Has "fat-shaming" gone too far?

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Has "fat-shaming" gone too far?

Postby LaoWai » Thu Feb 08, 2018 2:04 am

A plus-sized model recently came to my attention:

https://www.yahoo.com/news/model-slams-weight-critics-fat-shamed-dermatologist-150434953.html

Before reading the article, I was unaware of this model, and after reading the article, a quick search revealed almost no information of her as a model. Actually, a quick search revealed nothing about her except for this single controversy and some unrelated articles about plus-sized models. Maybe that's because I can't google properly.

Apparently, though, it's wrong for a doctor to tell this (frankly, obese) woman that she should think about losing some weight. Dermatologist or not, a doctor is a doctor; when my dentist recently suggested I should quit smoking, I just thought, "Well, he's a (sort of)* doctor, so of course he's going to comment on that." I had to get my prostate checked about six months ago, and the guy who stuck a finger in my butt wanted to know about my exercise routine; I assumed that was just a doctor being a doctor and having no sensitivity to the matter at hand. (Proctologists: note, the moment you're knuckle-deep in my rectum is not the time for chats about my physical activity or anything else.)

Is it not fair, then, to say that a woman who goes to a dermatologist should expect some feedback regarding her lifestyle? I feel like it is, especially since skin issues have a certain co-morbidity with being overweight.

*Just joking--of course dentists are real doctors...they have to memorize how to brush teeth, after all.
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Re: Has "fat-shaming" gone too far?

Postby NathanLoiselle » Thu Feb 08, 2018 3:06 am

Fat-shaming stopped being acceptable as soon as we started it. Back in the '00's. There were no fat people before then.
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Re: Has "fat-shaming" gone too far?

Postby sunglasses » Thu Feb 08, 2018 6:31 pm

I don't think it's unacceptable for a doctor to bring it up.

That's not fat shaming.

Fat shaming would be to insinuate her skin condition or whatever she saw him for was solely the result of her weight. Or to make derogatory comments.
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Re: Has "fat-shaming" gone too far?

Postby DamianaRaven » Thu Feb 08, 2018 10:16 pm

In my opinion, it's perfectly fine for ANY kind of medical professional to suggest a need to lose weight. As Sunny hinted, what's not OK is treating fat people differently than other patients. There are an unfortunate number of doctors who attribute every single complaint of a fat person to "a case of the deathfats." It's not really OK for doctors to demand that a patient lose weight before being treated for an issue that isn't directly and definitely affected by their weight... which describes the VAST majority of health problems.

Medical discrimination is a particularly insidious form of "fat shaming" because it enables the discriminator to point to the results of their own actions as "proof" that it's bad to be fat. For example, when a patient comes in with a chronic respiratory problem and their doctor gives them nothing more than "lose weight and come back," the patient's health deteriorates without evidence-based treatment and that deterioration is treated as evidence of the "dangers of obesity." It's not unlike the way employment discrimination leads to "proof" that [insert demographic here] are too lazy to deserve a fair job.

No one (who expects to be taken seriously) is really denying the health risks of obesity, but it likewise cannot be denied that there is a LOT of bad science (based on little more than bias, personal judgment, and good ole fashioned bullshit) surrounding the subject of obesity and weight loss.
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Re: Has "fat-shaming" gone too far?

Postby LaoWai » Sat Feb 10, 2018 12:00 am

sunny, and Damiana,

Thanks both for that affirmation. I hadn't considered the possibility of the doctor's basically refusing treatment based on the "you're fat" clause, but that may indeed have happened here. If so, it seems like it could have been stated, which it doesn't seem to have been.

Barring radical surgery, yeah, doctors should treat any condition regardless of weight. (I'm sure sunny will have better information on this, but it is my understanding that many elective surgical procedures do have to be put off until the patient loses a certain amount of weight because certain levels of...well, bigness...influence survival/recovery rates. Not to beat a horse after it's died, but most surgeons would tell me to quit smoking a month in advance, just to avoid "organ strain".)

Had the woman been denied treatment "'cuz you're fat, lol" it'd be a whole different conversation, but there doesn't seem to be any implication of that in this case.

That said, I'm assuming the woman in question isn't facing a face-transplant or something similar. Nothing in any of the articles said she was denied treatment, just that her doctor said, like, "Hey, you're overweight."

