dysmorphia if you think we’re similar in our struggles, dude.
Edit: I wanna clarify that I understand smaller people can also struggle with their weight and their health and their body’s worth. I just remember being that size and it’s night and day in terms of relatable challenges.
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i can confirm i treat my body like shit and i'm sub 170
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this post was submitted on 29 Dec 2024
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chapotraphouse
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