Am I alone in feeling as though big-publicity sob-stories like this detract from a real, actualized problem like Damiana is addressing (i.e., people being denied care based on weight)?
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Re: Has "fat-shaming" gone too far?

Postby DamianaRaven » Sat Feb 10, 2018 1:37 am

LaoWai wrote:Am I alone in feeling as though big-publicity sob-stories like this detract from a real, actualized problem like Damiana is addressing (i.e., people being denied care based on weight)?


Absolutely not, and it's true of pretty much any social problem. Publicly whining about trivialities always diminishes the credibility of people dealing with a legitimate version of that issue. It's like when women cry sexual harassment because "he keeps smiling at me." Seeing too much of that kind of thing does tend to make people dubious after a while.

In short:

"Someone said I'm overweight - that's fat shaming and I should never have to hear anything negative about obesity." Hysterical jackass.

"I'm pissed that my doctor insists I keep getting ear infections because I'm fat and won't prescribe me any medication for it until I lose twenty pounds." Legitimate complaint.
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Re: Has "fat-shaming" gone too far?

Postby Ceiling_Squid » Mon Feb 12, 2018 6:54 pm

Agreed, medical discrimination is a huge concern.

I can understand the idea of specifically making a point of the "lose weight" prescription, when a patient's size is exacerbating existing issues of relevance. For instance, being obese definitely makes certain types of medical procedure/surgery risky or untenable. It would be irresponsible for the doctor to not factor that in and point it out.

But I've heard it reported that many practitioners are extremely brusque, or use "lose weight" as a shortcut. You need to give a comprehensive and helpful diagnosis. Anything else is absolutely unacceptable - a patient came to you about a specific problem. Do your damn job, be empathetic, and try to find the root cause of the issue. Don't just rattle off "lose weight", until you've determined that there isn't some other issue that will deteriorate unchecked while your patient is trying to shed those 20 pounds.

Now, on the social end, outside of medical practice, I hope you'll indulge a little tangent:

I think what bugs me most about fat shaming is that we have a culture in the US that conflates any percieved health failing with an innate moral failing. Maybe that's a holdover from the ol' Calvinist and prosperity gospel playbook. If you're sick, or poor, or ugly, obviously you did something to deserve it. "Bootstraps! Lose weight, look beautiful, strike it rich, anyone can do it!" While personal responsibility is important, this mindset too easily translates to "look at that fat sad sack, he's not working hard enough. He's inferior."

It's easy to jeer at somebody or treat them callously if you think of them as morally inferior. I'll say it: the American mindset gives an easy excuse to the worst of us. It implicitly allows kicking people who don't fit the ideal, and blaming them for the scorn of others. Because, somehow, we've fooled ourselves into thinking that shaming is both justified and effective.
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Re: Has "fat-shaming" gone too far?

Postby LaoWai » Mon Feb 12, 2018 11:31 pm

Ceiling_Squid wrote:Agreed, medical discrimination is a huge concern[...]

But I've heard it reported that many practitioners are extremely brusque, or use "lose weight" as a shortcut. You need to give a comprehensive and helpful diagnosis. Anything else is absolutely unacceptable - a patient came to you about a specific problem. Do your damn job, be empathetic, and try to find the root cause of the issue. Don't just rattle off "lose weight", until you've determined that there isn't some other issue that will deteriorate unchecked while your patient is trying to shed those 20 pounds[...]


I'm trimming your quote down a little, just for my own sake, not for cherry-picking. (Doing so helps me focus somewhat on my even reason for responding, instead of just getting distracted by any...oh, look, a squirrel!)

I'm wondering how many times "lose weight" actually gets used as a shortcut. I am about 100% with what Damiana has expressed in earlier posts (which, is...wow, is there a special medal for that or something?*), and I definitely agree that weight shouldn't be used as a cover-all-bases excuse for not providing care. Yet, I'm curious--and this is genuine curiosity--about how often that happens. I mean, barring surgery (in which case, yeah, weight can be a massive factor in survival outcomes), are there that many instances of doctors refusing to treat patients entirely due to weight? Excluding instances of perceived fat-shaming, is this really a common trend?



*Not implying that Damiana is combative there, just that she seems like a person with whom I'd usually butt heads, making my agreement here seem almost peculiar. Maybe I'm the asshole...Naw.
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Re: Has "fat-shaming" gone too far?

Postby DamianaRaven » Tue Feb 13, 2018 12:40 am

LaoWai wrote:Excluding instances of perceived fat-shaming, is this really a common trend?


That would really depend on how you define "common." Fortunately, the VAST majority of doctors are competent professionals who don't indulge their personal bigotries at work. However, this is not to say that it's rare to come across a bad doctor. It's at least common enough that there are websites devoted to sharing horror stories and supportive advice. The most common complaint seems to be the overwhelming disbelief fat people face when they tell their doctor (in all honesty) that they don't actually spend all day on the couch gobbling cheeseburgers and ice cream. That IS a fairly common problem (even with doctors who otherwise provide competent and dignified treatment) and can be extremely humiliating and dehumanizing for someone who is trying very hard to lose weight and seeking help from an "authority figure" who (seemingly) believes that all fat people are lazy, dishonest, self-indulgent morons.

Another problem that isn't technically borne of malice or bigotry (just pants-on-head professional dereliction) is congratulating fat women (don't know if men get the same treatment) for sudden and rapid weight loss instead of treating it like the GIGANTIC red flag symptom that it usually is. Losing ten pounds in a week without doing anything differently is a very, very bad thing and there's no telling how many fat women have died needlessly due to a serious medical condition being waved away as "yay, be glad you're getting thin." By the time other symptoms start showing up, it could very well be too late! Just one more fatty who "ate themselves into an early grave." THAT'S why medical fat bias is such a terrible thing, not so much because "it's everywhere" as because doctors have the power and authority to convincingly blame the victims of their own fuckups and "she was killed by the deathfatz" makes a very convenient cover story for medical malpractice.

LaoWai wrote:*Not implying that Damiana is combative there, just that she seems like a person with whom I'd usually butt heads, making my agreement here seem almost peculiar. Maybe I'm the asshole...Naw.


It just feels that way because I have a powerful personality. You're not an asshole - very few people can endure my company in comfort and confidence. Those who can practically worship me, so I'm not complaining!
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Re: Has "fat-shaming" gone too far?

Postby gregfrankenstein » Wed Feb 14, 2018 4:31 am

Hell, it's counterproductive when doctors have a bias like that. I just means overweight people are going to avoid seeing the doctor altogether because they know the response will be, "Well, maybe you wouldn't have a cough if you could pull off a pair of skinny jeans."

Even if you're the fat shaming type who thinks it's an unspeakable evil to weigh too much, preventing unhealthy people from health is exactly the opposite of how you handle that.
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Re: Has "fat-shaming" gone too far?

Postby DamianaRaven » Wed Feb 14, 2018 5:00 am

*launches herself at him with a ballistic hug* You were missed!
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Re: Has "fat-shaming" gone too far?

Postby gregfrankenstein » Wed Feb 14, 2018 5:06 am

DamianaRaven wrote:*launches herself at him with a ballistic hug* You were missed!


YAY US.
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Re: Has "fat-shaming" gone too far?

Postby DamianaRaven » Wed Feb 14, 2018 5:12 am

At the risk of veering this thread off topic, where the fuck have you been and what the fuck have you been doing? *flips her clipboard across the ass, just in case*
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Re: Has "fat-shaming" gone too far?

Postby gregfrankenstein » Wed Feb 14, 2018 5:25 am

DamianaRaven wrote:At the risk of veering this thread off topic, where the fuck have you been and what the fuck have you been doing? *flips her clipboard across the ass, just in case*


This being TCS and all I can give the real answer, which was a several month spell of depression. Wheeeeeeeeeeeee! I appear to be in a better place now. Mentally, I mean. I didn't get sent to a farm upstate somewhere.

Then this week I finally got over my hatred of proprietary software long enough to install the Discord desktop app. And dramatic explosions in the chat room aside, it made me go, oh yeah, this forum is still a thing.
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Re: Has "fat-shaming" gone too far?

Postby DamianaRaven » Wed Feb 14, 2018 5:30 am

OK, so my butt is safe?
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